Supreme Court of Florida.
STATE of Florida, et al., Appellants,
v.
Wade POWELL, et ux., et al., Appellees.
No. 67755.
Oct. 30, 1986.
Rehearing Denied Dec. 22, 1986.
Petition was filed to review an order of the Circuit Court, Marion County, William T. Swigert, J., finding unconstitutional statute authorizing medical examiners to remove corneal tissue from decedents during statutorily required autopsies when the tissue is needed for transplantation. The District Court of Appeal certified that the case presented a question requiring immediate resolution. The Supreme Court, Overton, J., held that statute rationally promotes permissible state objective of restoring sight to the blind and is thus constitutional.
Reversed and remanded.
Shaw, J., filed a dissenting opinion.
[1] Dead Bodies
1
Statute authorizing medical examiners to
remove corneal tissue from decedents during statutorily required autopsies when
tissue is needed for transplantation rationally promotes permissible state
objective of restoring sight to the blind and is thus constitutional. West's
F.S.A. § 732.9185.
[2] Eminent Domain
2.26
(Formerly 148k2(1.1))
Statute authorizing medical examiners to
remove corneal tissue from decedents during statutorily required autopsies when
tissue is needed for transplantation does not effect taking of private property
by state action for nonpublic purpose in violation of State Constitution. West's
F.S.A. Const. Art. 5, § 3(b)(5); Art. 10, § 6; West's
F.S.A. § 732.9185.
[3] Constitutional Law
82(6.1)
(Formerly 92k82(6))
Right of next of kin to tort claim for
interference with burial does not rise to constitutional dimension of
fundamental right traditionally protected by Constitution.
[4] Constitutional Law
225.1
[4] Dead
Bodies
1
Statute authorizing medical examiners to
remove corneal tissue from decedents during statutorily required autopsies when
tissue is needed for transplantation does not create invidious classification
regarding next of kin of deceased persons, and thus, does not violate equal
protection clause. West's
F.S.A. § 732.9185; West's
F.S.A. Const. Art. 5, § 3(b)(5); U.S.C.A.
Const.Amend. 14.
*1188 Jim Smith, Atty. Gen. and Kenneth
McLaughlin, Asst. Atty. Gen., Tallahassee,
for State of Florida.
Alan C. Sundberg, George N. Meros, Jr. and F.
Townsend Hawkes of Carlton, Fields, Ward, Emmanuel, Smith and Cutler,
Tallahassee, for Medical Eye Bank, Inc., North Florida Lions Eye Bank, Inc.,
and Florida Lions Eye Bank, Inc.
Andrew G. Pattillo, Jr. and Russell W. LaPeer
of Patillo and McKeever, Ocala, for William H. Shutze, M.D., Thomas M. Techman,
M.D., and Keith Gauger.
Craig A. Dennis of Perkins & Collins,
Tallahassee, for Florida Society of Ophthalmology, Inc.
*1189 Donald W. Weidner, Associate Gen.
Counsel, Jacksonville, for Florida Medical Association, Inc.
Robert A. Ginsburg, Dade Co. Atty. and Robert
L. Blake, Asst. Co. Atty., Public Health Division, Jackson Memorial Hospital,
Miami, for Dade County, intervenor.
Jerome J. Bornstein and Mark P. Lang, Staff
Counsel, American Civil Liberties, Orlando, and Stephen T. Maher, American
Civil Liberties Union Foundation of Florida, Inc., University of Miami School
of Law, Coral Gables, for Wade Powell and Freda Powell.
James T. Reich, and Jack Singbush of Jack
Singbush, P.A., Ocala, for Erwin White and Susan White.
Frederick H. von Unwerth of Kilpatrick &
Cody, Washington, D.C., for the Eye Bank Association of America, Inc., amicus
curiae.
Melinda L. McNichols of Arky, Freed, Stearns,
Watson, Greer and Weaver, P.A., Miami, for Reverand Thomas J. Price, amicus
curiae.
Benedict P. Kuehne of Bierman, Sonnett, Shohat
and Sale, P.A., Miami, for the Rabbinical Association of Greater Miami, Temple
Beth Or, and Rabbi Rami Shapiro, PH.D., amicus curiae.
OVERTON, Justice.
This is a petition to review a circuit court
order finding unconstitutional section
732.9185, Florida Statutes (1983), which
authorizes medical examiners to remove corneal tissue from decedents during
statutorily required autopsies when such tissue is needed for
transplantation. The statute prohibits
the removal of the corneal tissue if the next of kin objects, but does not
require that the decedent's next of kin be notified of the procedure. The Fifth
District Court of Appeal certified that this case presents a question of great
public importance requiring immediate resolution by this Court. We accept jurisdiction pursuant to article
V, section 3(b)(5), Florida Constitution, and,
for the reasons expressed below, find that the statute is constitutional.
