Hunt v. Division of Family Services, 146 A.3d 1051

Background

Adam Hunt, born 02/19/2015, was diagnosed with severe injuries consistent with non-accidental trauma and placed on life support after DFS took custody for abuse/neglect concerns.
Family Court appointed AGAL to represent Adam's best interests; DFS sought to de-escalate medical care and place DNR/DNI orders with comfort measures on Adam's chart.
The Motion to De-Escalate Medical Treatment was heard June 30, 2015; initial emergency denial followed by later adjudicatory proceedings.
Medical experts unanimously opined that Adam had devastating brain injuries with no meaningful prospect of recovery, recommending withdrawal of life-sustaining treatment and comfort care.
Parents, though not having their parental rights terminated at that time, objected to the withdrawal of life support; DFS pursued custody and no-reunification findings.
In August 2015, the Family Court found Adam neglected/abused and, applying best-interests standards with clear and convincing evidence, ordered de-escalation of treatment, withdrawal of life support, and DNR/DNI orders, followed by appointment of a court-appointed independent medical expert.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Family Court has jurisdiction to de-escalate medical treatment and issue DNR/DNI for a minor in DFS custody	Hunt/Land: Court lacks authority to withdraw life support for a child without explicit statutory directive.	DFS/AGAL: Court has statutory parens patriae authority to decide medical care for a dependent child, including withholding/withdrawal of life support.	Yes; Family Court has jurisdiction to de-escalate and issue DNR/DNI for a child in state custody.
Whether such authority exists when parents’ rights are not terminated and they object	Parents retain rights to consent to medical treatment unless terminated; court cannot override without termination.	Parens patriae priority over parental rights; due process and best interests justify court intervention when abuse/neglect found.	Yes; court may decide in the child’s best interests even without parental termination.
Whether due process was violated by insufficient notice or process prior to the order	Father had limited preparation; potential ineffective assistance of counsel due to expedited proceedings.	Parents were represented, given notice, opportunity to be heard, and the proceedings balanced urgency with due process.	No; parents were afforded due process and meaningful opportunity to be heard.
Whether an independent medical examination was required before the de-escalation decision	An independent evaluator unaffiliated with treating hospital should be required.	Good practice but not mandatory; five weeks failed to produce an independent evaluator, and four treating physicians’ opinions were consistent.	Not required as a prerequisite; a court-appointed independent expert later corroborated the prior opinions.

Key Cases Cited

In re Truselo, 846 A.2d 256 (Del. Fam. Ct. 2000) (court authority to consent to medical care and deem life-support withdrawal for a dependent child)
Newmark v. Williams, 588 A.2d 1108 (Del. 1991) (best interests framework in child custody contexts; supports standard considerations)
In re Guardianship of Grant, 747 P.2d 445 (Wash. 1987) (non-exclusive factors for life-support cessation and guardianship decisions)
Custody of a Minor, 434 N.E.2d 601 (Mass. 1982) (jurisdictional basis for termination or withdrawal of continued life support)
In re C.A., 603 N.E.2d 1171 (Ill. App. Ct. 1992) (jurisdiction to terminate life-support under guardianship framework)
In re Christopher, 131 Cal. Rptr. 2d 122 (Cal. Ct. App. 2003) (parental rights vs. child's best interests in medical decision cases)
In re Arzuaga-Guevara, 794 A.2d 579 (Del. 2001) (parens patriae considerations in medical-decision cases)
In re Tavel, 661 A.2d 1061 (Del. 1995) (evidentiary standards in termination/withdrawal of treatment contexts)
Santosky v. Kramer, 455 U.S. 745 (U.S. 1982) (clear and convincing standard applicable to significant parental-rights decisions)
In re Christopher, 131 Cal. Rptr. 2d 122 (Cal. Ct. App. 2003) (illustrates balancing parental rights with child welfare in medical decisions)