St. Mary's Hosp. v. Ramsey, 85-339
| Decision Date | 27 March 1985 |
| Docket Number | No. 85-339,85-339 |
| Citation | 465 So.2d 666,10 Fla. L. Weekly 809 |
| Parties | 10 Fla. L. Weekly 809 ST. MARY'S HOSPITAL, Appellant, v. Mark RAMSEY, Appellee. |
| Court | Florida District Court of Appeals |
Nancy P. Phillips, of Metzger & Sonneborn, West Palm Beach, for appellant.
Robert P. Foley, West Palm Beach, for appellee.
David Bludworth, State Atty., and Paul O. Moyle, Asst. State Atty., West Palm Beach; for the State of Florida.
These emergency proceedings 1 arise out of a circuit judge's decision upholding the right of a patient to refuse a blood transfusion without which the patient, might well die within a few hours. We affirm.
The task before us now is much more difficult than the one we faced in Satz v. Perlmutter, 362 So.2d 160 (Fla. 4th DCA 1978), affirmed with opinion, 379 So.2d 359 (Fla.1980). 2 In that case, we were dealing with an old, terminally ill patient, in full command of his faculties and without minor children. By contrast, none of the foregoing pertain here, except that the patient is mentally alert and fully competent. This particular patient is but twenty-seven years old and though kidney disease requires his regular use of renal dialysis, his life expectancy is probably not unreasonably short if he accedes to the transfusion. Moreover, he is obligated to pay fifty dollars a week in support of his only minor child who lives with his former wife in In the foreground of this tragic factual backdrop is the state, concerned about possible criminal activity, the treating physician and the hospital, both thwarted by the refusal of the patient to cooperate, apprehensive as to the legal consequences of their acquiescence in the patient's adamant refusal of treatment and genuinely concerned for his welfare. For these reasons, the hospital has most urgently requested our appellate assistance.
Michigan. Finally, this particular patient is a Jehovah's Witness and his deeply held faith teaches that ingestion of whole blood will deny him both resurrection and eternal salvation.
The trial judge held that:
1. Mr. Ramsey is intelligent, rational and lucid and has made a competent decision not to accept a blood transfusion knowing he will die.
2. The state and petitioners have not demonstrated sufficient compelling interests to outweigh Mr. Ramsey's constitutional entitlement to privacy and to make this decision without governmental interference.
The basic question to be answered in this case is: Can an adult patient in full command of his faculties refuse a blood transfusion? We answer in the affirmative subject to the four caveats set forth in Perlmutter I: preservation of life, protection of the parties, prevention of suicide and the ethics of medical practice.
The preservation of life is not only a laudable goal for the state, for the physicians and for the health care facilities to aspire to, it is a compelling one. However, it is not an unswerving mandate. We have hitherto held that an adult patient has a constitutional right of privacy, a freedom to choose and a right of self-determination. Perlmutter I. Thus if an adult, competent patient refuses a blood transfusion, it would appear he has a right to do so, providing there is no overriding reason why his life should be preserved. Moreover blood transfusions are not without risk and we take judicial notice of the adverse consequences, perhaps abhorrent to the donee, which can arise from a transfusion of impure blood.
The patient's wishes in this case are rendered even more compelling because of the presence of deeply held religious convictions. In this connection, we read with approval the case of In the Matter of Osborne, 294 A.2d 372 (D.C.App.1972), where the court spoke about the thirty-four year old Jehovah's Witness' preference for everlasting life and salvation rather than a few more waking hours on this earth. It is hard to fault such a deeply held conviction.
As we see it, under the facts presented, this competent, sick adult has the right to refuse a transfusion regardless of whether his refusal to do so arises from fear of adverse reaction, religious belief, recalcitrance or cost. However, that is not to say we would permit him to make that same decision for others. Our conclusion here is restricted to the facts. A much more complex question is presented when a parent or guardian refuses a transfusion for another. This latter action is not an exercise of the right of self- determination, it is an assumed right to determine the destiny of another.
This is probably the most difficult hurdle to overcome in the case at bar. As we said in Perlmutter I, the protection of third parties is exemplified when the refusal of treatment and subsequent death results in the abandonment of minor children. In that case, there was no minor child. In the case at bar, there is a minor daughter. Yet, it is difficult...
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