McConnell v. Beverly Enterprises-Connecticut, ENTERPRISES-CONNECTICU

• Citation: 209 Conn. 692,553 A.2d 596
• Decision Date: 31 January 1989
• Docket Number: ENTERPRISES-CONNECTICU,Nos. 13477-13479,INC,s. 13477-13479
• Court: Supreme Court of Connecticut
• Parties: , 57 USLW 2473 John E. McCONNELL et al. v. BEVERLY, et al.

Page 596

553 A.2d 596

209 Conn. 692, 57 USLW 2473

John E. McCONNELL et al. v. BEVERLY ENTERPRISES-CONNECTICUT, INC., et al.

Nos. 13477-13479.

Supreme Court of Connecticut.

Argued Nov. 9, 1988.

Decided Jan. 31, 1989.

Richard A. Lynch, Asst. Atty. Gen., with whom were Henry A. Salton, Asst. Atty. Gen., and, on the brief, Joseph I. Lieberman, Atty. Gen., for the appellants in the first appeal (defendant Atty. Gen., defendant Com'r of Health Services, and defendant Chief Medical Examiner).

Susann E. Gill, Asst. State's Atty., with whom, on the brief, were John J. Kelly, Chief State's Atty., and Steven M. Sellers, Asst. State's Atty., for the appellant in the second appeal (defendant State's Atty. for the judicial dist. of Danbury).

Jerome A. Mayer, Bethel, with whom was James M. Mannion, Philadelphia, for the appellant in the third appeal (defendant guardian ad litem).

Steven A. Wise, New Canaan, with whom was Fenella Rouse, New York City, for the appellees (plaintiffs).

Ruth L. Pulda and Susan Price-Livingston, Hartford, filed a brief for the Connecticut Civil Liberties Union Foundation et al. as amici curiae.

Christopher J. Smith, Bridgeport, and James Michael Thunder, Chicago, Ill., filed a brief for the Committee to Protect the Rights of the Medically Dependent and Disabled et al. as amici curiae.

Emanuel Margolis, Stamford, Fenella Rouse, Elena N. Cohen, M. Rose Gasner, New York City, and Richard Wasserman, Hartford, filed a brief for the Soc. for the Right to Die, Inc., as amicus curiae.

Lawrence W. Berliner, Sr. Staff Atty., Hartford, filed a brief for the Office of Protection and Advocacy for Handicapped and Developmentally Disabled Persons as amicus curiae.

Giles R. Scofield III, New York City, Hilary Fisher Nelson, Harwinton, and Sheila Taub, filed a brief for the Concern for Dying as amicus curiae.

Before PETERS, C.J., and ARTHUR H. HEALEY, CALLAHAN, GLASS and COVELLO, JJ.

PETERS, Chief Justice.

This case concerns the right of a family, on behalf of a patient who is presently in a terminal coma, to implement the patient's clearly expressed wish for the removal of a gastrostomy tube that is artificially providing nutrition and hydration for the patient. The plaintiffs, John E. McConnell, Kathleen A. McConnell, James M. McConnell and Amy L. McConnell, brought an action seeking injunctive and declaratory relief from the life support services being provided to Carol M. McConnell by a private nursing home, the defendants Beverly Enterprises-Connecticut, Inc., doing business as Danbury Pavilion Healthcare, and John Horstman, the Pavilion's administrator. Other named defendants are the attorney general, the state's attorney for the judicial district of Danbury, the attorney appointed as guardian ad litem for Carol McConnell, the commissioner of health services for the state of Connecticut, and the chief medical examiner for the state of Connecticut. The trial court, after a hearing, found the issues for the plaintiffs and rendered judgment accordingly. Separate appeals have been taken by the attorney general, on his own behalf and on behalf of the defendant state officials, by the state's attorney, and by the guardian ad litem. ¹ We find no error.

Many of the underlying facts reported in the trial court's memorandum of decision are undisputed. Carol McConnell is the fifty-seven year old wife of the plaintiff John E. McConnell and the mother of the three other coplaintiffs. By profession, she is a registered nurse. Her last nursing positions were as head nurse and manager of the emergency room at Danbury Hospital.

On January 18, 1985, Mrs. McConnell sustained a severe head injury as the result of an automobile accident. She has never regained consciousness, despite excellent medical care, first at Danbury Hospital, then at the Greenery Rehabilitation Hospital in Boston, and, since July of 1986, at the defendant Danbury Pavilion. She is in an irreversible persistent vegetative state; there is no prospect of improvement. In the opinion of her attending physician, Dr. Robert L. Ruxin, her condition is terminal, and the trial court so found. Her life is presently sustained by means of a gastrostomy tube through which she receives nutrition and hydration.

The trial court made a further finding, challenged on appeal, that prior to her accident, Mrs. McConnell had clearly and knowingly expressed her wishes about her treatment, were she ever to be in a permanent vegetative state. The court found that, because of her professional training and experience, Mrs. McConnell understood the status of patients with traumatic brain damage and was fully familiar with all forms of life-sustaining equipment, including respirators and gastrostomy tubes. She had, in fact, expressly and repeatedly told her family and her co-workers that, in the event of her permanent total incapacity, she did not want to be kept alive by any artificial means, including life-sustaining feeding tubes.

