Dreier, J.d.c., Temporarily Assigned.
This matter involved an emergent application for the appointment of a Guardian Ad Litem and for an order permitting the staff physicians of Muhlenberg Hospital to effect a blood transfusion on the person of Anthony Lenard Patterson, a six day old infant. Anthony's parents are devout Jehovah's Witnesses and refused to permit such transfusion on religious grounds.
Anthony was born prematurely after 32 weeks gestation, and was found by his physician Dr. Rudolph Archer to be suffering from jaundice caused by an uncommon incompatibility between Mrs. Patterson's blood and the child's system. Dr. Archer, understanding the parents religious aversion to blood transfusions, permitted the child's bilirubin count to exceed the level at which, ordinarily, he would have ordered such transfusion; but as the level approached one which could produce serious hazards to the child, Dr. Archer contacted the Chief of Pediatrics and the Hospital Administrator, who in turn requested assistance from the Court. I convened a hearing at Muhlenberg Hospital at 5:30 P.M. on January 22, 1974 at which were present the parents, two fellow Jehovah's witnesses (ministers), two friends of the parents, as well as the hospital director, other hospital personnel and Dr. Archer. Testimony was taken stenographically by a Court Reporter.
Dr. Archer testified that a bilirubin count of 20 or 21 would, within a short period of time, produce severe and irreparable brain damage, seriously impairing the infant's mental facilities, and that the count had risen during the day to the area of 18-19. Based upon my preliminary interrogation of the parents, I determined that the Guardian Ad Litem should be appointed, and Mr. Dailey, the Director of Muhlenberg Hospital, was so designated. He testified that from the hospital records and from consultations with the Chief of Pediatrics, it was necessary for the hospital to have permission to transfuse the infant and accomplish a complete blood exchange in the event the bilirubin content advanced
beyond its present state. Both he and Dr. Archer agreed that the danger was not one of loss of life, unless secondary infection set in following the adverse consequences of the liver problem. I found as a fact that, although there was only incidental danger to life, there was, to a reasonable medical certainty, immediate danger of irreparable brain damage and concomitant severe mental retardation, in the event the transfusion would be withheld when the bilirubin count equalled or exceeded 20. The requested order was signed after the hearing. Although the transfusion was attempted, the child later died from deterioration of his general physical condition. Notwithstanding the death, the legal question raised justifies the reduction to writing of the reasons for my decision. State v. Perricone, 37 N.J. 463, 469 (1962).
The parents and ministers and friends argued that the transfusion was against God's law (see the references in State v. Perricone, supra., 37 N.J. at p. 471), and, in addition, had never been authorized by any New Jersey Court in a case where there was not immediate danger to life.
I noted at the hearing, that transfusions have been directed in John F. Kennedy Memorial Hospital v. Heston, 58 N.J. 576 (1971); State v. Perricone, supra., and Raleigh Fitkin-Paul Morgan Memorial Hospital v. Anderson, 42 N.J. 421 (1964), certiorari denied 377 U.S. 985, 84 S. Ct. 1894, 12 L. Ed. 2d 1032 (1964), but this case appears to be the first New Jersey case in which a blood transfusion has been ordered where the potential harm is serious injury, rather than death. The Perricone Court noted in passing that other States have ordered transfusions to save an infant's "life or mental health". 37 N.J., at p. 477.
In New Jersey, government action has been permitted in areas which would transgress religious beliefs where the general health of the community, rather than the saving of life, has been the beneficial goal. See Mountain Lakes Board of Education v. Maas, 56 N.J. Super. 245 (App. Div. 1959), affirmed 31 N.J. 537 (1960), certiorari denied 363 U.S. 843, 80 S. Ct. 1613, 4 L. Ed. 2d 1727 (1960), involving the
vaccination of children, and Young v. Board of Health of Somerville, 61 N.J. 76 (1972), involving fluoridation of the public water supply. In these instances, however, the action taken has affected the community rather than the individual. The parents questioned the Court's power to require particular medical treatment which, although it may be beneficial to the patient, it is not necessary to save the patient's life. They asked: "Where will this intrusion end?, and, "Is it not the forerunner of State control over an individual's life?"
Courts elsewhere in the country have considered this issue, and there is apparently a split of authority, although the majority view supports the action taken in this case. See In Re Sampson, 29 N.Y. 2d 900, 328 N.Y.S. 2d 686, 278 N.E. 2d 918 (1972), affirming 37 A.D. 2d 668, 323 N.Y.S. 2d 523 (3rd Dept. 1971), affirming 65 Misc. 2d 658, 317 N.Y.S. 2d 641 (1970); Morrison v. State, 252 S.W. 2d 97 (Mo. App. 1952); Mitchell v. Davis, 205 S.W. 2d 812 (Tex. Civ. App. 1947); Application of President and Directors of Georgetown College, Inc., 118 U.S. App. D.C. 80, 331 F. 2d 1000 (1964), rehearing en banc denied, 118 U.S. App. D.C. 90, 331 F. 2d 1010 (1964), certiorari denied 377 U.S. 978, 84 S. Ct. 1883, 12 L. Ed. 2d 746 (1964); and People ex rel. Wallace v. Labrenz, 411 Ill. 618, 104 N.E. 2d 769 (1952), certiorari denied 344 U.S. 824, 73 S. Ct. 24, 97 L. Ed. 642 (1952). Cf. Jehovah's Witnesses in State of Washington v. King County Hospital, 278 F. Supp. 488 (W.D. Wash. 1967), affirmed 390 U.S. 598, 88 S. Ct. 1260, 20 L. Ed. 2d 158 (1968), rehearing denied 391 U.S. 961, 88 S. Ct. 1844, 20 L. Ed. 2d 874 (1968) where a Washington statute empowering Superior Court judges to declare children dependent for the purpose of transfusions ...