The challenged statute provides:
Corneal removal by medical examiners.--
(1) In any case in which a patient is in need of corneal
tissue for a transplant, a district medical examiner or an appropriately
qualified designee with training in ophthalmologic techniques may, upon request
of any eye bank authorized under s. 732.918, provide the cornea of a decedent
whenever all of the following conditions are met:
(a) A decedent who may provide a suitable cornea for the
transplant is under the jurisdiction of the medical examiner and an autopsy is
required in accordance with s. 406.11.
(b) No objection by the next of kin of the decedent is
known by the medical examiner.
(c) The removal of the cornea will not interfere with the
subsequent course of an investigation or autopsy.
(2) Neither the district medical examiner nor his
appropriately qualified designee nor any eye bank authorized under s. 732.918
may be held liable in any civil or criminal action for failure to obtain
consent of the next of kin.
The trial court decided this case by summary
judgment. The facts are not in
dispute. On June 15, 1983, James White
drowned while swimming at the city beach in Dunellon, Florida. Associate Medical Examiner Dr. Thomas
Techman, who is an appellant in this cause, performed an autopsy on James' body
at Leesburg Community Hospital. On July
11, 1983, Anthony Powell died in a motor vehicle accident in Marion
County. Medical Examiner Dr. William H.
Shutze, who is also an appellant in this
cause, performed an autopsy on Anthony's body.
In each instance, under the authority of section
732.9185, the medical examiner removed corneal
tissue from the decedent without giving notice to or obtaining consent from the
parents of the decedent.
*1190 James' and Anthony's parents, who
are the appellees in this case, each brought an action claiming damages for the
alleged wrongful removal of their sons' corneas and seeking a judgment declaring
section
732.9185 unconstitutional. [FN1] The actions were
subsequently consolidated.
FN1. The Whites named
as defendants Shutze, Techman, Keith Gauger, who is an investigator for the
medical examiner's office in that district, and the State of Florida. The Powells named as defendants Shutze and
the Monroe Regional Medical Center.
Dade County, The Medical Eye Bank, Inc., North Florida Lions Eye Bank,
Inc., Florida Lions Eye Bank, Inc., Florida Medical Association, Inc., Florida
Society of Ophthalmology, Inc., and Eye Bank Association of America, Inc., were
each permitted to intervene as parties in support of the constitutionality of section
732.9185.
The Reverend Thomas J. Price of the Florida Conference of United
Methodist Churches and the Rabbinical Association of Greater Miami filed amicus
briefs in support of the appellees' position.
In its judgment, the trial court noted that section
732.9185 "has as its purpose the commendable
and laudable objective of providing high quality cornea tissue to those in need
of same," but declared the statute unconstitutional on the grounds that it
(1) deprives survivors of their fundamental personal and property right to
dispose of their deceased next of kin in the same condition as lawful autopsies
left them, without procedural or substantive due process of law; (2) creates an invidious classification which
deprives survivors of their right to equal protection; and (3) permits a taking of private property
by state action for a non-public purpose, in violation of article
X, section 6(a), of the Florida Constitution. The court concluded that the state has no
compelling interest in non-consensual removal of appellees' decedents' corneal
tissue that outweighs the survivors' right to dispose of their sons' bodies in
the condition death left them. [FN2] For the reasons expressed below, we reject
these findings.
FN2. The appellees
also challenged as unconstitutional § 406.11, Fla.Stat. (1983), which provides medical examiners with the authority to
perform autopsies under circumstances enumerated in the statute. The trial court upheld that statutory
provision, and that finding is not challenged in this proceeding.
In addressing the issue of the statute's
constitutionality, we begin with the premise that a person's constitutional
rights terminate at death. See Roe
v. Wade,
410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147 (1973); Silkwood
v. Kerr-McGee Corp.,
637 F.2d 743 (10th Cir.1980), cert. denied,
454
U.S. 833, 102 S.Ct. 132, 70 L.Ed.2d 111 (1981); Guyton
v. Phillips,
606 F.2d 248 (9th Cir.1979), cert. denied,
445
U.S. 916, 100 S.Ct. 1276, 63 L.Ed.2d 600 (1980). If any rights exist, they belong to the
decedent's next of kin.
Next, we recognize that a legislative act
carries with it the presumption of validity and the party challenging a
statute's constitutionality must carry the burden of establishing that the
statute bears no reasonable relation to a permissible legislative
objective. Johns
v. May,
402 So.2d 1166 (Fla.1981). See also Harrah
Independent School District v. Martin,
440 U.S. 194, 198, 99 S.Ct. 1062, 1064, 59 L.Ed.2d 248 (1979). In determining
whether a permissible legislative objective exists, we must review the evidence
arising from the record in this case.
