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Posted on April 24, 2017 at 5:00 AM
D.C. Superior Court Judge Russell Canan
The Superior Court of the District of Columbia has issued an innovative order in an end-of-life treatment conflict.

In June 2014, YP suffered cardiac arrest following a drug overdose.  Clinicians later determined that YP's brain injury was profound and severe.  YP's daughter and guardian wanted to withdraw life support.  But YP's siblings from Panama objected.  

The court ruled in favor of the guardian.  This order is interesting, because DC statutes provide that a guardian "shall not have" the power to consent to stopping life-sustaining treatment "unless it appears the incapacitated person would have consented."  

As the court observes, this statute seems to mandate a substituted judgment standard.  If there is zero evidence the the patient's wishes (as in this case), then it seems that a guardian may not consent  to stopping life-sustaining treatment.

The court found this result absurd and instead elected to follow the majority of jurisdictions that permit use of an objective best interest standard when there is insufficient evidence for a decision maker to exercise substituted judgment.

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