On the basis of these findings, the trial court concluded that the plaintiffs had proven a common law right to self-determination, supported by a constitutional right to privacy, under which they were entitled to the relief they sought. The court held that this common law right coexists with the provisions of General Statutes §§ 19a-570 through 19a-575, by which the legislature authorized the removal of life support systems under statutorily specified circumstances. Both of these legal rulings are challenged on appeal. If, however, the statute itself affords the plaintiffs the relief they seek in this case, we need not reach the issue of the statute's arguable exclusivity. ² In addition, the defendants challenge the evidentiary support for the trial court's factual findings.

I

Before we reach the merits of the plaintiffs' claims for relief, we must consider whether the trial court had the requisite subject matter jurisdiction to entertain them. The defendant attorney general raised at trial the claim that John E. McConnell, as conservator for his wife, had an obligation first to seek permission from the Probate Court for the withdrawal of the gastrostomy tube from Mrs. McConnell. The trial court rejected this argument, which the attorney general renews on appeal. We agree with the trial court.

Independent equitable actions are properly brought in the Superior Court as a general court of equity jurisdiction. Palmer v. Hartford National Bank & Trust Co., 160 Conn. 415, 433, 279 A.2d 726 (1971). While probate courts are courts of equity as well as of law; Donovan's Appeal from Probate, 41 Conn. 551, 559 (1874); " '[a] Probate Court judge is not a chancellor. His only equity powers are those which are incidental to, and connected with, the settlement of a particular estate.' " Marcus' Appeal from Probate, 199 Conn. 524, 529, 509 A.2d 1 (1986), quoting Palmer v. Hartford National Bank & Trust Co., supra, 160 Conn. at 429, 279 A.2d 726. The legislature has endowed the Superior Court and not the Probate Court with general equitable powers; General Statutes § 52-1; ³ and specifically with the power to issue declaratory judgments. General Statutes § 52-29(a). ⁴ Furthermore, the "Probate Court may not adjudicate complex legal questions which are subject to the broad jurisdiction of a general court of equity.... Thus, the Probate Court lacks essential powers necessary to handle independent equitable actions...." Palmer v. Hartford National Bank & Trust Co., supra, 430, 279 A.2d 726; see also Ramsdell v. Union Trust Co., 202 Conn. 57, 73, 519 A.2d 1185 (1987); Carten v. Carten, 153 Conn. 603, 615, 219 A.2d 711 (1966).

The instant action is of a declaratory nature and poses complex constitutional and statutory questions. Thus, we conclude that the trial court did not err in finding that it had "the power to decide this case and rule on the relief requested in [the] absence of prior probate court consideration."

II

We turn next to the terms of the Removal of Life Support Systems Act, General Statutes §§ 19a-570 to 19a-575, ⁵ in which the legislature, cognizant of a common law right of self-determination and of a constitutional right to privacy, sought to provide a statutory mechanism to implement these important rights. We must decide what role this act plays in the present litigation. The trial court held that the plaintiffs were entitled to relief without regard to the act, which the court construed to be nonexclusive. The defendants, by contrast, maintain that the act governs and precludes the relief sought by the plaintiffs. There is, however, a middle ground, a construction of the act that is consistent with the plaintiffs' affirmative claims for relief.

A

Although the United States constitution does not expressly provide a right to privacy, the United States Supreme Court has recognized a right to privacy in the penumbra of the Bill of Rights, specifically in the protections of the first, third, fourth and fifth amendments. Griswold v. Connecticut, 381 U.S. 479, 85 S.Ct. 1678, 14 L.Ed.2d 510 (1965). "[T]he Court has recognized that a right of personal privacy, or a guarantee of certain areas or zones of privacy, does exist under the Constitution." Roe v. Wade, 410 U.S. 113, 152, 93 S.Ct. 705, 726, 35 L.Ed.2d 147, reh. denied, 410 U.S. 959, 93 S.Ct. 1409, 35 L.Ed.2d 694 (1973). Justice Brandeis has referred to this right as "the right to be let alone--the most comprehensive of rights and the right most valued by civilized men." Olmstead v. United States, 277 U.S. 438, 478, 48 S.Ct. 564, 572, 72 L.Ed. 944 (1928) (Brandeis, J., dissenting). Although the court has recently construed this right to privacy narrowly; Bowers v. Hardwick, 478 U.S. 186, 106 S.Ct. 2841, 92 L.Ed.2d 140, reh. denied, 478 U.S. 1039, 107 S.Ct. 29, 92 L.Ed.2d 779 (1986); it has held that personal rights that are "implicit in the concept of ordered liberty"; id., 478 U.S. at 191, 106 S.Ct. at 2844, quoting Palko v. Connecticut, 302 U.S. 319, 325-26, 58 S.Ct. 149,...