A recent dispute about end-of-life care in New Jersey created the rare situation of the non-ruling of a court becoming a matter of national significance. The story of Ruben Betancourt and his family's dispute with medical providers over his care brings up complex questions regarding the intersection of medical malpractice and end-of-life care in New Jersey.
The Betancourt Story
Ruben Betancourt had surgery at Trinitas Regional Medical Center in Elizabeth, New Jersey, to remove a tumor from his thymus gland when he was 73 years old. The surgery went well, but Betancourt's breathing tube somehow became disconnected during his postoperative recovery at a different facility, causing severe and irreversible brain damage.
As a result, Betancourt needed a ventilator, kidney dialysis and a feeding tube to stay alive. Soon he developed terrible skin ulcers and infections.
The doctors at Trinitas believed Betancourt was in a persistent vegetative state and that it was futile to continue treating him. They said his brain was permanently and severely damaged, his kidneys would never work again and his skin would only continue to deteriorate. The hospital unilaterally imposed a do-not-resuscitate (DNR) order that instructed hospital staff not to try to revive Betancourt if his heart stopped.
Court Action
Betancourt's daughter and the rest of his family vehemently disagreed with Trinitas, arguing that he was still responsive. The family petitioned a New Jersey trial court to have the DNR order rescinded, and the court agreed, ordering Trinitas to continue treating Betancourt.
The hospital appealed the trial court's decision and sought to have the DNR order restored by the New Jersey Court of Appeals. In the midst of all the litigation, however, Betancourt passed away.
Subsequently, the New Jersey appellate court declined to rule on the dispute between Betancourt's family and Trinitas. The court issued an opinion stating that the contentious nature of the case in many respects did not make it useful for resolving broader issues of public policy concerning medical futility and decisions to stop care against families' wishes.
Complex Questions
Even though the court did not make a decision, the Betancourt case presented complex questions of both profound and universal application. The core issue of whether doctors have the ability to decide that medical care is futile and stop treatment regardless of the wishes of the patient's family, friends or guardians is a significant question that will become only more pressing as the population ages and medical technology advances.
The Betancourt case opened the door for clarification of the issue, but families and medical providers are left awaiting further legal guidance on how to address these difficult situations.
From our law offices in Hackensack and Manhattan, Kirsch Gartenberg Howard LLP has served individuals and businesses across northern New Jersey, including Bergen County, Essex County, Union County, Middlesex County and Passaic County, and the five boroughs of New York City since 1984.
