George Brent and the Minority Report-ization of State Intervention
September 8, 2010 | 14 Comments
Have you watched the movie adaptation of Philip K. Dick’s short story The Minority Report? You know the one. It was directed by Steven Speilberg and starred Tom Cruise. It was what some people call a blockbuster in 2002.
I have to admit, Tom Cruise aside, I’m a sucker for Philip K. Dick adaptations. Most are done quite well and Dick is, by my lights, an incredible story teller. The IMDB plot line goes as follows,
In the year 2054 A.D. crime is virtually eliminated from Washington D.C. thanks to an elite law enforcing squad “Precrime”. They use three genetically altered humans (called “Pre-Cogs”) with special powers to see into the future and predict crimes beforehand. John Anderton heads Precrime and believes the system’s flawlessness steadfastly. However one day the Pre-Cogs predict that Anderton will commit a murder himself in the next 36 hours. Worse, Anderton doesn’t even know the victim. He decides to get to the mystery’s core by finding out the ‘minority report’ which means the prediction of the female Pre-Cog Agatha that “might” tell a different story and prove Anderton innocent.
In the opening sequence of the film, Anderton (Cruise) is working his technological magic to figure out where a murder that the “Pre-Cogs” have predicted is about to take place. And our hero is working under a very tight time line. As Anderton races to put all of the clues together, we see the outlines of the crime coming together in perfect narrative form.
A seemingly normal family is having breakfast and starting out their day. The kids set off for school as the wife finishes making their lunches and clears away breakfast. A somewhat mousy husband tries to speak to the distracted and attractive wife. The husband then leaves for work. Some time later, realizing he has forgotten his glasses, the husband returns home to find another man in his house — in his bed — with his wife. He spies on them a bit and then begins to confront them in a deeply humiliated, tear-filled rage.
And just as the husband seems poised to do something rash, Anderton comes barreling up the stairs and tackles him as the rest of the Pre-Crime unit come crashing through the windows on ropes. It’s suspenseful stuff, I tell you. Ripe for a Hollywood loving audience.
But as the officers are confirming the identity of the husband via eye scan, charging him with his “pre-crime”, and dragging him off in cuffs, the husband makes one very salient point. Begging his wife to stand up for him, he screams, “I haven’t done anything!”
“Yet”, of course, is the unspoken answer. The balance of the movie goes on to explore how that answer is fundamentally flawed.
I couldn’t help but think of that scene as I read the story of George and Delores Brent.
Brent’s 81-year-old wife, Dolores, was admitted to the hospital in Trail, in southeastern B.C. near the border with Washington, in August 2009 after suffering a heart attack.
After she recovered, her husband told hospital staff he wanted to take her back to their home in nearby Montrose.
Instead, the hospital moved her into its long-term care wing, saying she was too frail to leave.
“She would ask me every day, ‘When can I get out of here?’” Brent said. “They stated that I wouldn’t be allowed to take her home.”
In the long-term care wing, Dolores Brent’s health deteriorated. She suffered a stroke, and dementia set in.
What ensued was protracted battle between health authorities and George Brent over the care of his wife. Brent, who still wanted to take Delores to their home, complained of the care she received in the long-term care wing of the hospital claiming that he and his daughter, “often found Dolores parched, cold, tied to her wheelchair or even sitting in her own waste.”
Eventually, feeling his complaints weren’t being addressed, Brent resorted to refusing to pay the medical bills that the hospital sent him. That’s when the province stepped in.
Hospital physicians then assessed Dolores Brent’s deteriorating mental state, and an administrator from the health authority signed a form declaring her incapable of managing her affairs.
The certificate of incapability, as it is known, automatically put B.C.’s Public Guardian and Trustee in charge of her finances instead of her husband even though she had signed an enduring power of attorney appointing George Brent to look after her affairs if she became incapable of doing so herself.
“To get Dolores the support she needs, it is our intention to issue a certificate of incapability,” said a letter from the health authority addressed to George Brent in March. “The Public Guardian and Trustee will plan with Dolores to best meet her financial and legal needs.”
…
The Public Guardian then sent a letter stating, “We have now obtained the authority to act on behalf of Dolores . … Please note that any power of attorney … is suspended until further notice from this office.”
Since then, thousands of dollars have been withdrawn from the couple’s joint bank account to pay for Dolores Brent’s care, George Brent said. The province has also staked a claim on the couple’s home and receives the tax bills for the property.
Frustrated yet? Of course you are. What right do medical bureaucrats and the state have to tread so callously over the lives of a husband and wife who have gone to the trouble of determining a course of action for themselves in good faith should one of them fall ill. Isn’t this a breach of the very cohesiveness that we so value in the act of marriage?
The state has an answer for you, though. It was all done in the name of Delores’ care.
In B.C., health authorities were given the power to issue a certificate of incapability and have the Public Guardian suspend an individual’s power of attorney so they could move quickly to protect an elderly person if they suspected a family member was mismanaging or stealing the person’s money.
“Involving the office of the Public Guardian and Trustee isn’t something we do lightly or very often,” said Cindy Kozak-Campbell of Interior Health. “It does need to be serious reasons around abuse and neglect and financial issues.”
