This section contains the nature of the case and procedural background.

On January 24, 1978, P filed this suit alleging that D was 72 years old, with no available help from relatives; that D resided alone under unsatisfactory conditions as a result of which she had been admitted to and was a patient in Nashville General Hospital; that D suffered from gangrene of both feet which required the removal of her feet to save her life; that D lacked the capacity to appreciate her condition or to consent to necessary surgery. Drs. Amos D. Tackett and R. Benton Adkins stated that D has gangrene on both feet and developed an infection along with the gangrene of her feet. This is placing her life in danger. They stated that D does not understand the severity or consequences of her disease process and does not appear to understand that failure to amputate the feet at this time would probably result in her death. The Chancellor appointed a guardian ad litem to defend the cause. The guardian ad litem stated: that D is presently in the intensive care unit of General Hospital, because of a gangrenous condition in her two feet. D feels very strongly that her present physical condition is improving, and that she will recover without the necessity of surgery. She is in possession of a good memory and recall, responds accurately to questions asked of her, is coherent and intelligent in her conversation, and is of sound mind. She is aware that P has filed this complaint, knows the nature of the complaint, and does not wish for her feet to be amputated. There is no psychiatric report of her mental capacity, and there is proof that she lacks the capacity to realize the need for protective services and the relief P requests should be denied. The court found D is in imminent danger of death and that P is designated responsible for the personal welfare of D. On January 26, 1978, a letter was filed from Dr. John J. Griffin, reporting that he found the patient to be generally lucid and sane, but concluding: ... she is functioning on a psychotic level with respect to ideas concerning her gangrenous feet. She tends to believe that her feet are black because of soot or dirt. She does not believe her physicians about the serious infection. There is an adamant belief that her feet will heal without surgery, and she refuses to even consider the possibility that amputation is necessary to save her life. There is no desire to die, yet her judgment concerning recovery is markedly impaired. ... my impression is that she does not appreciate the dangers to her life. I conclude that she is incompetent to decide this issue. A corollary to this denial is seen in her unwillingness to consider any future plans. Here again, I believe she was utilizing a psychotic mechanism of denial. The risks with surgery are great and her life-style has been permanently disrupted. If she has surgery there is a tremendous danger for physical and psychological complications. I believe she is incompetent to make the decision. The Court entered a further order vacating the stay of the first order and delaying surgery. The guardian ad litem moved for a new trial and stay of previous orders on grounds of the unconstitutionality of the statutes involved. It was denied. The court issued yet another order to P designating and authorizing it to act for and on behalf of D in consenting to the amputation of D's feet at any time that Drs. Amos D. Tackett and R. Benton Adkins join in signing a written certificate that D's condition has developed to such a critical stage as to demand immediate amputation to save her life. The guardian ad litem appealed.

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