The unrebutted evidence in this record
establishes that the State of Florida spends approximately $138 million each
year to provide its blind with the basic necessities of life. At present, approximately ten percent of
Florida's blind citizens are candidates for cornea transplantation, which has
become a highly effective procedure for restoring sight to the functionally
blind. As advances are made in the
field, the number of surgical candidates will increase,
thereby raising the demand for suitable corneal tissue. The increasing number of elderly persons in
our population has also created a great demand for corneas because corneal
blindness often is age-related.
Further, an affidavit in the record states:
Corneal transplants are particularly important in
newborns. The brain does not learn to
see if the cornea is not clear. There
is a critical period in the first few months of life when the brain
"learns to *1191 see."
If the cornea is not clear, the brain not only does not "learn to
see," but the brain loses its ability to "learn to see." Hence, corneal transplant in children must
be made as soon as practicable after the problem is discovered. Without the medical examiner legislation,
there would be virtually no corneal tissue available for infants and these
children would remain forever blind.
The record reflects that the key to
successful corneal transplantation is the availability of high-quality corneal
tissue and that corneal tissue removed more than ten hours after death is
generally unsuitable for transplantation. The implementation of section
732.9185 in 1977 has, indisputably, increased
both the supply and quality of tissue available for transplantation. Statistics
show that, in 1976, only 500 corneas were obtained in Florida for
transplantation while, in 1985, more than 3,000 persons in Florida had their
sight restored through corneal transplantation surgery.
The record also demonstrates that a
qualitative difference exists between corneal
tissue obtained through outright donation and tissue obtained pursuant to section
732.9185.
In contrast to the tissue donated by individuals, which is largely
unusable because of the advanced age of the donor at death, approximately
eighty to eighty-five percent of tissue obtained through medical examiners is
suitable for transplantation. The
evidence establishes that this increase in the quantity and quality of
available corneal tissue was brought about by passage of the statute and is, in
large part, attributable to the fact that section
732.9185 does not place a duty upon medical
examiners to seek out the next of kin to obtain consent for cornea
removal. An affidavit in the record
reveals that, before legislation authorized medical examiners in California to
remove corneas without the consent of the next of kin, the majority of the
families asked by the Los Angeles medical examiner's office responded
positively; however, approximately
eighty percent of the families could not be located in sufficient time for
medical examiners to remove usable corneal tissue from the decedents.
An autopsy is a surgical dissection of the
body; it necessarily results in a
massive intrusion into the decedent.
This record reflects that cornea removal, by comparison, requires an
infinitesimally small intrusion which does not affect the decedent's
appearance. With or without cornea
removal, the decedent's eyes must be capped to maintain a normal appearance.
Our review of section
732.9185 reveals certain safeguards which are apparently designed to limit cornea removal to
instances in which the public's interest is greatest and the impact on the next
of kin the least: corneas may be removed
only if the decedent is under the jurisdiction of the medical examiner; an autopsy is mandated by Florida law; and the removal will not interfere with the
autopsy or an investigation of the death.
Further, medical examiners may not automatically remove tissue from all
decedents subject to autopsy; rather, a
request must be made by an eye bank based on a present need for the tissue.
[1] We conclude that this record clearly establishes that this
statute reasonably achieves the permissible legislative objective of providing
sight to many of Florida's blind citizens.
We next address the trial court's finding that
section
732.9185 deprives appellees of a fundamental
property right. All authorities
generally agree that the next of kin have no property right in the remains of a
decedent. Although, in Dunahoo
v. Bess,
146 Fla. 182, 200 So. 541 (1941), this Court held
that a surviving husband had a "property right" in his wife's body
which would sustain a claim for negligent embalming, id.
at 183, 200 So. at 542, we subsequently clarified
our position to be consistent with the majority view that the right is limited
to "possession of the body ... for the purpose of burial, sepulture or
other lawful disposition," and that interference with this right gives
rise to a tort action. [FN3] *1192Kirksey v. Jernigan,
45
So.2d 188, 189 (Fla.1950). More recently, we affirmed the district
court's determination that the next of kin's right in a decedent's remains is
based upon "the personal right of the decedent's next of kin to bury the
body rather than any property right in the body itself." Jackson
v. Rupp,
228 So.2d 916, 918 (Fla. 4th DCA 1969), affirmed,
238
So.2d 86 (Fla.1970). The view that the next of kin has no
property right but merely a limited right to possess the body for burial
purposes is universally accepted by courts and commentators. See Lawyer
v. Kernodle,
721 F.2d 632 (8th Cir.1983); Sinai
Temple v. Kaplan,
54 Cal.App.3d 1103, 127 Cal.Rptr. 80 (1976); Dougherty
v. Mercantile-Safe Deposit & Trust Co.,
282 Md. 617, 387 A.2d 244 (Ct.App.1978); Finn
v. City of New York,
70 Misc.2d 947, 335 N.Y.S.2d 516 (Civ.Ct.1972), rev'd
on other grounds, 76
Misc.2d 388, 350 N.Y.S.2d 552 (Sup.Ct.1973); Sullivan
v. Catholic Cemeteries, Inc.,
113 R.I. 65, 317 A.2d 430 (1974); Sadler & Sadler, Transplantation and
the Law: The Need for Organized
Sensitivity, 57 Geo. L.J. 5 (1968);
Sanders & Dukeminier, Medical Advance and Legal Lag: Hemodialysis and Kidney Transplantation,
15 U.C.L.A.L.Rev. 357 (1968). Prosser
states:
FN3. The American Law
Institute sets forth the tort of interfering with the "right of
burial" as follows: "One who
intentionally, recklessly or negligently removes, withholds, mutilates or
operates upon the body of a dead person or
prevents its proper interment or cremation is subject to liability to a member
of the family of the deceased who is entitled to the disposition of the
body." Restatement
(Second) of Torts § 868 (1979).