Kozak-Campbell said she couldn’t speak directly about the Brent case, because of privacy issues.
“We stay focused on the person in care,” she said. “So, although the family may have wishes, it is going to be the safety and comfort of that person in care. And we look for a clean, safe living environment for them.”
I’m not unsympathetic to the idea that health authorities need to look out for the best interests of the patient, even when doing so runs counter to the wishes of the family. The Hippocratic Oath describes a physician’s obligation to keep patients from “harm and injustice”.
Here’s the problem, though, it is not, nor was it ever, by all accounts, clear that Delores was in harm’s way by being left in the care of her husband. George Brent did not say to authorities that all their medical hokey-pokey was for the birds and that his wife was fine and just needed to be in her home to recover. By all accounts, George Brent wanted to take his wife home once she had stabilized and make arrangements to give her the care she needed there.
And it is not at all clear that he couldn’t have done. It may well have cost a fair sum of money, but this is, after all, Brent’s wife of sixty-four years. One can only imagine that Brent, who by all accounts is perfectly capable of assessing his and his wife’s situation, was prepared to pay what was necessary to provide the appropriate care for his wife.
You can check out video of Brent’s story here via The National (it starts just after the 21 minute mark). It’s a short series of clips and so can’t be used as anything definitive. But listening to Brent’s story and watching him relay it, one doesn’t get the sense of a crazed and irrational husband bent on manipulating the power he had over his wife’s affairs in worrisome ways.
Authorities will point to one of the Brent’s children, Shannon Harrigan, who was opposed to her father taking her mother home, and voiced her concern to hospital staff about Brent saying that at least at home they could, “die together.” Of course, that sounds pretty fatalistic. Except for the fact that it’s true.
Delores Brent is 83 years old, has had a heart attack, a stroke, and is now beset with dementia. Sadly, her time left on this planet is not long. And her husband, while wishing to care for her, undoubtedly realizes this. Is it so wrong, acknowledging that death’s inescapable hand is near, that he should want to be near his wife in their home to deal with that greatest of fears?
All of which says nothing of the fact that another of the Brent’s children, Gwyn, has stuck by her father’s side, both morally and physically, throughout the whole ordeal.
But the province made the decision that George Brent was unable and/or unwilling to care for his wife without first having any evidence to support the claim. George Brent is left in the same position as the other husband in the scene from Minority Report that I relayed earlier. He is treated as if he has done something wrong without ever actually having done something wrong.
And that ultimately is the real crime here.
Perhaps George Brent wasn’t capable of caring for his wife in their home. Perhaps he was. But when the state starts to predict when and where it must intervene against the legal provisions and wishes of a citizen without any hard evidence of wrongdoing, well we’re all in about as much trouble as John Anderton shortly found himself in Minority Report, if not more.
Update: you can view a clipped version of the video coverage from The National here.
Tags: BC Health Authorities > Delores Brent > George Brent > Minority Report > Philip K. Dick > state intervention
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14 Responses to “George Brent and the Minority Report-ization of State Intervention”
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September 8th, 2010 @ 4:28 pm
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September 8th, 2010 @ 4:47 pm
Hi Scott,
I’ll play the side of our, well your, fascist overlords. It’s actually not possible to determine who is correct without more medical evidence. I’ve worked in mental health care for years and i’ve seen many people who very clearly could not care for themselves. However even most of those people were free to be out of psych hospital since there was no immediate harm, although pretty obvious long term harm. An elderly person who had just had a heart attack might need significant care; care that another elderly person may not be able to give. There have been quite a few dead bodies from people refusing medical care , mostly for religious reasons, so its not an academic question.
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Scott H. Payne Reply:
September 8th, 2010 at 4:51 pm
But the question is/was not whether Delores Brent needed medical care. Everyone agrees that she did/does. The question is whether George Brent was prepared to ensure it was provided. By all accounts, he was indeed prepared to do so and it seems distinctly unfounded for the health authorities to second guess George Brent’s intention to provide that care without some kind of compelling evidence to the contrary.
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Scott H. Payne Reply:
September 8th, 2010 at 5:24 pm
PS – thanks for the comment round these parts, Greg.
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September 8th, 2010 @ 5:59 pm
I agree with the comment, that it’s not possible to judge the correctness of the decision without more evidence, but I would not be at all surprised to learn that the court was very deferential to the position of those who wanted to take the wife’s care out of her husband’s hands. There’s also nothing uniquely Canadian about this story – stuff like this happens stateside.
Our society has a tendency to infantilize the elderly, to diminish the value of what they think, want, and say that they need, and to feel that “it’s no big deal” to take away their rights because the worst outcome is that they’re inconvenienced for a couple of years before they become mentally incompetent anyway or die.
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Scott H. Payne Reply:
September 8th, 2010 at 6:06 pm
It could be that the health authorities have some piece of information that they can’t share that exonerates or otherwise justifies their actions. I’m skeptical, but it is possible. I’ll keep an eye on the story and post updates as they become available.
