Don’t be afraid of the nursing home

Judge strikes law that allowed doctors to make medical decisions for mentally incompetent residents
(screenshot: Bay Area News Group video)

Judge Evelio M. Grillo struck down a law that didn’t require nursing homes to notify patients they have been deemed incapacitated or to give them the chance to object. (screenshot: Bay Area News Group video)

The following comes from a June 26 Kaiser Health News article by Anna Gorman. Kaiser Health News (KHN) is a nonprofit national health policy news service.

A California law allowing nursing homes to make medical decisions on behalf of certain mentally incompetent residents is unconstitutional, a state court ruled this week.

The law, which has been in effect more than 20 years, gave nursing homes authority to decide residents’ medical treatment if a doctor determined they were unable to do so and they had no one to represent them.

Alameda County Superior Court Judge Evelio M. Grillo wrote in the June 24 decision that the law violates patients’ due process rights because it doesn’t require nursing homes to notify patients they have been deemed incapacitated or to give them the chance to object.

Grillo acknowledged the decision is likely to “create problems” in how nursing home operate but wrote that patients’ rights are more compelling.

“The stakes are simply too high to hold otherwise,” the judge wrote. Any error could deprive patients of their rights to make medical decisions that “may result in significant consequences, including death.”

The medical decisions on incapacitated residents without representatives are made by a team that includes a physician and a nurse.

The fact that nursing homes are making end-of-life decisions without patient input is a big concern, according to the ruling. The decision cited one nursing home resident who was found to be mentally incapacitated and who had no representative. The facility staff made a decision to take him off life-sustaining treatment and he passed away in 2013.

The ruling came after the California Advocates for Nursing Home Reform, an advocacy group, filed a lawsuit in 2013 against the state Department of Public Health. The suit alleged that nursing homes used the law to administer anti-psychotic drugs, place residents in physical restraints and deny patients life-sustaining treatment.

 

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  1. Do you want the administrator of a nursing home to have the right to decide if you should live or die? If you are a patient in a lot of pain and have numerous health problems, you probably would not be the favorite patient of the staff. Does that mean you should “get the needle?” You will not be notified and will have no advocate on your side. This is America? Pray that you won’t spend your last days (?) in a nursing home. Even convicted murderers have a lawyer to plead their cases to prevent them from being summarily put to death..

  2. Anne T. says:

    Well at least Judge Grillo seems to have a good conscience. God bless him. When his turn comes, may he pass into his eternal reward smoothly and peacefully naturally.

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