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Elderly woman refuses emergency surgery unless she can change
her will
In January 2020, at the age of 92, a woman was hospitalised with
a life-threatening leg condition.
During the day she underwent two unsuccessful procedures to
restore blood flow to the leg, and at about 2pm she was given
anaesthetic agents and other drugs.
Around 6:30pm, the doctors informed her that she required
emergency surgery on her leg, and she signed a consent form for
that surgery.
However, immediately before her scheduled 8pm surgery, the woman
adamantly refused consent to the operation unless she could change
her will.
Change of will substantially disinherits daughter
The woman's doctors knew that if they did not perform the
surgery quickly, they would be forced to amputate her leg due to
gangrene. So, they obliged her request, writing out a document
titled "Change of Will", capturing her instructions that
she wished to bequeath her house, the substantial part of her
estate, to her son.
The doctors read back to the woman what they had written, she
signed the change of will and the doctors witnessed her signature.
She then underwent the surgery.
The change of will document was quite different from the
woman's previous wills and formal expressions of testamentary
intention. In a 2005 will, a 2009 codicil, and an informal
testamentary document executed in 2018, the woman had divided her
property equally between her son and daughter.
Woman dies and daughter challenges change of will in court
The woman survived the surgery.
However, three weeks later she died due to post-surgical
complications, thus setting the stage for a family dispute over her
final wishes.
The daughter commenced proceedings in the Supreme Court of NSW,
seeking a declaration that the January 2020 change of will document
was of no legal effect. This would mean that her mother's
estate would be divided equally between her and her brother, in
keeping with the 2005 will and 2009 codicil.
The son countered that the 2020 change-of-will document was his
mother's last will, and so he was entitled to inherit the bulk
of his mother's estate.
The questions before the court were whether the woman was of
sound mind when she signed the change-of-will document; and whether
she knew and approved of its contents.
CASE A
The case for the son
CASE B
The case for the daughter
As the anaesthetist who served as my expert witness said:
"... if the surgical team felt that [my mother] was capable of
consenting to her own surgery, then it would reasonably follow that
the team would also estimate her to have testamentary capacity to
complete the change of will".
The medical notes from the night of the surgery do not record
my mother showing any signs of cognitive impairment, and the
doctors involved in making the change of will gave evidence that
they did not actually observe any obvious signs of cognitive
impairment.
It may be true that Mum had previously wanted my sister and me
to inherit equally, but in the lead up to her surgery,
circumstances had changed and it made perfect sense that she wanted
to change her will. She knew exactly what she was doing.
Mum and my sister had grown apart in recent years. I was the
one living with Mum and caring for her daily in her final years.
Mum became less mobile and more dependent on me for assistance in
her daily routine and for transportation to see her doctors,
friends, church attendance and shopping up until her death.
My sister didn't even ask Mum to the memorial services she
held for our father during the last five years of Mum's life.
In December 2019, we had Christmas at our house and my sister
didn't even come. Nor did she contact Mum between 30 December
2019 and 10 January 2020. Then, when Mum died in late January, my
sister was away on holiday.
It's clear that Mum was of sound mind when she made the
change of will and that she knew and approved of its contents. The
court must find that the change of will is valid.
This last-minute change of will was very out of character for
Mum, who in the past has always sought legal advice to ensure
careful estate planning.
Mum made the change of will when she was seriously ill and on
heavy medications. In the afternoon of the day of the surgery, Mum
had been given buprenorphine, midazolam, fentanyl, and oxycodone,
all of which can cause cognitive impairment. As my expert witness
says, it would be surprising if my mother was not seriously
impaired. This is why the general advice given to patients
following either anaesthesia or sedation is that they should not
"drive, operate machinery or complete legal documents"
within 24 hours following the procedure.
The doctors in the operating theatre did not make positive
enquiries about my mother's mental state and they should
have.
Mum always wanted to treat my brother and me equally. She told
me many times that my brother and I would each receive half of her
estate. Nothing happened that would cause her to deviate from this
plan. I've always been close to Mum, and even in later years we
attended many family functions together.
It's true that my brother took on a greater burden of
mum's daily care in her final years, but since he wasn't
paying her any rent and he was unemployed, he was well placed to
help her. By contrast, I was living some distance away and managing
a busy family.
The year 2019 was a difficult one for me. I was dealing with
difficult personal matters and did not see my mother as often as
usual. I didn't want to burden her with my problems when she
had enough of her own to deal with. It was also difficult to visit
my mother because my brother was living with her, and he
doesn't like me.
I only went on the holiday in January 2020 because it was
pre-booked, and mum wanted me to go. No-one was expecting her
condition to deteriorate the way it did.
It's clear that Mum wasn't of sound mind when she
signed the change of will document, nor did she know or approve of
its contents. The court must find that the change of will was
invalid.
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