Matter of Warren

Julia Warren was an elderly woman suffering from a series of severe, life-threatening medical issues. Warren was also in a persistent vegetative state, which her physician, Dr. Ryan, believed would be permanent. In the event Warren suffered a cardiac or pulmonary arrest, Dr. Ryan recommended that cardio-pulmonary resuscitation (CPR) not be performed on Warren because the physical act of performing CPR on Warren would likely be both futile and fatal. Based on Dr. Ryan’s recommendation, Frank Murphy (plaintiff), Warren’s guardian, petitioned the court for authority to enter a do-not-resuscitate order (DNR) for Warren. Dan Wheeler (defendant) was appointed as Warren’s guardian ad litem for the proceedings. Murphy argued that, because the guardianship statute gave him authority to consent to medical procedures on Warren’s behalf, it also gave him authority to refuse consent for any medical procedure if doing so were in Warren’s best interest. Wheeler countered, arguing that CPR should not be withheld for Warren on the unilateral recommendation of Dr. Ryan. Wheeler did not present any medical evidence to counter Dr. Ryan’s testimony. There was no evidence presented regarding any relevant wishes Warren might have expressed prior to her incompetency. The trial court denied Murphy’s petition, holding that Murphy could not issue a DNR for Warren because (1) Dr. Ryan’s recommendation was based on quality-of-life considerations and (2) there was no evidence about what Warren’s wishes would be under the circumstances. Murphy appealed.