Massachusetts' highest court rules that, absent an express limitation in the document itself, the state's health care proxy statute permits an agent to commit a principal to a mental health facility, provided the principal does not object. Cohen v. Bolduc (Mass. Sup. Jud. Ct., SJC-08554, Jan. 11, 2002).
In 1998, Helen Bolduc, then seventy-four years old, executed a health care proxy naming her daughter as her agent. By its express terms, the proxy placed no limitations on the agent's authority. In June 2000, the proxy was activated when Mrs. Bolduc's attending psychiatrist at a nursing home where she was a resident determined that she was suffering from auditory hallucinations and paranoid and psychotic thought, and that she lacked the capacity to make or communicate health care decisions. Mrs. Bolduc was admitted to McLean Hospital, a psychiatric facility, under emergency hospitalization procedures. On July 2, Mrs. Bolduc''s daughter, acting as her agent, applied on her mother's behalf for "conditional voluntary" admission, which placed no time limits on her mother's confinement. On August 7, Mrs. Bolduc revoked her proxy and indicated her intention to leave the hospital. Two days later the hospital filed a petition for involuntary commitment. Mrs. Bolduc filed a motion to dismiss, which the motion judge denied and instead ordered her committed for six months. Mrs. Bolduc appealed. Before the appeal could be heard, Mrs. Bolduc was discharged from the hospital. The Appellate Division heard the case anyway and dismissed the appeal, whereupon Mrs. Bolduc appealed again.
Massachusetts' health care proxy statute gives the agent the authority to make all health care decisions on the principal''s behalf. "Health care," in turn, is defined as "any treatment, service or procedure to diagnose or treat the physical or mental condition of a patient" G. L. c. 201D, 1. Mrs. Bolduc argued that commitment to a mental health facility is beyond the scope of "treatment" as defined in the statute. She also contended that she had been denied due process in connection with her retention at the hospital.
The Massachusetts Supreme Judicial Court rules that, absent an express limitation by the principal in the health care proxy itself, the proxy statute does not prevent an agent from committing a principal to a mental health facility, provided the principal does not object. The court finds no indication that the legislature intended the scope of "treatment" to be limited. 'Restricting the range of choices available to a person who enters into a proxy arrangement,' the court writes, ' would hinder the control over medical decision-making the statute seeks to foster.' If the principal objects, or if she revokes her proxy after it has been activated, the proxy statute provides that the agent has no further authority to make treatment decisions without a court determination that the principal is incapacitated. The court rules that in this case Mrs. Bolduc received adequate process to protect her rights to refuse medical treatment.
For the full-text of this decision, go to: https://www.masslaw.com/masup/1000602.htm .
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