46 Mass. App. Ct. 335 | Mass. App. Ct. | 1999
When a seventeen year old patient, Rena,
On January 26, 1999, Rena lacerated her spleen in a snowboarding accident and was brought into the hospital’s emergency room. Upon examination, it was determined that in order to keep her blood count at a stable level a blood transfusion might become necessary to keep Rena alive. Both the patient and her parents indicated that they would not consent to a blood transfusion. The hospital then filed a complaint for declaratory relief in the Superior Court seeking authority to administer a blood transfusion if the same became necessary to treat her injury. At a hearing, the hospital presented medical evidence that there was a potential need for this authority in the event a blood clot broke loose from the spleen laceration, which might result in a massive hemorrhage, which in turn might require a blood transfusion to sustain her life. At this hearing, the wishes of the parents and those of Rena through her attorney were made known to the judge. Based on the best interests of Rena and the State’s interest in the preservation of life and protection of the welfare of a minor, the judge, as previously recited, entered a temporary order allowing Rena’s physicians to administer a blood transfusion in the event of a life-threatening, traumatic event. At a subsequent hearing, the judge entered a final order authorizing the hospital “to administer a blood transfusion to [Rena] in the event that a life-threatening, traumatic event occurs during her treatment that requires, in the medical opinion of her treating physicians, the administration of a blood transfusion.” A petition for interlocutory review of this order was filed on her behalf with a single justice of this court. The single justice recognized that the order was not interlocutory but final in its nature. She therefore authorized the filing of an appeal to be heard on an expedited basis on the original record.
The sole issue in this case is whether the judge erred in concluding that the best interests of an unemancipated minor
The law is well settled in this Commonwealth that a competent adult may refuse medical treatment even if the treatment is necessary to save her life. Norwood Hosp. v. Munoz, 409 Mass. 116, 122-123 (1991). The law is also clear that when parents refuse medical treatment necessary for the preservation of an unemancipated child’s life, a court may authorize the treatment to be administered after weighing the child’s best interests, the parents’ interests, and the State’s interests.
Although the judge did consider Rena’s wishes and her
Because the Supreme Judicial Court has not decided that the State’s interest in preserving a child’s life will invariably control in every case where State intervention is sought for life-saving measures, see Matter of McCauley, 409 Mass, at 139 n.3; Care & Protection of Beth, 412 Mass, at 198, we ordinarily would remand this case to the Superior Court for an expedited hearing to determine the best interests of the child in light of this opinion and to reassess the three-part balancing test of Rena’s best interests, the rights of her parents, and the interests of the State. The hospital has informed us, however, that on the day after the presentation of oral argument in this case, Rena was discharged from the hospital. Consequently, there no longer appears to be an immediate need for the hospital’s authorization or judicial intervention in this matter. We, therefore, vacate the final order, not on the merits, but because it has become moot.
So ordered.
We use a pseudonym.
The Illinois Supreme Court has determined that the test that should be applied in circumstances such as this is whether the minor is mature enough to make an informed decision. In re E.G., 133 111. 2d 98, 110-112 (1989). This concept has been adopted by our Legislature in allowing a judge to authorize a minor to have an abortion without parental consent if the judge determines that the minor is mature enough to make an informed decision. G. L. c. 112, § 12S. See In re Swan, 569 A.2d 1202 (Me. 1990), in which the Maine Supreme Judicial Court rejected a substituted judgment test in favor of giving preference to the wishes of a minor if the minor has the capacity to weigh the risks and benefits involved.
We recognize that our laws provide no bright line as to when a minor reaches an age to make certain decisions in life. In criminal proceedings a seventeen year old is deemed capable of making all decisions relative to that proceeding. An emancipated minor may consent to his or her own medical treatment, excluding an abortion or sterilization, and a minor who is married,