DIVORCE, BLOOD TRANSFUSIONS, AND OTHER LEGAL ISSUES AFFECTING CHILDREN OF JEHOVAH'S WITNESSES

BLOOD TRANSFUSIONS & PARENTAL OBLIGATIONS

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JEHOVAH'S WITNESS PARENTS WILL ALLOW THEMSELVES TO DIE
AND THEIR CHILDREN TO BE REARED BY SOMEONE ELSE
RATHER THAN ACCEPT A BLOOD TRANSFUSION

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The law in the United States regarding Jehovah's Witnesses and their refusal to accept blood transfusions is somewhat settled. Most competent adults have the constitutional right to refuse to accept a life-saving blood transfusion, even if such refusal means they will die. What about Jehovah's Witnesses, who are competent adults, but who have minor children to rear? Early on in this "battle", some courts recognized the right of Jehovah's Witness children to be reared by the parents who gave them life and brought them into this world.  However, as occurred in other scenarios, more and more courts started allowing Jehovah's Witness Parents to refuse life-saving blood transfusions and die, thus leaving their children to be reared by the surviving parent, or other relatives and friends.
 
This is possibly one segment of this "battle" that some courts may be willing to revisit. Freedom of religious belief is absolute in the United States. Freedom to exercise religious beliefs is not absolute.  Are the rights of a Jehovah's Witness Parent really superior to the rights of their children, especially in a scenario where the parent ends up dead and the child prematurely loses a natural parent?  Should our courts really give higher priority to a parent's right to free religious expression which results in that parent's death over the right of that parent's child to have the normal parent-child relationship with a living natural parent? The rearing of a child is more than providing financial support for that child. What about all the other factors involved in the natural parent-child relationship? What happens to the children if something happens to the surviving parent?
 
The WatchTower Society prepares Jehovah's Witnesses to always repeat in court that they do not want to die. Why then are Jehovah's Witnesses dying?  Because the WatchTower Society told them in 1945 that the Bible forbids blood transfusions.  The WatchTower Society initially taught Jehovah's Witnesses that they were obligated to resist the administering of a blood transfusion.  Parents were encouraged to kidnap their own children away from hospitals. Jehovah's Witnesses receiving a transfusion were encouraged to physically resist such.  However, the WatchTower Society now teaches Jehovah's Witnesses that it is NOT the act of receiving a transfusion that is a sin, but rather it is the consenting to such that is the sin.  Therefore, when a transfusion is court-ordered, the recipient does not sin according to the WatchTower Society.  Thus, if American courts would simply recognize that most Jehovah's Witnesses are forced to resist only in the courtroom, but not in the emergency room, then many lives could be saved.  Jehovah's Witnesses will cooperate in the farce. Simply allow them to protest loud enough and they will be silently satisfied.

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CROWN v. GORDON LEIGHTON was a highly publicized 2010-13 British criminal court case which is significant for illustrating problem issues in THREE areas of the Jehovah's Witness religion -- "Confidentiality", "Child Molestation", and deaths of "JW Parents with Parental Obligations" due to rejecting blood transfusions. Gordon Leighton, now age 53, is one of only a few non-celebrity Jehovah's Witnesses who have twice been the subject of the international news, decades apart, for different reasons.

In February 1993, Gordon Leighton and his 28 year-old wife, Yvonne Leighton, of Washington, Tyne and Wear, made international headlines only 10 days after Yvonne Leighton gave birth to the couple's second child. Gordon Leighton and Yvonne Leighton had decided that Yvonne Leighton would allow herself to die rather than accept a life-saving blood transfusion. It would be left to Gordon Leighton to rear not only their newborn son, but also the couple's SIX YEAR YEAR-OLD DAUGHTER, Rachel Leighton.

After having birthed her son, Yvonne Leighton needed a routine dilation and curettage of her uterus (D&C) performed, which sometimes requires the administration of a blood transfusion due to blood loss. The possibility of excessive blood loss was fully explained to the Leightons over three separate occasions, and the Leightons consciously chose to submit legal documents which forbid the doctors to administer any blood transfusions, even if such were necessary to save Yvonne's life. The headquarters of the WatchTower Society in England was contacted, and one of their Attorneys was even dispatched to  Sunderland General Hospital to ensure that no blood transfusions were administered to Yvonne Leighton.

Yvonne Leighton, who was conscious most of the time, died "over a protracted period of several hours" surrounded by her Jehovah's Witness husband, relatives, and friends. Yvonne's doctors administered what "blood alternatives" were permitted by the WatchTowwer Society, but nothing could save Leighton but a transfusion of whole blood. Hospital staff were forced to stand by helplessly, all the while fully knowing that they could easily save Yvonne's life, and forestall the resulting consequences to her two surviving children and husband. The media reported that, "The medical team were distraught. The anesthetist was continually trying to get her to change her mind."

Nearly 17 years later, in December 2009, an "unidentified female" -- presumably Rachel Leighton -- went to the Body of Elders at the Lambton Congregation of Jehovah's Witnesses, in Washington, and disclosed that she had been sexually molested by Gordon Leighton when she was a child.

Rather than immediately notifying the police or other legal authorities, the Body of Elders notified the LEGAL DEPARTMENT at England's WatchTower Society Headquarters -- which is what JW Elders are trained and required to do by the WatchTower Society. The WatchTower Society's Legal Department did NOT instruct the Body of Elders to notify the police, but instead, instructed the BOE to form a "judicial committee" consisting of three Elders, and to conduct an "investigation". That "judicial committee" consisted of local Elders David Scott and Henry Logan, and Simon Preyser, an Elder from a nearby Sunderland congregation.

After the judicial committee's "investigation", a "judicial committee meeting" was conducted in April 2010, during which, Gordon Leighton was presented with the findings of that investigation, and asked to respond. Gordon Leighton reportedly initially denied the child molestation accusation, but eventually "confessed" that he possibly may have done some things whenever he had had too much to drink.

The local Body of Elders, who would have been in constant contact with the WatchTower Society's Legal Department, later publicly admitted that notifying the police was not even considered as an option at that point in time. Gordon Leighton was not even disfellowshipped (excommunicated). Rather, due to Leighton's supposed "repentent" attitude and behavior, his position as a "Ministerial Servant" (deacon) in the congregation was removed, and he was officially "reproved", but without the reason being disclosed to the members of the congregation.

It is "supposed" that it was shortly thereafter that Gordon Leighton reportedly assaulted and possibly battered an "unidentified person", and that it was only then, when involvement of the police was inevitable, that Leighton was quickly disfellowshipped from the congregation. It is also "supposed" that it was this assault/battery which finally motivated the "victim" to notify the authorities, not only about that assault/battery, but also about their having been sexually molested as a child by Leighton.

During the following official police investigation, Gordon Leighton denied the child molestation accusations. When police thereafter repeatedly approached the three aforementioned JW Elders for their assistance with their investigation, all three JW Elders -- acting on instructions from the WatchTower Society's Legal Department -- claimed "clergy privilege", and refused to disclose any information due to "confidentiality".

Gordon Leighton was eventually formally charged with two counts of indecency with a child and seven counts of indecent assault. Once again, the three JW Elders were asked to cooperate in Leighton's prosecution, but they all three refused to cooperate per their instructions from WatchTower HQ.

Judge Penny Moreland issued a witness summons to the three JW Elders. When WatchTower Society Attorney, Richard Daniel, and the three JW Elders legally challenged the witness summons, Judge Moreland refused to withdraw the summonses, and ordered the JW Trio to appear in her court. Judge Moreland stated: "It is apparent that the three elders who were present when this conversation took place are in possession of relevant evidence as to a point which is of real significance in this case. They claim the right of confidentiality. They claim that what they heard said by the defendant during the course of that meeting ought to be subject to privilege, as ministers of religion. Public interest is clearly in favour of this evidence being given. What was said by the defendant on that occasion is of great significance in the trial."

Despite Judge Moreland's ruling, the JW Elders still refused to make any statements to the police until just hours before they were called to testify, which they finally did. At trial, in July 2013, Gordon Leighton once again denied accusations that he had sexually molested his daughter, Rachel, and denied that he had confessed to such during the "judicial committee meeting". A jury listened to the evidence for six days, including Leighton's repeated denials. Gordon Leighton was found guilty on two counts of indecency with a child, and six counts of indecent assault. Leighton was also found guilty on the more recent assault charge. Leighton was sentenced to 13 years in prison.

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DARREN HOLSTON v. SHERIEF HOLSTON and ENGLEWOOD HOSPITAL AND MEDICAL CENTER is an excellent "read between the lines" 2008-09 New Jersey case, in which WatchTower attorneys Paul D. Polidoro and Philip Brumley intervened UNSUCCESSFULLY!