A number of decisions have involved the mishandling of dead
bodies.... In these cases the courts
have talked of a somewhat dubious "property right" to the body,
usually in the next of kin, which did not exist while the decedent was living,
cannot be conveyed, can be used only for the one purpose of burial, and not
only has no pecuniary value but is a source of liability for funeral
expenses. It seems reasonably obvious
that such "property" is something evolved out of thin air to meet the
occasion, and that it is in reality the personal feelings of the survivors
which are being protected, under a fiction likely to deceive no one but a
lawyer.
W. Prosser, The Law of Torts, 43-44
(2d ed. 1955) (footnotes omitted). The
Maryland Court of Appeals has summarized the law as follows:
It is universally recognized that there is no property in a
dead body in a commercial or material sense.
"[I]t is not part of the assets of the estate (though its
disposition may be affected by the provision of the will); it is not subject to replevin; it is not property in a sense that will
support discovery proceedings; it may
not be held as security for funeral costs;
it cannot be withheld by an express company, or returned to the sender,
where shipped under a contract calling for
cash on delivery; it may not be the
subject of a gift causa mortis;
it is not common law larceny to steal a corpse. Rights in a dead body exist ordinarily only
for purposes of burial and, except with statutory authorization, for no other
purpose." Snyder
v. Holy Cross Hosp.,
30 Md.App. 317 at 328 n. 12, 352 A.2d 334 at 340,
quoting P.E. Jackson, The Law of Cadavers and of Burial and Burial Places
(2d ed. 1950).
Dougherty,
282 Md. at 620 n. 2, 387 A.2d at 246 n. 2.
[2] Under the facts and circumstances of these cases, we find
no taking of private property by state action for a non-public purpose in
violation of article
X, section 6, of the Florida Constitution. We note that the right to bring an action in
tort does not necessarily invoke constitutional protections. Decisions of the United States Supreme Court
have clearly established that the loss of a common law right by legislative act
does not automatically operate as a deprivation of substantive due
process. Tort actions may be restricted
when necessary to obtain a permissible legislative objective. See Duke
Power Co. v. Carolina Environmental Study Group, Inc.,
438 U.S. 59, 88 n. 32, 98 S.Ct. 2620, 2638 n. 32, 57 L.Ed.2d 595 (1978).
*1193 [3] Appellees also assert that their right to control the
disposition of their decedents' remains is a fundamental right of personal
liberty protected against unreasonable governmental intrusion by the due process clause. Appellees argue that, because the statute
permits the removal of a decedent's corneas without reference to his family's
preferences, it infringes upon a right, characterized as one of religion,
family, or privacy, which is fundamental and must be subjected to strict
scrutiny. Appellees rely upon a line of
decisions from the United States Supreme Court which recognize the freedom of
personal choice in matters of family life as one of the liberties protected by
the due process clause. See, e.g., Cleveland
Board of Education v. LaFleur,
414 U.S. 632, 94 S.Ct. 791, 39 L.Ed.2d 52 (1974);
Roe
v. Wade,
410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147 (1973);
Wisconsin
v. Yoder,
406 U.S. 205, 92 S.Ct. 1526, 32 L.Ed.2d 15 (1972).
Appellees also point out that the United States Supreme Court has found rights
to personal privacy in connection with activities relating to marriage, Boddie
v. Connecticut,
401 U.S. 371, 91 S.Ct. 780, 28 L.Ed.2d 113 (1971);
procreation, Skinner
v. Oklahoma,
316 U.S. 535, 62 S.Ct. 1110, 86 L.Ed. 1655 (1942); contraception, Griswold
v. Connecticut,
381 U.S. 479, 85 S.Ct. 1678, 14 L.Ed.2d 510 (1965); abortion, Roe v. Wade; and child-rearing and education, Pierce
v. Society of Sisters,
268 U.S. 510, 45 S.Ct. 571, 69 L.Ed. 1070 (1925). According to appellees, the theme which runs
through these cases, and which compels the invalidation of section
732.9185, is the protection from governmental
interference of the right of free choice in decisions of fundamental importance
to the family.
