Werth v. Taylor
475 N.W.2d 426, 190 Mich. App. 141 (1991)
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Rule of Law:
A physician does not commit battery by administering a medically necessary life-saving procedure to an unconscious patient, despite prior refusals, if those refusals were not contemporaneous with the life-threatening emergency and made while the patient was fully informed of the imminent risk of death.
Facts:
- Cindy Werth and her husband Donald Werth are Jehovah’s Witnesses, whose religious beliefs prohibit accepting blood transfusions.
- Two months prior to her delivery date, Cindy Werth preregistered at Alpena General Hospital and signed a 'Refusal to Permit Blood Transfusion' form.
- Upon admission to the hospital for labor on May 8, 1986, Donald Werth signed another refusal form on his wife's behalf.
- After giving birth to twins, Cindy began to hemorrhage from her uterus, creating a medical complication.
- A physician discussed the need for a dilation and curettage (d & c) procedure with the Werths and revisited their refusal of blood, assuring them the procedure was routine and a transfusion was unlikely to be needed.
- Cindy was placed under general anesthesia for the d & c.
- During the procedure, Cindy's condition worsened dramatically, her blood pressure fell, and the situation became life-threatening.
- Dr. Michael Taylor, an anesthesiologist, determined a blood transfusion was essential to save Cindy's life and, despite being informed of her religious beliefs, ordered the transfusion while she remained unconscious.
Procedural Posture:
- Cindy and Donald Werth filed a civil lawsuit against Dr. Michael Taylor in a Michigan circuit court (the trial court), alleging civil battery.
- Defendant Taylor filed a motion for summary disposition, arguing that his actions did not constitute battery.
- The trial court granted the defendant's motion and entered an order dismissing the battery claim against Dr. Taylor.
- The plaintiffs, Cindy and Donald Werth (appellants), appealed the trial court's dismissal to the Michigan Court of Appeals.
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Issue:
Does a physician commit battery by administering a medically necessary, life-saving blood transfusion to an unconscious patient who had previously refused transfusions on religious grounds, when those refusals were made before the life-threatening emergency arose?
Opinions:
Majority - Neff, P.J.
No. A physician does not commit battery by providing a life-saving transfusion to an unconscious patient because consent is implied in a medical emergency unless there is a valid, contemporaneous, and fully informed refusal. While a competent adult has the right to refuse medical treatment, this right must be exercised with a full understanding of the consequences. Here, Cindy Werth's refusals were not contemporaneous with the life-threatening emergency; they were made when she believed she was undergoing a routine procedure and did not appreciate the immediate risk of death. The law implies the consent of an unconscious patient for necessary life-saving procedures. To override this implied consent and the medical evidence of necessity, a patient's refusal must be a 'fully conscious contemporaneous decision.' Because Cindy was unconscious and her prior refusals were not made with an understanding of the imminent life-or-death stakes, the doctor's decision to provide the transfusion was not a battery.
Analysis:
This decision establishes a high threshold for enforcing a patient's advance refusal of life-saving medical treatment in an emergency. By requiring the refusal to be both 'fully informed' of the specific, imminent threat and 'contemporaneous' with it, the court prioritizes the preservation of life and protects physicians who act in an emergency to save an incapacitated patient. This creates a significant legal hurdle for battery claims based on pre-written directives or discussions that occurred before a patient's condition became critical. The ruling suggests that general refusals may be deemed legally insufficient when a patient is unconscious and facing an unforeseen, life-threatening crisis.