Darren Holston's wife, Sherief Holston, was reared as a Jehovah's Witness. On August 5, 2008, the Holston's went to Englewood Hospital and Medical Center in order for Sherief Holston to give birth to her third child. Sherief Holston executed an advance directive that provided that Sherief did not want a blood transfusion under any circumstance, even if a physician determined it would save her life. Sharief gave birth that day without the need for a blood transfusion.

On August 6, 2008, Sherief underwent a post-partum tubal ligation at the Medical Center, following which she suffered severe internal bleeding and had to be placed in a medically-induced coma to help keep her alive.

On August 12, 2008, Darren Holston filed an emergency verified complaint in local court seeking to compel the Medical Center to administer a blood transfusion to Sherief. Following a hearing that same day, Judge Contillo determined that the directive did not apply to Sherief's tubal ligation; appointed Darren as Sherief's special medical guardian; and permitted the special medical guardian to order any medically necessary blood transfusions.

UNIDENTIFIED PARTIES challenged that judge's ruling, and appealed. The NJ appellate court agreed with the UNIDENTIFIED PARTIES, and granted an emergency stay of the original court order. However, later that same evening, the Supreme Court of New Jersey reversed and reinstated the original trial order. Sherief received a blood transfusion; emerged from the coma; and was discharged from the hospital in good health.

The NJ appellate court remanded the matter back to the trial judge, who dismissed the case as now moot. Englewood Hospital and Medical Center wanted the trial court to rule on the original issues, and proceeded to appeal the "mootness" ruling. On appeal, the Hospital was joined by the WatchTower Society in requesting that the original issues be addressed. The NJ appellate court affirmed the trial judge's decision and reasoning.

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ON APPLICATION OF ST. JOSEPH'S HOSPITAL was a 2003 New York court case which runs contrary to every other court case on this webpage. In January 2003, officials at Syracuse's St. Joseph's Hospital sought court intervention when an unidentified local JW father was unconscious and in desperate need of a blood transfusion. The JW father's family refused to consent, but at the emergency hearing, the man's JW Son admitted that his father had stated in the past, that in the case of a life and death situation, that he would consent to a transfusion. Evidently, this JW father was sharp enough to know that the WatchTower is wrong on this issue, and fortunately for him, he had expressed his decision to his family. The judge authorized the transfusion, and the JW recovered.

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IN RE MARIA ISABEL DURAN was a 2001 Pennsylvania appellate court decision.  Maria Duran was the 34 year old wife of Lionel Duran.  Maria Duran was the mother of three children, including two teenagers who lived at home. Maria was a Jehovah's Witness.  In the mid 1990s, Maria had a medical condition which necessitated a liver transplant.  As a Jehovah's Witness forbidden to accept blood transfusions, Maria contacted the WatchTower Society for doctors and hospitals who would perform a liver transplant without performing blood transfusions. Maria was directed to the University of Pittsburgh Medical Center.  In 1997, Maria traveled from her home in New York to Pittsburgh to be evaluated as a candidate for a liver transplant procedure.
 
In February 1998, Maria executed a "Durable Power of Attorney", a standardized form supplied by the WatchTower Society, which at that time was typically distributed at meetings of Jehovah's Witnesses every January/February, and often completed at the Kingdom Hall, so that fellow JWs could "witness" the signature; and for JWs whose family are not JWs, agree to being named "agent".  That standardized WatchTower document read:
"I am one of Jehovah's Witnesses. On the basis of my firmly held religious convictions, see Acts 15:28, 29, and on the basis of my desire to avoid the numerous hazards and complications of blood, I absolutely, unequivocally and resolutely refuse homologous blood (another person's blood) and stored autologous blood (my own stored blood) under any and all circumstances, no matter what my medical condition. This means no whole blood, no red cells, no white cells, no platelets, and no blood plasma no matter what the consequences. Even if health-care providers (doctors, nurses, etc.) believe that only blood transfusion therapy will preserve my life or health, I do not want it. Family, relatives or friends may disagree with my religious beliefs and with my wishes expressed herein. However, their disagreement is legally and ethically irrelevant because it is my subjective choice that controls. Any such disagreement should in no way be construed as creating ambiguity or doubt about the strength or substance of my wishes."

In her DPA, Maria Duran appointed Larry M. Johnson, as her health-care agent.  Larry Johnson was a Jehovah's Witness Elder, who lived in the Pittsburgh area.  Johnson was most likely an area member of the WatchTower Society's "Hospital Laison Committee" (HLC), which monitors the admission of Jehovah's Witnesses into hospitals throughout the United States, and tries to make certain that Jehovah's Witnesses do not agree to accept blood transfusions.  Maria Duran moved in with the Johnson family in mid 1999, after the University of Pittsburgh Medical Center informed Maria that she was close to receiving a liver and advised her to move closer to Pittsburgh.
 
On July 19, 1999, Maria underwent her first liver transplant operation. Prior to the operation, Maria provided her doctors with copies of her DPA and reiterated her refusal to accept any blood transfusions. Maria's body rejected the first liver. A second operation was Maria's only chance for survival.  Larry Johnson, as Maria's appointed health-care agent, consented to a second liver transplant operation. Maria's body rejected the second liver as well.  Maria's own failing liver caused her to slip into a comatose state. Maria's condition rapidly deteriorated and doctors estimated that without a blood transfusion she would die within the next twenty-four hours. Only with a transfusion, doctors projected, would Maria have a chance of survival.
On July 27, 1999, in an attempt to save his wife's life, Lionel Duran, orally petitioned the local Court to be appointed Maria's emergency limited guardian for the purpose of consenting to a blood transfusion. The court heard testimony from the treating physician, Dr. Stephen Bowles, Lionel Duran, and Maria's sister, Velma Santiago. A court-appointed attorney represented Maria. Larry Johnson was not given notice of the hearing.  The Court granted Lionel Duran's petition. Johnson filed exceptions to the court's order on August 3.  Meanwhile, Maria's husband consented to the blood transfusions for Maria.  However, Maria died on August 19, 1999.
 
On August 25, before returning home to New York to his three grieving motherless children, Lionel Duran thought that he had taken care of all legalities by withdrawing his guardianship petition and asking the court to dismiss further proceedings.
 
However, the WatchTower Society would not allow the matter to rest with Maria's death. Larry Johnson then filed a memorandum of law requesting that the local court rule on the exceptions he had filed back on August 3 -- despite their technical mootness due to Maria's death. The Court affirmed their prior order. Larry Johnson then filed an appeal.
 
On appeal, Larry Johnson a/k/a WatchTower Society argued that the trial court violated Maria Duran's common law and constitutional rights when it appointed her husband as emergency guardian to consent to a blood transfusion on behalf of Maria in spite of her religious beliefs and prior directives.  The appellate court agreed with the WatchTower Society, stating in part:
 
"Appellant has raised both constitutional and common law challenges to the court's order. We note that courts should avoid deciding issues on constitutional grounds where the issue may be resolved on non-constitutional grounds. ...
 
"The right to refuse medical treatment is deeply rooted in our common law. ...
 
"The right to control the integrity of one's body spawned the doctrine of informed consent. ... This doctrine demands that if the patient is mentally and physically able to consult about his or her condition, the patient's informed consent is a prerequisite to treatment. ...

 ...
 
"While this right is fundamental to our concept of personal autonomy, it may be outweighed by any one of four state interests: 1) protection of third parties; 2) protection of the ethical integrity of the medical profession; 3) preservation of life; and 4) prevention of suicide. ...
 
"When evaluating the state's interest in protecting third parties, 'the primary focus is on whether the patient has dependents who would be left emotionally and financially bereft were the patient to refuse medical treatment.' Fiori, ... [No further comment here, but see below.]
 
... ...
 
"The right of a Jehovah's Witness to refuse a blood transfusion was examined previously in Dorone, ...
 
"The instant case is distinguishable from Dorone. Here, Maria clearly indicated her resolute refusal of blood transfusions. Her DPA was unequivocal in its pointed refusal of a blood transfusion under any circumstance. Her [standardized WatchTower prepared] statement that, 'even if health-care providers ... believe that only blood transfusion therapy will preserve my life or health, I do not want it' indicates her resolve to refuse blood under life threatening conditions. ... Maria also clearly indicated that her refusal of blood was an unwavering religious conviction. The fact that Maria presented the hospital staff with copies of her DPA minutes before her operation demonstrates her continued affirmation to abstain from blood. Maria's appointment of Appellant as her personal health care agent was another clear demonstration that her desire to abstain from blood be given a voice when she could not provide one.

"There is also evidence of Maria's desire to refuse blood, independent of her DPA. The Center had performed liver transplants for Jehovah's Witnesses without the transfusion of blood. Maria specifically chose the Center to perform her operation, as it could accommodate her religious beliefs. Maria also discussed her beliefs with her husband and family prior to the liver transplant operation. Finally, she verbalized her refusal of a transfusion to the hospital staff prior to her operation. Under these facts, Maria clearly expressed her desire not to receive blood transfusion therapy. This refusal of medical treatment is protected by Pennsylvania common law. ...

