In re Guardianship of Tschumy

Decision Date17 September 2014
Docket NumberNo. A12–2179.,A12–2179.
Citation853 N.W.2d 728
PartiesIn re the GUARDIANSHIP OF Jeffers J. TSCHUMY, Ward.
CourtMinnesota Supreme Court

Michael J. Biglow, Law Offices of Michael J. Biglow, Minneapolis, MN, for appellant Jeffers J. Tschumy, ward.

Robert A. McLeod, Karla M. Vehrs, Lindsey E. Middlecamp, Lindquist & Vennum

LLP, Minneapolis, MN; and Charles W. Singer, Minneapolis, MN, for respondent Joseph Vogel.

Lori Swanson, Attorney General, Nathan Brennaman, Deputy Attorney General, Saint Paul, MN, for amicus curiae State of Minnesota.

Diane B. Bratvold, Jennifer A. Lammers, Amie E. Penny Sayler, Briggs and Morgan, P.A., Minneapolis, MN and Benjamin Peltier, Saint Paul, MN; and Teresa Knoedler, Minneapolis, MN for amici curiae Minnesota Hospital Association and Minnesota Medical Association.

OPINION

GILDEA, Chief Justice.

The question presented in this case is whether court approval is required before a guardian who has the power to consent to necessary medical treatment for a ward under Minn.Stat. § 524.5–313(c)(4)(i) (2012), may consent to remove the ward from life-sustaining treatment when all the interested parties agree that such removal is in the ward's best interests. The district court held that a guardian who possesses the medical-consent power under Minn.Stat. § 524.5–313(c)(4)(i), cannot consent to the removal of a ward's life support without prior court approval. The court of appeals reversed, holding that unless otherwise limited by court order, a guardian given the statutory medical-consent power has the authority to consent to the removal of life-sustaining treatment without a separate order from the district court. Because we conclude that the guardian did not need further court approval, we affirm.

On September 24, 2007, a social worker at appellant Jeffers Tschumy's nursing facility filed a petition asking the Hennepin County District Court to appoint a guardian for Tschumy. The social worker said 53–year–old Tschumy was “an incapacitated person” who “lack[ed] sufficient understanding or capacity to make or communicate responsible decisions concerning his person.” According to the social worker, Tschumy was “facing multiple medical issues” and was “unable to make informed medical decisions.”

After a hearing, the district court appointed Tschumy's then conservator to be his guardian. The court found “clear and convincing evidence” that Tschumy was “an incapacitated person” who needed a guardian. See Minn.Stat. § 524.5–310(a)(1) (2012) (“The court may appoint a ... guardian ... only if it finds by clear and convincing evidence that ... the respondent is an incapacitated person.”). The court made several findings of fact regarding Tschumy's needs at the time, many of which referred to his inability to make medical decisions for himself. The court said Tschumy needed assistance providing for his “health care, housing, food, transportation, and finances,” and acknowledged that Tschumy did not appropriately manage his diabetes. The court also found that Tschumy was “incapable” of exercising certain “rights and powers,” including the ability to consent to necessary medical care. In the letters of guardianship, the court gave the guardian the authority to, among other things, [g]ive any necessary consent to enable, or to withhold consent for, the Ward to receive necessary medical or other professional care, counsel, treatment or service.”

On October 6, 2009, the court replaced the first guardian with respondent Joseph Vogel. The court gave Vogel the same powers as the prior guardian and also named Vogel to be Tschumy's conservator. The successor letters of general guardianship said Vogel had the power and authority to [g]ive any necessary consent to enable, or to withhold consent for, the Ward to receive necessary medical or other professional care, counsel, treatment or service.”

On April 15, 2012, Tschumy choked on a sandwich and went into respiratory and cardiac arrest

. Tschumy lost his pulse, and the group home staff administered CPR. Doctors at Abbott Northwestern Hospital were able to remove fragments of the sandwich, but a CT scan showed Tschumy had an “anoxic brain injury.”1 In a report later filed with the district court, Tschumy's attorney laid out a dire prognosis for Tschumy. He said that since Tschumy had been in the hospital, “his conditions of severe and irreversible anoxic encephalopathy,2 continuous seizures, and respiratory failure have not improved.” Initial opinions of the doctors regarding Tschumy's “dismal prognosis for return of meaningful neurologic recovery” were confirmed as time passed, “as his seizures [could not] be controlled without deep sedation” and seizure medication. Tschumy's treatment team was in “unanimous agreement that this unfortunate man [had] suffered irreversible brain damage and [could not] survive.”

