## Facts

- Rosaria Candura, a 77-year-old widow, was hospitalized with gangrene in her right foot and lower leg.
- Treating physicians recommended prompt amputation to address the condition.
- After initial indecision, Candura refused to consent to the operation and maintained that refusal, with brief later vacillation.
- Her daughter, Grace R. Lane, petitioned the Probate Court to be appointed temporary guardian with authority to consent to amputation on Candura’s behalf.
- The Probate Court appointed Lane as temporary guardian and authorized her to consent to the surgery.
- A guardian ad litem appointed for Candura appealed from that order.

## Issues

1. Whether the evidence and findings supported a determination that Candura lacked legal competence to decide whether to undergo the recommended amputation.
2. If Candura was competent, whether a court could authorize guardianship and substituted consent to override her refusal of life-saving treatment.

## Decision

- The Appeals Court reversed the order appointing a temporary guardian with authority to consent to amputation.
- The court held the record did not support a finding that Candura lacked the legally required competence to make the decision herself.
- The court held Candura had the right to refuse medical treatment or surgery, and her leg could not be amputated unless she consented.

## Legal Principles

- A competent adult has a protected right to refuse medical treatment, including life-saving treatment.
- The controlling inquiry is whether the patient has the legally requisite competence of mind and will to make the treatment decision, not whether the decision is medically advisable.
- A court may not impose substituted decisionmaking through guardianship without sufficient evidence and findings of legal incompetence.
- Recognized state interests (including preservation of life and protection of third parties) may justify overriding refusal in some situations, but they do not displace the choice of a competent person on these facts.

## Conclusion

The court concluded that Candura was not shown to be legally incompetent and therefore retained authority to refuse amputation, requiring reversal of the temporary guardianship order authorizing surgery without her consent.


Lane v. Candura, 6 Mass. App. Ct. 377, 376 N.E.2d 1232 (1978)