"Moreover, after a careful review of the record, there is no evidence to suggest that any state interest in this case was compelling enough to override Maria's refusal of blood. ... There is no evidence that the state's interest in protecting third parties is implicated here. [INCREDIBLE???] The transcript of the hearing to appoint Lionel Duran emergency guardian is devoid of testimony regarding the emotional and financial relationship between Maria and her two teenage children. ... Therefore, we will not manufacture evidence and conjecture in a strained attempt to apply this exception to the instant facts." [Therefore, why create "law" in the meantime?]

... ...
On appeal, Larry Johnson a/k/a WatchTower Society next argued that Lionel Duran should not have been appointed Maria's emergency guardian because Maria had already appointed a health care representative when she executed her DPA.  Johnson/WatchTower also contended that Lionel Duran should not have been appointed emergency guardian for the express purpose of consenting to a blood transfusion because his beliefs conflicted with Maria's regarding blood transfusion therapy. The appellate court agreed with the WatchTower Society, stating in part:
"When a patient has executed a DPA and named a personal representative, that choice is given paramount importance. ...
 
"In the instant case, Maria executed a valid DPA contemplating an emergency situation that might require a blood transfusion. After deliberation, Maria recorded her emphatic refusal of blood transfusion therapy under all circumstances. Maria also appointed her own health care agent to ensure that this order was obeyed. ... Therefore, Maria was not in need of a guardian. ... When the very situation contemplated by Maria's DPA arose, the court should have given effect to Maria's unequivocal directions. ... Moreover, no one alleged that Appellant had acted contrary to Maria's wishes or best interest. ... Therefore, the appointment of Lionel Duran as guardian for the express purpose of consenting to a blood transfusion contradicted Maria's clear and unequivocal directions. ... To hold differently would devitalize personal health care directives and devalue the common law right to personal autonomy. Accordingly, we agree with Appellant that the trial court erred when it appointed Lionel Duran as Maria's emergency guardian."

In their final argument of the appeal, Larry Johnson a/k/a WatchTower Society contended that Lionel Duran knew that Larry Johnson was Lionel's wife's duly appointed health care agent.  Johnson/WatchTower also contended that Lionel Duran knew Johnson's whereabouts at all times prior Duran's oral motion for appointment as Maria's emergency guardian. Johnson concludes that he should have been notified of the hearing to appoint a new guardian.  The appellate court agreed with the WatchTower Society, stating in part:
"... Maria's DPA named Appellant as her personal representative for health care. ... Maria informed the doctors and hospital staff of her DPA and provided copies of this document prior to surgery. She also discussed her DPA with family members before her treatment began. During the course of Maria's treatment, doctors and staff at the Center sought Appellant's consent to a kidney dialysis, a biopsy and the second liver transplant. ... When, however, a blood transfusion in contravention of Maria's DPA was required, no one looked to Appellant for consent, or informed him of a hearing to displace his guardianship. Lionel Duran and the hospital staff knew where to find Appellant in an emergency situation, as they had on the three prior emergency consent situations. Thus, it was reasonable under these circumstances to afford Appellant notice of the hearing in question. ... Accordingly, Appellant was entitled to notice of the hearing.

"It is a difficult thing to decline potentially life-saving treatment for a loved one, rendered mute by her condition, on the basis of her devotion to religious beliefs. Nevertheless, absent evidence of overarching state interests, the patient's clear and unequivocal wishes should generally be respected.

"Based upon the foregoing analysis, we conclude that this appeal is cognizable despite its technical mootness. Additionally, we hold that under the circumstances of this case, Maria's self-determination to refuse blood transfusion therapy is protected by Pennsylvania common law. The trial court abrogated Maria's right when it appointed Lionel Duran as emergency guardian, as the evidence was insufficient to implicate state interests. Finally, we conclude that Appellant, as Maria's named guardian, was entitled to notice of the hearing to appoint an emergency guardian. Thus, we reverse the trial court's order."
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In March 2000, residents of Virginia, Maryland, and Washington D.C. watched continuous, often live, news reports about an ongoing manhunt for a police fugitive on the loose. On March 8, 2000, that career criminal, named Joseph Palczynski, attempted to carjack a Jehovah's Witness family on their way to the Kingdom Hall in Joppa, Maryland. Palczynski twice shot Jennifer McDonel, 37, who was driving the family auto. The McDonels managed to drive away until they could stop and allow Thomas McDonel to drive his wife to Franklin Square Hospital. There, Jennifer McDonel died after the couple both refused to consent to a needed blood transfusion. Thomas McDonel expressed regret that he would now be forced to rear their one year-old daughter, Lydia McDonel, on his wages as a janitor. He also regretted that his wife's employer only provided a $25,000.00 life insurance policy.
 
Interestingly, two days later in Virginia, Joseph Palczynski's vehicle run out of gasoline near the home of a Jehovah's Witness Elder named William Louis Terrell. Palczynski first asked for help with his vehicle, and afterwards kidnapped Terrell. Terrell, who afterwards explained to reporters that he had recently read an article in the WatchTower Society's AWAKE! magazine advising kidnap victims to cooperate with their kidnappers, drove Joseph Palczynski back to Maryland while quoting Bible verses (recruiting). Terrell even stopped at three or more stores, and went in alone, and purchased supplies for Palczynski, while he waited outside in the truck. Terrell shopped at a Target, purchased a portable TV at Best Buy, and bought survival supplies at an army surplus store. Once back near his home, Palczynski walked away from Terrell's pickup truck, after Terrell promised Palczynski that he would not report anything to the police. Palczynski went on to kidnap others over the next few days. One later victim questioned why in the world Terrell never telephoned the police from inside one of the stores in which he shopped, nor alerted any store employees. [Because, the AWAKE! magazine article did not tell Terrell that he could do so.] Some people even questioned police as to why Terrell was not charged with aiding and abetting Palczynski. Interestingly, a few months after Palczynski was killed, the AWAKE! magazine carried an article praising Terrell's actions that day.
 
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STAMFORD HOSPITAL v. VEGA was a 1996 Connecticut Supreme Court decision.  WatchTower attorney, Donald T. Ridley, represented Nelly Vega during her appeal. A separate Connecticut attorney filed an amicus curiae brief for the Watchtower Bible and Tract Society of New York, Inc.
 
On August 26, 1994, Nelly E. Vega was admitted as a patient to Stamford Hospital to deliver her first child. That evening, Vega, a Jehovah's Witness, executed a release requesting that no blood or its derivatives be administered to her during her hospitalization, and relieving the hospital and its personnel of liability for any adverse effects that might result from her refusal to permit the use of blood in her treatment. Vega's husband also signed the release.  After giving birth to her child, Nelly Vega hemorrhaged and was in need of a blood transfusion to save her life. When Vega and her husband continued to refuse to consent, the Hospital sought a court order to administer the life-saving transfusions.  The trial judge granted the Hospital's petition on the grounds of preserving life and protecting the newborn child from "abandonment".
 
After Vega recovered, she and her husband, with the support of the WatchTower Society's Legal Department, appealed.  An appellate court dismissed the appeal, but the Connecticut Supreme Court gave ear. The Supreme Court found both the trial and appellate court decisions to be erroneous. The Supreme Court of Connecticut held that a hospital's interest in preserving a patient's life and in protecting the medical profession's ethical integrity were not sufficient to take priority over the common law right of bodily self determination of a Jehovah's Witness to refuse a blood transfusion. Neither could the state justify forcing a parent to accept blood transfusions against religious beliefs in order to prevent orphaning of their children. There was no abandonment on the part of the mother as there was no immediate danger to the baby’s health. Whether Vega's child grew up with one rather than two parents, or, for that matter, with no parent at all was simply not enough to justify disregarding Vega's common law right of bodily self determination.
 
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PERKINS v. LAVIN and AKRON CITY HOSPITAL was a 1994 Ohio appellate court decision. Bonita Perkins gave birth to a baby at Akron City Hospital on September 26, 1991. Perkins was discharged two or three days later. After going home, she began hemorrhaging and was forced to return to the hospital. She specifically informed Hospital's employees that she was not to be provided any blood or blood derivatives and completed and signed a form to that effect:

"I REQUEST THAT NO BLOOD OR BLOOD DERIVATIVES BE ADMINISTERED TO [PERKINS] DURING THIS HOSPITALIZATION, NOTWITHSTANDING THAT SUCH TREATMENT MAY BE DEEMED NECESSARY IN THE OPINION OF THE ATTENDING PHYSICIAN OR HIS ASSISTANTS TO PRESERVE LIFE OR PROMOTE RECOVERY. I RELEASE THE ATTENDING PHYSICIAN, HIS ASSISTANTS, THE HOSPITAL AND ITS PERSONNEL FROM ANY RESPONSIBILITY WHATEVER FOR ANY UNTOWARD RESULTS DUE TO MY REFUSAL TO PERMIT THE USE OF BLOOD OR ITS DERIVATIVES." 
It became necessary to perform an emergency dilatation and curettage. Perkins continued to bleed and her condition deteriorated dramatically. Her blood count dropped, necessitating administration of blood products as a life-saving measure. Her husband, who is not a Jehovah's Witness, consented to a blood transfusion, which was administered.  Perkins fully recovered.
 
