The Case of Mary Hier: When Substituted Judgment Becomes Sleight of Hand
Annas, George J.
Hastings Center Report. 1984 Aug; 14(4): 23-25.
Mary Hier, a 92-year old, institutionalized mentally ill woman, had pulled out her gastric feeding tube, resisted its reinsertion, and objected to receiving injections of Thorazine. Using the substituted judgment doctrine, a Massachusetts probate judge concluded that Mrs. Hier would accept the drug if she were competent but would refuse a gastrotomy to replace the feeding tube. The decision was upheld on appeal. Whether the best interests of the patient were served is discussed in terms of devaluing the life of the mentally handicapped and discriminating against them under the guise of protecting their rights. (KIE abstract)
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