First Appellate Division Upholds Health Care Decisions Act for Persons with Mental Retardation

First Appellate Division Upholds Health Care Decisions Act for Persons with Mental Retardation

The First Appellate Division affirmed a lower court ruling by New York County Surrogate Eve Preminger upholding the constitutionality of the Health Care Decisions Act in The Matter of Chantel R.New York States Mental Hygiene Legal Service (MHLS) argued that the Act was unconstitutional because it violated the Equal Protection clause of the U.S. Constitution by treating persons with mental retardation differently than people without mental retardation in regard to health care decision making.


The issue arose during a proceeding to appoint Chantel R.s mother as guardian. When asked how she would regard a decision by her mother to withhold life sustaining treatment, Chantel appeared to object to the hypothetical question. MHLS then insisted that her mother be precluded from making such decisions. New York Surrogate Eve Preminger held a hearing and heard evidence in this case which substantiated that Chantel was unable to make health care decisions herself. MHLS appealed to the Appellate Division.


The Court stated that The Surrogate properly concluded that a person with mental retardations expression of a desire to continue life-sustaining measures is categorically distinguishable from the same desire expressed by a mentally competent individual because only the latter has the capacity to appreciate the consequences of the decision. The Court recognized that a person with mental retardation has never had the capacity to make these decisions and understand the consequences of such decisions.


First Appellate Division Upholds Health Care Decisions Act for Persons with Mental Retardation2


To go back to the days before the Health Care Decisions Act, when there was no one to make an end of life decisions for persons with mental retardation, would be condemning them to unnecessary suffering as was illustrated in the Pouliot case credited with spurring the passage of the Act. In that case, Sheila Pouliot, a severely mentally retarded person, became terminally ill and, in spite of the fact that her doctors felt it was futile and her sister and the ethics board of the treating hospital objected, she was kept alive for several weeks. It is alleged that she was in pain and suffered. This is the situation that must be avoided.


It is unknown whether or not NY MHLS will appeal the Appellate Division decision. For the sake of all individuals with mental retardation and/or developmental disabilities in New York State I hope they do not. The fact that one has a developmental disability should not deny such individual the right to have an advocate, in this case, a court-appointed 17A Guardian, to provide the same rights to a death with dignity and without pain as you and I .


The Court held that any disparity in treatment of a mentally retarded person is justified by legitimate state interests, that respondent has been accorded due process and is not aggrieved on such grounds and that the asserted vagueness of any statutory provision with respect to the withholding or withdrawal of medical treatment is not before us. Therefore, we affirm the ruling in all respects.

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