Thereafter, Perkins sued her doctor and the Hospital for assault and battery and intentional infliction of emotional distress.  The trial court granted the two defendants' motion for summary judgment dismissing Perkin's complaint. Perkins appealed.
 
The Ohio appellate court first ruled that the lower court's dismissal of the assault and battery claim was erroneous, stating in part:
"In granting defendant's motion for summary judgment, the trial court held:  'There must be evidence that [defendant] intended to injure [plaintiff], or committed the act with the belief that such injury is substantially certain to occur. There was no evidence of such intent; in fact, the opposite must be inferred. [Defendant] performed the blood transfusion with the intent to preserve [plaintiff's] life, and not to cause her harm.'
 
"'Battery' includes innocent intentional contact and even intentional contact meant to assist the complainant, if that contact is unauthorized ...
 
"In this case, plaintiff specifically informed defendant that she would consider a blood transfusion offensive contact. Although both parties have noted that plaintiff's husband provided his consent for the transfusion, defendant has not, at least as yet, argued that his consent was sufficient to overcome plaintiff's direction that she was not to receive a transfusion. Plaintiff submitted sufficient evidence to the trial court to establish that there was, at least, a genuine issue whether defendant intentionally invaded her right to be free from offensive contact. Because of plaintiff's recognition that defendant acted to save her life, a jury may find that she is entitled to only nominal damages. Regardless of that, however, the trial court erred in granting defendant's motion for summary judgment dismissing plaintiff's assault and battery claim. ...
 
With regard to Perkins claim of intentional infliction of emotional distress, this court affirmed the trial court's summary dismissal, sating in part:
"A plaintiff may state a cause of action against a defendant who intentionally or recklessly engages in extreme and outrageous conduct ...

"Defendant's conduct that plaintiff claimed was an intentional infliction of emotional distress on her was the provision of a blood transfusion that saved her life and provided her an opportunity to raise the baby girl to which she had given birth just days before. Rather than an average member of the community exclaiming that defendant acted outrageously by providing that transfusion, such a person would view it as outrageous if defendant had not provided it. Accordingly, there was no genuine issue of material fact and defendant was entitled to judgment as a matter of law dismissing plaintiff's claim for intentional infliction of emotional distress.

Perkins finally got the jury trial that she wanted so badly, in June 1995. Even though this was a heartland jury, and not a left-coast or right-coast jury, it still took the jurors 90 minutes for their common sense to kick in and tell Perkins that she should go home thankful that she was alive.

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In July 1993, a 25 year old Jehovah's Witness, named Carlton Thomas Johnson chose to die rather than accept a blood transfusion. Johnson's decision was supported by his new wife, Tonya Johnson, who was four months pregnant with the couple's first child. Johnson was a recent convert to the Jehovah's Witnesses. While attending a WatchTower Convention in Dallas, Texas, the Shreveport, Louisiana, father-to-be was struck by another automobile while he was changing a flat tire while stopped in the center lane of I-20.  Tonya Johnson stated: "He wanted to raise his baby in God's word, to give him things he didn't have growing up, he said. That's why we were at the convention."

Johnson was unconscious on arrival at Dallas' Methodist Medical Center.  However, emergency room doctors found the WatchTower Society supplied "NO BLOOD" card in Johnson's wallet. However, the hospital decided to honor the card only after Johnson's wife also refused to consent to blood transfusions, and insisted that Johnson himself still ascribed to the convictions outlined on the card.

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IN RE MATTER OF PATRICIA DUBREUIL was a 1993 Florida Supreme Court decision.  WatchTower attorney Donald T. Ridley helped represent Patricia Dubreuil in this appeal.  William E. Hoey, Tequesta, submitted an amicus curiae brief for the Watchtower Bible and Tract Society of New York, Inc., the parent corporation of the Jehovah's Witnesses.  The American Civil Liberties Union Foundation of Florida, Inc. also submitted an amicus curiae brief.
 
On the evening of April 5, 1990, Patricia Dubreuil was admitted to Memorial Hospital in Hollywood, Florida, through its emergency room. Dubreuil was in an "advanced stage" of pregnancy. Dubreuil signed a standard consent form agreeing to the infusion of blood if it were to become necessary. By the early morning hours of April 6, physicians determined that Dubreuil was ready to deliver her child and that a Caesarean section delivery would be appropriate. Dubreuil consented to the Caesarean section, but notwithstanding the routine consent form she had signed, she withheld consent to the transfusion of blood on the basis of her values and religious convictions as a Jehovah's Witness. Michael Dubreuil was subsequently delivered by Caesarean section at approximately 5:30 a.m. on April 6.

Dubreuil experienced a significant loss of blood during delivery because of a severe blood condition that prevents her blood from clotting properly. Attending physicians determined that a blood transfusion was required to save her life, but Dubreuil still refused to consent. Because of the extreme medical emergency that existed on the morning of April 6, medical authorities, with police assistance, contacted Luc Dubreuil, Patricia's estranged husband. He had not accompanied Patricia when she went to the hospital hours earlier. When Luc Dubreuil arrived shortly thereafter, he consented to the blood transfusion. Physicians relied upon Luc's written consent and transfused a quantity of blood into Patricia during the morning of April 6.

Luc and Patricia Dubreuil were still married but were separated and living apart when this incident arose. They are the natural parents of the newborn infant, Michael, and three other minor children, Cary, Tina, and Tracy, who at the time, respectively, were twelve, six, and four years old and living with their mother. Luc was not a Jehovah's Witness. Luc's consent was supported by Patricia's two brothers, who were not Jehovah's Witnesses, while Patricia's mother, who is a Jehovah's Witness, backed her daughter's decision.

After the first blood transfusion on April 6, physicians apparently believed that transfusions would continue to be needed. Unsure of its legal obligations and responsibilities under these circumstances, the hospital petitioned the circuit court for an emergency declaratory judgment hearing to determine the hospital's authority or duty to administer blood transfusions to Patricia Dubreuil over her objections. A hearing was conducted at 3:00 PM on April 6.  It was attended by counsel representing Patricia and the hospital. No testimony was taken, but during the hearing the hospital's counsel received a telephone call advising that Patricia, who had been unconscious, had just become conscious, appeared lucid, and was able to communicate. When asked at that time whether she would consent to a blood transfusion, Patricia again refused.  At 3:30 PM, the trial court announced judgment in favor of the hospital, allowing it to administer blood as physicians deemed necessary. The hospital continued to administer blood, and Patricia survived.

The trial court issued a written order on April 11, 1990 concluding that "there has been no suggestion as to the means or methods of caring for the four minor children of Patricia Dubreuil, if she should die. In the absence of some suggestion or showing as to the availability of proper care and custody of the four minor children, in the event of the death of Patricia Dubreuil, this court believes that the demands of the state (and society) outweigh the wishes of Patricia Dubreuil and that every medical effort should be made to prolong her life so that she can care for her four minor children until their respective majorities."

Patricia's attorneys moved for rehearing, indicating that she continued to object to blood transfusion and that she had an "extended family as well as friends who are willing to assist in the rearing of her minor children in the event of her demise." The Circuit Court denied rehearing on April 12. The Fourth District affirmed by a 2-1 vote.

Patricia sought discretionary review with the Supreme Court of Florida, arguing that the decision below violated her state and federal constitutional rights of privacy, bodily self-determination, and religious freedom. It accepted, stating:  "We recognize that the present case is moot given that Patricia received blood and was released from the hospital. However, we accept jurisdiction because the issue is one of great public importance, is capable of repetition, and otherwise might evade review. ... ...  For the foregoing reasons, we quash the district court's decision."
 
The Rights of Privacy and Free Exercise of Religion:   "... the Florida Constitution guarantees that "a competent person has the constitutional right to choose or refuse medical treatment, and that right extends to all relevant decisions concerning one's health." ... In cases like this one, the privacy right overlaps with the right to freely exercise one's religion to protect the right of a person to refuse a blood transfusion because of religious convictions. ... ...

"The state has a duty to assure that a person's wishes regarding medical treatment are respected. That obligation serves to protect the rights of the individual from intrusion by the state unless the state has a compelling interest great enough to override this constitutional right. The means to carry out any such compelling state interest must be narrowly tailored in the least intrusive manner possible to safeguard the rights of the individual.
 
