Imagine you have received among the worst pieces of news a parent can get: Your son lies in a hospital on life support after an overdose. While you and the family are trying to make sense of the situation, and to make some of the hardest decisions parents, children and siblings may ever have to make — whether or not to terminate life support — the homeless person who gave your child the drugs that are ending his life arrives at the hospital and insists on taking control of the end of life decisions on the grounds that she and your son had a relationship that in the statute is “similar to that of a spouse.”

The couple was homeless and hungry, and you permitted them to sleep in a tent in your backyard while they were saving money for an apartment. Your son had told you and his adult daughter the woman was only a friend. And the only “financial” relationship they might have had was buying drugs together.

You suspect the woman was high when she arrived at the hospital and refused to give doctors important details about how long your son had been unresponsive.

The hospital is informed of all this. And the hospital lets her take control anyway.

It sounds absurd and unlikely, and yet according to Linda Dow and her family, it happened to them in September 2016. In the interest of full disclosure, Dow is an administrative employee at the Boothbay Register.

How could such a thing happen? In 1999, in Maine, unwed but committed partners could not participate in their loved one’s medical care if they had not signed a power of attorney or an advance directive. There had been instances of gay or lesbian couples not being permitted to be in a hospital room with a dying partner. Because marriage was not a possibility for them at that time, without expensive legal arrangements, such couples were often at the mercy of distant relations who had no knowledge of what the partner would have wanted, and no requirement to attempt to respect his or her wishes.

In 1999, “An Act to Prioritize Surrogates for Medical Decisions” elevated unwed committed couples to just below legal spouses. That portion of the act reads, “An adult who shares an emotional, physical, and financial relationship similar to that of a spouse.”  The intent was to provide relief for couples who couldn’t marry in 1999, and couples who chose not to marry for other reasons – such as older couples who do not marry because they would lose a portion of their Social Security income or do not want to affect their children’s inheritances.

It worked well for these situations, but as the opioid epidemic continues, there are situations when boyfriends and girlfriends who may not be as committed will find themselves in a position to make life or death decisions for a drug user, above adult children, parents and adult siblings. Part of the law, aside from the priority list, states that surrogates have to be acting in good faith and in the patient’s best interest. According to Gordon Smith of the Maine Medical Association, “Any surrogate has to be acting in good faith on the patient’s behalf.” He told the Joint Standing Judiciary Committee, “A fellow drug user who leaves the scene of an overdose and refuses to cooperate with medical personnel is not a competent surrogate, and the hospital should have given that role to the parents and the adult daughter, who were present.” Smith had planned to testify against changes to the act, but after hearing Dow’s testimony, chose to speak neither for nor against.

In interviews and her testimony to the Judiciary Committee, Dow explained how the Act affected her family. On Sept. 10, Dow and her husband Geoffrey of Boothbay Harbor were called and informed that their son, Nathan, was being airlifted from an emergency room in Augusta to Central Maine Medical Center in Lewiston after a heroin overdose. He was unconscious. The woman who was with him at the time called 9-1-1 and then left the scene, according to the night’s paramedic’s logs. The woman died of an overdose in December 2016. In the interests of her family’s privacy, we are not using her real name.

The paramedics had no idea how long Nathan had been unresponsive, but knew it had been at least 10 minutes from the time of the call to 9-1-1 to the time they arrived. During the flight, his body was chilled to preserve his brain, since no one knew how long he hadn’t been breathing.

The Dows arrived a few minutes after their son was brought in. An hour and a half later, “Jessica” arrived and said she was his girlfriend, but gave no information about what happened or where the drugs came from. Because Jessica said she was his girlfriend, the hospital transferred surrogacy rights to her, Dow said. Dow told the Judiciary Committee she believed Jessica arrived at the hospital high; that a social worker at the hospital told the Dows, if the couple had pooled funds for drugs, that qualified as a “financial relationship”; and that the social worker advised them to “make nice” with Jessica.

CMMC said it cannot disclose any information about a patient in its care.

Nathan Dow did not have a medical power of attorney or an advance directive in place, which is not surprising, given his age of 37. Most people do not sign such a document in their youth. However, the Maine Medical Association recommends all adults, regardless of age, sign an advance directive as part of a medical checkup and give a copy to the person they have selected to be their surrogate.

Dow testified that during the course of the weekend, the family pleaded with Jessica to relinquish her rights to Nathan’s care. She finally did so, to Nathan’s 19-year-old daughter Kayleigh, on Monday night. By Tuesday night, the family decided together to terminate life support, and Nathan died on Sept. 13, 10 minutes after life support was discontinued.

Linda Dow said Nathan probably succumbed so quickly because he had been clean for a long time before taking drugs on Sept. 10. She is not sure what led him to take drugs that night, but she said he had been agitated earlier in the evening after finding Jessica in the tent in her backyard with another man. “He’d been clean for a year, but that night, he was distraught. I think he probably saw heroin as an escape.”

“It’s been tough,” Dow said of the intervening months. “Kayleigh is in counseling. Her posts on Facebook make me cry.” She said Kayleigh and Nathan had only recently gotten to know one another because Nathan had been staying away from her while suffering from addiction, realizing his influence wasn’t the best possible one for the young girl.

However, Dow said in an interview, a tragic and horrific situation was made infinitely worse by not having any control over what was happening to her son, and having to relinquish control to a heroin addict who was not acting in good faith and didn’t have Nathan’s best interest at heart.

Once the worst of her grief had played out, Dow contacted Rep. Stephanie Hawke (R-Boothbay Harbor), who tried to change the rules so parents and adult children fall above girlfriends and boyfriends in the state statute.

Dow and Hawke attempted to move the non-spousal partners below adult children and parents, in an amended bill called “An Act to Prioritize Family Members as Surrogates For Medical Decisions,” LD 1607, but the bill failed along party lines. Hawke spoke to Gov. Paul LePage and told him of the Dows’ experience, and he agreed to put the bill forth again as a governor’s bill.

The bill appeared before the Judiciary Committee on May 23. Speaking in favor of the amendment were Hawke, Linda and Kayleigh Dow, and David Sorensen, one of LePage’s staffers, who said the governor had found the family’s story compelling and said if there is no proof of a committed relationship then the family should have the final say in the matter.

Speaking in opposition to the bill was Leo Delicata, a public policy advocate for Legal Services for the Elderly, who said the family should never have had to go through what they went through, and that the law was badly applied, but that in general, the bill supports not only gay and lesbian couples who are unwed, but especially elderly couples.

Speaking neither for nor against was Smith, who was aghast at how the family had been treated, and promised to get in touch with the hospital to see what had gone wrong. He told the committee, it should be possible to craft language to make this situation impossible. “The hospital had the authority under the law to give the surrogacy to someone acting in good faith,” he said.

Hawke said she was hopeful the bill’s language would remain the same.

A work session scheduled that day was tabled because of the lateness of the hour; it was rescheduled for the next day, but did not begin until late in the afternoon.

The result of that work session was a divided report, which typically means the issue is referred back to the full Legislature. However, it may not be heard this session; except for some last minute emergency measures, the Legislative session ends May 31.

Dow worries that other family members will fall into the same nightmare. “I can’t believe we’re the only family who has faced this,” she said. “There have been hundreds of overdose deaths in Maine, more than one a day last year. And no one should have to go through what we went through. Something has got to change.”