Baby F - Oklahoma Supreme Court Requires Clear & Convincing Evidence to Stop Life Support

This week, the Oklahoma Supreme Court issued its opinion in the Baby F case. 



The court held that for children in DHS custody, Oklahoma courts may authorize the withdrawal of life-sustaining

medical treatment or the denial CPR only after determining by clear and convincing evidence that it is in the best interest of the child to do so.



Clear and convincing evidence requires roughly 80% certainty instead of the typical preponderance/probability (>50%) standard in civil law.



Facts of the Case



The 3-month-old baby boy was one of several siblings taken into state custody in 2013, after state officials alleged the mother appeared to be under the influence of substances and the family could not care for the children. The baby had been diagnosed with several anomalies and genetic issues.



The baby's condition continued to deteriorate. A pediatric doctor at The Children's Center Pediatric Rehabilitation Hospital described the baby's prognosis as "grim," and stated that it was the consensus among staff members that care should shift from "aggressive management to palliative so as not to prolong unnecessary suffering and discomfort."



Lower Court Proceedings



The state went to court to seek a do not resuscitate order in December 2014. Oklahoma County District Judge Lisa Tipping Davis granted the state's request over an objection from the baby's attorney, but delayed implementation of her ruling to give the attorney a chance to appeal.



After the baby's condition deteriorated even further, the state went back to court. A proceeding was held in which custody of the baby was returned to his mother and father so they could consent to the do not resuscitate order.  The baby died the next day.



Supreme Court



While the baby died, the Supreme Court proceeded with the case to provide guidance to the lower courts.  



It held that a judge "shall not authorize the withdrawal of life-sustaining medical treatment or the denial of the administration of cardiopulmonary resuscitation on behalf of a child in DHS custody without determining by clear and convincing evidence that doing so is in the best interest of the child."