"... Among the factors we have identified that could be considered in determining whether to give force to a patient's right to refrain from medical treatment is the protection of innocent third parties ... 

"The arguments made in this Court present two basic issues.  First, we must determine whether it is appropriate for a hospital to assert the state interests in an attempt to defeat a patient's decision to forgo emergency medical treatment. Second, assuming the state interests were properly presented in this case, we must decide whether Patricia's rejection of a blood transfusion constituted, as the district court found, abandonment of the couple's minor children and amounted to a state interest that was compelling enough to override her constitutional rights of privacy and religious freedom, by the least intrusive means available
.

Asserting the State Interests:  "Patricia argues that Memorial Hospital should not have intervened in her private decision to refuse a blood transfusion. She claims that the "State" has never been a party in this action, has not asserted any interest, and that the hospital has no authority to assume the State's responsibilities. The hospital argues in its brief that as a public health care facility owned and operated by a special taxing district established under Florida law, it acted as a unit of local government and stood in the shoes of the State for the purposes of asserting the state interests. However, at oral argument, the hospital expressed substantial discomfort in assuming the role of the State in such proceedings. Consequently, both parties agreed that a procedure should be established by which the State can properly intervene if there is reason to do so.

"In most prior Florida decisions where state interests were asserted under analogous medical emergency situations, the State Attorney joined as a party at some point in the proceedings. ... ... One noteworthy exception is Public Health Trust of Dade County v. Wons ... (Fla. 1989), where, as in this case, the state interests were argued by a public health care provider without further intervention of the State. In discussing the need for court proceedings and the requisite burden of proof, we said "it will be necessary for hospitals that wish to contest a patient's refusal of treatment to commence court proceedings and sustain the heavy burden of proof that the state's interest outweighs the patient's constitutional rights." ... We merely assumed, based on the facts in that case, that the health care provider would raise the state interests. Until today, we were not asked to determine whether it is appropriate for a health care provider, as opposed to another party, to assert the state interests in the first instance.

"One noteworthy exception is Public Health Trust of Dade County v. Wons, (Fla. 1989) [A PRIOR CASE INVOLVING ANOTHER JEHOVAH'S WITNESS], where, as in this case, the state interests were argued by a public health care provider without further intervention of the State. In discussing the need for court proceedings and the requisite burden of proof, we said "it will be necessary for hospitals that wish to contest a patient's refusal of treatment to commence court proceedings and sustain the heavy burden of proof that the state's interest outweighs the patient's constitutional rights." ... We merely assumed, based on the facts in that case, that the health care provider would raise the state interests. Until today, we were not asked to determine whether it is appropriate for a health care provider, as opposed to another party, to assert the state interests in the first instance.
 
"We conclude that a health care provider must not be forced into the awkward position of having to argue zealously against the wishes of its own patient, seeking deference to the wishes or interests of nonpatients - in this case Patricia's husband, her brothers, the children, and the State itself. Patients do not lose their right to make decisions affecting their lives simply by entering a health care facility. Despite concededly good intentions, a health care provider's function is to provide medical treatment in accordance with the patient's wishes and best interests, not as a "substitute parent" supervening the wishes of a competent adult. Accordingly, a health care provider must comply with the wishes of a patient to refuse medical treatment unless ordered to do otherwise by a court of competent jurisdiction. A health care provider cannot act on behalf of the State to assert the state interests in these circumstances. This is an appropriate role for the State to play directly, not through the legal artifice of a special taxing district.

... ...
 
"... When a health care provider, acting in good faith, follows the wishes of a competent and informed patient to refuse medical treatment, the health care provider is acting appropriately and cannot be subjected to civil or criminal liability.

"Although this procedure absolves the health care facility of any obligation to go to court, we recognize the need for the State and interested parties to have the opportunity to seek judicial intervention if appropriate. Accordingly, a health care provider wishing to override a patient's decision to refuse medical treatment must immediately provide notice to the State Attorney presiding in the circuit where the controversy arises, and to interested third parties known to the health care provider. The extent to which the State Attorney chooses to engage in a legal action, if any, is discretionary based on the law and facts of each case. This procedure should eliminate needless litigation by health care providers while honoring the patient's wishes and giving other interested parties the right to intervene if there is a good faith reason to do so. ...

 
Protecting Innocent Third Parties:   "The state interest raised in this case is the protection of innocent third parties, which the parties and courts in other jurisdictions under similar circumstances have termed the prevention of abandonment of minor children. Until Dubreuil, no other reported Florida appellate decision had found abandonment in this context. The case most closely on point in this Court's jurisprudence is Wons, where abandonment was discussed but not found.
 
"Norma Wons, a 38-year-old woman, had been suffering from dysfunctional uterine bleeding, and physicians said she could die without a blood transfusion. However, she refused based on her religious convictions as a Jehovah's Witness. Norma lived with her husband Henrich and their two minor children, who were twelve and fourteen years of age. Henrich was also a Jehovah's Witness and supported Norma's decision. Henrich worked to support the family, and during Norma's illness the children had been cared for in Henrich's absence by Norma's sixty-two-year-old mother, who was in good health. Testimony established that if Norma were to die, her mother and two brothers, who also were Jehovah's Witnesses, would assist in taking care of the children. The trial court ruled that Norma's refusal would deny the children the intangible right to be reared by two loving parents, and the state interest in protecting the two minor children overrode Norma's right to refuse lifesaving medical treatment. The Third District reversed, finding that there was no showing of an abandonment of the minor children to override Norma's constitutional rights. The district court said that:

'the societal interest in protecting Mrs. Wons' two minor children ... - although a vital and troubling consideration in this case - cannot, in our view, override Mrs. Wons' constitutional right to refuse a blood transfusion under the circumstances of this case. This is so because, simply put, Mrs. Wons' probable, but not certain, demise by refusing the subject blood transfusions will not result in an abandonment of her two minor children. According to the undisputed testimony below, she has a tightly knit family unit, all practicing Jehovah's Witnesses, all of whom fully support her decision to refuse a blood transfusion, all of whom will care for and rear the two minor children in the event she dies. Her husband will, plainly, continue supporting the two children with the aid of her two brothers; her mother, a sixty-two-year-old woman in good health, will also care for the children while her husband is at work.  Without dispute, these children will not become wards of the state and will be reared by a loving family. ... .'
   
"This Court generally approved the district court's rationale and held that the state interest in maintaining a home with two parents for the minor children does not override a patient's constitutional rights of privacy and religion to refuse a potentially lifesaving blood transfusion. ...
   
"... there was no abandonment proved in that case, so the protection of innocent third parties could not have been a 'compelling interest sufficient to override the competent patient's right to refuse treatment." ... Because there was no abandonment in Wons, we did not decide in that case 'whether evidence of abandonment alone would be sufficient in itself to override the competent patient's constitutional rights.' ...
 
"The trial court in Dubreuil found abandonment and held it to be an overriding state interest. The court distinguished Wons, noting that Luc no longer lived with Patricia and the children; Luc was not a Jehovah's Witness and consented to the transfusion; and Patricia presented no evidence of how the children would be cared for in the event of her death.
 
"In a split decision, the district court affirmed by reasoning that Wons put the burden on the hospital to prove abandonment, and under the emergency circumstances and limited evidence presented, the hospital carried its burden. The district court focused on the fact that no evidence was presented about Luc, his ability to care for the couple's children, or the ability or willingness of any others to help care for the children in the event of Patricia's death. The court rejected the argument that a presumption against finding abandonment should exist in the absence of firsthand evidence to the contrary, suggesting that if any presumption were to apply, it would be a presumption in favor of finding abandonment given the ages of the children and the preexisting custody conditions.

"The district court concluded that because there was no showing that the children of tender years would be protected in the event of their parent's death, the trial court did not abuse its discretion by concluding that 'there was an overriding interest in the state as parens patriae that outbalances the mother's free exercise and privacy right to reject the transfusion.'

"In dissent, Judge Warner observed that Luc, as the natural father, is the children's legal guardian and is responsible for their care as a matter of Florida law ...  Judge Warner relied on our decision in Wons to conclude that because the hospital failed to present compelling evidence that abandonment would result from the rejection of medical treatment, no compelling state interest was established to override Patricia's decision. ...
 
"In her argument to this Court, Patricia urges us to eliminate from this line of cases any consideration given to the state interest in protecting innocent third parties from abandonment, claiming that it is inherently unsound and dangerous and cannot be consistently applied. She argues, for example, that it will lead beyond blood transfusions to major medical procedures ranging from Caesarean sections to heart bypass surgery; or it will allow courts to compel a pregnant Catholic woman who is the single parent of a minor child to have an abortion against her religious beliefs if taking the pregnancy to term would endanger the mother's life. She also argues that the rule eventually will go well beyond the protection of minor children, compelling a single adult, who cares for her dependent elderly parent or grandparent, to receive unwanted medical treatment in order to advance the state interest in protecting the elderly dependent.

