Editorial Note: This post by Lois Sampson, an Elders’ Rights Advocate with the Seniors At Risk Coalition, is the first of several on this theme. The message for readers who think that neither they nor their relatives have been or are likely to be in the position that Arthur Hippe was in is that Arthur’s is the kind of case where the kidnapping can be seen, yours or your relatives may not be. If you are being given a medication you don’t need, you are kidnapped. The fact that the jailer seems like a friend can make the problem worse – your relatives and friends will not mobilize behind you. The medical system has a blind spot when it comes to recognizing when it is causing the problem it then insists on treating you for. This topic was covered two years ago in a series of Munchausen posts. At a time when many complain about over-treatment, this is an issue that needs to be brought to the attention of policy-makers.
Arthur Hippe, a 66-year-old man, was hospitalized with a stroke in 2010. He entered Ajax Pickering Hospital in Toronto walking and talking. However, a few days later a doctor told his wife Marilyn Nelson that she should “just let him go”. She asked the doctor what that meant, and was told that the hospital could just withhold food and water and give him some medications to keep him comfortable until death, and that it would only take a few days. Shocked, Marilyn refused. A few days later the hospital began to administer a drug called Haldol (haloperidol) to Arthur, without Marilyn’s consent. Within a short period of time, Arthur was no longer able to walk or talk, and his muscles began to contract.
Marilyn got a second opinion from a neurologist who, after a thorough assessment, stated that Arthur should be able to recover almost all of his abilities with physiotherapy, and that he should not be given Haldol or drugs of that nature. The hospital ignored the neurologist’s opinion completely.
Arthur never received any physio whatsoever over the next three years in hospital and, worse, he was heavily drugged during that entire time, all without legal authority/consent from his wife Marilyn who had power of attorney for personal care (substitute decision making (SDM) authority).
The hospital doctor wrote letters to Marilyn saying that the hospital was going to declare her incapable to act as SDM unless she agreed to the doctor’s treatment plan. During this time, the hospital falsely accused Marilyn of slapping Arthur; Marilyn went to police who investigated and found no basis for the hospital’s allegations. Despite this, and a strongly worded letter from her lawyer that their actions were unlawful, the hospital banned Marilyn for several months. Finally, the hospital permitted Marilyn to visit one hour a day, but only if she remained under guard constantly (an indignity she endured for almost two years).
All along, Marilyn tried desperately to have Arthur transferred to a rehab facility or to a long-term care home, but the hospital doctors and health care authorities continually obstructed her every effort, claiming Arthur was violent, needed physical and chemical restraints, and at one point falsely stating he was blind, all in an effort to diminish his opportunities for transfer.
At this time, Marilyn asked for help from Seniors at Risk. A few months later, in June 2012, the doctors declared that Arthur was dying and that he should be now be designated as “palliative”. Marilyn disagreed vehemently. So the hospital asked the Public Guardian and Trustee (PGT) to approve the drug prescriptions and treatment plan which included multiple physical restraints applied daily and a palliative designation stating he was dying and not expected to live for more than six months. The PGT quickly consented, without consulting Marilyn.
Seniors at Risk helped Marilyn obtain records and challenge the doctors’ actions in court (a quasi- judicial body called the Consent and Capacity Board). We obtained additional expert medical opinion confirming that Haldol was likely to have very harmful even deadly effects for a man in Arthur’s condition, that indeed he was suffering these effects, and his death, if it was imminent, would likely be caused or hastened by Haldol. The medical expert offered to testify in court but was prevented from doing so. During the Board hearing proceedings, the hospital doctors stated in writing that they would halt Haldol until the Board decision was rendered. However, it was discovered that the doctors had during this time, on at least four occasions, secretly ordered that Arthur be injected with Haldol. The hospital/doctors admitted to “battery” but there were no consequences for their actions, and the “incident” was completely ignored by the Board.
In June 2013, after four months of hearings, the Consent and Capacity Board ruled that Marilyn was indeed Arthur’s lawful substitute decision maker, and that the hospital had conspired with the Public Guardian & Trustee to unlawfully usurp decision-making authority for personal care and for finances. The Board confirmed that Marilyn Nelson was Arthur Hippe’s lawful substitute decision maker for personal care and for finances (property). Then, in virtually the next breath, the Board stated that Marilyn “must comply with the doctors’ treatment plan within 15 days, or her SDM authority would be forfeited to the Public Guardian & Trustee.” In other words, the only authority that a person holding power of attorney has is to rubber-stamp what doctors want to do.
Seniors at Risk advised Marilyn to appeal the decision (thereby preserving her SDM authority for the interim), and helped her to prepare court documents (since she could not afford a lawyer). In October 2013, a few days after we filed the appeal factum, we organized a group of people to free Arthur from Ajax-Pickering Hospital. Our group descended on the hospital without warning. In the presence of guards, we provided documents demanding that Arthur be discharged, which staff accepted. We quickly wheeled him outside, where he took his first breaths of fresh air in two years.
We whisked Arthur into a waiting medical transport and on to Mount Sinai, a teaching hospital in downtown Toronto. There, doctors immediately and without prompting discontinued Haldol and said that Arthur was stable enough to return home! The hospital graciously allowed Marilyn and Arthur to remain in an emergency cubicle together for 24 hours to give us enough time to equip their home with a hospital bed, Hoyer lift, home care relief and the requisite personal care items.
Today Arthur Hippe continues to live happily at home where he is cared for by his wife Marilyn Nelson, relieved with occasional home care support. He remains drug-free (except for blood pressure medication), and his health has improved considerably thanks to physio and rehab services that Marilyn arranged for after he returned home.
Note: The Seniors at Risk group covertly filmed Arthur Hippe’s breakout from hospital, as well as his triumphant laughter-filled return home. Those videos have not yet been made public, but we plan to do so in the near future.
- Second opinion of Dr. L. Georgevich, neurologist 2010-06-22.
- Letter from (MRPs) C. Price and Dr. R. Stas 2011-06-24 saying that they “feel strongly that any decision other than to consent to the proposed treatment plan is not a decision made in accordance with these principles” (of law, namely prior capable wish and best interests of the patient – allegations which were not true).
- Letter from Marilyn Nelson’s lawyer, 2012-02-13 stating that the doctors’ actions were unlawful.
- Chart of drugs administered to Arthur Hippe, all without consent.
- Literature provided by a pharmacologist as evidence of effects of long-term neuroleptic administration (i.e. Haldol).