In re Westchester County Medical Center

139 A.D.2d 344, 532 N.Y.S.2d 133, 1988 N.Y. App. Div. LEXIS 9149

This text of 139 A.D.2d 344 (In re Westchester County Medical Center) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re Westchester County Medical Center, 139 A.D.2d 344, 532 N.Y.S.2d 133, 1988 N.Y. App. Div. LEXIS 9149 (N.Y. Ct. App. 1988).

Opinions

OPINION OF THE COURT

Mangano, J. P.

The crucial question to be resolved on the instant appeal is whether clear and convincing evidence was adduced at a hearing to establish that the presently incompetent patient, Mary O’Connor, expressed a desire, when she was competent, to exercise her common-law right to refuse all artificial life support systems, which would include nasogastric feeding and intravenous feeding. Our review of the record compels us to hold that this question must be answered in the affirmative.

I

The health of Mary O’Connor, a 77-year-old widow, began to deteriorate in July 1985 when she suffered the first of a series of progressively debilitating strokes. Her last stroke, in December 1987, affected her ability to swallow, and, after several months of hospitalization at Dobbs Ferry Hospital, she was transferred in February 1988 to the Ruth Taylor Institute, a nursing home associated with the Westchester County Medical Center (hereinafter WCMC). At the time of her admission to the Ruth Taylor Institute, the respondents Helen A. Hall and Joan Flemming, Mrs. O’Connor’s daughters, submitted to the Institute a document, signed by them, which indicated that it was their mother’s wish that no artificial life support systems be started or maintained to sustain her life. On June 20, 1988, Mrs. O’Connor was transferred to WCMC, and was diagnosed as having multiinfarct dementia, dehydration and sepsis. Upon her admission to WCMC, it was determined that an attempt to feed Mrs. O’Connor through a puree diet would be futile since by then she had lost her ability to swallow. [346]*346Accordingly, she was put on intravenous feeding. Mrs. O’Con-nor is neither comatose nor in a persistent vegetative state. However, she only responds sporadically to some simple questions (although not always appropriately), and obeys some very simple commands. It is conceded by all the parties to this proceeding, as well as by both medical experts who testified at the hearing, that Mrs. O’Connor is not competent to make any decisions regarding her medical treatment. In addition, the record demonstrates, through the testimony of the medical experts called by both sides in this dispute, that the damage suffered by Mrs. O’Connor as a result of the multiple strokes is "irreparable”, that there is no chance for "a meaningful mental status recovery”, and that "she will never improve from” her present condition.

The intravenous feeding of Mrs. O’Connor, at best, will be effective for only several weeks, due to its relatively low caloric content, and the progressive obliteration of Mrs. O’Connor’s venous access. As a result, WCMC commenced the instant proceeding in mid-July 1988, inter alia, for permission to insert a nasogastric tube so that nourishment could be delivered directly to her digestive tract. Mrs. O’Connor’s attending physician was of the view that if the nasogastric tube were not inserted at the appropriate time, and the intravenous feeding were discontinued, Mrs. O’Connor would die in approximately 7 to 10 days. On the other hand, the insertion of the nasogastric tube would, in the attending physician’s "guess”, or "top of the head opinion”, prolong Mrs. O’Connor’s life, for several months or perhaps "a year or two”. The application of WCMC was opposed by the respondents Hall and Flemming, who during the hearing, sought to have the intravenous feeding discontinued.

After a full hearing on the issues, the Supreme Court, Westchester County, by judgment dated July 26, 1988, denied the petition of WCMC, and directed that the intravenous feeding be discontinued. The Supreme Court found that there was clear and convincing evidence that Mary O’Connor, when competent, expressed a desire not to be maintained by artificial life support systems in her current condition, and that the effect of her expressed desire was to include nasogastric tube and intravenous feeding.

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Bluebook (online)
139 A.D.2d 344, 532 N.Y.S.2d 133, 1988 N.Y. App. Div. LEXIS 9149, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-westchester-county-medical-center-nyappdiv-1988.