Stamford Hosp. v. Vega
| Citation | 236 Conn. 646,674 A.2d 821 |
| Decision Date | 16 April 1996 |
| Docket Number | No. 15162,15162 |
| Court | Supreme Court of Connecticut |
| Parties | , 64 USLW 2686 The STAMFORD HOSPITAL v. Nelly E. VEGA. |
Donald T. Ridley, pro hac vice, with whom was Ikechukwu Umeugo, West Haven, for the appellant (defendant).
Paul E. Knag, with whom were Martin A. Clarke, Stamford, and, on the brief, William H. Narwold and Charles D. Ray, Hartford, for the appellee (plaintiff).
Susan Snook, West Hartford, filed a brief for the Watchtower Bible and Tract Society of New York, Inc., as amicus curiae.
Before PETERS, C.J., and BORDEN, BERDON, KATZ and PALMER, JJ.
The dispositive issues in this certified appeal are whether: (1) the Appellate Court improperly dismissed the defendant's appeal as moot; and (2) the trial court improperly granted the plaintiff's request for an injunction permitting it to administer blood transfusions to the defendant against her wishes. The defendant, Nelly E. Vega, a patient under the care of the plaintiff, Stamford Hospital (hospital), appeals, following our grant of certification, 1 from the judgment of the Appellate Court dismissing as moot Vega's appeal from the judgment of the trial court, which had granted the hospital's request for an injunction permitting it to administer blood transfusions to Vega. We conclude that: (1) the appeal falls within the exception to the mootness doctrine for cases that are capable of repetition, yet evading review; and (2) under the circumstances of this case, the trial court's order permitting the hospital to transfuse Vega against her will violated her common law right of bodily self-determination. Accordingly, we reverse the judgment of the Appellate Court.
The facts and procedural history are undisputed. On Friday, August 26, 1994, Vega was admitted as a patient to the hospital to deliver her first child. That evening, Vega, a Jehovah's Witness, executed a release requesting that no blood or its derivatives be administered to her during her hospitalization, and relieving the hospital and its personnel of liability for any adverse effects that might result from her refusal to permit the use of blood in her treatment. 2 Vega's husband also signed the release.
According to the amicus curiae, which is the Watchtower Bible and Tract Society of New York, Inc., the parent organization of the Jehovah's Witnesses, the Jehovah's Witnesses comprise a Christian religious faith whose adherents devote themselves to the study of God's word and strive to apply its counsel in all aspects of their lives. Jehovah's Witnesses believe that the scripture directs them to abstain from receiving blood, and that an individual who receives blood will be denied resurrection and eternal salvation. They also consider a nonconsensual blood transfusion to be a gross physical violation as well as a violation of the individual's values. Accordingly, when Jehovah's Witnesses seek medical care, they regularly refuse blood transfusions.
On August 27, 1994, Vega delivered a healthy baby. Following the delivery, Vega bled heavily as a result of a retained piece of the placenta. Her obstetrician, Savita Sood, recommended a dilation and curettage in order to stop the bleeding. Although Vega agreed to permit Sood to perform the dilation and curettage, she refused to allow a blood transfusion. Prior to undergoing the procedure, she had signed another release requesting that she be given no transfusions and releasing the hospital from liability. Despite the dilation and curettage, Vega continued to hemorrhage.
Vega's physicians tried a number of alternatives to the use of blood, but her condition continued to worsen. Eventually, when she was having difficulty breathing, her physicians placed her on a respirator in the intensive care unit. Vega and her husband maintained throughout these events that, although she might die without blood transfusions, it was against their religious beliefs to allow the use of blood. Because Sood and the other physicians involved in Vega's care believed that it was essential that she receive blood in order to survive, the hospital, at 2 a.m. on August 28, 1994, filed a complaint against Vega, requesting that the court issue an injunction that would permit the hospital to administer blood transfusions to her. 3
The trial court convened an emergency hearing at the hospital at 3:25 a.m. on August 28. Although Vega's attorney, who was en route to the hospital, had not yet arrived, the court appointed Vega's husband as her guardian ad litem and began hearing testimony. Vega's doctors testified that they had exhausted all nonblood alternatives and that, with reasonable medical certainty, she would die without blood transfusions. Her husband testified that, on the basis of his religious beliefs as a Jehovah's Witness, he continued to support his wife's decision to refuse transfusions and believed that she would take the same position if she were able to participate in the hearing.
