New Jersey's “Granny Doe” Squad: Arguments about Mechanisms for Protection of Vulnerable Patients

Letter addressed to New Jersey long-term care facilities by Hector M. Rodriguez, dated August 30, 1988.

American Academy of Pediatrics v. Heckler, 561 F. Supp. 395 (D.C. 1983). Here the court ruled that the Secretary of Health and Human Services had failed to follow proper procedures (Administrative Procedure Act) in promulgating the so called “Baby Doe” regulations.

N.J.S.A. 52:27G1 et seq. The authors wish to point out that on occasions the Ombudsman has sought to legislatively extend the office's jurisdiction to acute hospitals.

Ibid.

In re Conroy , 98 N.J. 321, 486 A. 2d 1209 (1985).

Ibid.

Ibid.

In re Farrell , 108 N.J. 335, 529 A.2d 404 (1987). Kathleen Farrell was a competent, 37 year old, terminally ill patient with amyotrophic lateral sclerosis (ALS) being cared for at home. Her husband, in keeping with her decision, requested an appointment as her special medical guardian with express permission to remove his wife's respirator. The court held that as long as two doctors concurred in her competence and prognosis, no court intervention was necessary to honor her decision to remove the mechanism. (Mrs. Farrell died during the pendency of the appeal to the New Jersey Supreme Court).

Letter, supra note 1.

The Commission on Legal and Ethical Issues in Health Care Delivery (a.k.a. The Bioethics Commission) was established by the legislature in 1986. It is charged with recommending legislative responses to a wide range of health care issues.

Commentary at N.J. Bioethics Commission task force meeting, October 12, 1988.

The Record (Bergen Co., N.J.), October 19, 1988, p. 13.

American Medical News, November 4, 1988, p. 27.

Letter to the Commission on Legal and Ethical Problems in the Delivery of Health Care (a.k.a. the Bioethics Commission) by McDonald Harry R. LaPenta Samuel C. , dated September 23, 1988.

Letter to Governor Thomas H. Kean by NJSNA President Jean R. Marshall, RN, dated October 3, 1988.

In re Quinlan , 70 N.J. 10, 355 A.2d 647, cert, denied subnom. Garger v. New Jersey, 429 U.S. 922 (1976).

In re Jobes , 108 N.J. 394, 529 A.2d 434 (1987).

In re Peter , 108 N.J. 365, 529 A.2d 419 (1987).

In re Farrell , 108 N.J. 335, 342 n.2, 529 A.2d 404, 407 n.2 (1987).

Conroy supra note 5.

Quinlan , supra note 16, at 58.

Jobes , Supra note 17, at 451–452.

New Jersey Law Journal, November 30, 1988, p. 18.

Ibid.

Letter to Senator Gabriel M. Ambrosio, dated November 14, 1988, p. 10.

Letter by Scofield Giles R. , Esq. to Alan J. Weisbard, Esq., Executive Director, Commission on Legal and Ethical Problems in the Delivery of Health Care, dated October 11, 1988.

Ibid.

Two states, New York and New Jersey, have created statewide bioethics commissions. New Jersey has enacted legislation establishing a permanent Commission on Legal and Ethical Problems in the Delivery of Health Care to study bioethical issues. N.J. Stat. Ann 52-9y1-6 (West 1986). In March of 1985, Governor Mario Cuomo established by Executive Order the New York State Task Force on Life and the Law to develop recommendations for public policy arising from recent advances in medical technology.

The Star Ledger, Friday, March 17, 1989, p. 1.

On December 13, 1989, the New Jersey Hospital Association and the Medical Center at Princeton commenced a declaratory judgment action challenging the Ombudsman's letter of August 30, 1988 as rulemaking in violation of the state's Administrative Procedure Act (The New Jersey Hospital Association and the Medical Center at Princeton, et al, v. Hector M. Rodriguez, as ombudsman, Docket No. L88-6457). At the time of submission of this article, the Medical Society of New Jersey, the New Jersey State Nurses Association and the New Jersey Association of Non-Profit Homes for the Aging have joined in seeking to declare the letter procedurally invalid. Currently, this action has been transferred to the Appellate Division of the Superior Court of New Jersey. It is important to note, however, that in the American Academy of Pediatrics v. Heckler, 561 F. Supp. 395 (D.C. 1983), the challenged regulations provided the substantive basis for action by the Secretary of Health and Human Services. Here the Ombudsman's authority to participate in treatment decisions of the institutionalized elderly patient stems from separate and currently unchallenged statutes and court decisions.

Ibid.

Conroy, supra note 5, at 381.

Peter, supra note 18, at 383.

Jobes, supra note 17, at 421.

Commentary at N.J. Bioethics Commission task force meeting, November 9, 1988.

David M. Price, and Patricia A. Murphy, “Emotional Depletion in Critical Care Staff,” Journal of Neurosurgical Nursing, 17 (1985), pp. 114–118.