Update: Bret Bohn now ward of the state

Photo courtesy Bohn family.

Photo courtesy of the Bohn family.

After 12 days in court, Lorraine Phillips-Bohn and her husband say their son, Bret Bohn, is now under guardianship of the state against his will. Bohn’s family claims hospital officials and ruling Superior Court Judge Erin B. Marston have ignored their son’s original power of attorney, which gave Bret Bohn’s parents the right to make medical decisions on behalf of their son.

Bohn’s general power of attorney and health care power of attorney were drafted in 2007, before Bohn’s current illness. 

According to court documents, during the course of Bohn’s medical treatment at Providence Alaska Medical Center, his parents informed the medical staff of these documents and began acting accordingly.

Shortly after Bohn’s parents began acting in accordance to their son’s power of attorney, “a conflict soon arose between the medical staff and Bohn’s parents, who said that Bohn was being overly medicated and wanted their son to stop using any medications and leave the hospital immediately.” The document goes on to say that Bohn’s parents ignored medical advice from doctors at Providence that their son was gravely ill and could die if removed from the hospital.

After several nights of insomnia, Bohn’s parents brought him to the Providence Alaska Medical Center emergency room to seek treatment on Oct. 16, 2013. During this first emergency room visit, Bohn was given two prescriptions, one for anxiety, the other for sleep, then was released to go home.

Phillips-Bohn says after taking these medications, her son experienced a seizure and was brought back to the emergency room. While in the emergency room for the second time, Bohn experienced two more seizures and was admitted into the intensive care unit, where he stayed for several days.

Bohn’s parents were told their son would be released to go home with them on Oct. 22.

However, officials at Providence moved him to the fifth floor medical unit instead of the promised discharge.

According to Phillips-Bohn, her son remained on the fifth floor of the hospital for weeks, and doctors treated him with as many as 22 different medications at one time without a proper diagnosis.

Erik Guzman, Bohn’s long-time friend, spent as much time at the hospital as he could supporting Bohn and would often spend nights at Bohn’s bedside.

Guzman said he saw a lot of changes in Bohn by the time he entered the hospital to the last time he was permitted to visit Bohn on Dec. 24. Guzman said on some days Bohn was coherent and talkative, but began to deteriorate quickly after the many medical tests he was given.

Some of these tests included MRIs, spinal taps and blood transfusions, which all came back negative.

According to Guzman, Bohn had needle holes along his spine and complained his back hurt. Eventually Bohn became agitated, and at one point, he fought five security guards and several nurses while attempting to remove his IVs and catheter so he could leave on his own.

Guzman said during one of his visits, Bohn said, “I’m tired. I’m beat up. I just want to go home. I’m tired of being poked. My back hurts. I’m tired of getting needles in my back. I’m tired and just want to go home.”

Phillips-Bohn said she tried to get her son to stay at the hospital even though he wanted to leave, because she wanted him to get well. But officials are saying she tried to help him escape.

Of this incident, Guzman said, “He tried to voluntarily leave the hospital. … He had been wanting to get out since the first week he was there. He decided he was going to walk out of the hospital because they were not going to let him out. He walked halfway down the floor he was on and that’s as far as he went.”

Bohn’s family members eventually asked for a transfer to Alaska Regional Hospital for a second opinion, but they say this request was denied.

The last time Bohn was seen by friends and family was in December, and he was wearing an ankle bracelet monitor in order to prevent any further escape attempts.

After months of tests, and while the issue of guardianship was before the court, Bohn was finally diagnosed with autoimmune encephalitis.

Dr. Souhel Najjar, a nationally known expert on autoimmune encephalitis, explained there are several types of the disease.

Autoimmune encephalitis is a disorder in which a body turns against its brain,” he said in a phone interview. “The body produces antibodies that target the brain tissue and cause inflammation in multiple areas of the brain.”

One of the systems that can be affected is the limbic system, which is the area of the brain that affects emotion and behavior.

Najjar said, “It is not unusual that the patients (with autoimmune encephalitis) will be mistaken for a mental disorder.”

According to Najjar, there is an 80 percent survival rate for patients who have been diagnosed with autoimmune encephalitis if the disease is caught early and treated aggressively with proper medication.

Since Bohn is now a ward of the state, the court-appointed guardian and medical team can authorize Bohn’s hospitalization and treatment plan.

In an open letter to the Legislature dated Feb. 19, 2014, Providence Alaska Medical

Center outlines policies regarding patient privacy laws, and rules about the role of court-appointed guardians and visitation. The following is an excerpt from the open letter.

