Court Opinion

ID: 9537183
Source: CourtListenerOpinion
Date Created: 2023-08-07 07:13:54.615943+00
Date Added: 2024-06-11T14:56:11.174953
License: Public Domain

FELDMAN, Vice Chief Justice,
concurring.
I join in the court’s opinion, except that portion (154 Ariz. at 223-24, 741 P.2d 690-91) which holds that the final determination to refuse or discontinue medical treatment may be made by the guardian without court supervision or approval. On this question, the court has followed the lead of Quinlan and held that the decision in a best-interest case may be made by the guardian in consultation with the family and the physicians. No court order is necessary before implementation of the decision. See In re Quinlan, 70 N.J. 10, 355 A.2d 647, cert. denied, 429 U.S. 922, 97 S.Ct. 319, 50 L.Ed.2d 289 (1976).
Although one may argue either side of the question, I believe that it would be better policy—even where there is unanimity of opinion between the guardian, the family, and the doctors—that “substituted judgment” and “best interest” decisions be validated by court order. The question of whether to refuse or discontinue treatment is not simply a medical, issue to be left to the doctors; although the medical evidence is in many ways determinative, the final decision incorporates a range of ethical, moral, and societal values which should not be left solely to doctors, family members, or representatives of the court, no matter how well informed and well meaning they might be. See Annas, Reconciling Quinlan and Saikewicz: Decision Making for the Terminally III Incompetent, 4 AM.J. LAW & MEDICINE 367 (1979). Such decision making requires the final validation— not necessarily by adversarial hearing— and the detached and neutral inspection of a judicial officer, accountable to the law, and therefore to the public. See Superintendent of Belchertown State School v. Saikewicz, 373 Mass. 728, 370 N.E.2d 417 (1977).
If the question were whether to commit a patient for psychiatric treatment for a period of thirty days, no group of doctors, no group of family members, and no guardian appointed by the court could be given the final authority to accomplish such a result, even though they all agreed it was “for her own good.” See A.R.S. §§ 36-520 et seq. In my view, the decision to end whatever life remains in the patient should be given no less care and attention before it becomes irrevocable. Surely, if the system guarantees the patient a hearing before commitment, it must require some hearing before refusal or termination of treatment necessary for life support.