Lane v. Candura

Rosaria Candura (defendant) was a widow in her late 70s with some mild senility symptoms. Candura sometimes had difficulty with the concept of time and with concentrating on a thought. Candura was also occasionally hostile, combative, or defensive. Other than these symptoms, Candura was mentally aware and sharp. However, Candura had significant, ongoing gangrene problems in her right foot and lower leg. Candura had two surgeries to remove part of her foot and one toe, but the gangrene continued. Candura’s doctors believed she would probably die unless she had the entire leg amputated to stop the gangrene. At first, Candura agreed to the amputation, but then she changed her mind. Although Candura’s competence had not been questioned when she made her earlier medical decisions, her refusal to agree to the leg amputation prompted concerns about her competence to make her own medical decisions. Two different psychiatrists examined Candura to assess whether she was competent to refuse medical treatment. Candura refused to discuss her decision with one of the psychiatrists, who then determined that she was not competent, possibly because the gangrene was reducing her ability to make decisions. The other psychiatrist was able to convince Candura to discuss the reasons for her decision. Candura said that she had a desire to get well but was not convinced the surgery would accomplish that goal. Candura was also concerned that having only one leg would mean becoming an invalid and either being a burden on her children or living in a nursing home. Candura did not want either situation. Finally, Candura admitted that she had been unhappy as a widow and was not worried about dying. The second psychiatrist determined that Candura was capable of making rational decisions. A court was then asked to determine whether Candura was competent to make her own medical decision to refuse the leg amputation.