## Facts

- Jeffers J. Tschumy, an incapacitated adult with major cognitive and physical impairments, was under a court-ordered guardianship.
- In 2009, the district court appointed Joseph Vogel as successor general guardian and granted him statutory authority to consent to or withhold consent to medical treatment for the ward.
- In 2012, Tschumy suffered a severe hypoxic brain injury, became comatose, and required life-sustaining interventions (including mechanical ventilation and IV nutrition/hydration); physicians concluded the condition was irreversible and terminal.
- Tschumy had no health care directive and no known family or close contacts; the guardian could not locate anyone able to speak to the ward’s preferences.
- The treating physicians and the hospital ethics committee determined continued life-sustaining treatment was medically futile and recommended withdrawal.
- Vogel agreed withdrawal was in the ward’s best interests and sought to authorize removal of life support.
- The hospital petitioned the district court to clarify or amend the guardianship authority, expressing concern that a guardian could not withdraw life support without court approval when no directive existed.
- The district court (1) authorized Vogel to consent to withdrawal in this case and (2) issued a separate declaratory order stating guardians generally must obtain court approval to terminate life support absent an advance directive.
- Vogel appealed only the declaratory order.

## Issues

1. Whether a guardian’s statutory power to consent to or withhold medical treatment includes authority to authorize withdrawal of life-sustaining treatment for a ward without obtaining separate court approval when the ward lacks a health care directive.

## Decision

- The Minnesota Court of Appeals reversed the district court’s declaratory order.
- The court held that Minn. Stat. § 524.5-313(c)(4)’s medical-consent authority includes the power to consent to withdrawal of life-sustaining treatment, including disconnection of life support.
- The court concluded that additional, case-by-case judicial approval is not required unless the guardianship order limits the guardian’s medical-consent powers.

## Legal Principles

- Statutory authority to “consent to” or “withhold consent for” medical care encompasses decisions to discontinue life-sustaining treatment; the statute does not distinguish between starting and stopping treatment.
- Courts may not impose a judicial-approval prerequisite for withdrawal of life support that is not found in the guardianship statute.
- The absence of a health care directive does not, by itself, restrict a guardian’s statutory medical-consent authority when the guardian has been appointed with full medical decision-making powers.
- A guardian’s exercise of medical-consent authority remains subject to fiduciary duties and a best-interests standard, informed by medical judgment and established clinical/ethics processes.

## Conclusion

The court held that Minnesota’s guardianship statute grants a duly appointed guardian with medical-consent authority the power to authorize withdrawal of life-sustaining treatment for an incapacitated ward without obtaining a separate court order, and it reversed the district court’s contrary declaratory rule.


In re Guardianship of Tschumy, 834 N.W.2d 764 (Minn. Ct. App. 2013)