We
reject appellees' argument. The cases
cited recognize only freedom of choice concerning personal matters involved in
existing, ongoing relationships among living persons as fundamental or
essential to the pursuit of happiness by free persons. We find that the right of the next of kin to
a tort claim for interference with burial, established by this Court in Dunahoo,
does not rise to the constitutional dimension of a fundamental right
traditionally protected under either the United States or Florida
Constitution. Neither federal nor state
privacy provisions protect an individual from every governmental intrusion into
one's private life, see Florida
Board of Bar Examiners Re: Applicant,
443 So.2d 71 (Fla.1983), especially when a
statute addresses public health interests.
Whalen
v. Roe,
429 U.S. 589, 97 S.Ct. 869, 51 L.Ed.2d 64 (1977)
(state accorded wide latitude in constitutional privacy terms to safeguard
health); Roe v. Wade (review less
exacting when state asserts effort to safeguard health).
The record contains no evidence that the
appellees' objections to the removal of corneal tissues for human transplants
are based on any "fundamental tenets of their religious beliefs." Wisconsin
v. Yoder,
406 U.S. at 218, 92 S.Ct. at 1534. "[T]he very concept of ordered liberty
precludes allowing every person to make his own standards on matters of conduct
in which society as a whole has important interests." Id.
at 215-16, 92 S.Ct. at 1533.
[4] We also reject the trial court's finding that section
732.9185 creates
an invidious classification regarding the next of kin of deceased persons. "Legislatures have wide discretion in
passing laws that have the inevitable effect of treating some people
differently from others." Parham
v. Hughes,
441 U.S. 347, 351, 99 S.Ct. 1742, 1745, 60 L.Ed.2d 264 (1979). We find that the
statute's effect on the next of kin is incidental and does not offend equal
protection.
In view of our finding that the appellees have
no protectable liberty or property interest in the remains of their decedents,
we need not address the argument that section
732.9185 violates procedural safeguards
guaranteed by the due process clause. See
Board
of Regents v. Roth,
408 U.S. 564, 92 S.Ct. 2701, 33 L.Ed.2d 548 (1972).
In conclusion, we hold that section
732.9185 is constitutional because it rationally
promotes the permissible state objective of *1194 restoring sight to the
blind.
[FN4] In
so holding, we note that laws regarding the removal of human tissues for
transplantation implicate moral, ethical, theological, philosophical, and
economic concerns which do not readily lend themselves to analysis within a
traditional legal framework. Applying
constitutional standards of review to section
732.9185 obscures the fact that at the heart of
the issue lies a policy question which calls for a delicate balancing of
societal needs and individual concerns more appropriately accomplished by the
legislature.
FN4. Courts in Georgia and Michigan have upheld the
constitutionality of cornea removal statutes similar to Florida's. See Georgia
Lions Eye Bank, Inc. v. Lavant,
255 Ga. 60, 335 S.E.2d 127 (1985), cert.
denied, 475
U.S. 1084, 106 S.Ct. 1464, 89 L.Ed.2d 721 (1986); Tillman
v. Detroit Receiving Hospital,
138 Mich.App. 683, 360 N.W.2d 275 (1984).
For the reasons expressed, we reverse the
trial court's order and remand this cause to the trial court with directions to
enter judgment consistent with this opinion.
It is so ordered.
McDONALD, C.J., and ADKINS, BOYD, EHRLICH and
BARKETT, JJ., concur.
SHAW, J., dissents with an opinion.
SHAW, Justice, dissenting.
Before setting out my disagreements with the
substance of the majority opinion, it is necessary to first clarify the
procedural posture of these cases.
The
Whites brought a complaint in four counts against appellants Gauger, Techman
and Shutze concerning the circumstances surrounding an autopsy and cornea
removal performed on their teenage son following his accidental drowning on 15
June 1983. Techman and Shutze are
medical doctors and, respectively, an assistant medical examiner and the
medical examiner in the Fifth Judicial Circuit. Gauger is a non-medical investigator in
Marion County. As amended in four
counts, the complaint alleges, inter alia, as follows. Count I alleges that the Whites had objected
to the autopsy and any alteration of their son's body; that no cause of death other than accidental
drowning was reasonable in that five persons, including an off-duty highway
patrolman, had witnessed the drowning;
that appellant Shutze had established a policy and mechanism for
performing autopsies on all drowning victims contrary to section
406.11, Florida Statutes (1981); that decisions on autopsies in Marion County
are made by Gauger, a private employee of Shutze & Techman P.A., who
obtains and transports bodies to Lake County where autopsies are performed; that appellant Shutze permitted Gauger to
falsely represent himself as a member of the medical examiner's staff; that Shutze & Techman P.A. performed
autopsies on a piecework basis and directly benefited from the number of
autopsies performed; that the autopsy was
performed contrary to section
872.04, Florida Statutes (1981); that appellant Gauger was untrained in opthamology and unqualified to be designated
under section
732.9185, Florida Statutes (1981), as a person to
provide corneas; that conditions
precedent to removal of corneas under section
732.9185 were not met; and that the Whites have suffered damages by
reason of extreme mental pain and anguish for which compensatory and punitive
damages should be paid. Counts II and
III are actions pursuant to chapter 86, Florida Statutes (1981), seeking
declaratory judgments as to the Whites' rights, duties, and privileges under sections
732.9185 and 406.11 which allege that both sections are unconstitutional both
facially and as applied. Count IV is an
action alleging violation of civil rights under Title
42, U.S.C. § 1983 and the United States Constitution.
