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In re Hughes

Decided: August 31, 1992.

IN THE MATTER OF ALICE HUGHES


On appeal from Superior Court, Chancery Division, Camden County.

King, Dreier and Gruccio. The opinion of the court was delivered by Gruccio, J.A.D.

Gruccio

On May 13, 1991, Alice Hughes (Ms. Hughes), a 39-year-old devout Jehovah's Witness, was admitted to Cooper Hospital/University Medical Center to undergo a hysterectomy. A principal tenet of the Jehovah's Witness faith is the belief that receiving blood or blood products into one's body precludes resurrection and everlasting life after death.

At the time of her admission to the hospital, Ms. Hughes signed forms expressing her desire not to receive any blood or blood products. She also verbally expressed this intention to her treating physician, Dr. Isadore Ances.

Unanticipated problems arose during surgery which, in Dr. Ances' opinion, required blood transfusions to save Ms. Hughes' life. Dr. Ances contacted Jimmy Hughes, Ms. Hughes' husband, to discuss the emergency situation and his wife's vital need for blood. While on the phone Mr. Hughes, also a Jehovah's Witness, authorized transfusions.

Cooper Hospital initiated an emergency hearing before Judge Fratto at 1:37 a.m. on May 14, 1991, for the purpose of having a temporary guardian appointed for Ms. Hughes to allow additional transfusions after the surgery. She was unconscious and incapable of expressing her desires at the time. Appearing at the emergency hearing were Dr. Ances, Jimmy Hughes,

Laura Bennett (Ms. Hughes' sister), and Alinda Ross (Ms. Hughes' daughter).

Specific testimony was given by Dr. Ances regarding his communications with Ms. Hughes, who had been his patient for a mere six weeks. He testified that Ms. Hughes told him that she was a Jehovah's Witness and that she did not want blood products. He informed her that a time could arise when blood might be needed to save her life. He also told her that, given the procedure and the size of her uterus, it was unlikely that she would need blood during the surgery. Ms. Hughes did not discuss the depth of her religious convictions with Dr. Ances, although he was aware that she had signed hospital forms refusing blood. Dr. Ances told the judge that he assumed Ms. Hughes was aware of the ramifications of refusing blood and therefore did not specifically discuss them with her.

Jimmy Hughes testified that his wife is a very religious person and expressed her desire to refuse blood, even in an emergency. He further stated that he initially authorized the transfusions by telephone because he was upset and far from home when told that his wife could die without them. When asked whether blood should still be refused, he would not answer.

Laura Bennett, Ms. Hughes' sister, testified that she discussed her religious beliefs with Ms. Hughes before the surgery and believed that she would not want a blood transfusion. She said that Ms. Hughes told her that under no circumstances was she to receive blood. In her opinion, Ms. Hughes understood the consequences of not receiving blood and made a fully-informed decision.

Ms. Hughes' teenage daughter, Alinda Ross, also testified that her mother told her she would not want to receive blood. Yet, Alinda voiced concern about her mother's death and whether any blood substitutes could be given.

After hearing testimony from Dr. Ances and Ms. Hughes' family, the judge found that the evidence was unclear as to

whether she would want blood or blood products if it meant saving her life. As a result, the judge appointed the hospital's risk manager as temporary guardian for the limited purpose of giving consent to the administration of blood and blood products. The order explicitly extended only until Ms. Hughes regained consciousness and became competent to make her own decisions regarding the administration of blood. The order automatically expired upon her discharge from the hospital. Thereafter, Ms. ...


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