Opinion ID: 2062379
Heading Depth: 2
Heading Rank: 1

Heading: In re A.C.

Text: Relying primarily on this court's reference in In re A.C., 573 A.2d 1235, 1243 (D.C.1990) (en banc), to the tenet common to all [5] medical treatment cases: that any person has the right to make an informed choice, if competent to do so, to accept or forego medical treatment, Khiem contends that the trial judge's order unlawfully overrode his common law right to bodily integrity. [6] He claims that before authorizing psychotropic medication, the trial judge was required to make a determination whether Khiem was competent to decide whether such medication should be administered to him. Khiem further maintains that if the judge found him not to be competent to make that decision, then the judge was obliged to apply the principle of substituted judgment to ascertain what Khiem's wishes would have been if he had been competent to decide. See A.C., supra, 573 A.2d at 1249-51; In re Boyd, 403 A.2d 744, 750-52 (D.C.1979). Extracting A.C. from its context, [7] Khiem evidently maintains that in light of our decision in that case, trial judges are now without authority, as a matter of local common law, to order any medical treatment over a patient's objection, whether that objection is interposed directly by the patient or indirectly through the substituted judgment process. This rule, according to Khiem, is absolute; the court in A.C., he insists, recognized no limits on who is protected by this common law principle. Our decision in A.C., as Khiem interprets it, would effectively enable a criminal defendant in his position to determine unilaterally whether he may be brought to trial. We discern nothing in A.C. which would support such a one-sided doctrine. Khiem's bold approach derives any vitality which it may have from the court's use in the A.C. opinion of the words all, 573 A.2d at 1243, and every, id. at 1247. We recently reiterated in United States v. Alston, 580 A.2d 587, 594 n. 12 (D.C.1990), that this type of argument is predicated on a misconception of the nature and uses of judicial precedent, and therefore makes far too much out of too little: In Kraft v. Kraft, 155 A.2d 910 (D.C. 1959), the court pointed out that: It is well to remember that significance is given to broad and general statements of the law only by comparing the facts from which they arise with those facts to which they supposedly apply. 155 A.2d at 913. See also Armour & Co. v. Wantock, 323 U.S. 126, 132-33, 65 S.Ct. 165, 168, 89 L.Ed. 118 (1944), where the Supreme Court aptly stated: It is timely again to remind counsel that words of our opinions are to be read in the light of the facts of the order under discussion. To keep opinions within reasonable bounds precludes writing into them every limitation or variation which might be suggested by the circumstances of cases not before the Court. General expressions transposed to other facts are often misleading. (Emphasis added.) This court specifically noted in A.C., supra, 573 A.2d at 1245-46, that the right to accept or reject medical treatment is not absolute. We commented that our discussion of the circumstances in which a patient's wishes may be overridden, even in the context of the case then before us, presupposed a major bodily invasion, and we explicitly declined to draw the line between major and minor surgery. Id. at 1246 & n. 10. We found it unnecessary to decide, see A.C., supra, 573 A.2d at 1246 & n. 11, whether Hughes v. United States, 429 A.2d 1339 (D.C.1981) and United States v. Crowder, 177 U.S.App.D.C. 165, 543 F.2d 312 (1976), cert. denied, 429 U.S. 1062, 97 S.Ct. 788, 50 L.Ed.2d 779 (1977), both upholding as reasonable minor surgical intrusions under the skin to remove bullets from criminal suspects, would be decided differently in light of Winston v. Lee, 470 U.S. 753, 105 S.Ct. 1611, 84 L.Ed.2d 662 (1985), in which the Supreme Court rejected the government's request to recover a bullet from a defendant's chest by major surgery requiring a general anesthetic. Our discussion in the A.C. opinion of those cases necessarily recognized that law enforcement interests might be implicated in other cases, but we refrained from opinion on questions unrelated to the merits of the case before us. This court thus explicitly left open in A.C. the very kinds of issues which Khiem now claims to be foreclosed by that decision. A.C. was not about, and could not decide, how much weight should be given in the judge's calculus to the government's interest in bringing to trial an accused who has been indicted for premeditated murder. The United States never had the opportunity in A.C. to present that law enforcement interest for the court's consideration. A.C. may not be converted, by barristerial ingenuity or judicial alchemy, into a sweeping rejection of contentions which were neither before the court nor relevant to the issues then at hand. We therefore cannot give A.C. the significance for the present controversy which Khiem attributes to it.