"Patricia's argument has some merit. Parenthood, in and of itself, does not deprive one of living in accord with one's own beliefs. Society does not, for example, disparage or preclude one from performing an act of bravery resulting in the loss of that person's life simply because that person has parental responsibilities.
 
"Nonetheless, we decline at this time to rule out the possibility that some case not yet before us may present a compelling interest to prevent abandonment. ... Therefore, we think the better course is the one we took in Wons, where we held that 'these cases demand individual attention' and cannot be covered by a blanket rule. ...
 
"Next, Patricia argues that even if the prevention of abandonment may be a valid state interest, there was no proof in this record that an abandonment would have occurred had Patricia died after refusing medical treatment. We agree.

"Both the circuit and district courts failed to properly consider the father of the four children, Luc Dubreuil. Under Florida law, as Judge Warner's dissent correctly observed, a child with two living natural parents has two natural guardians who share equally the responsibilities of parenting.
 
"'If one parent dies, the natural guardianship shall pass to the surviving parent, and the right shall continue even though the surviving parent remarries. If the marriage between the parents is dissolved, the natural guardianship shall belong to the parent to whom the custody of the child is awarded.' ... Thus, Florida law unambiguously presumes that had Patricia died under these circumstances, Luc would have become the sole legal guardian of the couple's four minor children and would have been given full responsibility for their care in the absence of any contravening legal agreement or order. ..
 
"The State could rebut this strong legal presumption only by presenting clear and convincing evidence that Luc would not properly assume responsibility for the children under the circumstances. ... However, there was absolutely no such evidence presented in this case, as the record is silent as to Luc's ability or desire to care for the children. The record shows only that Luc and Patricia were married but separated, their minor children were under Patricia's care, Luc did not accompany his wife to the hospital, he was readily available when called to Patricia's bedside on the morning of April 6, and he was available to 'consent' to an emergency treatment for Patricia.
 
"Likewise, there was no evidence presented as to whether anyone else, including the families of Luc and Patricia, would take responsibility for the children. To the contrary, Patricia said in an affidavit on rehearing that extended family members and friends (Jehovah's Witnesses saying so for purposes of this lawsuit) were willing to assist in raising the children in the event of Patricia's death.

"Moreover, we do not know if Luc or any other interested party was given the opportunity to address these issues. According to the parties' stipulation, neither Luc nor any other family members attended the emergency hearing, and the record contains no evidence that notice of the hearing was provided. ...
 
"We conclude that the district court erred in holding that sufficient evidence was presented to satisfy the heavy burden required to override the patient's constitutional right to refuse medical treatment. The State alone bore that burden, which the hospital, standing in the State's shoes, did not carry.

"Moreover, the district court erred by suggesting that absent firsthand proof, the law should presume abandonment under these circumstances. To the contrary, the law presumes that when one parent is no longer able to care for the couple's children, the other parent will do so. The district court's decision effectively presumed that Luc had abandoned his children when he separated from his wife. That presumption is unacceptable. The
state cannot disparage a person's parental rights nor excuse a person's parental responsibilities based on martial status alone. ..
 
"Likewise, although not intended by the district court, its rationale could be read by some to perpetuate the damaging stereotype that a mother's role is one of caregiver, and the father's role is that of an apathetic, irresponsible, or unfit parent. ... The law has evolved to move away from inappropriate gender-based distinctions. ... We do not want the district court's rationale misinterpreted to reinforce these outdated ideas in a manner that effectively denies a woman her constitutional right to refuse medical treatment as guaranteed by ... the Florida Constitution. Such an interpretation would also undermine the principle of shared parental responsibility, to which this state adheres. ...

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NORWOOD HOSPITAL v. MUNOZ was a 1991 Massachusetts Supreme Court court decision.  Yolanda Munoz, a thirty-eight year old woman, had a history of stomach ulcers. On April 11, 1989, Munoz vomited blood and collapsed in her home. Ernesto Munoz took his wife to the Norwood Hospital emergency room. Physicians at Norwood Hospital gave Yolanda Munoz medication which stopped the bleeding. Munoz was then admitted to the hospital as an inpatient. During the evening, her hematocrit (the percentage of red blood cells to whole blood) was 17%. A normal hematocrit level for an adult woman is approximately 42%. Ms. Munoz was placed under the care of Dr. Joseph L. Perrotto. It was his medical opinion that the patient had a 50% probability of hemorrhaging again. If Munoz started to bleed, Dr. Perrotto believed that she would in all probability die unless she received a blood transfusion. Ms. Munoz, however, refused to consent to a blood transfusion in the event of a new hemorrhage.

Yolanda and Ernesto Munoz were baptized as Jehovah's Witnesses over sixteen years ago. They are both members of the Jamaica Plain Kingdom Hall of Jehovah's Witnesses.  They attended three religious meetings every week. A principal tenet of the Jehovah's Witnesses religion is a belief, based on interpretations of the Bible, that the act of receiving blood or blood products precluded an individual resurrection and everlasting life after death.

Norwood Hospital had a written policy regarding patients who refuse to consent to the administration of blood or blood products. According to this policy, if the patient arrives at the hospital in need of emergency medical treatment and there is no time to investigate the patient's circumstances or competence to make decisions regarding treatment, the blood transfusion will be performed if necessary to save the patient's life. If the patient, in a nonemergency situation, refuses to consent to a blood transfusion, and the patient is a competent adult, not pregnant, and does not have minor children, the hospital will accede to the patient's refusal. If the patient, in a non- emergency situation, refuses to consent to a blood transfusion, and the patient is a minor, an incompetent adult, pregnant, or a competent adult with minor children, the hospital's policy is to seek judicial determination of the rights and responsibilities of the parties.

Although no longer in an emergency situation once her ulcer stopped bleeding, Yolanda Munoz had a minor son, Ernesto, Jr.  Thus, on April 12, the hospital filed a complaint for a declaratory judgment in the Norfolk Division of the Probate and Family Court requesteing that Munoz be required to accept blood transfusions, which her attending physician believed to be reasonably necessary to save her life. On that same day, the judge granted a temporary restraining order authorizing the hospital to "administer transfusions of blood or blood products in the event that Yolanda Munoz hemorrhages to the extent that her life is severely threatened by loss of blood in the opinion of her attending physicians." The court also appointed Mr. Jonathan Brant to serve as guardian ad litem for five year old Ernesto, Jr.

On April 13, the judge held a full evidentiary hearing. Dr. Perrotto stated in an unchallenged affidavit that, if Mrs. Munoz were to begin bleeding again, she would have an excellent chance of recovering if she received a blood transfusion. If she started to bleed, however, and did not receive a blood transfusion, she would probably die. In addition, Dr. Perrotto stated that there was no alternative course of medical treatment capable of saving the patient's life. Ernesto Munoz and James Joslin, Mrs. Munoz's brother-in-law, testified at the hearing in favor of allowing Mrs. Munoz to refuse the blood transfusion. The guardian ad litem's report, which recommended that the hospital's request for a declaratory judgment be denied, was admitted in evidence.

On April 14, the judge granted the declaratory judgment authorizing blood transfusions which were "reasonably necessary to save Yolanda Munoz's life." The judgment also absolved the hospital and its agents from any civil or criminal liability, except for negligence or malpractice, which might arise from a blood transfusion. On May 11, 1989, the judge issued a detailed opinion explaining his reasons for granting the declaratory judgment. The judge found the patient competent; she understood the nature of her illness, and the potential serious consequences of her decision, including the risk of imminent death if her bleeding resumed and blood transfusions were not administered. While recognizing that a competent adult may usually refuse medical treatment, the judge stated that the hospital could administer the blood transfusions because, if they did not and Mrs. Munoz subsequently died, Ernesto, Jr., would be "abandoned."

The judge concluded that the State's interest in protecting the well-being of Ernesto, Jr., outweighed Ms. Munoz's right to refuse the medical treatment. Ernesto Munoz worked sixteen hours a day, Monday through Friday, and seven hours on Saturday driving his own commercial truck.  Yolanda Munoz worked at a beauty salon from 9 A.M. to 3 P.M., three days a week.  Ernesto, Jr., was enrolled in a day-care center Monday through Friday, from 9 A.M. until 4 P.M. The judge found that Yolanda Munoz was the "principal homemaker and principal caretaker of Ernesto, Jr." The judge also found that, while Ernesto's father, who lived in the home, was available to assist in caring for Ernesto, Jr., his assistance would be inadequate because of his advanced age, his inability to speak English, his unemployment, his lack of a driver's license, and because he had not, in the past, played a significant role in caring for his grandson. In addition, the judge found, that while Sonia and James Joslin, Ernesto's sister and brother-in-law, expressed a willingness to help Ernesto take care of the child in the event that Mrs. Munoz died, the family had not formulated a concrete plan for the care and support of Ernesto, Jr. The judge concluded that Mrs. Munoz's death "would be likely to cause an emotional abandonment of Ernesto, Jr., which would more probably than not be detrimental to his best interests." The judge ruled that "the State, as parens patriae, will not allow a parent to abandon a child, and so it should not allow this most ultimate of voluntary abandonments."