The Powells also brought a complaint in four
counts against appellants Shutze and Monroe Regional Medical Center (MRMC)
concerning the autopsy and cornea removal performed on their twenty-year-old
son following his death in a single vehicle accident on 11 July 1983. Count I alleges that appellants performed an
arbitrary, capricious and unlawful autopsy and removed corneas without meeting
the conditions precedent of section
732.9185.
Count II *1195 alleges that section
732.9185 is facially unconstitutional and
directly contrary to section
732.910, et seq., Florida Statutes (1981). Counts
III and IV allege mental anguish and financial loss caused by, respectively, appellants Shutze and MRMC.
The two cases were consolidated and came
before the trial judge on motions for summary judgment. In the order under appeal, the trial judge
found that section
406.11 was constitutional on its face and as
applied, but that section
732.9185 was facially unconstitutional. The trial judge did not rule on a motion
that section
732.9185 was unconstitutional as applied. The order comes directly to us on the
certification of the Fifth District Court of Appeal that it contains a question
of great public importance which requires immediate resolution.
The only question legitimately before us is
whether the trial court erred in granting a summary judgment that section
732.9185 is facially unconstitutional. In the present posture of the case, we are
not presented with the issues of whether sections
406.11 and 732.9185 were complied with in performing these autopsies and
cornea removals, of whether the two sections have been constitutionally
applied, of whether section
406.11 is facially constitutional, of whether any
or all of the appellants are liable, and of the Whites' rights, duties and
privileges under sections
406.11 and 732.9185. Without
specifying that it is addressing the narrow issue of the facial
constitutionality of section
732.9185, the majority opinion addresses a wide
range of issues which are only tenuously related to the narrow issue before us.
The majority then reverses and remands with directions that a judgment
for appellants (defendants) be entered.
In my view this disposition is completely premature. My review of the record indicates there are
substantial questions of material fact which preclude entry of summary
judgments for the defendants.
The thrust of the majority opinion appears to
be that the state and its agents have an unqualified right to the body of a
decedent provided at some point the remains of the remains are turned over to
the next of kin. I do not believe this
is the law. I am persuaded, as was the
trial judge below, that since time immemorial it has been the duty and the
right of the next of kin to take control, possession, and custody of the body
and remains of a deceased family member.
These duties and rights, predicated on religious, moral, and
philosophical grounds, were recognized at common law and were not totally
surrendered to the state when our constitutions were adopted. These rights are not only reserved to the
people under article
I, section 1 of the Florida Constitution, but are
affirmatively protected as religious, liberty, and privacy rights under article
I, sections 3, 9, and 23 and by various statutes of the state.
The scope of the common law and the rights
retained by the people should not, in my view, be narrowly construed. As the United States Supreme Court has said:
What is the common law?
According to Kent: "The
common law includes those principles, usages, and rules of action applicable to
the government and security of person and property, which do not rest for their
authority upon any express and positive declaration of the will of the
legislature." 1 Kent, Com. 471. As Blackstone says: "Whence it is that in our law the
goodness of a custom depends upon its having been used time out of mind; or, in the solemnity of our legal phrase,
time whereof the memory of man runneth not to the contrary. This it is that gives it its weight and
authority; and of this nature are the
maxims and customs which compose the common law, or lex non scripta, of
this Kingdom. This unwritten, or
common, law is properly distinguishable into three kinds: 1. General customs; which are the universal rule of the whole
Kingdom, and form the common law, in its stricter and more usual
signification." 1 Bl.Com. 67. In Black's Law Dictionary, page 232, it is
thus defined: "As distinguished
from law created by the enactment of legislature, the common law comprises the
body of those principles and rules of action *1196 relating to the
government and security of persons and property, which derive their
authority solely from usages and customs of immemorial antiquity, or from
the judgments and decrees of the courts recognizing, affirming, and enforcing
such usages and customs; and, in this sense, particularly the ancient unwritten law
of England."
