The Supreme Court of Delaware affirmed the family court judgment to de-escalate medical treatment for a minor child who was neglected and abused by his parents, holding that the family court's authority to de-escalate medical treatment and to withdraw life support was supported by its authority to consent to medical care under state law, that the family court found by clear and convincing evidence that it was in the best interests of the child to de-escalate his medical care, and that the court had authority to act, under the facts of the case, even though there had been no termination of parental rights. The supreme court found that under Div. of Family Servs. v. Truselo, 846 A.2d 256, there are several factors that a court must analyze when making a best interest determination for a child’s medical care: (1) evidence about the patient's present level of physical, sensory, emotional, and cognitive functioning, (2) the degree of physical pain resulting from the medical condition, treatment, and termination of the treatment, (3) the degree of humiliation, dependence, and loss of dignity probably resulting from the condition and treatment, (4) the life expectancy and prognosis for recovery with and without treatment, (5) the various treatment options, and (6) the risks, side effects, and benefits of each of those options. In addition, the court found that under In re Christopher I., 106 Cal. App. 4th 533, parental rights are not absolute and parents can, by their own actions, forfeit their rights to determine what is and is not in the best interest of their child. Under 13 Del. C. § 1103, the state determines that nothing should prevent a court from immediately assuming custody of a child and ordering whatever action may be necessary, including medical treatment, to protect his or her health and welfare. In this case, a child was placed into custody of the Division of Family Services after he was neglected and severely abused by his parents, resulting in near-fatal injuries. After evaluations and testimony by medical professionals and a guardian ad litem, the family court ruled that it would be in the best interest of the child to de-escalate his medical care, withdraw life support, enter do not resuscitate and do not re-intubate orders on his medical chart, provide him with comfort care, and allow him to die in peace. The child’s parents appealed the decision, arguing that without termination, they still retained parental rights to make decisions for their child, and further argued that they were not afforded due process. Because the family court had authority to act on the Motion to De-Escalate Medical Treatment, under the facts of the case, even though there had been no termination of parental rights, the judgment was affirmed.
Cite: No. 439/449; 2015 Del. LEXIS 450 (Del. Sept. 16, 2015)
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