Can One Person Make a Difference? Celebrating National Healthcare Decisions Day

• Date: 01 March 2024
• Author: Karren Jo Pope-Onwukwe

Bifocal Vol. 45 Issue 4

119

Can One Person Make

a Dierence?

Celebrating National

Healthcare Decisions Day

By Karren Jo Pope-Onwukwe

This article rst appeared in the ABA Senior Lawyers

Division Voice of Experience in February 2018. Re-

printed with permission from the author.

Did you know that National Healthcare Decisions

Day (NHDD) has its own website: https://www.

nhdd.org and that it occurs on April 16th every year?

It is one of over 1,200 national days celebrated in the

United States (https://nationaldaycalendar.com). The

Maryland General Assembly passed legislation that be-

came eective October 1, 2016 adding NHDD to the

list of state Commemorative Days requiring the Gover-

nor to issue an annual proclamation. In 2006, attorney

Nathan Kottkamp organized the Virginia Advance Di-

rective Day and had participation from all of the hospi-

tals in the state, he had even more participation in 2007

and in 2008 he made it a national day.

How Did We Get Hear?

Have you ever been in a hospital waiting room and the

doctor comes out to discuss a patient’s status? Normal-

ly, this type of interaction is pretty routine, the doctor

shares information with the family gathered at the hos-

pital and everyone is relieved. Unfortunately, in some

cases the doctor may inform the family that the pa-

tient is in a coma or a persistent vegetative state or a

drug-induced coma. Sometimes the doctor must inform

the family that there is nothing medically that can be

done for the patient and a decision must be made to

discontinue life-sustaining treatment. Under these sce-

narios the doctor needs a surrogate decision-maker to

give informed consent to medical treatment. For many

Americans this presents a problem because the patient

has never signed an Advance Medical Directive.

Most Americans are familiar with the litigation that

may arise out of these types of scenarios caused by

conicts between legal, medical and faith/social con-

straints. There are three cases that stand out: In 1976

Karen Ann Quinlan the 21year-old young lady in a

persistent vegetative state whose parents had to sue the

hospital to remove their daughter from life-support. In

1990 Terri Schiavo’s husband and her parents began a

legal battle to determine whether the 26 year-old should

be disconnected from her feeding tube as her husband

wished or allowed to stay on as her parents wished. The

case went before the Florida Supreme Court, the US

Supreme Court, even the US Congress and the White

House. The 1990 the US Supreme Court heard the case

of Nancy Cruzon, a young woman who at the age of 24

had been in a permanent vegetative state for seven years

and was being kept alive by a feeding tube. Nancy’s

parent’s were suing for the right to remove the feeding

tube, the state of Missouri argued that it needed, “clear

and convincing evidence” of what Nancy would have

wished to occur. The Court ruled in favor of the Cru-

zons, ruling that individual’s have a constitutional right

to be free of unwanted medical intervention.

In 1991, Congress passed the Patient Self-Determi-

nation Act (PSDA) that mandated that patients be in-

formed of their rights and be oered information about

advance directives. In response to and in an eort to

avoid litigation, hospitals created Ethics Committees

to help address conicts or uncertainty. According to

the American Medical Association, the 1990’s saw the