State appeals court rules on doctor obligations (UPDATE)

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By CARRIE ANTLFINGER
Associated Press

MILWAUKEE (AP) — The government has no constitutional obligation to provide health care to patients in state doctors’ care, a state appeals court ruled Thursday.

Disability Rights Wisconsin filed a lawsuit in May 2009 against five University of Wisconsin Hospital and Clinics doctors, claiming they violated the rights of two developmentally disabled patients by withholding medical treatment. One, a minor who had pneumonia and required artificial nutrition and hydration, died.

The doctors were acting on guidance by parents or legal guardians who directed them to discontinue care.

The 4th District Court of Appeals agreed Thursday with a ruling by Dane County Circuit Court Judge Daniel Moeser, who said the government doesn’t have a constitutional obligation “to provide health care, offer services or act to save a person’s life.”

The appeals court judges also cautioned that the ruling wasn’t an opinion on doctors’ potential obligations or whether the actions violate tort law or professional codes, but solely on the fact that Disability Rights Wisconsin hadn’t presented sufficient legal argument that the doctors violated the constitution.

Disability Rights Wisconsin attorney Mitchell Hagopian said they plan to take the case to the state Supreme Court, and that the doctors should have kept treating the patients.

“This isn’t about providing medical care, it’s about cutting off medical care that has already started,” he said.

University of Wisconsin Hospitals and Clinic spokesman Lisa Brunette released a statement saying the case involved only the issue of whether physicians have an obligation under the state constitution to treat patients.

“All physicians have an ethical obligation to treat patients in a way that takes the best interests of the patient into account. That standard was not at issue in the case and remains the law,” according to the statement.

According to court documents, a minor with severe developmental disabilities had pneumonia in 2006 and the minor’s parents decided to provide only limited medical interventions if the minor developed pneumonia again. When signs of the illness reoccurred the same year, the minor received no treatment and artificial feeding and hydration was discontinued. The person later died.

The other case involved a 72-year-old woman with developmental disabilities who had a respiratory condition suggesting pneumonia in 2008. She was originally treated with antibiotics but her guardian and family decided to discontinue that and not give her a feeding tube. Her condition improved and the doctor resumed medication, according to court documents. She later recovered.

Disability Rights Wisconsin contended that three previous court cases established that an incompetent patient’s surrogate decision-maker may not refuse medical treatment on behalf of the patient if the person is not in a persistent vegetative state. The appeals court said those cases cited involve issues surrogate decision-makers, not state-employed doctors.

The original lawsuit had claims against the hospital, the medical school and University of Wisconsin System, but they were either dismissed or settled since 2009.