Although Munoz's ulcer did not hemorrhage after the entry of the judgment, and she was released from the hospital without receiving a blood transfusion, she appealed (probably on the urging of the WatchTower's Legal Department). Munoz argued that the trial judge erred because she has a right, as a competent adult, to refuse life-saving medical treatment, and the State's interests do not override that right. The Massachusetts Supreme Court agreed, stating in part:

"... This court has recognized the right of a competent individual to refuse medical treatment. We have declared that individuals have a common law right to determine for themselves whether to allow a physical invasion of their bodies. ... We have stated that 'a person has a strong interest in being free from nonconsensual invasion of his bodily integrity.' ... See Roe v. Wade, ... .

"The right to bodily integrity has been developed further through the doctrine of informed consent, ... Under the doctrine, a physician has the duty to disclose to a competent adult 'sufficient information to enable the patient to make an informed judgment whether to give or withhold consent to a medical or surgical procedure.' ... It is for the individual to decide whether a particular medical treatment is in the individual's best interests. As a result, 'the law protects [a person's] right to make her own decision to accept or reject treatment, whether that decision is wise or unwise.'

"There is no doubt, therefore, that Ms. Munoz has a right to refuse the blood transfusion. Initially, it is for her to decide, after having been informed by the medical personnel of the risks involved in not accepting the blood transfusion, whether to consent to the medical treatment. The fact that the treatment involves life-saving procedures does not undermine Ms. Munoz's rights to bodily integrity and privacy, except to the extent that the right must then be balanced against the State's interests. ...

...

"Numerous courts have recognized the right of a competent individual to refuse medical treatment even if that decision will hasten death. ...

"Ms. Munoz argues that, in addition to her rights to bodily integrity and privacy, she has a right secured by the free exercise clause of the First Amendment to the United States Constitution to object to the administration of blood or blood products because to consent to the blood transfusions would violate one of the principal tenets of her Jehovah's Witnesses faith. Some courts have recognized a free exercise right on the part of Jehovah's Witnesses to refuse blood transfusions. ... We do not think it is necessary, however, to decide whether Ms. Munoz has a free exercise right to refuse the administration of blood or blood products, since we have already held that she has a common law and constitutional privacy right to refuse a blood transfusion. Also, we need not decide whether a patient's right is strengthened because the objection to the medical treatment is based on religious principles. ...

"The New York Court of Appeals reached a similar conclusion in Fosmire v. Nicoleau, supra. The court refused to consider whether the constitutional rights of a Jehovah's Witness, who refused blood transfusions, were violated when the lower court ordered that the transfusion be administered. The court refused to reach the constitutional issues since it held that the patient had a common law and statutory right to decline the blood transfusion. ...

... ...

"The State's interests. The right to refuse medical treatment in life-threatening situations is not absolute. ... We have recognized four countervailing interests: (1) the preservation of life; (2) the prevention of suicide; (3) the maintenance of the ethical integrity of the medical profession; and (4) the protection of innocent third parties. ...

"The judge determined that the patient did not want to die. Declining potentially life-saving treatment may not be viewed properly as an attempt to commit suicide.  ... Therefore, it is clear that the second interest listed above does not apply in this case. ...

"... The State has an interest in preserving life, especially in a case such as the present one where the patient's affliction is curable. ... The State's interest in preserving life has 'two separate but related concerns: an interest in preserving the life of the particular patient, and an interest in preserving the sanctity of all life.' ... As to the former, the State's concern is weakened when the decision maker (the individual who refuses to consent to the treatment) is also the patient 'because the life that the state is seeking to protect in such a situation is the life of the same person who has competently decided to forgo the medical intervention; it is not some other actual or potential life that cannot adequately protect itself.'  ... In cases where a competent adult refuses medical treatment for herself, the State's interest in preserving the particular patient's life will not override the individual's decision. ...

"... preservation of life is the more abstract notion of protecting the sanctity of life. In determining whether this concept applies, we must keep in mind that the right to privacy is an 'expression of the sanctity of individual free choice and self-determination as fundamental constituents of life. The value of life as so perceived is lessened not by a decision to refuse treatment, but by the failure to allow a competent human being the right of choice.'  ...  'The duty of the State to preserve life must encompass a recognition of an individual's right to avoid circumstances in which the individual [herself] would feel that efforts to sustain life demean or degrade [her] humanity.'

"In this case, the patient, a fully competent adult, determined for herself that she could not consent to the administration of blood or blood products because to do so would violate a sacred religious belief. The patient decided that she would rather risk death than accept the blood transfusion. We can assume that, for this patient, death without receiving a blood transfusion is preferable to life after receiving the transfusion. The quality and integrity of this patient's life after a blood transfusion would be diminished in her view. Therefore, we conclude that the State's interest in protecting the sanctity of life must give way to the patient's decision to forgo treatment.

"... The State has an interest in maintaining the ethical integrity of the medical profession by giving hospitals and their staffs a full opportunity to assist those in their care. ... However, we have stated that 'so long as we decline to force the hospital to participate .. there is no violation of the integrity of the medical profession.'  ... We have recognized that medical ethics do not require that a patient's life be preserved in all circumstances. ... Last, the ethical integrity of the profession is not threatened by allowing competent patients to decide for themselves whether a particular medical treatment is in their best interests. ... In the circumstances of this case, the State's interest in maintaining the ethical integrity of the profession does not outweigh the patient's right to refuse blood transfusions.

"... The final, and in this case the most compelling, State interest is the protection of the patient's minor child. The State as parens patriae has an interest in protecting the well-being of children. See Prince v. Massachusetts, ... (1944). The issue is whether a competent adult can be prevented from exercising her right to refuse life-saving medical treatment because of the individual's duties to her child.

"The Florida State courts recently have addressed this issue. ... The patient in Wons was a thirty-eight year old woman, mother of two minor children, who suffered from dysfunctional uterine bleeding. The patient's physicians informed her that she required treatment in the form of blood transfusions. The patient, however, refused to consent to the transfusions because of her beliefs as a Jehovah's Witness. It was the physicians' medical opinion that, if the patient did not consent to the blood transfusions, she would probably die. The trial judge granted an order authorizing the transfusion, but a Florida District Court of Appeals reversed, holding that the State's interest in protecting the patient's children did not override the patient's right to refuse the medical treatment because the patient's possible death would not result in the abandonment of her two children. ... As the court pointed out, the testimony showed that the patient came from a tightly knit family, all practicing Jehovah's Witnesses, and all of whom supported her decision to refuse the blood transfusion. ... The court also pointed out that the patient's husband and mother were willing to take care of the children in the event that the patient died. ... The court concluded that 'there is no showing of an abandonment of minor children, and, consequently, [the patient's] constitutional right to refuse a blood transfusion is not overridden under the circumstances of this case.' ...

"In Fosmire v. Nicoleau, ... (1990), the New York Court of Appeals apparently has held that the State's interest in protecting minor children will never be allowed to override the right of a competent individual to refuse medical treatment. The court explained that 'at common law the patient's right to decide the course of his or her own medical treatment was not conditioned on the patient['s] being without minor children or dependents.' ...

"We need only state that we agree with the reasoning of the Florida court, and hold that, in the absence of any compelling evidence that the child will be abandoned, the State's interest in protecting the well-being of children does not outweigh the right of a fully competent adult to refuse medical treatment. Our review of the record in this case reveals no such compelling evidence. ... The evidence shows that Ernesto Munoz supported his wife's decision not to consent to the blood transfusion. There is no evidence in the record that Ernesto was unwilling to take care of the child in the event that Ms. Munoz died. We note that the father has the financial resources to take care of the child and to make sure that the child's material needs are satisfied. We also note that Ernesto's sister and brother-in-law supported Ms. Munoz's decision, and were willing to assist Ernesto in taking care of the child.

"There can also be no doubt that, if Ms. Munoz had died, the entire family, including the young child, would have suffered a great loss. However, the State does not have an interest in maintaining a two-parent household in the absence of compelling evidence that the child will be abandoned if he is left under the care of a one-parent household. 

