The New Jersey Supreme Court has ruled that an affidavit of merit is required in a medical malpractice suit filed by a hospital patient who pulled out a breathing tube and refused to have it reinserted.

The justices said a jury could not reach a determination as to a nurse’s responsibility under these circumstances without the benefit of expert opinion on the appropriate balance between patient autonomy and prescribed treatment. The patient was within her right to refuse reinsertion of the breathing tube, and the right to make decisions concerning one’s body is protected by statute and by the federal constitutional right of privacy, the court said.