Western
Union Telegraph Co. v. Call Publishing Co.,
181 U.S. 92 101-02, 21 S.Ct. 561, 564, 45 L.Ed. 765 (1901) (emphasis supplied).
The right to privacy under section
23 is particularly pertinent in my view because
the right to be let alone and to be free from government intrusion into private
life is, in large part, simply a constitutional affirmation of common law
rights and customs surrounding the exercise of private, as contrasted to
public, liberties. The right to possess
and control the body of a deceased loved one and to honor and celebrate the
decedent's life and death through appropriate commemoration is a quintessential
privacy right.
These personal rights of the next of kin are
qualified only by the overriding police power of the state to regulate the care
and disposition of dead bodies for the protection of public health and
welfare. I have no doubt that the state
may require an autopsy when there is a founded suspicion that death was by criminal
action, when there is a likelihood that the death was caused by a communicable
disease, or, even, when the death is simply inexplicable and the cause needs to
be determined. I do not agree that the
agents of the state may be constitutionally granted carte blanche to conduct
autopsies based on whim, bureaucratic convenience, curiosity, pecuniary gain,
or "policy." A significant
question of material fact is whether the agents exceeded their statutory authority and we should have this
issue resolved before we address the constitutionality of the statutes. The record consists largely of a series of
depositions and affidavits taken or given in connection with the Whites'
complaint and with the motions for summary judgments. The Powells' complaint was filed well after
the Whites' complaint and contains little of record.
The assistant state attorney assigned to
Marion County was deposed and testified as follows regarding the policy of
performing autopsies. He was of the
opinion that autopsies should be conducted on all drowning and vehicle accident
victims and had communicated this policy to the medical examiner and law
enforcement personnel. Autopsies were
necessary even if there was no suggestion of criminal culpability or doubt
about the cause of death. Autopsies were needed in case there were civil suits
arising from the death and were important to insurance companies, families, and
anyone who might have an interest in the facts. He did not believe the medical examiner had
discretion to forego an autopsy when one of the enumerated circumstances of section
406.11 existed, for example, an accidental
death. He had conducted an
investigation into the cornea removals from decedent White and found the
removals were performed on the authority of the investigator, appellant
Gauger. Further, in his opinion, there
had been an objection by the White family to
the removal of the corneas prior to their removal.
The medical examiner, appellant Shutze,
recited the following in two affidavits.
It is the policy of the medical examiner's office to perform full
autopsies on all persons who die in Marion County by accident, including,
specifically, drowning or motor vehicle accidents. The medical examiner bases this policy on section
406.11 and the request of the state attorney's
office. The purposes of autopsies are to
(1) determine cause of death, (2) identify health or safety hazards, (3) obtain
evidence of criminal conduct, and (4) advance the understanding of medical
science. Appellant Gauger is an
investigator working for appellant Shutze's professional association; he is not an employee of the medical
examiner's office. Appellant Gauger has
been instructed to notify the medical examiner's office of all deaths in Marion
County. Appellant Gauger is the medical
examiner's authorized designee for Marion County under section
732.9185.
The medical examiner or an assistant *1197 medical examiner makes
the final decision on whether an autopsy should be performed in each specific
instance. Appellant Techman performed
the autopsy on the Whites' decedent and appellant Shutze performed the autopsy
on the Powells' decedent. Objections to
autopsies are considered but the final decision is made by the medical examiner
or assistant medical examiner.
Objections to cornea removals are not solicited but are honored if known.
Eye bank personnel, not the medical examiner's office, determine the
suitability of corneas for transplant.
The assistant medical examiner, appellant
Techman, in an affidavit recited statements on the general policy and practices
of the medical examiner's office which parallel those of appellant Shutze. In addition, appellant Techman recited that
he performed the White autopsy and signed the death certificate. He alone made
the decision to perform the autopsy, relying on policy, section
406.11, and the request of the state attorney's
office. He had no police report
available and his only knowledge of the circumstances surrounding the death was
based on the investigator's report by appellant Gauger. The report reflected the contact with the
family but did not indicate any objection to an autopsy. Had there been any, he would nevertheless
have performed the autopsy. He had no
knowledge that the corneas were going to be removed, did not authorize their
removal, and learned of their removal for the first time when he began the
autopsy.
Appellee White was deposed and testified as
follows. He was called to the hospital
where his son's body had been taken and met with appellant Gauger. He never met or talked with appellants Shutze
and Techman. Appellant Gauger told him
that the son's death was a simple accidental drowning with no suggestion of
foul play. However, he was told state
law required an autopsy be performed and
that the body was to be shipped to another county for that autopsy. Appellee
White objected strenuously to the autopsy but believed he had no recourse under
the law and asked that the intrusion be kept to a minimum. Appellant Gauger
told him it would only be necessary to make a small incision into the chest to
probe the lungs. Nothing was said of
cornea removal and he only learned of it when he viewed his son's body at the
funeral home following the return of the body after the autopsy. The body's eyes, particularly the right eye,
were noticeably sunken into the skull.