The court, relying on the state's interests in preserving life and protecting innocent third parties, 4 and noting that Vega's life could be saved by a blood transfusion, granted the hospital's request for an injunction permitting it to administer blood transfusions to her. The court then stayed the order until Vega's attorney had arrived and had been given an opportunity to present argument and additional evidence. 5 At 6:20 a.m. on August 28, the court reinstated its judgment permitting the hospital to administer blood transfusions to Vega and terminated the stay incident to any appeal taken by Vega. Vega was then given blood transfusions, recovered, and was discharged from the hospital.
Vega appealed to the Appellate Court from the trial court's judgment. The hospital moved to dismiss the appeal on the ground of mootness, and the Appellate Court granted the hospital's motion. This certified appeal followed.
We first consider the issue of mootness. The Appellate Court granted the hospital's motion to dismiss the appeal as moot, rejecting Vega's arguments that (1) there were collateral consequences 6 flowing from the trial court's order, and (2) the appeal fell within the exception to the mootness doctrine for issues of public importance that are capable of repetition, yet evading review.
Subsequent to the Appellate Court's ruling, we decided Loisel v. Rowe, 233 Conn. 370, 660 A.2d 323 (1995), in which we clarified the standards for determining whether an otherwise moot case is nonetheless justiciable because it is capable of repetition, yet likely to evade review. We, therefore, requested that the parties to this appeal address the question of what impact, if any, Loisel has on this case. The hospital no longer contends that the case is moot because it concedes that, under the criteria we set forth in Loisel, this case is capable of repetition, yet is likely to evade review. Notwithstanding the hospital's concession, and the resulting lack of dispute between the parties, because the question of mootness implicates our subject matter jurisdiction; Gagnon v. Planning Commission, 222 Conn. 294, 297, 608 A.2d 1181 (1992); we consider the issue of mootness.
Loisel v. Rowe, supra, 233 Conn. at 382, 660 A.2d 323. All three requirements must be met in order for this exception to the mootness doctrine to apply. Id., at 382-83, 660 A.2d 323. We conclude that this case satisfies all three requirements.
A challenge to the issuance of an injunction permitting the administration of nonconsensual blood transfusions will virtually always become moot long before appellate litigation can be concluded or even, as in this case, initiated. Of necessity, a medically necessary blood transfusion must be accomplished, if at all, as soon as reasonably possible after its need becomes apparent to the patient's health care provider. Once a court order is issued permitting such a transfusion against the patient's will, and the court lifts any stay of that order, as it will inevitably do, we cannot expect the health provider that sought the order to await the outcome of an appeal before complying with the order. Thus, any order that is challenged on appeal is, by its very nature, of such limited duration that it is virtually certain that it will become moot before appellate litigation can be concluded.
Furthermore, although Vega herself may not again be subjected to nonconsensual blood transfusions, she is nonetheless a suitable party to bring this appeal. It is reasonably likely that the issues raised in this appeal will arise in the future when other Jehovah's Witnesses experience medical conditions that require blood transfusions. 7 The amicus informs us that, in the six years preceding this appeal, it received reports of, or was directly involved with, fifteen instances in Connecticut in which Jehovah's Witnesses encountered problems related to their refusal of transfusions. The hospital certainly expects the issue to recur, as is indicated by the fact that it has a release form specifically directed to the refusal of transfusions. Thus, as a member of an identifiable group for whom the issue of nonconsensual blood transfusions can...
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