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gregiank Reply:
September 8th, 2010 at 6:22 pm
I don’t know the health care privacy rules in Canada. I’m familiar with some cases hereabouts, mostly child abuse investigations or DV matters, where the state was prohibited by law from discussing all the info in the case while advocates and talking heads blathered all over the place. It leads to a jaundiced view of the case.Important info to show the states view was not part of the discussion.
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Scott H. Payne Reply:
September 8th, 2010 at 6:27 pm
The health authorities have stated that they can’t discuss the case specifically because of privacy issues. So it’s not that I think they’re being secretive. I’m just skeptical, given what we know, that were they able to talk, they would offer a satisfying account of their actions. But I acknowledge that I could be wrong about that. And every story I’ve seen on this issue, which is not many at this point, has mentioned the privacy bind in which the province finds itself. I also made a point of including that comment in the rebuttal of the health authorities for precisely that purpose.
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September 8th, 2010 @ 8:05 pm
I’m certainly leaning your way Scott me lad. Procedurally speaking, however, this choice by the province makes brutal sense. Excessive conservatism in these instances covers the authorities ass. You can see the exact same phenomena in doctors in America who over proscribe needless tests in order to protect against lawsuits. Erring on the side of overcaution is cruel to the Brents, but covers the administrators butt. If they had discharged Mrs. Brent and the Mr. had taken her home and then climbed into a running car with her in a closed garage the daughter would have thrown a screaming hissy fit and someone in the administration of the hospital would have been in serious danger of loosing their job.
How to correct this? I don’t know. Change human nature? Human organization nature? Dunno.
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Aaron Reply:
September 8th, 2010 at 10:10 pm
Leaving the mythology of “defensive medicine” for another day…. Really, the question is where and on what terms Mrs. Brent is going to die. Not that she is going to die – that’s inevitable. Western culture tends not to deal well with death, no matter how imminent or inevitable.
I have heard no suggestion of fear that Mr. Brent would not care for his wife to the maximum extent of his abilities. It may be that, had she gone home with him, his wife’s health would have been negatively affected despite his best efforts. But it it not unreasonable for him to make that decision with her or, consistent with the power of attorney she granted to him for her consistent with what he believed to be her wishes.
I was touched by a similar issue not so long ago, in which an elderly woman was dying and her family was considering home hospice care – nobody disputed that she wanted to die at home, with her family. One of her children objected and insisted upon seeking maximum medical intervention. The other family members, including the husband, were afraid of being wrong – “What if she can live another year or more if she’s treated.” After some very expensive inpatient medical treatment a CT of the brain was performed that revealed severe, irreversible atrophy, and she died a week later in a hospital.
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September 9th, 2010 @ 7:06 pm
It would seem to me that if the State, as an entity, has standing to assume guardianship over someone’s medical care, they (at least ought to) have standing to assume the right to publish the reasoning behind that decision.
Invoking privacy laws is fine up to a point, but if you’ve already abrogated the citizen’s right to make their own decision (or rescinded the citizen’s already made decision, in the case of the power of attorney), it follows that you’ve already decided that the citizen’s right to privacy is of minimal concern.
I don’t think it’s reasonable for the State to claim patient default right to confidentiality as a justification for withholding evidence of its rationale for infringing on the patient’s already established explicitly invoked right to decision-making.
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trizzlor Reply:
September 9th, 2010 at 9:37 pm
I think this hinges on who was actually privy to that information. You seem to suggest that we, that is the general public, deserve to know all of the details but that’s not as clear cut. If the patient and her family all have access to the full decision and the capacity to appeal it, as well as any enterprising lawyer who would like to take on the case (as long as they are bound by attorney client privilege and do not release the information publicly); that seems like a fair compromise and I would imagine it’s close to the protocol in this specific situation. The fact that the patient has dementia and can no longer wave her right to privacy is what makes this particularly tricky unless we want anyone not of sound mind to be stripped of that right automatically.
To me what’s fascinating about this incident is that all of the pieces of the law were made with good intent: I actually want people who have suffered dementia to have some kind of public guardian rather than to be left fending for themselves; I actually want the health-care system to look out for predatory relatives looking to bilk their dying kin; I actually want a guaranteed right to privacy for those who can no longer make the decision to waive it; and so forth. Yet putting all of these good intentions together makes for some nightmarish situations like the one Scott envisions.
As a liberal, my gut-reaction is that this could simply be fixed with more oversight and engineering (an independent “blue-ribbon” committee, as is all the rage now; or a system where these incidents get anonymized and open for public scrutiny at the end of each year). But that justification just doesn’t feel like much of a comfort in this case.
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Scott H. Payne Reply:
September 10th, 2010 at 5:04 pm
trizzlor, the unfortunate consequence here also happens to be that in poorly applying each of these laws in an incompetent manner, the province/state ultimately undermines the legitimacy of their use in appropriate circumstances.
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September 10th, 2010 @ 10:21 pm
[...] at my other blogging haunt, my colleague (of left-ish tendencies) Scott Payne examines the perils of government intervention into such things as health care. He highlights the plight of Dolores and George Brent. Though [...]