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Lana Barnes

Lana Barnes

file, Star Tribune

HOSPITALS VISITED

According to court documents, Albert Barnes has been admitted to these regional medical centers since 2008: Regions; St. Joseph's; St. John's; United; University of Minnesota; Abbott Northwestern; Unity; Hennepin County Medical Center; the VA hospital; the Mayo Clinic; Methodist.

Editorial: Little progress on end-of-life care

  • January 21, 2011 - 7:42 PM

Star Tribune

Twenty years ago, a high-profile legal battle over a dying elderly Minnesota woman ignited a national life-support debate.

This week, as a similar case garnered headlines in the state, it became sadly clear that we are no closer to agreeing on the best answer for the hard question Helga Wanglie's case posed:

What's the right thing to do when doctors decide that medical care is futile or unethical but the patient's loved one wants to preserve even the smallest spark of life?

If anything, despicable "death panel" demagoguery has made any end-of-life care issue virtually untouchable.

Given that volatile political climate, the unusual legal action initiated recently by Park Nicollet's Methodist Hospital is both courageous and commendable.

Doctors caring for 85-year-old Albert Barnes of Scandia, Minn., are seeking to replace his wife with a new guardian, arguing that she is no longer acting in his best interest and "fails to advocate as a competent health care agent.''

According to a court petition filed Jan. 14, Albert Barnes has been in a "non-communicative, vegetative state since 2005'' and suffers from a long list of serious conditions: end-stage respiratory distress, end-stage kidney failure, end-stage dementia, a progressive neurological disorder, recurrent pneumonia and infections. He is dependent on a ventilator and a feeding tube.

Court records indicate that Lana Barnes, 56, moves her husband from hospital to hospital, shopping for a doctor to agree that her husband can be cured with treatments that often have already been tried.

Albert Barnes, for example, already has a shunt for brain swelling that his wife believes is responsible for his dementia. Some treatments actually may have harmed him -- antibiotics given for questionable infections could have accelerated his kidney failure. In court documents, Lana Barnes is described as having a "fixed delusion" about her husband's possible recovery.

Methodist's doctors, to their credit, risked bad publicity to pursue court action they believe will protect their patient. This week, a judge delayed a final ruling on guardianship but temporarily shifted responsibility for his care to a local firm called Alternate Decision Makers.

The heartwrenching Barnes case illustrated how little has changed since the 1991 legal battle over Wanglie, a former Minneapolis teacher who lapsed into a persistent vegetative state in 1990 and was kept alive on life-support treatment at Hennepin County Medical Center.

The hospital had gone to court in an attempt to halt Wanglie's treatment against her family's wishes; it sought to replace her husband with a new guardian. A judge ruled against the hospital; Wanglie died within days of the 1991 ruling.

Cases like Wanglie's and Barnes' don't often make headlines but are more common than many believe, according to renowned medical ethicist Art Caplan of the University of Pennsylvania. Not wanting a court fight or bad publicity, many hospitals just continue to treat patients for whom there is no hope of recovery.

One state --Texas -- has a law offering guidance for such cases. Other cases wind up in the courts. Judges almost always side with the family but often make clear their discomfort with judicial remedies.

The call to action eloquently stated in a 2010 New Jersey Appellate Court guardianship decision should be heeded: "The issues presented are profound and universal in application. They warrant thoughtful study ... not in the context of overheated rhetoric in the battlefield of active litigation ... but in thoughtful consideration by the Legislature as well as executive agencies and Commissions charged with developing the policies that impact on the lives of all.''

Readers: What do you think of this case? To be considered for publication as a letter to the editor, write no more than 250 words to opinion@startribune.com. Include your name and the city where you live.

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