Patients (regardless of age or medical condition) have a common law right to refuse medical treatment -- including artificial feeding -- and that they do not lose that right upon becoming incompetent so long as they meet the "clear and convincing evidence" standard (which Delio clearly did). The fact that Delio was in a PVS and not terminally ill, combined with his relative youth (34) may even make more compelling his previously expressed desire not to be sustained by artificial means "because of the potentially long and indefinite period that a young person without a terminal illness may continue to live in a vegetative condition, deriving no benefit other than mere existence from the life-sustaining treatment, but suffering the continued indignities and dehumanization created by his or her helplessness." The court also noted, with regard to its interest in preserving life: "Clearly there is no benefit to the state in preserving Daniel's existence under circumstances he would have found demeaning and degrading to his humanity and which would serve merely to lessen the value of his life by denying him the right to chose the course of his medical treatment."

The court sided with the Elbaums, saying the New York's "clear and convincing evidence" standard had been met. It ordered the nursing home to transfer Elbaum to a facility where her wishes could be honored. If no such facility could be found, it ordered the nursing home's staff to carry out the withdrawal, or, if no staff members could be found willing to comply with Elbaum's wishes, that a family designated physician be allowed into the home to do so.