Court Opinion

ID: 9527525
Source: CourtListenerOpinion
Date Created: 2023-08-07 03:31:16.796859+00
Date Added: 2024-06-11T13:25:50.193596
License: Public Domain

O’Connor, J.
(concurring, with whom Nolan and Lynch, JJ., join). I agree that the judgment should be reversed and that the Probate and Family Court should enter a new judgment declaring that, in the event of a new hemorrhage, Yolanda Munoz (Munoz) has a right to refuse blood transfusions, and that that right must be respected by medical personnel and all others. Critical to my thinking, however, unlike the thinking of the court, is that Munoz’s withholding of consent to transfusion is based on her belief that her acceptance of transfusions might preclude her from resurrection and everlasting life after death. That is the sole reason that Munoz would risk death rather than accept blood from another. Munoz, the judge found, does not want to die. Those facts lead me to agree with the result reached by the court. However, I cannot subscribe to an opinion that endorses, as I believe this opinion does, a right to assisted suicide.
In Brophy v. New England Sinai Hosp., Inc., 398 Mass. 417 (1986), the case on which the court primarily relies, the trial judge found that, if Brophy had been competent, he would have chosen to decline the provision of food and water through a gastrointestinal tube, not because that procedure would be ineffective in prolonging his life and not because the procedure would be painful or humiliating, but because, given the circumstances, Brophy would rather be dead than alive. In that context, this court held that Brophy’s interest in self-determination was greater than the State’s interest in the preservation of life. Three dissenting Justices, including *132me, characterized the court’s decision as an unacceptable endorsement of suicide.
In this case, the court takes pains tó say that its decision is not influenced by the fact that Munoz’s refusal to accept transfusions is grounded on religious belief or concern about salvation. Rather, relying largely on the Brophy case, the court concludes that Munoz’s right of self-determination, without reference to her concern about the hereafter or any other motive, is superior to any countervailing State interest. In the absence of a necessity to protect innocent third parties, a necessity which I agree is not present in this case, the court concludes that, “[i]n cases where a competent adult refuses medical treatment for herself, the State’s interest in preserving the particular patient’s life will not override the individual’s decision.” Ante at 126. That is to say, as the court said in Brophy, that, apart from possible countervailing interests of innocent third parties, a competent adult, and presumably an incompetent adult pursuant to substituted judgment, may reject any and every form of life-prolonging assistance for any reason whatsoever including disenchantment with life, and that that choice takes precedence over the State’s interest both in preserving the individual’s life and in promoting the sanctity of all human life. I write separately to disassociate myself from any such thesis. I subscribe to the result reached by the court only because I believe that Munoz indeed has a right, which ought to be recognized and respected, to risk death, if she deems that necessary, to preserve her immortal soul.1

The court responds in footnote 5 to my concurring opinion. Footnote 5, too, deserves a response.
As I have stated, in Brophy the trial judge found that Brophy’s primary purpose in declining food and water would have been to end his life. Brophy’s specific intention, then, attributed to him by a process of substituted judgment, was to terminate his life by the act or omission for which the court’s approval was sought and given. The court was bound by the trial judge’s findings. The court endorsed Brophy’s suicide and the conduct of those who assisted it despite the court’s contrary claim in Brophy, supra at 434 n.29 and again here that it did not do so.
The court points to my statement as the author of the court’s opinion in Harnish v. Children’s Hosp. Medical Center, 387 Mass. 152, 154 (1982), *133in which I quoted with approval from the case of Wilkinson v. Vesey, 110 R.I. 606, 624 (1972), as follows: “Every competent adult has a right ‘to forego treatment, or even cure, if it entails what for him are intolerable consequences or risks however unwise his sense of values may be in the eyes of the medical profession.’ ” As any fair reading of Harnish would disclose, and as I was careful to say in my separate opinion in Brophy, supra at 450, “[t]he court’s explicit recognition of an individual’s right to be free of nonconsensual invasion of his bodily integrity in Harnish ... in no sense implied recognition of a right to commit suicide.” In Harnish, the concern to which the quoted statement was addressed was a patient’s right to adequate information about risks and potential benefits to enable her to make an intelligent decision about whether to undergo elective surgery.
The court states, “It is difficult to understand how the court’s decision endorses suicide in the absence of any evidence that Ms. Munoz wanted to die.” Ante at 124 n.5. There should be no difficulty. It is clear from the court’s opinion that the court is not influenced in the slightest by the absence of evidence that Munoz wanted to die. If there were such evidence, the court’s result would be no different. The court makes clear that Munoz’s right to forgo blood transfusions was absolute, and that her purpose was exclusively her business and was irrelevant to the court’s holding. In similar fashion, the judge’s finding in the Brophy case that Brophy’s primary objective would have been to end his life did not deter the court from holding that removal of the feeding tube was permissible.
The court characterizes as “troubling” a perceived suggestion in my concurring opinion “that Ms. Munoz’s right to refuse medical treatment arises from, and depends on, her particular religious beliefs.” Ante at 124 n.5. The court’s perception is entirely unwarranted, as is its concern that my “suggestion” would require courts to decide which religious beliefs deserve protection. My concurring opinion says no such thing explicitly or implicitly. The obvious message delivered by the concurring opinion is that the State’s interest in preserving individual human lives and in promoting the sanctity of all human life must take precedence over an individual’s desire to terminate his or her life, whether by commission or omission, but the State’s interests must give way to the choice of an individual, whether grounded in one religion or another or without reference to religion, as to how best to live.