State law requires health care providers to make reports of harm to Adult Protective Services whenever they have reasonable cause to believe a vulnerable adult suffered abuse or neglect. Under state law, when a patient is not competent to make medical decisions on heir own behalf, their (1) guardian, (2) health care agent, or (3) surrogate are allowed to make heath care decisions on their behalf. Health care providers are permitted under state law, and required by their standard of care, to decline to comply with the direction of a surrogate if they determine that the surrogate is not abiding by the wishes, values and best interest of the patient. AS 13.5w.060(h). Health care providers are also permitted under state law, and required by their standard of care, to decline to comply with the direction of a guardian, agent, or surrogate if that direction requires health care that is contrary to generally accepted health care standards. AS 13.52.060(f)

When a temporary or permanent guardian is appointed by the court for a patient, that guardian will, in most cases, have the sole authority to make health care decisions on behalf of the patient, including decisions regarding medication and ho long the patient should stay in the hospital.

Accordingly, when a guardian the sole authority to make health care decisions for the patient, Providence confers with the guardian regarding the treatment of the patient and obtains the necessary consent to treatment from the guardian.

Providence only restricts visitation to a patient when that patient request no visitors or when restricting visitation is medically necessary and in the best interests of the patient. There are many different types of medical situations in which restricting visitation, including visitation by family members may be medically necessary. Providence attempts to work with the family and the patient to reinstitute visitation as soon as doing so is both in the best interest of the patient and requested by the patient.

For patients that do not have capacity and have a guardian appointed, Providence also confers with the guardian in regards to any restrictions on visitation.”

The last time family and friends spoke to Bohn, he told them he does not trust anyone at Providence. Bohn allegedly said, “I tell them no, but they don’t listen.”

Bohn’s parents believed their son when he said that, stating they witnessed Bohn’s objections to treatment first-hand, as well as the medical staff ignoring his requests not to be medicated.

According to the court, the Bohn family sought advice from lawyer and family friend Rhonda Butterfield in late October. The documents say Butterfield met with Bohn’s parents and Providence doctors to discuss Bohn’s treatment, specifically the medications he was receiving.

The papers say, “After subsequent meetings with Ms. Phillips, Ms. Butterfield began to have ‘very serious concerns’ for Mr. Bohn’s safety at the hands of Ms. Phillips. Ms. Phillips was quoted to have told Ms. Butterfield that ‘I would rather (Bret) die in my arms than have any more drugs’ and added that she would ‘start making funeral arrangements’ for Mr. Bohn.”

Testimony by Bohn’s physician Dr. Joseph J. Krakker, adult nurse practitioner Heather Brock and Dr. Peter Abraham, along with medical records provided to the court, stated that due to Bohn’s symptoms of delirium, hallucinations and incontinence, Bohn was unable to testify on his own behalf. 

I think one of the takeaways is, this can really happen to anyone and people’s rights are regularly ignored when this sort of thing happens,” Jim Gottstein, a lawyer with the psychiatric rights law project Psych Rights, said. “It’s kind of like their rights are ignored legally, like when the U.S. stole the land from the Indians fair and square. Not always, but in this case, they violated his rights but they seem to have a court order so someone can say his rights weren’t violated, but when you look at what happened you can say that his rights were. Now one thing that’s clear is no one can really talk to Bret to see how he feels about this, which I think is really important — and that’s not to doubt in any way what the parents are saying.”

Phillips-Bohn said she loves and misses her son, and her arms are aching to hold him and to hug him.

It’s the same feeling when I lost my first son, who was still-born. I ached to have a baby in my arms, to love. … He’s (Bohn) an adult now, but he’s my son, and I love him,” she said. “I just want him to know, and I feel that he knows that (that I love him), because we are real close.”

The court documents say, “Mr. Bohn’s parents have continued to act independently of medical opinion and the course of treatment prescribed by Mr. Bohn’s doctors. Therefore, the Office of Public Advocacy must be appointed to meet the best interests of Mr. Bohn as to his medical decisions.”

The documents later say Bohn’s parents, family and friends do not have the ability to follow medical directives and treatment, and his parents wish to stop their son’s medication and treatment.

Butterfield stated to the court, “During the course of my conversations with Lorraine (Phillips-Bohn), it became crystal clear that Lorraine is adamantly, absolutely without exception, opposed to Bret having any medication, tests or medical treatment, even when his doctors deem it necessary and even when it means the difference between life and death.”

A court visitor also substantiated Butterfield’s statement regarding Phillips-Bohn’s beliefs about medical treatment.

Under the law, Bohn’s parents are no longer a party to their son.

 

View the original Bohn story here: http://www.thenorthernlight.org/2014/01/14/man-allegedly-held-against-will-at-hospital/
All information regarding the court case came from Police State USA.

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