Plaintiff brings this action seeking the removal of a life-sustaining food nutrition system from his comatose*fn1 wife, a resident of Lincoln Park Nursing Home.
The nursing home opposes this action, and moves for the appointment of a "life advocate," one who will "fight for the life" of Nancy Ellen Jobes, i.e., for the continuation of all available means of medical treatment, regardless of her physical or mental condition.
Nancy Ellen Jobes is now 30-years-old. She has been lying unconscious since April 1980, when she sustained an anesthesiological misadventure during the course of surgery.
Plaintiff and Nancy Ellen were married in 1976. In March 1980 she was hospitalized for what appeared to be minor injuries sustained in an automobile accident. She was then four and one-half months pregnant. At first it was believed that the fetus was still alive. Subsequently, it was determined that the fetus had died.
On April 2, 1980, Ms. Jobes underwent surgery for removal of the fetus. During the course of this operation, she sustained an acute cardiopulmonary collapse and a severe loss of oxygen to the brain. This caused massive brain damage, resulting in her non-cognitive state.
In 1984, during the pendency of a malpractice action brought on her behalf, Ms. Jobes was adjudicated incompetent.
Ms. Jobes is incontinent. She requires a catheter for the removal of bodily waste. At first, she received sustenance through a nasogastric tube. In December 1980, it became necessary to insert a gastrotomy tube into her stomach. In June 1985 this device also failed and a feeding jejunostomy tube was surgically implanted in her small intestine. Liquid nutrition and water, regulated by a pump, continuously drip through the tube. On at least three occasions, Ms. Jobes has been hospitalized for complications resulting from utilization of the "j-tube."
Participating in this action are: plaintiff, who brings this action as guardian of the person and property of his wife; Richard Kahn, the court-appointed guardian ad litem for Nancy Ellen Jobes; the Office of the Public Advocate; the Office of the Ombudsman for the Institutionalized Elderly, to the extent deemed necessary by that office to protect the interests of its elderly constituents;*fn2 and the nursing home.
When the nursing home first sought to bring this motion, the matter was deferred until the guardian ad litem reported his position to the court. Thereafter, Mr. Kahn responded that, based upon all information now available to him, it is in the best interests of, and in accordance with the wishes of Nancy Ellen Jobes, to remove the "j-tube" automatic feeding system, thereby permitting termination of her life. He reserves the right to alter this opinion if facts and circumstances provided at or before the trial reveal that Ms. Jobes is not permanently non-cognitive.
Contrary to the initial contention asserted by the nursing home, it is not the function of the guardian ad litem in these life-support cases to argue for continuation of the incompetent ward's life in each and every case. Such a view misconceives the time-honored obligation of the guardian ad litem to act in the best interests of the ward. In re Grady, 85 N.J. 235, 264 (1981). The role of the guardian ad litem is "to insure the protection of the rights and interests of a litigant who is ...