Matter of Westchester Medical Center O'Connor.

• Author: Barkow, Joel Mark
• Position: Withdrawal of lifesaving medical treatment

Matter of Westchester Medical Center (O'Connor)

HELD: Before withdrawing lifesaving medical treatment from

an incompetent patient, there must be clear and convincing

proof that the patient, while competent, made a firm and settled

commitment that such treatment be withheld under such

medical circumstances.

In July 1985, seventy-seven year old Mary O'Connor suffered a stroke resulting in brain damage and related disabilities rendering her unable to care for herself. Matter of Westchester County Medical Center (O'Connor), 72 N.Y.2d 517, 523, 531 N.E.2d 607, 608-09 (1988). Her daughter and another woman provided her with full-time care. Id. at 523, 531 N.E.2d at 609. In December 1987, Mrs. O'Connor had her second major stroke causing further physical and mental disabilities, among which was an impaired gag reflex. Id. She was transferred to a long-term geriatric care facility associated with the Westchester County Medical Center (hereinafter the hospital). Id. There Mrs. O'Connor's two daughters placed in their mother's medical file a document signed by them stating that their mother previously expressed her wish that "no artificial life support be started or maintained in order to continue to sustain her life." Id.

Mrs. O'Connor's condition worsened, resulting in a complete loss of her gag reflex. Id. at 524, 531 N.E.2d at 609. She received limited nourishment and antibiotics intravenously which resulted in marked improvement. Id. However, because her inability to swallow persisted, her doctor determined that a nasogastric tube was necessary to provide her with proper nourishment. Id. Such was objected to by Mrs. O'Connor's daughters. Id. Consequently, the hospital initiated legal action seeking court authorization to use the nasogastric tube. The hospital claimed that, without use of the tube, Mrs. O'Connor would die of thirst and starvation. Id. The daughters counterclaimed seeking an order directing the hospital to discontinue the intravenous feeding. Id. at 527, 531 N.E.2d at 611.

The trial court denied the hospital's petition while granting the counterclaim on the finding that Mrs. O'Connor's "past expressions plainly covered any form of life-prolonging treatment." Id. The appellate division affirmed, noting that greater specificity would place an undue burden on those seeking to avoid life-prolonging treatment. Id. The case was appealed to New York's highest court.

The New York Court of Appeals initiated its analysis by recognizing the...