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Betancourt v. Trinitas Hospital - The Appellate Opinion

Posted Aug 13 2010 9:09am

This morning, the New Jersey Appellate Division released  its opinion  in Betancourt v. Trinitas Hospital  In a nutshell, the hospital (and amici hospital association and medical society) lost.  The Appellate Division dismissed their appeal of the trial court's ruling ordering the hospital to continue dialysis that they thought medically inappropriate for a PVS patient.

The court decided that the appeal was moot:  "We recognize that determining what medical treatment should be provided to incompetent or dying patients presents a matter of substantial public importance and that such matters are capable of evading judicial review; however, we are not of the view that the particular circumstances presented here - including the allegations of medical negligence as well as the substantial unpaid hospital bills - are likely to reoccur."

The court first observes that the case is literally moot because Mr. Betancourt died.  It next recognizes that there are exceptions to the mootness doctrine where a case is of "substantial public importance," "capable of evading judicial review," and "likely to recur."  The court finds that only the first two factors are satisfied.  Rather than address the general underlying issues, the court anchors this case to its particular facts.  Concluding that those peculiar facts are unlikely to recur, it can provide no useful guidance by rendering an opinion on the merits of this case.

Despite the procedural posture of the appeal, the court has designated its opinion to be published.  And it provides substantial dicta on the merits.  In footnote 9, for example, it strongly suggests that the state Advance Directives Act provides no basis for unilateral refusal of life-sustaining treatment.

The Court ended its opinion by inviting the other branches of government to tackle the issue:  "While we dismiss the appeal, we do not see our declination to resolve the issue on this record and in this case to be an end to the debate. The issues presented are profound and universal in application.They warrant thoughtful study and debate not in the context of overheated rhetoric in the battlefield of active litigation, such as marked the Schiavo debate, but in thoughtful consideration by the Legislature well as Executive agencies and Commissions charged with developing the policies that impact on the lives of all."

UPDATE:  The Star-Ledger's reporting of the case is here

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