The funeral director explained this sunken condition of the eyes as
caused by the cornea removal.
The record also contains minor corrections to
a deposition by appellant Gauger.
However, the deposition itself is not contained in the record. This deposition could be highly significant
in that appellant Gauger appears to be the central figure in these episodes.
Attempting to recount all of the significant
questions of material fact which appear on the face of this record would be
excessively burdensome and would be of little benefit at this stage of the
proceedings. Moreover, any list would
likely be incomplete. It is
appropriate, however, to refer to several as illustrative of the issues not yet
addressed. The two overarching issues
are, first, whether the policies and practices of the medical examiner's office
followed in these two cases are consistent with the provisions of sections 406.11 and 732.9185. Second, assuming
the statutes were complied with, were they constitutionally applied. Section
925.09, Florida Statutes (1981), authorizes the
state attorney to have an autopsy performed when "it is necessary in
determining whether or not death was the result of a crime." Two significant questions of material fact
engendered by this section are whether these two autopsies, and accompanying
cornea removals, were performed under the authority of the state attorney, and,
if so, was that authority legally exercised.
Section
406.11(1) authorizes the medical examiner to
perform such autopsies as he deems necessary to determine the cause of
death. An additional question of
material fact is whether the medical examiner's office has a policy or practice
of performing autopsies on all accident victims, specifically drowning *1198
and vehicle accident victims. In this
connection, I note also section
872.01, Florida Statutes (1981), titled Dealing
in dead bodies; section
872.04, Florida Statutes (1981), titled Autopsies; consent required, exception; and chapter 936, Florida Statutes (1981),
titled Inquests of the Dead.
Significant questions of material fact also arise in connection with section
732.9185.
Two general questions, with numerous subsidiary questions, are whether
the conditions precedent to cornea removal were present and whether the
provisions of section
732.9185 were followed. The issue of the constitutionality of sections
406.11 and 732.9185, as applied, is inchoate at this stage of the proceeding.
The legislature is apparently of the view,
contrary to the majority, that a decedent's next of kin have the right to
possess and control the decedent's body and that both the decedent and next of
kin may control the removal and donation of human organs. The various provisions of chapter 245,
Florida Statutes (1981), titled Disposition of Dead Bodies, are grounded
on the right of the next of kin to claim control and possession of dead
bodies. Section 245.07 appears to rule
out the state's use of dead bodies for the advancement of medical science
unless the bodies are unclaimed or donated under section 245.11. [FN1] On the question of the donation and removal
of organs, chapter 732, part X, Florida Statutes (1985), authorizes and
establishes programs whereby both the decedent and survivors may donate organs
of a decedent. Section 732.912 is
particularly pertinent. Subsection (1)
authorizes the donation of organs by will;
subsection (2) authorizes the donation of a decedent's organs by next of
kin in a priority order and also recognizes the right of next of kin to veto
the removal or donation of organs. Moreover, section
732.9185(1)(b) itself recognizes the right of the
next of kin to veto the donation of the cornea. [FN2] The crucial point
is that part X of chapter 732 is grounded on the right of the decedent and next
of kin to control the removal and disposition of organs taken from the body of
the decedent. If this is not so, part X is grounded on
air. It is a conundrum in that it is
simply not legally possible nor permissible to donate or control the donation
of an article which does not belong to the donor.
FN1. This does not
mean that medical science may not be advanced as a by-product of
autopsies which are legally conducted for other reasons under § 406.11. It does suggest, however, that advancement
of medical science, without more, is not legal justification for conducting an
autopsy on bodies which come into the hands of the medical examiner.
FN2. Section
732.9185(1)(b) states: "[n]o objection by the next of kin of
the decedent is known by the medical examiner." Subsection (2) provides that the medical examiner
will not be held liable for "failure to obtain consent of the next of
kin." The words "failure to
obtain" suggest an unsuccessful effort.
These provisions are apparently being interpreted as authority not to
seek consent from next of kin who are physically present and readily available
to grant or deny consent. Is that the
legislative intent? The trial court
should hear arguments and address this point.
I agree that these cases present issues of
great public importance which may, at some point, require this Court's
attention. At this point, however,
there is substantial doubt that sections
406.11 and 732.9185 have been correctly interpreted and applied by the
cognizant authorities in Marion County.
The issues presented by these suits, particularly the counts requesting
a declaratory judgment of the rights, duties, and privileges of the next of
kin, are likely to be with us a long time and to become even more intense as
medical science advances and organ transplants increase in number. I am simply
not prepared to rush to judgment on issues as important as these based on a
summary judgment. These issues are
important, but we are not a legislative body rushing to enact emergency
legislation to meet an urgent state need before the end of a legislative
session. These cases should be remanded
with instructions that the trial go forward and a record be developed.
497 So.2d 1188, 11 Fla. L. Weekly 557
END OF
DOCUMENT