## Facts

- Leo M. Yeager, born in 1924, had no known relatives or acquaintances and suffered from multiple serious medical and mental health conditions.
- In 1998, a Colorado court found Yeager legally incapacitated and appointed the Morgan County Department of Human Services (MCDHS) as his guardian.
- The guardianship order allowed MCDHS to make ordinary medical decisions but required court involvement for “extraordinary medical actions,” expressly including no-CPR/no-code orders.
- As Yeager’s condition worsened, MCDHS petitioned in 2002 for authorization to execute a do-not-resuscitate (DNR) order; the court appointed independent counsel for Yeager and also appointed a guardian ad litem.
- The parties stipulated Yeager had advanced dementia, congestive heart failure, chronic obstructive pulmonary disease, and anemia.
- At a 2003 evidentiary hearing, Yeager’s physician testified CPR had about a 1% chance of success and, even if successful, would likely leave Yeager worse off; CPR risked serious injury (including rib fractures and pneumothorax) and would aggravate his conditions, with minimal life expectancy expected.
- Yeager’s counsel opposed authorization, arguing Colorado law presumes consent to CPR absent a DNR and there was no evidence of Yeager’s personal wishes.

## Issues

1. Whether a county department of human services, acting as court-appointed guardian for an incapacitated adult, qualifies as a “person” authorized to execute a DNR under Colorado’s CPR directive statute.
2. Whether a guardian, with court approval, may authorize a DNR for an incapacitated ward without evidence of the ward’s expressed preferences when competent medical evidence shows CPR would be futile and harmful despite a statutory presumption favoring CPR.
3. Whether the appeal should be decided after the ward’s death during the pendency of the appeal.

## Decision

- The Colorado Court of Appeals affirmed the order authorizing MCDHS to execute a DNR for Yeager.
- The court held MCDHS, as a court-appointed public-agency guardian, is a statutory “person” permitted to act under Colorado’s CPR/DNR framework.
- The court held a guardian may obtain court approval for a DNR for an incapacitated ward without proof of the ward’s prior wishes when uncontroverted medical evidence shows CPR would likely be nonbeneficial and cause suffering.
- Although Yeager died during the appeal, the court reached the merits because the questions were likely to recur yet evade review in guardianship and end-of-life disputes.

## Legal Principles

- Statutory terms are construed in context with related guardianship provisions; when the probate code authorizes appointment of an appropriate public agency as guardian, the CPR/DNR statute’s reference to a “person” may include that governmental guardian acting for the ward under judicial supervision.
- The statutory presumption of consent to CPR operates as a default for emergencies when wishes are unknown; it does not require CPR where competent medical judgment shows CPR would be futile or inhumane and a guardian seeks court authorization for a DNR.
- In guardianship matters, courts may authorize extraordinary medical decisions based on the ward’s best interests when the ward’s preferences cannot be determined, particularly where there is no evidence of contrary wishes and the medical evidence is uncontroverted.
- Appellate courts may decide otherwise moot end-of-life guardianship disputes when the issues are capable of repetition yet evade review.

## Conclusion

The court upheld a court-approved DNR for an incapacitated adult with no known family, ruling that a county human services department appointed as guardian may act under Colorado’s CPR/DNR statute and that the presumption favoring CPR does not bar a guardian-initiated DNR when medical evidence shows CPR would likely fail and cause harm.


People ex rel. Morgan Cnty. Dep’t of Hum. Servs. v. Yeager, 93 P.3d 589 (Colo. App. 2004)