This Would Almost Be Funny...

Except that the Massachusetts Supreme Judicial Court's bizarre sentence below (starting with "In short") was written to justify letting someone die because it was impossible to know what the person wanted:

On April 26, 1976, William E. Jones, superintendent of the Belchertown State School (a facility of the Massachusetts Department of Mental Health), and Paul R. Rogers, a staff attorney at the school, petitioned the Probate Court for Hampshire County for the appointment of a guardian of Joseph Saikewicz, a resident of the State school. Simultaneously they filed a motion for the immediate appointment of a guardian ad litem, with authority to make the necessary decisions concerning the care and treatment of Saikewicz, who was suffering with acute myeloblastic monocytic leukemia. The petition alleged that Saikewicz was a mentally retarded person in urgent need of medical treatment and that he was a person with disability incapable of giving informed consent for such treatment.

...

Drawing on the evidence before him including the testimony of the medical experts, and the report of the guardian ad litem, the probate judge issued detailed findings with regard to the costs and benefits of allowing Saikewicz to undergo chemotherapy. The judge's findings are reproduced in part here because of the importance of clearly delimiting the issues presented in this case. The judge below found:

"1. That the majority of persons suffering from leukemia who are faced with a choice of receiving or foregoing such chemotherapy, and who are able to make an informed judgment thereon, choose to receive treatment in spite of its toxic side effects and risks of failure.

...

In short, the decision in cases such as this should be that which would be made by the incompetent person, if that person were competent, but taking into account the present and future incompetency of the individual as one of the factors which would necessarily enter into the decision-making process of the competent person. Having recognized the right of a competent person to make for himself the same decision as the court made in this case, the question is, do the facts on the record support the proposition that Saikewicz himself would have made the decision under the standard set forth. We believe they do. [SUPERINTENDENT OF BELCHERTOWN STATE SCHOOL v. SAIKEWICZ, 370 N.E.2d 417, 373 Mass. 728 (1977)]

In short, this guy can't clearly state what he wants or doesn't want, has never done so, has no legal guardian, until this question came up, and most people would choose to live--so the Massachusetts Supreme Judicial Court ordered him to not be treated. He died three months later of pneumonia, as a result of leukemia.

If Saikewicz had been able to express an opinion as to whether he wanted to live or die, that would be one thing. If he had been competent to make that decision at an earlier time, and had told someone (even just casually), "I would rather die than go through chemotherapy," I could live with that. If the Court believed that most people facing a similar situation would be inclined to die a relatively quick and painless death rather than suffer the consequences of chemotherapy, I suppose that I would only be griping about them making a decision based on what "most people" wanted. But they had absolutely nothing but their own decision of what an incompetent person would have wanted if he had been competent but he was taking into account that he was incompetent.

Like I said at the beginning--it would almost be funny, if it didn't read like a Marx Brothers version of the Nazis T4 program.

And in case you are wondering: I'm reading this case because this is one of the "substituted judgment" cases that plays a part in the right of mental patients to refuse treatment.