Supporting Family Health Care Decisions

Life and the Law in New York State

In the 1980s, a series of NYS Court of Appeals cases created a disturbing body of case law in regard to decision making for incapacitated patients. In 1981, a pair of cases were decided together (Eichner/Storar). From this point on, the Court has held to the position that NYS law demands a competent refusal in order to forgo life sustaining treatment. Never competent adults (like John Storar, a 52 year old profoundly retarded man with bladder cancer) would be forced to endure ANY treatment, if deemed "life sustaining." If a previously competent patient were fortunate enough to anticipate the EXACT treatment to refuse in advance (like Brother Fox in Eichner), that would be honored. If not however, there could be no substituted judgment. That view was upheld in the 1989 O'Connor case, which also set the evidence standard at "clear and convincing" (the highest civil standard available).

Even jurists who concurred with the O'Connor opinion, such as Judge Stewart F. Hancock Jr, felt the Storar precedent left them no choice, but that it was seriously deficient. In his concurring opinion, Hancock wrote: "In my view, however, there are serious deficiencies in Storar, making it particularly unrealistic and unsatisfactory for deciding cases involving circumstances more extreme than those presented here. I believe that a critical need exists for a change in the present New York rule -- either through legislative action or judicial decision," and went on to describe the New York rule as, "unrealistic, often unfair or inhumane and, if applied literally, totally unworkable." Judge Hancock later wrote (in another concurring opinion) in Elbaum v. Grace Plaza: "There could be few more compelling demonstrations of the need for legislative change than the history of this prolonged struggle over the continuance of gastrointestinal feeding between a nursing home and the family of an irreversibly comatose and hopelessly ill elderly woman."

In 1992, the New York State Task Force on Life and the Law published When Others Must Choose; deciding for patients without capacity. This report included a legislative proposal for surrogate decision making in those cases where the patient has not (or could not) execute a Health Care Proxy. The legislation (with some modifications) was introduced in the Assembly soon thereafter.

The Task Force on Life and the Law has been recognized as the model of sound public policy study of important issues of life and death. The Task Force members include leaders in the fields of law, medicine, nursing, philosophy and bioethics, as well as patient advocates and representatives of diverse religious communities.

The Task Force's reports and recommendations have been cited in a number of important federal and state court decisions, including decisions by the United States Supreme Court and the New York Court of Appeals. The Task Force has provided a sane voice in the debate over assisted suicide with a 1994 report: When Death is Sought opposing assisted suicide, and a 1997 Supplement that reinforces that opposition to euthanasia and assisted suicide. Read more about the Task Force activities on the Department of Health website.

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Artificial Hydration and Nutrition

One issue which has been part of the debate is the question of artificial hydration and nutrition. This is a complex issue that is not easily resolved by slogans and simple answers. A full discussion of this issue is available on this site: Artificial Hydration and Nutrition page

Literacy Study

A literacy study done at Sarah Lawrence College is summarized here. The Health Advocacy Program at the college conducted the study and feels the data reinforces the need for FHCDA type legislation in NYS.

For more information, E-mail Family Decision Coalition
For questions about website, E-mail Jack Freer