Opinion ID: 1318692
Heading Depth: 1
Heading Rank: 3

Heading: state's power to order ect

Text: [4, 5] The State can act in derogation of Schuoler's right to refuse ECT even if that right is constitutionally protected. A state can limit even fundamental liberty interests by regulations (1) justified by a compelling state interest, and (2) narrowly drawn. Roe v. Wade, 410 U.S. 113, 35 L.Ed.2d 147, 93 S.Ct. 705 (1973). These strict due process guidelines are appropriate for limiting the application of RCW 71.05.370(7). We conclude that a court can order imposition of ECT upon a nonconsenting involuntarily committed patient when the petitioning party proves (1) a compelling state interest to administer ECT, and (2) that ECT is both necessary and effective for furthering that interest. In prior cases this court has acknowledged certain state interests sufficiently compelling to justify overriding a patient's objection to medical treatment. Four state interests commonly listed are: (1) the preservation of life; (2) the protection of interests of innocent third parties; (3) the prevention of suicide; and (4) maintenance of the ethical integrity of the medical profession. Ingram, at 842, quoting Colyer, at 122. Thus to satisfy the first prong of the due process inquiry a court asked to order ECT for a nonconsenting patient should consider whether a countervailing state interest as compelling as those listed in Ingram and Colyer exists. [4] To satisfy the second prong of the due process inquiry a court must determine whether ECT is both necessary and effective. The court should consider medical prognosis with and without the treatment, as well as alternative treatments available. Finally, after making both inquiries, the court should set forth relevant findings to support its conclusions. In this case, the court's decision begins to meet constitutional requirements. The doctors' testimony reveals a compelling state interest in treating Schuoler. Dr. McCarthy testified that because of her disabilities and repeated admissions to medical facilities Schuoler has constituted a tremendous financial burden for the State, Report of Proceedings, at 15; Dr. Hardy testified that without treatment Schuoler may end up in the back wards of [a] state hospital, a helpless creature that nobody can ever take care of. Report of Proceedings, at 53. Both doctors testified that drug therapy was not helping Schuoler, and that with ECT she had an 80 percent chance of recovery.