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Superintendent of Belchertown State School v. Saikewicz

Supreme Judicial Court of Massachusetts

July 2, 1976, Argued ; November 28, 1977, Decided

No Number in Original

Opinion

 [*729]   [**419]  On April 26, 1976, William E. Jones, superintendent of the Belchertown State School (a facility of the Massachusetts Department of Mental Health), and Paul R. Rogers, a staff attorney at the school, petitioned the Probate Court for Hampshire County for the appointment of a guardian of Joseph Saikewicz, a resident of the State school. Simultaneously they filed a motion for the immediate appointment of [***4]  a guardian ad litem, with authority to make the necessary decisions concerning the care and treatment of Saikewicz, who was suffering with acute myeloblastic monocytic leukemia. The petition alleged that Saikewicz was a mentally retarded person in urgent need of medical treatment and that he was a person with disability incapable of giving informed consent for such treatment.

On May 5, 1976, the probate judge appointed a guardian ad litem. On May 6, 1976, the guardian ad litem filed a report with the court. The guardian ad litem's report indicated that Saikewicz's illness was an incurable one, and that although chemotherapy was the medically indicated  [*730]  course of treatment it would cause Saikewicz significant adverse side effects and discomfort. The guardian ad litem concluded that these factors, as well as the inability of the ward to understand the treatment to which he would be subjected and the fear and pain he would suffer as a result, outweighed the limited prospect of any benefit from such treatment, namely, the possibility of some uncertain but limited extension of life. He therefore recommended "that not treating Mr. Saikewicz would be in his best interests."

 [***5]  A hearing on the report was held on May 13, 1976. Present were the petitioners and the guardian ad litem. 1 [***6]  The record before us does not indicate whether a guardian for Saikewicz was ever appointed. After hearing the evidence, the judge entered findings of fact and an order that in essence agreed with the recommendation of the guardian ad litem. The decision of the judge appears to be based in part on the testimony of Saikewicz's two attending physicians who recommended against chemotherapy. The judge then reported to the Appeals Court the two questions set forth in the margin. 2 An application for direct appellate review was allowed by this court. On July 9, 1976,  [**420]  this court issued an order answering the questions reported in the affirmative with the notation "rescript and opinion . . . will follow." 3 We now issue that opinion.

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373 Mass. 728 *; 370 N.E.2d 417 **; 1977 Mass. LEXIS 1129 ***

Superintendent of Belchertown State School & another v. Joseph Saikewicz

Prior History:  [***1]  Hampshire.

Petition for guardianship filed in the Probate Court for the county of Hampshire on April 26, 1976.

The case was reported to the Appeals Court by Jekanowski, J. The Supreme Judicial Court granted a request for direct review.

The case was submitted on briefs.

CORE TERMS

patient, chemotherapy, incompetent person, incompetent, probate judge, leukemia, guardian ad litem, circumstances, ethical, remission, pain, life-prolonging, Probate, factors, rights, cases, medical treatment, suffering, appoint, prolong, acute, substituted judgment, administered, decisions, right to privacy, best interest, side effect, withholding, disease, drugs

Constitutional Law, Substantive Due Process, Privacy, General Overview, Healthcare Law, Healthcare Litigation, Actions Against Healthcare Workers, Medical Treatment, Patient Consent, Informed Consent, Bill of Rights, Fundamental Rights, Unenumerated Rights, Patient Confidentiality, End-of-Life Decisions, Abortion, Right to Privacy, Failures & Refusals to Treat, Incompetent, Mentally Disabled & Minors, Right to Refuse Treatment, Scope, Equal Protection, Disability, Family Law, Family Protection & Welfare, Dependent & Disabled Adults, Guardians, Civil Procedure, Jurisdiction, Subject Matter Jurisdiction, Estate, Gift & Trust Law, Probate Proceedings, Jurisdictional Sources, Statutory Sources, Jurisdiction Over Actions, General Jurisdiction, Preliminary Considerations, Equity, Appointment, Judicial Officers, Judges