Opinion ID: 2276022
Heading Depth: 1
Heading Rank: 3

Heading: Best Interest Test

Text: The Court of Appeals erred when it adopted the best interest test announced in Rasmussen. The Court of Appeals was mistaken when it held that KRS 311.631 authorized a guardian to exercise substitute decision-making for an incompetent person based on the best interest standard. Such a conclusion was considered and clearly explained in DeGrella to the effect that the best interests was to be viewed exclusively from the standpoint of the health and well-being of the ward and synonymous with the decision the ward would choose to make if conscious and competent to do so. As noted in DeGrella : We do not go to the next step, as the Arizona court did in the Rasmussen case, to decide that best interest can extend to terminating life-sustaining medical treatment where the wishes of the ward are unknown. 858 S.W.2d at 705. The Court of Appeals does not define what it means by best interest and thus opens the door to any subjective interpretation of such a standard. The majority of this Court recognized in DeGrella that using substituted judgment that incorporates a quality of life assessment creates a very dangerous situation which can involve the application of subjective values in determining a minimum that can be accepted as a quality life. The right to live is a natural and fundamental right. It arises automatically and not as a result of any personal surrogate or governmental choice. In applying the strict scrutiny test, we find that the state can make no showing that its interests outweigh the private interests of the individual as guaranteed by the federal and state constitutions. The state, through its agents, must prove that a governmental interest in the nontreatment of a patient overrides the interest in life of the patient. Such a burden was not satisfied in this case and could not be satisfied in any case involving a ward of the state. The State attempted to present evidence that providing life-sustaining measures to Woods denied him a meaningful life, was inhumane, futile, not in his best interest, and abusive. Such beliefs amount to a personal subjective judgment by state bureaucrats about the quality of life of the ward. The State should not be allowed to determine the quality of life question. The public policy of Kentucky as expressed in Chapter 387 is to consider the wishes of the ward in the manner expressed by him and to involve the ward in decision-making to the greatest extent possible. Decisions under KRS 311.629 and KRS 311.631 may be irreversible, but all such decisions should err on the side of caution, if at all. Here, although the trial judge found Woods to be permanently unconscious as defined by law, the guardian ad litem indicated that Woods began to improve dramatically the evening of the trial. There is some medical evidence that Woods was actually no longer in a persistent vegetative state but was recovering from anoxic encephalopathy. The function of legal process, as that concept is embodied in the Constitution, and in the realm of factfinding, is to minimize the risk of erroneous decisions. Because of the broad spectrum of concerns to which the term must apply, flexibility is necessary to gear the process to the particular need; the quantum and quality of the process due in a particular situation depend on the need to serve the purpose of minimizing the risk of error. Greenholtz v. Inmates of Nebraska Penal and Correctional Complex, 442 U.S. 1 at 13, 99 S.Ct. 2100, 60 L.Ed.2d 668 (1979).