'The parens patriae doctrine invoked herein cannot, we think, measure increments of love; it cannot mandate a two-parent, rather than a one-parent, family; it is solely concerned with seeing that minor children are cared for and are not abandoned.'  Wons v. Public Health Trust  ...  In these circumstances the State's interest in protecting the welfare of the patient's child does not outweigh her right to refuse the blood transfusions.

"... The patient had the right to refuse to consent to the blood transfusion even though she would have in all probability died if she had started to hemorrhage. The State's interests in preserving the patient's life, in maintaining the ethical integrity of the profession, and in protecting the well-being of the patient's child, did not override the patient's right to refuse life-saving medical treatment. Accordingly, the judgment is reversed and a new judgment declaring the rights of the parties, consistent with this opinion, is to be entered in the Probate Court."

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In March 1991, a Jehovah's Witness named Thomas Poole died after falling 50 feet from the rafters of the Broward Performing Arts Center in Fort Lauderdale, Florida.  The construction worker suffered multiple bone fractures and internal injuries. Doctors at Broward General Medical Center operated on Poole's bone fractures for about two hours, but they did no further surgery after Poole and his wife, Janet Poole, refused to consent for blood transfusions to be administered as needed to save his life. The hospital petitioned a local court for authorization to administer transfusions, but the local judge denied the request. Even the fact that Poole's death would mean someone else would have to rear his two children meant nothing to the judge.
 
The Medical Examiner who performed the autopsy said the decision to not consent to blood transfusions contributed to his death: "There was an awful lot of internal bleeding in the abdomen. He would have needed surgery, and would have needed blood for that surgery." Janet Poole fully supported her husband's decision, stating, "We've been Jehovah's Witnesses for 13 years, and I agree with my husband completely."  The Poole's decision left open many questions as to what was the actual cause of Poole's death, and how much worker's compensation insurance was due Janet Poole and her two children.
 
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In June 1991, Cedric Thames, 23, of Bloomington, Illinois, was seriously injured in an automobile accident, when his vehicle was struck by a DUI driver, named Stacey White, 27. Transported to Brokaw Hospital in Normal, doctors informed Thames' Jehovah's Witnesses wife, Lori Thames, and other family members that he would need a blood transfusion to survive. Despite the fact that Cedric Thames was the father of two young children, his family refused to allow the doctors to administer transfusions.
 
Cedric Thames died 18 hours after the accident due to excessive blood loss. The DUI driver was later sued by the Thames' family for "wrongful death", even though Thames would have lived if they only had allowed doctors to administer a blood transfusion. In the criminal trial, the DUI driver was sentenced to 3 years in prison, after the jury refused to convict on the charge of reckless homocide, but did convict on felony driving under the influence of alcohol.
 
Thames Mother, named Willie Gregory (double-checked), and other JWs, screamed "religious prejudice" because White was not convicted on the greater charge that would have sent her to prison for 14 years. Willie declared that the criminal prosecution was really not about White, "Our faith was more on trial than Stacey White."
 
 
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IN THE MATTER OF MANGIONE was a 1990 New York court decision. Joanne Mangione, and John Mangione, both age 30, were Jehovah's Witnesses living in Buffalo, New York.  Joanne Mangione was a licensed practical nurse. In December 1990, Joanne Mangione was admitted to Sisters Hospital to deliver her second child.  The Jehovah's Witnesses couple also had a 3-year-old child. Mangione developed a post-labor pneumonia related respiratory infection. Her illness became such that blood transfusions were required to save her life.  Both Mangione and her husband refused to consent.  The hospital sought and obtained authorization to administer life-saving transfusions from a local court.  However, the WatchTower Society drew a line in the sand on this case. Two practicing attorneys, who were Jehovah's Witnesses, came to Mangione's rescue.  Local New York attorney, Albert J. Rydzynski, and Atlanta, Georgia attorney, Billy E. Moore raised so much stink that the Hospital was afraid to administer the transfusions, even though a local judge had approved such.  The JW attorneys even forced the Hospital to sign an agreement that no transfusions would be administered. During this same time, local JW Elders were meeting with the media and giving their "witness" about the "sins" of blood transfusions.  Within a few days, all the involved Jehovah's Witnesses got their wish.  Joanne Mangione's name was added to the list of WatchTower martyrs.
 

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On June 30, 1990, a Jehovah's Witnesses mother of four children, including the newborn she had just delivered via caesarian section, chose to die rather than consent to a blood transfusion.  Tammy Herbolt, 29, refused the transfusion because it was against her WatchTower beliefs.  Her Jehovah's Witnesses husband, Jim Herbolt, agreed with her decision. This tragedy played out at St. Luke Hospital, in Fort Thomas, Kentucky. Doctors and nurses tried to stem the tide of blood coming from the incision and Herbolt's uterus, but only a transfusion would have saved her. Unknown if the grieving husband later filed a malpractice lawsuit.

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In June 1991, a Jehovah's Witness named Judy Sowin, 39, of Amelia, Virginia, was seriously injured in an automobile accident which occurred as she, her husband, and their youngest child were on their way to attend a meeting at the Kingdom Hall of Jehovah's Witnesses. Sowin died three hours later at the Medical College of Virginia Hospital after she refused to consent to the blood transfusions needed to save her life.  Sowin left behind her husband to care for the child that was with them, plus other children.
 
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TEXAS v. DAVIS was a 1988-91 Texas court decision. At some point prior to October 30, 1988, a Jehovah's Witness, named Lillie Mae Davis, of Houston, separated from her husband Nathan Lee Davis, 31, affiliation unknown. On that date, Nathan Davis spotted Lillie Davis, and her daughter, Kaleela, 10, who apparently was not Nathan Davis' daughter, riding in a car driven by Albert Matthews (who thereafter relocated to Phoenix, Arizona) on Veterans Memorial Parkway.
 
Wondering what his estranged wife and step-daughter were doing riding with Al Matthews (who reportedly turned out to be her boyfriend), Davis attempted to get Matthews to stop his auto, but he apparently would not stop. In his efforts to stop the Matthews vehicle, Nathan Davis, who was a railroad locomotive driver, "accidentally" made contact with the Matthews vehicle a number of times. Finally, Matthews crashed head-on into a third vehicle driven by two females. All five people were injured, and were transported to Hermann Hospital.
 
Lillie Mae Davis was thrown from the Matthews vehicle when it collided with the third vehicle, and she received a broken leg and internal injuries. Lillie Davis refused to consent to needed blood transfusions -- at the scene, and later in the ER. Lillie Davis died from blood loss four hours after arriving at Hermann Hospital. Given the specifics above, it is unknown who reared the daughter that she left behind.
 
In March 1991, in this state prosecution, a jury passed over a number of possible felony convictions, and convicted Nathan Lee Davis of misdemeanor negligent homicide. Davis was eventually sentenced to 30 days in jail, eight months probation, and 200 hours community service. He also was being sued civilly by the two females in the third vehicle.
 
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WERTH v. TAYLOR ET AL was a 1987-91 Michigan appellate court decision. In August 1985, Cindy Werth, the mother of two children, became pregnant with twins. About two months before the expected date of delivery, Cindy went to Alpena General Hospital to preregister. She filled out several forms, including a "Refusal to Permit Blood Transfusion" form. Cindy went into labor on May 8, 1986, and entered Alpena General Hospital on that date. While she was being admitted, Donald Werth signed another "Refusal to Permit Blood Transfusion" form. Cindy gave birth to her twins on the evening of May 8, 1986.
 
Following delivery, Cindy was found to be bleeding from her uterus, and eventually an emergency D&C was performed after it had been re-confirmed that Cindy would not consent to a transfusion if such became necessary. However, the D&C did not stop Cindy's uterine bleeding, and her life was at risk. At that point, a blood transfusion was administered to save the unconscious Werth's life. The Werth's showed their appreciation by suing the hospital and every doctor present in the operating room for "battery" and medical malpractice.
 
The local trial court ruled against the Werths, who appealed. The Michigan appellate court affirmed the trial court's decision. Using Dorone, the court held: Only the contemporaneous refusal of treatment by a fully informed, competent adult patient is sufficient to override evidence of medical necessity, and no action lies for battery for treating a patient without such refusal. In other words, the Michigan court ruled that Werth's refusal would have had to been made at the point that death would have been an absolute certainty under conditions where Werth was fully informed and absolutely competent. Otherwise, doctors and hospitals should not be penalized for saving lives.
 
 
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MORE PARENTAL OBLIGATIONS COURT CASE SUMMARIES ON NEXT PAGE - 4B
 

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RECOMMENDED READING:

Wifely Subjection: Mental Health Issues in Jehovah’s Witness Women

Blood Transfusions: A History and Evaluation of the Religious, Biblical, and Medical Objections (Jehovah's Witnesses perspective)

Blood, Medicine, and the Jehovah's Witnesses: The Hidden History of the Watchtower's Position on the Blood Issue

Jehovah's Witnesses and the Problem of Mental Illness


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