In re Guardianship of Tschumy

Jeffers Tschumy was unmarried, had no children, and was confined to a nursing home because of mental impairments, partial paralysis, and the aftereffects of a stroke. A mental-ability evaluation found that Tschumy was moderately-impaired and required assistance with housing, food, finances, and healthcare. Based on the evaluation, the court found that Tschumy was incapacitated and appointed Joseph Vogel (plaintiff) as his guardian. The guardian appointment order gave Vogel the power to consent, or withhold consent, to medical treatment on Tschumy’s behalf. Tschumy refused to discuss end-of-life care with Vogel. Approximately three years later, Tschumy suffered a severe, irreversible brain injury and became comatose. Tschumy required life-support in the form of a mechanical ventilator, intravenous fluids, and intravenous nutrition. Tschumy did not have an advance healthcare directive. Vogel was unable to locate any friends or family who might know Tschumy’s wishes, religious beliefs, or moral views regarding end-of-life care. Allina Health System (Allina) (defendant), where Tschumy was hospitalized, filed a motion to clarify whether Vogel needed court approval to discontinue Tschumy’s life-support. Tschumy’s doctors and Allina’s medical ethics committee agreed that Tschumy’s condition was terminal, that further medical intervention was futile, and that life-support should be terminated. Vogel agreed with the hospital’s recommendation to terminate life-support but argued that court approval was not necessary. Allina argued that court approval was necessary because Tschumy did not have an advance healthcare directive. The district court issued two orders: (1) authorizing Vogel to terminate Tschumy’s life-support; and (2) holding that guardians need court approval to terminate life-support for wards absent a valid advance healthcare directive. Vogel appealed the second order.