In death versus bureaucracy, bureaucracy is winning. Buster Edmo is proof of that.
Right now, Hugh "Buster" Edmo is lying in a hospital room at the University of Utah hospital with a broken neck. Several days ago he fell down the stairs at his home on the Shoshone Indian reservation in Fort Hall, Idaho, and was flown to the Salt Lake City hospital. He's unconscious, lost an unknown amount of brain activity because of the time he was without oxygen, and at the age of 88, doctors don't expect him to recover. His living will expresses his wishes to not be kept alive artificially.
Yet he still is. Edmo will survive the weekend before his daughters take him off life support. They decided about 2:30 p.m. Friday to remove him, but then found out that even if he died immediately upon pulling the plug, the necessary paperwork to transport him home couldn't be done by 4 p.m. The next opportunity to do it would be Monday.
Thus, his four daughters had two choices: One is that they could ignore the living will and keep him alive for thousands of dollars a day so when he died they could take him home and bury him within hours of his death, as is their tradition. Or they could take him off life support Friday and keep him in the hospital's morgue until Monday, thus denying him the proper tribal funeral procedure.
"It was just agonizing," said Julie Edmo Durfee, one of Edmo's daughters. "It was just a nightmare, really."
The biggest challenge is that for a family, death is a personal, intimate experience. For the government, it's an official process that must be properly documented. Once a person dies, the death record is created by a funeral director, filled out by a family member and signed by a doctor, then transmitted to the county where the death occured. The county then files the certificate and transmits it to the state's Department of Vital Records and Statistics. In the case of the Edmos, where a transit permit is needed, the county reviews the death certificate, forwards it to the state office and then issues the transit permit.
Pam Davenport, the spokeswoman for the Salt Lake Valley Health Department, which will be processing Edmo's death, said once the paperwork is complete the transit permit can be issued, although it includes specific directions about how and where the body can be transported and requires a funeral director to do the transporting. A new state law also requires that a funeral director request the transit permit. Those permits also can't be issued until the person is actually dead.
Since the state's office of vital records closes at 4 p.m., nobody can officially die between 4 p.m. Friday and Monday morning. Deaths that occur after-hours or on weekends aren't made final immediately, which isn't a problem when a body is being embalmed and buried in the same county in which the person died. The problem arises when the family doesn't want embalming and wants to move the body, because the transit permit can't be issued immediately.
Hence the decision to postpone Edmo's death to Monday morning instead of Friday afternoon.
"There is just no way that any of us could make vital records in time," said Susan Turpen, a funeral director with the Alternative Society of Utah. The family turned to her for help after she signed the death certificate of Lorenzo Farmer, a 3-month-old from the same reservation who died in June and whose parents had to fight to be able to transport his body without embalming to go through their traditional funerary process.
The problem in the Farmers' situation was a new law requiring a death certificate to be signed by a licensed funeral director, thus involving a funeral home even when the family wasn't interested. Because of Turpen's involvement, who is willing to sign the death certificate at no charge, this wasn't the issue. The timing was.
"Vital records is most helpful, but here's the problem," Turpen said. "The state doesn't OK overtime for them."
The government needs a contingency plan for when deaths don't happen between 9 a.m. and 5 p.m. Monday through Friday and paperwork and transport is needed immediately, she said. Something needs to be done so leaving a family member on a ventilator for two extra days against his wishes, isn't the best option.
Durfee spent much of Friday, when not debating how to handle the situation, remembering two years ago, when a sister died at St. Mark's Hospital in Salt Lake City. Tribal Pride came down from the reservation to pick up her body, bringing the casket and a traditional blanket, and the whole family participated in wrapping the body and placing it in the casket.
"It was like the family coming together to take care of her," she said.
In contrast, Friday was spent debating whether to take Edmo off the ventilator, then wondering how to deal with this new challenge of burying him. She's hoping since they decided to wait until Monday, all of the family can be around to send him away together.
"Hopefully it'll go a lot smoother on Monday," she said.
Heidi Toth can be reached at 344-2543 or htoth@heraldextra.com.
This story appeared in The Daily Herald on page A1.
Posted in News on Friday, July 28, 2006 11:00 pm
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