Opinion ID: 795353
Heading Depth: 4
Heading Rank: 2

Heading: Balancing Interests

Text: 35 A determination that a prisoner's right to refuse medical treatment has been impaired does not end the inquiry. A prisoner can establish liability for the violation of a constitutional right only if his individual liberty interest outweighs the relevant countervailing state interests. Turner, 482 U.S. at 89, 107 S.Ct. 2254. The prisoner's interest in being provided with information about proposed medical treatment and his right to refuse that treatment must be balanced against the state's interest in effective prison administration. The importance of this state interest is not open to debate, and the Supreme Court has instructed us generally as to where to strike the balance between the state's interest and prisoners' constitutional rights: The state may infringe upon a prisoner's constitutional rights so long as the infringing regulation or policy is `reasonably related to legitimate penological interests.' Washington, 494 U.S. at 223, 110 S.Ct. 1028(quoting Turner, 482 U.S. at 89, 107 S.Ct. 2254). This standard applies when determining the validity of a prison regulation claimed to infringe on an inmate's constitutional rights ... even when the constitutional right claimed to have been infringed is fundamental, and the State under other circumstances would have been required to satisfy a more rigorous standard of review. Id. at 223, 110 S.Ct. 1028. 36 Therefore a prisoner's right to refuse medical treatment need not be honored if legitimate penological interests require the prisoner to be treated. If prison officials, including doctors, identify situations in which they reasonably believe that treatment is required, notwithstanding the prisoner's asserted right to refuse it, the right must give way. Obvious examples would be the treatment of an infectious disease, avoidance of contaminations, or prevention of disruption by illness-induced behaviors. On the other hand, one can conceive of instances when legitimate penological interests would not justify interfering with a prisoner's rights to medical information and to refuse treatment, such as end-of-life decisions. Thus, a prison may compel a prisoner to submit to treatment despite his general right to refuse such treatment when prison officials, in the exercise of professional judgment, deem it necessary to carry out legitimate penological objectives. White, 897 F.2d at 113. 37 If legitimate penological interests dictate that a particular treatment must be administered even if the prisoner would have refused it, then because there is no constitutional right to refuse treatment, there is no corollary right to be informed about the treatment. The Constitution does not require prison officials to convey information intended to allow the prisoner to exercise a right that is unavailable to him. We leave to prison officials and physicians the determination of what information is appropriately passed along to prisoner-patients in situations where treatment is mandated.