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Law School Case Brief

In re Westchester Cty. Med. Ctr. ex rel. O'Connor - 72 N.Y.2d 517, 534 N.Y.S.2d 886, 531 N.E.2d 607 (1988)


The "clear and convincing" evidence standard requires proof sufficient to persuade the trier of fact that the patient held a firm and settled commitment to the termination of life supports under the circumstances like those presented. As a threshold matter, the trier of fact must be convinced, as far as is humanly possible, that the strength of the individual's beliefs and the durability of the individual's commitment to those beliefs makes a recent change of heart unlikely. The persistence of the individual's statements, the seriousness with which those statements were made and the inferences, if any, that may be drawn from the surrounding circumstances are among the factors which should be considered.


An elderly woman was a hospital patient who, as a result of several strokes, was mentally incompetent and unable to obtain food or drink without medical assistance. Appellant hospital filed an application for authorization to insert a feeding tube in the patient, while the patient's children (respondents) filed a counterclaim to discontinue feeding and all such intervention pursuant to her wishes. The trial court denied the hospital's application, and on appeal, the Appellate Division of the Supreme Court of the Second Judicial Department (New York) affirmed the trial court. The hospital appealed.


Should the court grant the hospital's application to insert a feeding tube in a patient?




The Court of Appeals of New York reversed the order and granted appellant hospital's application. The Court noted that none of the doctors who testified knew the patient before she became incompetent; thus, they knew nothing of her attitudes toward life-sustaining measures. While the patient had made statements with respect to declining artificial life support as to people suffering terminal illnesses, this was not her situation. The patient was not in a coma or vegetative state, but was awake and conscious. On the record, it could not be said that the patient elected to die under such circumstances, and there was not clear and convincing evidence that she had made a firm and settled commitment, while competent, to decline this type of medical assistance.

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