## Facts

- Francis B. Landy was admitted to John F. Kennedy Memorial Hospital in April 1981, terminally ill, and soon stopped breathing.
- He was placed on a mechanical ventilator through a tracheal tube and suffered permanent brain damage, with deteriorating mental status and no meaningful responsiveness.
- His physician determined it was impossible to wean him from the ventilator and diagnosed his condition as terminal.
- Before becoming incompetent, Landy executed a written living will stating he did not want to be kept alive by artificial means in a terminal, hopeless condition.
- Gladys Landy, his wife, was appointed his guardian after a finding of incompetency and requested disconnection of the respirator consistent with the living will.
- The hospital sought a declaratory judgment, citing concern about potential civil and criminal liability if extraordinary life support were withdrawn.
- Landy died while still on the respirator, but the trial court deemed the controversy justiciable because it implicated recurring situations involving terminally ill, incompetent patients.

## Issues

1. Whether a court-appointed guardian must obtain prior court approval before terminating extraordinary life support for a comatose, terminally ill patient who executed a living will.
2. Whether withdrawal of extraordinary life support under these circumstances can occur without exposing consenting family, physicians, and the hospital to civil or criminal liability absent a court order.

## Decision

- The Supreme Court of Florida answered the certified question in the negative.
- The court held that prior court approval was not required in this type of case to relieve consenting family members, attending physicians, and the hospital and its administrators from civil and criminal liability.
- The court approved recognition of a privacy-based right to refuse life-sustaining treatment, but rejected a categorical requirement of judicial pre-approval.
- The court indicated judicial involvement remains available for disputed or uncertain cases, rather than as a mandatory prerequisite when the patient’s wishes and medical circumstances are clear.

## Legal Principles

- A competent adult has a right to refuse medical treatment, including life-sustaining procedures; in Florida this right is grounded in the state constitutional right to privacy.
- A valid living will is a significant written expression of a patient’s treatment preferences and may guide decisions after the patient becomes incompetent.
- When the patient is terminally ill and incompetent, and the living will clearly rejects extraordinary artificial life support, a guardian may authorize withdrawal in consultation with family and physicians without first obtaining a court order.
- Mandatory judicial pre-approval is not required in every case; courts are principally needed when there are conflicts, doubts about the directive’s validity or applicability, or allegations of bad faith.
- Good-faith compliance with a valid living will and appropriate medical determinations can permit withdrawal of extraordinary life support without imposing civil or criminal liability on those acting with consensus.

## Conclusion

The Florida Supreme Court held that, where a terminally ill, incompetent patient’s valid living will clearly rejects extraordinary life support and the guardian, family, and physicians agree, a prior court order is not required to withdraw such support or to protect participants from civil and criminal liability.


John F. Kennedy Mem'l Hosp., Inc. v. Bludworth, 452 So. 2d 921 (Fla. 1984)