Court of Chancery Denies Emergency Petition to Change Code Status
The Delaware Court of Chancery recently denied an emergency petition (the “Petition”) to change the code status of J.L.S., a person with an alleged disability, filed by his court-appointed guardian (the “Guardian”). The Guardian sought to withdraw life-sustaining support based on a major reduction in J.L.S.’s health. The Court of Chancery denied the Petition, finding that the Guardian failed to present evidence sufficient to override J.L.S.’s full code healthcare instruction.
J.L.S. had been continuously hospitalized since April 2024, when he completed a Delaware Medical Orders for Scope of Treatment (DMOST) form electing Do Not Resuscitate (“DNR”) status. J.L.S.’s medical record stated that J.L.S. later changed his preference from DNR to full code, and had capacity to make that decision, when he was hospitalized again on October 25, 2024.
By February 2026, J.L.S. was experiencing a significant health decline, prompting the Guardian to seek guidance from the Court of Chancery regarding an end-of-life care decision. The Guardian filed the Petition, seeking court authorization to change J.L.S.’s code status, withdraw life-sustaining treatment, and transition J.L.S. to comfort-focused, palliative care. The Petition was supported by two physicians who testified that medical procedures would not improve J.L.S.’s quality of life nor result in meaningful recovery, recommending the change sought by the Guardian.
To come to a decision in this case, the Court first had to resolve a conflict between the Uniform Health-Care Decisions Act (the “Act”), which amended Title 16 of the Delaware Code, and Court of Chancery Rule 178-A. The Act requires court approval before a guardian can act inconsistent with a health care directive, while Rule 178-A does not require court approval if medical providers confirm a reduction in health and that the person is not expected to recover. Applying 10 Del. C. § 361(b), which prohibits court rules from enlarging or modifying substantive rights, the Court held that the Act controls, and therefore court approval was mandatory regardless of the medical prognosis.
On the merits, the Court held that J.L.S.’s October 2024 full code election — made with documented capacity — revoked the April 2024 DMOST. The Guardian neither sought a finding of incapacity at the time of the October 2024 election nor produced clear and convincing evidence that withdrawal of treatment would reflect J.L.S.’s actual wishes. Accordingly, the Petition was denied.
This blog entry was primarily authored by Sierra Turner.
