## Facts

- Abe Perlmutter, a 73-year-old man, was diagnosed with amyotrophic lateral sclerosis (ALS), a terminal condition with no cure and short life expectancy.
- The disease progressed to near-total immobility and an inability to breathe without a mechanical respirator.
- Perlmutter remained mentally competent and understood that removing the respirator would likely result in death within less than an hour.
- Perlmutter repeatedly sought removal of the respirator, including attempting to remove it himself; hospital staff reconnected it.
- With the approval of his adult family, Perlmutter petitioned for an order allowing discontinuation of the respirator and preventing interference with his choice.
- The trial court granted relief, reasoning that Perlmutter’s constitutional right of privacy permitted him to leave the hospital or remain without the respirator and restraining others from interfering.
- The State Attorney appealed the final judgment.

## Issues

1. Whether a competent, terminally ill adult has a constitutional right (privacy/bodily self-determination) to refuse or discontinue extraordinary life-sustaining treatment, including mechanical respiration.
2. Whether removing life-sustaining treatment at the patient’s informed request constitutes unlawful killing under Florida murder or manslaughter statutes, or is barred by the State’s asserted duty to preserve life.

## Decision

- The District Court of Appeal affirmed the trial court’s judgment.
- The court held that a competent, terminally ill adult may refuse or discontinue extraordinary medical treatment, including a mechanical respirator.
- The court rejected the argument that compliance with the patient’s decision constitutes murder or manslaughter under Florida law.
- The court concluded that, on these facts, the State’s interest in preserving life did not override the patient’s right to decline extraordinary treatment.

## Legal Principles

- A competent adult’s decision to refuse or discontinue extraordinary medical treatment is protected by constitutional privacy and bodily integrity interests.
- When a competent, terminally ill patient knowingly declines extraordinary life-sustaining measures, allowing the underlying disease to take its course is legally distinct from unlawful killing.
- The State’s general interest in preserving life may yield to an informed, competent patient’s refusal of extraordinary treatment in narrowly defined circumstances, including family agreement and absence of minor dependents.

## Conclusion

The court upheld an order permitting a mentally competent, terminally ill patient to discontinue mechanical respiration and barring interference, recognizing a privacy-based right to refuse extraordinary life-sustaining treatment and holding that honoring that choice is not criminal homicide on the specific facts presented.


Satz v. Perlmutter, 362 So. 2d 160 (Fla. Dist. Ct. App. 4th Dist. 1978)