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Statutory Citations
Massachusetts

Massachusetts Health Care Proxies by Individuals Act [1990], Mass. Ann. Laws ch. 201D.


Documents

Free advance directive documents and instructions from Partnership for Caring.


Court Cases
Massachusetts
Case Brophy v. New England Sinai Hospital, Inc., 398 Mass. 417, 497 N.E.2d 626 (1986).
Court Massachusetts Supreme Judicial Court
Year 1986
Patient (age) Paul Brophy (48)
Nutrition + hydration Gastrostomy
Mental capacity Persistent Vegetative State (PVS)
Decision maker(s) Patricia Brophy (wife and legal guardian)
Setting New England Sinai Hospital (Boston, MA)
Patient's Wishes Patricia Brophy, Brophy's court appointed guardian ad litem, seven brothers and sisters, and five adult children all agreed that Mr. Brophy would not have wanted continued treatment in his condition.
Court's Decision

The court accepted the "substituted judgment" of the family, despite the fact that Paul Brophy had never expressed his medical treatment preferences in writing, and never explicitly referred to artificial feeding in his conversations. It argued that individuals have a common law and constitutionally protected right to be free from "nonconsensual invasion of one's bodily integrity." It also argued that the state's interest in preserving life is overridden by the individual's interest when "the burden of maintaining corporal existence degrades the very humanity it was meant to serve." The court rejected the argument that removing the tube would constitute a suicide, writing that: "The law recognizes the individual's right to preserve his humanity, even if to preserve his humanity means to allow the natural process of disease or affliction to bring about a death with dignity." It noted that artificial nutrition and hydration was a medical procedure that could be rejected like any other, and that withdrawing feeding was no different (and just as acceptable) as withholding feeding in the first instance. Finally, it rejected the argument that allowing removal of the tube would somehow degrade the medical profession (the Academy of Neurology and the American College of Physicians both filed "friend of the court" briefs on Patricia Brophy's behalf. See American College of Physicians position statement).

Outcome The U.S. Supreme Court (Justices Rehnquist, Brennan, and White) refused to hear an appeal of the case. Brophy was transferred to Emerson Hospital (Concord, MA) where the tube was removed. He died peacefully eight days later. The cause of death was listed at pneumonia.
Citation Partnership for Caring, Inc. (2001), Fact Sheet, Brophy v. New England Sinai Hospital, Inc.
 
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Case In re Guardianship of Jane Doe, 411 Mass. 512, 583 N.E.2d 1263 (1992), cert. denied sub nom. Doe v. Gross, 112 S. Ct. 1512 (1992).
Court Massachusetts Supreme Judicial Court
Year 1992
Patient (age) "Jane Doe" (33)
Nutrition + hydration Nasogastric tube
Mental capacity Persistent Vegetative State (PVS)
Decision maker(s) Court appointed guardian
Setting A Massachusetts state hospital
Patient's Wishes The patient had been profoundly retarded since infancy, and so her preferences were unknown. The court appointed guardian determined, with input from Jane Doe's parents, that withdrawal of tube feeding was the appropriate course of action to recommend.
Court's Decision The decision of the court appointed guardian was supported by a deeply divided court. The court majority concluded that even though Jane Doe had never been competent to make a medical decision on her own, this fact did not bar use of the legal doctrine of "substituted judgment." In this particular case, the court argued that the views of her parents were "the best mirror of [her] wishes, had she ever been competent to form a preference."
Outcome
Citation Partnership for Caring, Inc. (2001), Fact Sheet, In re Guardianship of Jane Doe.
   

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