Case Scenario: A MOTHER'S RIGHT, A CHILD'S DEATH

Harrell, a Jehovah's Witness, was 6 months pregnant when physicians discovered a lifethreatening blood condition that could rapidly deteriorate, placing both her life and the life of the fetus in jeopardy. Because of her religious beliefs, Harrell objected to a blood transfusion. After an emergency hearing during which the Harrells could not summon an attorney, the court ruled that a blood transfusion could be given to Harrell if it was necessary to save the life of the fetus and that after the child was born a blood transfusion could be given to the child if necessary to save the child's life. The Harrells appealed. The child was delivered by Caesarean section and died 2 days later. No blood transfusion was given to Harrell or to the child. As a result, the hospital and the state claimed that the appeal of the trial court's order was moot. Because of the hospital's serious misunderstanding about its standing to bring such proceedings, the Florida District Court of Appeal addressed the issue as capable of repetition yet evading review. The Florida constitution guarantees that a competent person has the constitutional right to choose or refuse medical treatment and that right extends to all relevant decisions concerning one's health.

The state has a duty to ensure that a person's wishes regarding medical treatment are respected. That obligation serves to protect the rights of the individual from intrusion by the state unless the state has a compelling interest great enough to override this constitutional right (e.g., protection of innocent third parties). Harrell argued that the hospital should not have intervened in her private decision to refuse a blood transfusion. She claimed that the state had never been a party in this action, had not asserted any interest, and that the hospital had no authority to assume the state's responsibilities The Florida District Court of Appeal concluded that a health care provider must not be forced into the position of having to argue against the wishes of the facility's own patient. Patients do not lose their right to make decisions affecting their lives when they enter a health care facility. A health care provider's function is to provide medical treatment in accordance with the patient's wishes and best interests, not supervene the wishes of a competent adult. A health care provider must comply with the wishes of a patient to refuse medical treatment unless ordered to do otherwise by a court of competent jurisdiction. A health care provider cannot act on behalf of the state to assert state interests. When a health care provider, acting in good faith, follows the wishes of a competent and informed patient to refuse medical treatment, the health care provider is acting appropriately and cannot be subjected to civil or criminal liability.

Ethical and Legal Issues

1. Is the Florida District Court of Appeal's conclusion binding in all states?

2. Do you think the hospital made the correct decisions in this case? Discuss your answer.