Doe v. Wilson.

• Author: Salyer, David R.
• Position: Right to die for ALS patient - Tennessee

HELD: A fully competent adult patient in the latter stages of

amyotrophic lateral sclerosis (ALS) may successfully seek a

declaratory judgment permitting her physician to disconnect life

support without incurring criminal or civil liability.

Jane Doe, a middle-aged farmer's wife, was hospitalized in 1984 suffering from the advanced stages of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. Doe v. Wilson, No. 90-364-II, slip op. at 1-2 (Ch. Ct. Davidson County, Tenn. filed Feb. 12, 1990). ALS is a degenerative, fatal disease that attacks the spinal cord, resulting in "progressive loss of control of muscles of the body and by increasing paralysis." Id. at 1. While paralysis progressively renders the body useless, "the mind typically remains clear until death." Id. Such was the case with Jane Doe.

At the time of her hearing, Mrs. Doe was almost completely paralyzed, and though she could hear and understand speech, her ability to communicate had regressed to thumbs up or thumbs down responses. Id. at 2. She was also "respiratory dependent." Id. While her physical condition was certain to deteriorate even more, her mental capacity remained keen and aware. Id. Faced with the hopelessness of her situation, Jane Doe had requested, both personally and in writing, that her physician, Dr. James P. Wilson, disconnect her respirator. Id. Dr. Wilson would later testify that following such a directive would reduce Mrs. Doe's life expectancy to "less than one-half hour." Id. Jane Doe was fully aware of the consequences of respirator removal. Id.

Jane Doe then sought a declaratory judgment that would permit Dr. Wilson to disconnect her respirator, as she had requested, without fear of prosecution or civil liability. Id. at 1. As a case of first impression in the state of Tennessee, the court heard oral arguments, conducted a bedside hearing, and considered an amicus brief submitted by the state attorney general. Id.

Chancellor Allen High began his consideration of the matter by reviewing the law concerning the right of a competent patient to decline medical treatment. Id. at 2-3. The court acknowledged the long established common law "right of a person to control his own body." Id. at 3. This right had been extended to include declining medical lifesaving treatment in the case of State v. Northern, 563 S.W.2d 197, 214 (Tenn. 1978). Slip op. at 3. Furthermore, this common law right was embodied in Tennessee's "living will" statute...