Dr. Richard Urso's Battle for Patient Autonomy

Patient Autonomy

Autonomy is a pillar of medical ethics, the moral principles that doctors follow when caring for their patients. For example, a doctor cannot simply impose their will on a patient, nor question their competence just because they disagree with them.

Patient autonomy is a fundamental right every patient has to be in charge of their own person. Autonomy allows them to make their own decisions about their medical care or financial decisions.

We each have the ultimate authority to determine what happens to our own bodies, and to actively participate in our own decision-making process regarding our treatment options. It means we can ask questions, gain clarity, and ultimately accept or refuse any treatment.

By definition, a patient has maximal autonomy when they receive informed consent. Patients not only deserve but are required to process relevant information that includes potential risks, benefits, and alternatives. At best, they should receive general risks and benefits, and then specific ones to their individual case.

When A Patient is Deemed to Not Have the Mental Capacity to Make their Own Decisions

Sometimes, people with the following conditions may not be able to make their own decisions: dementia, traumatic brain injury (TBI), severe learning disability, mental health condition, stroke, coma, or unconsciousness.

There are exceptions: someone with a stroke of the brain may understand everything that is told to them and all that they read or watch on TV, but they are unable to speak. Their mouths cannot form the words. I know what this feels like, because I had this exact problem with my TBI.

The Mental Capacity Act

In the UK for example, the NHS has The Mental Capacity Act (MCA) that:

• Assumes a person has the capacity to make a decision themselves, unless it’s proven otherwise;

• Whenever possible, requires people to help the individual make their own decisions;

• Tells people not to treat the individual as lacking capacity to make a decision just because they made an unwise decision;

And if someone makes a decision for someone without capacity, it cannot be self-serving and must be in the person’s best interests. The care and services provided to someone without capacity should be the “least restrictive” of their basic rights and freedoms. A trusted person can be appointed “to make a decision on their behalf, should they lack capacity in the future”.

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Introduction

I apologize that this is a disturbing accounting of Dr. Richard Urso and his attempts to remain his own person in charge of his own persona. For all the awful things that a human can do to another, I could not sit idly and watch a fellow physician, a kind-hearted one, be mistreated in any way.

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How It Began for Me

Last month while gardening in my greenhouse, Carolina called me in regards to Dr. Richard Urso, who was also listening on speakerphone. We exchanged fondest hellos. I had no idea that anything was happening with him, and it was shocking to learn that there were issues regarding his autonomy.

Carolina added Dr. Richard Fleming to the call, and then she added Dr. Paul Alexander. Dr. Fleming told all of us that he examined Dr. Urso in person, finding him to be mentally aware and able to make his own decisions.

Expressive Aphasia

This is a common occurrence with a stoke in “Broca’s Area”, which causes “Broca’s aphasia”, the ability to understand but no form words. Mine completely healed, as you know that I speak freely and without impediment.

There are different types classifications that are based on the area of the brain that has been damaged, as well as the affected area of language (reading, writing, talking, writing, repetition). Most commonly, speaking and writing are affected, leading to frustration.

Dr. Urso had previously suffered a stoke and was unable to speak in sentences. I had an expressive aphasia for many years after my traumatic brain injury.

I could tell that Dr. Urso would best be able to respond to “Yes” or “No” questions.

Alzheimer’s Disease

After being a mathemetician and physicist, computer programmer and Contract Monitor for the International Space Station, I also knew how to communicate, as my father died of Alzheimer’s disease when he was still in his 50’s. My daughter was only age two, but we visited him several times a week and were very close to him for the years he was in a nursing home before passing away.

We learned his mannerisms, which spoke to us more than words. And of course, we know his likes and dislikes, his favorite foods and sports, and we accommodated him as best as possible.

A Power of Attorney (POA)

At the end of the telephone discussion, Dr. Urso agreed that he wanted Carolina to be his Power of Attorney (POA). Dr. Paul Alexander suggested that I help Carolina to acquire and accomplish what I said could be done, i.e., obtaining the correct POA paperwork for Texas by searching online, so that she could help him keep his autonomy. I readily accepted.

The next day, we toiled through each item for both a medical and financial POA. It encompassed the usual for any POA: not only decisions for health care regarding ventilators and autopsy, funeral, and burial, but also financials regarding banking and investments, patents, and gifts. Dr. Urso decided what he did and did not want, and that is how the form was completed.

We sat down and grunged out a lengthy POA. Even at the end of this grueling effort, Dr. Urso was singularly instrumental in reading the paperwork after it was printed in front of him. He found typos. He found pagenation issues. I think we had to redo the document more than three times before the margins were perfect and all the i’s were dotted.

We hardly took a break. It was now past the end of the day and into the night, the notary public put her stamp on it.

We did it.

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The Tweet

Source: https://x.com/patriot_agg/status/1877391699699183700

The Thread

Dr. Urso confirms that he did not write the resignation letter:

Another Tweet

Source: https://x.com/carolina_bonita/status/1877171824720752895

The Thread

The Video

The Video

NOTE: This is a very disturbing video, showing a friend of Dr. Urso who heard in his voice the pleading for help. The “caregiver” slaps him and pushes him.

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Carolina is keeping abreast of Dr. Urso, and he is keeping in constant touch with her. Here is his recent picture:

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Where We Are

I want to thank God for watching over Dr. Richard Urso!

I want to thank Carolina, Dr. Richard Fleming, and Dr. Paul Alexander for doing their part to help put Dr. Urso’s life back together. I also understand that there are several other doctors who have examined Dr. Urso in person and who are submitting statements to the Court in evidence that he still possesses his faculties.

I am proud that I helped Dr. Richard Urso choose his own destiny and maintain his persona. May the court find the same.

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WHAT I REALLY THINK

I am most disturbed by the woman. That woman was manhandling him, and if she was taking payment and not doing her job caring for him, it sure seems like that is Elder Abuse. Thank God that Dr. Urso has known Carolina as his Manager for different affairs, and he shall be in good hands with her.

There is an upcoming court proceeding that will determine Dr. Urso’s fate. If you could possible serve as a witness to help, there is Carolina’s plea:

Let us please pray for Dr. Urso, pray for Carolina as she appears before the Judge.

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LET US PRAY

Father God,

You are the Protector of all who love You, and we thank You for watching over Dr. Urso and sending Carolina to him! Guard him, keep him, heal him, and bring him back to the things that he loves to do, WE BESEECH YOU ON BENDED KNEE, GREAT LORD OF ALL THE AGES!

Help Carolina speak with Your words given to her by Your Holy Spirit, and may she gain strength and wisdom through her love for You, WE PRAY, MIGHTY FATHER OF ALL LOVE AND LIGHT! Cast You halo upon her!

Bless the Judge and let him or her show great favor upon Your son and daughter, Holy God! May we receive a wonderful report that Dr. Urso’s wishes have been upheld and that Carolina officially may continue to keep his best interests in mind!

And we thank You for our own freedoms, our capacity to know right from wrong, HOLY GOD! Thank You for our many blessings and may we be more grateful than ever for all You have given us!

We praise You, the Almighty, the King of Creation! Our souls praise You, Our help and salvation! We bow down before You in praise and glad adoration!

In the Name of Jesus!

Amen!

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