On April 23, 2012, Allina Health System, d/b/a Abbott Northwestern Hospital, filed a motion asking the Hennepin County District Court to amend the successor letters of general guardianship to “specifically authorize the guardian to request removal of life support systems.” The district court held a hearing the next day. Vogel opposed the motion to amend the successor letters, arguing that he already had the authority to approve the removal of life support. The court appointed attorney Michael Biglow to represent Tschumy, investigate what Tschumy would want, and make a recommendation to the court.

At a separate hearing the next week, Vogel testified that he had been a professional guardian and conservator for 24 years. Vogel said that prior to the April 2012 incident, he had tried to talk to Tschumy about what he would want to do in end-of-life situations, but that Tschumy “did not wish to talk about advanced directives.” Vogel was not surprised by Tschumy's unwillingness because of Tschumy's “severe and chronic mental illness, and his attitudes towards the medical profession.” Nonetheless, Vogel testified that he believed he had the authority to direct the hospital to remove Tschumy's life support. He said the court authorized him to “provide medical decision making for Mr. Tschumy when [he] was unable to do so and that medical decision making would be not only the provision of different medical services but the ending of those services ... [if] appropriate.” Vogel said he visited Tschumy, talked to doctors and nurses, and relied on his own observations of Tschumy over the course of the guardianship to decide that the hospital should remove Tschumy's life support.

Tschumy's attorney, Michael Biglow, also testified. Based on his investigation, Biglow said he believed Tschumy “would not want to be inside, confined to a hospital bed, having medical decisions made for him, by medical personnel and therefore, he would most likely opt not to have these life support services in place.” Tschumy, he said, “would prefer to be ... allowed to die naturally.” Biglow also noted in his report that the hospital's ethics committee recommended that life support be removed because the “burdens and risks” of continued treatment “heavily outweigh any possible benefits.”

In an order filed May 11, 2012 (“May order”), the district court authorized the guardian and the hospital to remove Tschumy's life support systems. The court held that the medical power granted to a guardian does not grant the guardian the unrestricted authority to direct the removal of life support but said it would explain that holding in a later order, so as not to postpone Tschumy's removal from life support. Tschumy was removed from life support, and he died soon thereafter. On May 17, 2012, the court discharged Vogel as Tschumy's guardian.

On October 18, 2012, the district court filed a second order (“October order”), explaining why it concluded guardians do not have the power under Minn.Stat. § 524.5–313(c)(4)(i), to direct the removal of life support without prior court approval. The court explained that the medical power granted to guardians under the statute does not give guardians the unrestricted authority to direct the removal of life support. According to the court, the power to direct removal of life support “is not inherent in any of the enumerated powers normally granted a guardian,” and therefore guardians seeking that power needed specific authorization from the district court.

Vogel appealed the district court's October order.3 The court of appeals asked the parties to file “informal memoranda” addressing three questions: whether the district court's October order was independently appealable, whether Vogel had standing to appeal, and whether the appeal was moot. In re Guardianship of Tschumy, No. A12–2179, Order at 3–4 (Minn.App. filed Dec. 19, 2012). After the parties filed their informal memoranda, the court of appeals ruled that the case was properly before it. In re Guardianship of Tschumy, No. A12–2179, Order at 4 (Minn.App. filed Feb. 20, 2013). Specifically, the court found that the appeal was timely, Vogel had standing to appeal, and the case was not moot because it was “capable of repetition, yet evad[ed] review” and involved an important public issue of statewide significance. Id. at 2–4.

With respect to the merits of the case, the court of appeals reversed the district court. In re Guardianship of Tschumy, 834 N.W.2d 764, 775 (Minn.App.2013). The court of appeals held that absent a limitation in the guardianship order, “the medical-consent power granted to a guardian” under Minn.Stat. § 524.5–313(c)(4) includes the power to authorize disconnection of a permanently unconscious ward's life-support systems “without further authorization from the district court.” Id. at 775. We granted the petition for review that Biglow, Tschumy's court-appointed attorney, filed.

I.

We turn first to the question of whether we have jurisdiction to decide this case. The parties do not contend that we lack jurisdiction. But the existence of a justiciable controversy is essential to our exercise of jurisdiction, so we can raise the...

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