Hospital officials want Rosemary Frost to receive additional treatments.
By DONG-PHUONG NGUYEN
© St. Petersburg Times, published August 4, 2001
TAMPA -- After watching cancer-stricken friends suffer painful deaths, 71-year-old Rosemary Frost told relatives never to allow doctors to perform life-saving measures if she were terminally ill.
But as Frost slipped in an out of consciousness after being severly burned, a doctor testified Friday, she mouthed the word "no" when asked if she wanted to die.
Now her words are at the center of a dispute between her family and Tampa General Hospital that will decide her fate.
A hearing officer Friday ordered two doctors to examine Frost and decide if she is terminally ill, one of the conditions needed for an oral living will to be considered legally binding.
The hospital filed a petition this week in Hillsborough Circuit Court to continue treating Frost against her family's wishes. Her family thinks she is suffering and should be allowed to die peacefully.
But the attending physician testified Friday that she is not terminally ill and wants to continue treatment to save her life.
Dr. Wayne Cruse, chief of the burn unit at the hospital, testified over a speakerphone that Frost indicated to him she does not want to die.
"I've communicated with her twice about our dilemma we all are in," Cruse said. "I believe she knew she was communicating with me . . . I asked if she wanted me to let her die. She shook her head "no' twice."
Cruse said he posed the question again two days later. "She mouthed the word "no' twice," he said.
Her children, who did not witness the encounters, are disputing Cruse's account, saying she is heavily sedated and not lucid enough to decide for herself.
The Kenneth City woman has been in the intensive care unit since July 19 when her nightgown caught on fire while she tried to light a cigarette. She suffered third-degree burns over 54 percent of her body.
She has undergone two surgeries and needs more skin grafts, Cruse said. If the family does not allow additional surgery, the chances she will die are "100 percent," he said.
Nick Ficarrotta, the hearing officer, instructed each side to hire a doctor to offer opinions about her condition. Ficarrotta said he would rule after reviewing their findings at a second hearing. That date has not been set.
"This is a tough case," Ficarrotta said during the two-hour hearing, which took place in a courthouse conference room.
Frost's youngest son, Mark, brought with him his mother's living will. The papers, yellowing around the edges, appeared to be documents in which she had filled in the blanks. Her children found the documents on her dresser, on top of a will-making kit purchased by her oldest son after she had expressed concern over her friends' deaths, Mark Frost said.
While it states that she did not want extraordinary measures taken after a catastrophe, it was never signed by witnesses, making it invalid.
While Cruse estimated Frost's chances of survival with additional surgeries at 10 percent to 20 percent, he does not think she is in a terminal condition.
"I think she has a very poor prognosis," he said. "(But) I think she can survive this thing."
Mark Frost said if she does live, her quality of life will be diminished to a level that she considered "her worst nightmare."
The family called upon a cousin who is a geriatric specialist at Harvard Medical School. Virginia Cummings testified over the telephone that her aunt will undoubtedly suffer.
"Our concern is that she will have such a low quality of life . . . should she survive, it's sort of futile to go ahead with surgery," Cummings said.
Frost's oldest son, Mike Frost, testified over the telephone that he and his siblings have nothing to gain over their mother's death; she has about $1,700 in her bank account. He said they are only doing what she would have wanted.
"She always pondered this situation and was quite adamant about not suffering," he said. "I believe if she knew what was going on right now, she'd be absolutely horrified."
Obtain a form that meets Florida's legal requirements (those issued by Florida agencies should) and compare it to others so you can tailor it to your needs.
Discuss the issues in the document with family, friends, clergy and doctor. Clarify your values and wishes. Ask about medical procedures you don't understand, and why and when they might be used. Ask the people you will count on if they are willing to make these choices for you.
Complete the form. Cross out statements or add them, within reason, to suit your needs. Make certain the witnessing is done correctly.
Distribute copies to family, friends and doctor. Review annually to ensure it still reflects your desires, and initial and date it. If significant changes are made, the safest course is to collect and toss all copies of the previous document and replace with the new one.
LifePath Hospice in Tampa; toll-free 1-800-209-2200. Provides free one-page advance directives and living wills.
Hospice of Florida Suncoast; (727) 586-4432. Provides free living wills.
Aging with Dignity; http://www.agingwithdignity.org; toll-free 1-888-594-7437. Its Five Wishes Booklet has been praised as the "first living will with a heart," delving into emotional and spiritual issues as well as medical concerns.