Case In re Guardianship of Browning, 568 So. 2d 4 (Fla. 1990).
Court Florida Supreme Court
Patient (age) Estelle Browning (89)
Nutrition + hydration Nasogastric tube
Mental capacity Major and permanent brain damage (from stroke); conscious but incompetent to make medical decisions; a condition bordering on Persistent Vegetative State (PVS)
Decision maker(s) Doris Herbert, 2nd cousin and legal guardian
Setting Florida nursing home
Patient's Wishes Browning's living will stated that she would want medical treatment withheld or withdrawn (including tube feeding) if she was in a "terminal condition" and if her death was "imminent." Doris Herbert and several neighbors testified that Mrs. Browning would not want to be maintained on life support in her present condition.
Court's Decision The court determined the Browning's living will was operative because her condition was 'terminal" since she would surely die shortly after the withdrawal of tube feeding. More generally, the court found that the right to privacy charted in Article I, section 23 of the Florida Constitution, covers all health care decisions, is not limited to the type of treatment at issue in this case, and that the right to forgo treatment is not lost when the patient is unable to make medical decisions on his or her own behalf.
In addition, the court found that none of the traditional state interests (preservation of life, prevention of suicide, protection of innocent third parties, and preservation of medical profession's ethical integrity) were significant when balanced against Browning's right to refuse treatment.
The court also noted, however, that there must be "clear and convincing evidence" of a patient's desire to forgo life-sustaining treatment and that, in the absence of a written evidence, the burden of proof is on the party seeking to forgo treatment. Further, the patient must have no reasonable probability of recovering competence (certified by the primary...