Court Battle Over a Ventilator Takes a Patient From Minnesota to Texas – The New York Times

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Scott Quiner, who was unvaccinated and hospitalized with Covid-19, had been on a ventilator for weeks when doctors told his wife they would be taking him off the machine.
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Scott Quiner, an operations manager at a transportation company in Minnesota, became sick with Covid-19 in October.
Mr. Quiner, 55, who was unvaccinated, was hospitalized the next month, and his case became so severe that he had to be placed on a ventilator, according to court records. For weeks, he remained on the ventilator at Mercy Hospital in Coon Rapids, Minn., a city of 62,000 people about 16 miles north of Minneapolis.
Then, on Jan. 11, hospital officials told Mr. Quiner’s wife, Anne, that they would be removing him from the ventilator in two days, over her objections.
What followed was a legal case that raised questions over who has the right to make wrenching life-or-death decisions when patients cannot speak for themselves. It also underscored the tensions between people who refuse the coronavirus vaccine and the hospitals that have been filled with patients sick with the virus, a majority of them unvaccinated.
In court papers, Mercy Hospital did not provide specific reasons for why it moved to take Mr. Quiner off the ventilator. Allina Health, which oversees the hospital, declined to comment on Mr. Quiner’s case, citing patient privacy.
In a statement, it said that it had “great confidence in the exceptional care provided to our patients, which is administered according to evidence-based practices by our talented and compassionate medical teams.”
Ms. Quiner did not respond to messages seeking comment.
On Jan. 12, Ms. Quiner pleaded for a lawyer’s help on the “Stew Peters Show,” a podcast whose host has falsely called coronavirus vaccines “poisonous shots” and given a platform to pandemic conspiracy theories.
She said that aside from her husband’s lungs, his organs were functioning and “there was nothing wrong with his brain.” Only a couple of days earlier, she said, her husband had opened his eyes “and was more alert.”
“I’m thinking, ‘Why are you killing him?’” said Ms. Quiner, whose husband had made her his health care agent in 2017. Under Minnesota law, that means she has the authority to make medical decisions on his behalf if he is unable to himself.
The day of her podcast appearance, she found a lawyer, Marjorie Holsten, who immediately filed a motion for a restraining order to keep the hospital from taking Mr. Quiner off the ventilator.
Judge Jennifer Stanfield, of the Tenth Judicial District Court in Anoka County, granted the order. On Jan. 15, Mr. Quiner was flown to a hospital in Texas, where, Ms. Holsten said, his condition has improved significantly. She declined to identify the hospital.
Ms. Holsten said: “He was cognizant until they administered a ton of sedatives. That was when he was put on the ventilator.” Mr. Quiner had lost 30 pounds and was described as the “most malnourished patient” a doctor at the Texas hospital had ever seen, Ms. Holsten said.
On Saturday, he died, Ms. Holsten said. He was survived by his wife and three children.

In court papers, lawyers for Mercy Hospital said Mr. Quiner’s treatment was based “on best available medical science and authority.” In a motion, the lawyers asked Judge Stanfield to issue an order that said the hospital had the authority to remove the ventilator.
Specialists were consulted and the treatment was “in compliance with Mercy’s policies and procedures regarding medically nonbeneficial interventions,” the lawyers wrote.
Mr. Quiner did not specify whether he wanted to be kept alive on machines in his advance directive, a legal document declaring what treatments he does and doesn’t want.
On the form, he specified his wishes only under a section that asked about spiritual and religious beliefs.
“Request prayer from family and friends at bedside,” he wrote.
Hospitals in Minnesota have been overwhelmed by a combination of patients with Covid-19 and those with other conditions, particularly in the Minneapolis and St. Paul area, according to the Covid-19 Hospitalization Tracking Project at the University of Minnesota.
Omicron in retreat. Though the U.S. is still facing overwhelmed hospitals and more than 2,000 Covid-19 deaths a day, encouraging signs are emerging as new cases have started to fall nationally, signaling that the Omicron-fueled spike has finally begun to relent.
Free tests and masks. Americans have started to receive free tests from the U.S. government in the mail after it began accepting orders last week. The Biden administration said it would send 500 million rapid tests to Americans via the U.S. Postal Service and make 400 million N95 masks available at pharmacies and health centers.
Around the world. New Zealand imposed its highest level of Covid restrictions across the country after at least nine Omicron cases were reported. In Hong Kong, multiple apartment buildings were locked down and 37,000 people were ordered to undergo testing after an outbreak in a housing complex.
Staying safe. Worried about spreading Covid? Keep yourself and others safe by following some basic guidance on when to test, which mask to pick and how to use at-home virus tests. Here is what to do if you test positive for the coronavirus.
On Thursday, only 1 percent of adult beds in the intensive care unit were available, according to the Minnesota Department of Health.
Scarcity of resources can be a factor in a hospital’s decision to withdraw care, but it is rarely a top one, said Thaddeus Pope, a professor who teaches health law and bioethics at Mitchell Hamline School of Law in St. Paul.
Under Minnesota statute, medical providers who believe a health care agent is not acting in the best interest of a patient should go before a judge, he said.
“It’s an uncommon situation where you’re going to overrule what the agent says,” Professor Pope said. “The hospital doesn’t make health care decisions. The patient does, and if the patient lacks the capacity, the health care agent does.”
Before going to court, doctors should try to communicate effectively with a health care agent, he said. If that fails, doctors should present their argument before an ethics committee, which ideally would include community members in addition to health care workers, to determine if the health care agent’s authority should be overruled, Professor Pope said.
The decision to take away life-sustaining machines is more straightforward when doctors have determined that a patient meets the criteria for brain death, said Dr. Mary Groll, a professor of health sciences at North Central College in Naperville, Ill.
But if a patient’s brain function is intact and a meaningful life remains possible, the decisions about medical care fall more clearly on a patient or that patient’s proxy, Dr. Groll said. Doctors should then have frank conversations about the kind of future a patient may face, she said.
Medical training has become more focused on prioritizing the medical wishes of a patient, Dr. Groll said.
“At the end of the day, it all begins and ends with your patient,” Dr. Groll said. “Your care begins with that person and it ends with that person, and they should be at the center of the decision making.”


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