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To: Graymatter; All
Well done, between the two of us :)

This new case just popped up on google news:

Wife fights VA hospital over living will

John Mollica signed a living will seven years ago specifying what life-sustaining treatments he wanted if he were close to death and could not speak for himself.

The document now has become the center of a debate between his wife of 12 years, Natasha Mollica, and officials at Veterans Affairs Medical Center in Elsmere. John Mollica has been a patient there more than three months; he is unconscious and cannot speak after suffering a stroke Aug. 1.

Natasha Mollica, of Frederica, and her Dover attorney oppose hospital officials, who have said they want to remove John Mollica's feeding tube to comply with his living will. The document says that Mollica, 64, does not want artificial food or fluids if he ever has a debilitating condition from which there is no reasonable hope for recovery, such as a coma or vegetative state.

In a vegetative state, patients have no higher brain functions but their bodies continue to have sleep cycles and their eyes and limbs may move.

Natasha Mollica said she believes her husband is not in a such a condition and the portion of his living will that gives her power of attorney for his health care decisions should prevail. The document allows her to speak for her husband in medical care situations when he cannot speak for himself and written documents do not speak for him. She wants him to continue on the feeding tube.

"If he's supposed to die, let him die the natural way, from his sickness," she said.

Hospital officials maintain Mollica is terminally ill and that his living will makes clear he does not want a feeding tube keeping him alive in that situation. Department of Veterans Affairs policy in such cases says a health care agent - in this case Natasha Mollica - may not override a patient's specific instructions.

The debate has surfaced at a time that living wills are getting national attention. Florida's Terri Schiavo, 39, did not have such a document, and her family's battle over her feeding tube has received widespread news coverage.

Natasha Mollica said her husband executed the document at a veteran's hospital in Brooklyn, N.Y., without an attorney. She said she was honored that her husband gave only her the power to make decisions on his behalf. They took the paperwork home and filed it. She said their copy lacked the page declaring John Mollica did not want artificial food or fluids if he went into a permanently debilitated state.

Early this week she agreed that page, produced by the hospital through Department of Veterans Affairs records, is probably authentic. Thursday evening, she said she had doubts.

Hospital attorneys mum

Attorneys for the hospital said they would not discuss the Mollica case, and they advised hospital staff not to comment for this story. But their views are reflected in medical records released to the Mollicas' attorney, Stephen A. Hampton.

After attending a meeting that included the hospital chief of staff, chief of medicine, nurses, social workers and risk managers, Dr. Dominick Galluzzo wrote in Mollica's medical record on Oct. 15, that "the group's consensus is that Mr. Mollica made his wishes clear."

Delaware Right To Life, a pro-life organization, has no immediate plans to enter the debate, but stands ready to support Natasha Mollica if needed, group President Moira Sheridan said Thursday. She said she believes a feeding tube is basic health care that should not be denied. "No one deserves to die a slow and painful death, which is exactly what would happen if the feeding tube were removed," she said.

Mollica was conscious when he was hospitalized in July, but days later had a stroke that everyone agrees substantially impaired his health. He slipped into unconsciousness and has not spoken since. Natasha Mollica said it was her husband's second stroke this year.

Today he is bedridden. He can open one eye, can move his right arm and leg and has some movement in his left lower leg, said Vicki Santoro, a nurse who visited Mollica Oct. 24 at Hampton's request. Santoro works at Jenner's Pond, a continuing care retirement community in Pennsylvania.

Mollica breathes on his own and has a tube that clears mucus to guard against him choking because he cannot swallow, Santoro said. Mollica lifted his right arm and held her hand during the visit. She said she was unsure whether the movement was purposeful. "He looked like a strong man," she said this week.

Mollica's feeding tube goes in through his nose and winds down into his stomach. The Oct. 15 medical note says hospital officials determined that, in honoring Mollica's wishes, the tube would not be reinserted if it became dislodged.

Tube out for hours

Natasha Mollica said she contacted Hampton, the attorney, on Oct. 16 after she learned her husband had gone without the tube for several hours the previous day. The hospital delayed its implementation of Mollica's living will until Oct. 24 after attorneys got involved.

Then at Natasha Mollica's urging it was extended again until today so she could get a second opinion on whether her husband is in a vegetative state. An outside neurologist was supposed to examine John Mollica Thursday, but had not done so that evening.

Hampton said he has hoped to resolve the matter outside of the courts because court cases can become time-consuming. Neither he nor the hospital have sought a judge's intervention, although that is an option.

Jose Lopez, a Philadelphia attorney for the hospital, said the living will is valid in Delaware even though it was signed in New York, because it was executed in a federal veterans' hospital and Mollica is a patient in such an institution now.

Records indicate that as early as Sept. 18 a hospital ethics consultation was held on Mollica's case. A report suggested Mollica's final wishes be honored and recommended the hospital chaplain speak with his wife. The chaplain did so on multiple occasions, according to records.

But Natasha Mollica said she is not convinced her husband won't recover. He had a heart attack and another stroke earlier this year and woke up despite medical predictions he would not recover.

"Maybe he will get better," she said.

John Mollica served two years in the Army. His wife said he receives no military pension. Natasha Mollica was reared in Russia, the daughter of a French father and Russian mother, who are both deceased. She has no children.

Both Natasha Mollica and Santoro, the nurse who examined her husband, agree the dispute raises questions about the value of living wills. Santoro, said the case demonstrates that people who sign the documents are putting power into the hands of physicians, who decide when to implement them.

"You're really losing what you set out to gain," she said.

But living wills, often referred to officially as advance directives, have widespread public support.

Barbara Snapp Danberg, an attorney specializing in estate planning and advance directives, said the documents are key instruments for health-care decisions. This case, which she is not a part of, demonstrates the importance of having an attorney help prepare the papers, she said. Her office also keeps copies of the documents.

Reach Mary Allen at 324-2794 or mallen@delawareonline.com.

787 posted on 11/07/2003 12:29:21 AM PST by msmagoo
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To: msmagoo
I find this VERY interesting:

"Natasha Mollica said her husband executed the document at a veteran's hospital in Brooklyn, N.Y., without an attorney. She said she was honored that her husband gave only her the power to make decisions on his behalf. They took the paperwork home and filed it. She said their copy lacked the page declaring John Mollica did not want artificial food or fluids if he went into a permanently debilitated state.

"Early this week she agreed that page, produced by the hospital through Department of Veterans Affairs records, is probably authentic. Thursday evening, she said she had doubts."

How very conveinent for the hospital! Do I smell something a little rotten here?

Their error, as I see it, "...executed the document at a veteran's hospital in Brooklyn, N.Y., without an attorney.

856 posted on 11/07/2003 7:40:55 AM PST by Budge ( <>< .)
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