Care and Protection of Beth,
587 N.E.2d 1377 (1992).


Facts: The Department of Social Services ("DSS") petitioned the court, alleg¬ing that a newborn baby, whose parents were minors, was in need of care and protection. The court ordered physical and legal custody of the child to DSS. Shortly thereafter, the baby's mother was found to be in need of care and pro-tection and her custody was placed with DSS. DSS returned physical custody of the baby to the mother. The mother and baby were in an automobile accident. As the result of the accident, the baby could not "see, hear, or engage in any purposeful movement." Her breathing was artificially regulated. She was fed through a feeding tube that was permanently inserted in her stomach. DSS and the child's mother (Ps) petitioned the court for the appointment of a guard-ian ad litem for the child arid for the court to authorize the entrance of a "no code" in the child's medical chart.

Issue: Did the court correctly find in accordance with the substituted judgment doc-trine that the young child would choose to refuse resuscitation?

Rule: A judge may rule on substituted judgment on a minor child who was less then three months old when she went into a vegetative state and who is now five and half years old

Holding: Department of Social Services (DSS), as guardian of child in irreversible coma and of child's mother, petitioned for entry of substituted judgment as to what further medical care should be given to child. The District Court Department, Holyoke Division, Edward J. Shea, J., entered substitute judgment determination calling for “no code” (do-not-resuscitate) order. Child's guardian ad litem sought relief, and Wilkins, J., reserved and reported matter. The Supreme Judicial Court, Abrams, J., held that evidence supported finding that child would choose to decline resuscitative medical treatment in event of respiratory or cardiac arrest.
Affirmed.

AnalysisThe infant was in a car accident, in which her car seat straps wrapped around her neck, leaving her in an irreversible coma. Both she and her mother, also a minor, were in the custody of the Massachusetts Department of Social Services. The mother and the Department jointly sought the appointment of a guardian ad litem for the infant and filed a motion for an entry of substituted judgment regarding the medical care given to the infant. The district court, substituting its judgment for the infant, found that, if competent, the infant would not have chosen resuscitation by extraordinary measures. The court entered a "no code" order. The guardian ad litem sought relief from the order. The court affirmed, holding that the district court's findings that the impact on the infant's family would have been small, that the infant did not have real hope of improvement, and that a full-code effort would result in a substantial degree of bodily invasion, were sufficient to support the "no code" order. The court also held that the State's interest in preserving life was reconciled with the interest of the individual to reject the traumatic cost of prolonging life.