Is it murder for a health care facility to maintain an elderly patient very heavily drugged and then reduce the intravenous glucose to extremely low levels in order to induce death by starvation?

Answer 1

In most cases, it may (and that's a big MAY, as I'll get into below) depend on the elderly person's will or power of attorney. If there is a valid legal document that the elderly person signed while competent and of sound mind that states that he or she does not want to be kept alive by artificial means, the answer is no, it's not murder. What you're describing is the typical practice of hospice care throughout the country. When a patient states as their legal wishes in a power of attorney that they do not wish to be kept alive by artificial means, even if the patient, after some sort of trauma, was originally placed under ICU care with extensive drugs, the removal of all drugs (including a glucose drip) from their system is not considered murder, as those drugs and the drip are considered an artificial means by which they are kept alive. Further, regardless of whether there is a power of attorney document, the health care facility will look to the legal next of kin for decision making purposes, assuming the elderly patient is incapacitated and unable to make decisions on his or her own behalf. If that legal next of kin signs a "do not resucitate" (DNR) order or moves the patient from the ICU, where extensive life saving drugs and a glucose drip are administered, to hospice, where no drugs and no drip are administered, it's perfectly legal, even if the person dies. The health care provider has no way of knowing whether or not anyone even has a power of attorney, which I'll get into more below.

Also keep in mind that even if a power of attorney that states that the patient wants to be kept alive by artificial means is found after the patient's death, if there was no way for the family members to have discovered the document prior to the death, wrongdoing on the part of the family and on the part of the healthcare provider still won't legally be found.

On the other hand, if a power of attorney that states that the patient wants to be kept alive by artificial means is discovered and it is found that the family members knew or should have known, there may be civil or criminal penalties for the family members, depending on the specific circumstances and the law in your jurisdiction. However, the health care provider wouldn't likely be found At Fault in this situation, as they were simply following what they thought were the wishes of the patient and/or his or her legal next of kin. Powers of attorney (POA) are documents usually drafted by lawyers and signed by the patient with signatures by the requisite number of witnesses for the state in question. After the POA is signed, the patient takes the original copies and it's up to the patient what to do with it. POAs are not filed with the court as a matter of public record, like court case records or property records. The patient could do anything with the POA once he or she and the witnesses sign it. So, for example, if a patient puts a POA in a safe deposit box that his or her relatives have no access to prior to the patient's death, or hides it behind a wall or something, the family has no way of knowing what the patient's wishes are. What's more, even if the POA is in plain sight in the patient's home, because it's not filed with the court and not a matter of public record, there's no burden on the health care provider to know or should have known what the wishes of the patient are or were.

The only possible exception to this rule would be if the patient provided his or her POA to the health care provider, knowing that the health care provider he or she gave the POA to would be the one he or she went to if a life threatening emergency arose. In that case, if the patient gave the health care provider a copy of a valid POA that stated that he or she wished to be kept alive by artificial means, and the health care provider still put the patient into hospice (again, which is where no life saving aids are administered), civil or criminal penalties may result, but that would still depend on the language of the POA and the law in your jurisdiction.