Opinion ID: 2276022
Heading Depth: 1
Heading Rank: 1

Heading: common law background.

Text: As in DeGrella, supra , Woods's guardian ad litem does not question the right of a competent person to forego medical treatment by either refusal or withdrawal. Id. at 703 (quoting Union Pac. Ry. Co. v. Botsford, 141 U.S. 250, 251, 11 S.Ct. 1000, 1001, 35 L.Ed. 734 (1891), superseded by rule on other grounds as stated by Privee v. Burns, 46 Conn.Supp. 301, 749 A.2d 689, 695-96 (1999); and Schloendorff v. Soc'y of N.Y. Hosp., 211 N.Y. 125, 105 N.E. 92, 93 (1914), abrogated on other grounds by Bing v. Thunig, 2 N.Y.2d 656, 163 N.Y.S.2d 3, 143 N.E.2d 3, 9 (1957), and superseded by statute on other grounds as stated by Retkwa v. Orentreich, 154 Misc.2d 164, 584 N.Y.S.2d 710 (1992)). That right derives from the common law rights of self-determination and informed consent, DeGrella, 858 S.W.2d at 709; see also Cruzan, 497 U.S. at 270, 110 S.Ct. at 2847 (The logical corollary of the doctrine of informed consent is that the patient generally possesses the right not to consent, that is, to refuse treatment.); and in the liberty interest protected by the Fourteenth Amendment to the United States Constitution (nor shall any State deprive any person of life, liberty, or property, without due process of law), [10] id. at 278, 110 S.Ct. at 2851 (The principle that a competent person has a constitutionally protected liberty interest in refusing unwanted medical treatment may be inferred from our prior decisions.); and, perhaps even more so, by Section 1 of the Constitution of Kentucky (All men are, by nature, free and equal, and have certain inherent and inalienable rights, among which may be reckoned: First: The right of enjoying and defending their lives and liberties.) (emphasis added). But see Quinlan, 355 A.2d at 663 (right to refuse treatment was a corollary of the right to privacy expressed in cases such as Roe v. Wade, 410 U.S. 113, 152-53, 93 S.Ct. 705, 726-27, 35 L.Ed.2d 147 (1973), and Griswold v. Connecticut, 381 U.S. 479, 85 S.Ct. 1678, 14 L.Ed.2d 510 (1965)). However, this right is not absolute. The individual's liberty interest must be balanced against relevant state interests. Cruzan, 497 U.S. at 279, 110 S.Ct. at 2851-52. Courts and commentators have identified four state interests that may limit a person's right to refuse medical treatment: (1) preserving life; (2) preventing suicide; (3) safeguarding the integrity of the medical profession; and (4) protecting innocent third parties. E.g., Satz v. Perlmutter, 362 So.2d 160, 162 (Fla.App.1978); Superintendent of Belchertown State Sch. v. Saikewicz, 373 Mass. 728, 370 N.E.2d 417, 425 (1977); In re Conservatorship of Torres, 357 N.W.2d 332, 339 (Minn.1984); In re Conroy, 98 N.J. 321, 486 A.2d 1209, 1223 (1985); In re Colyer, 99 Wash.2d 114, 660 P.2d 738, 743 (1983) (en banc); President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Deciding to Forego Life-Sustaining Treatment 31-32 (1983) (hereinafter President's Commission). It is also universally accepted that the state may not deprive citizens of their constitutional rights solely because they do not possess the decisional capacity to personally exercise them. Youngberg v. Romeo, 457 U.S. 307, 315, 102 S.Ct. 2452, 2458, 73 L.Ed.2d 28 (1982) (certain liberty interests still intact after involuntary commitment); Jackson v. Indiana, 406 U.S. 715, 731, 92 S.Ct. 1845, 1854, 32 L.Ed.2d 435 (1972) (indefinite commitment of criminal defendant incompetent to stand trial violates Fourteenth Amendment right of due process). Thus, the right to refuse medical treatment embodied in the constitutional liberty interest extends not only to the competent but also to the incompetent, because the value of human dignity extends to both. Saikewicz, 370 N.E.2d at 427. See also Rasmussen by Mitchell v. Fleming, 154 Ariz. 207, 741 P.2d 674, 685-86 (1987) (en banc); Conservatorship of Drabick, 200 Cal.App.3d 185, 245 Cal.Rptr. 840, 855 (1988), abrogated by statute on other grounds as recognized by In re Conservatorship of Wendland, 26 Cal.4th 519, 110 Cal.Rptr.2d 412, 28 P.3d 151, 165 (2001); Foody v. Manchester Mem'l Hosp., 40 Conn.Supp. 127, 482 A.2d 713, 718 (1984); Severns v. Wilmington Med. Ctr., Inc., 421 A.2d 1334, 1347 (Del.1980); John F. Kennedy Mem'l Hosp. v. Bludworth, 452 So.2d 921, 926 (Fla.1984); In re P.V.W., 424 So.2d 1015, 1019 (La.1982); In re Martin, 450 Mich. 204, 538 N.W.2d 399, 406 (1995); Quinlan, 355 A.2d at 664; Eichner v. Dillon, 73 A.D.2d 431, 426 N.Y.S.2d 517, 546 (N.Y.App.Div.1980) (To deny the exercise because the patient is unconscious is to deny the right.), aff'd, 52 N.Y.2d 363, 438 N.Y.S.2d 266, 420 N.E.2d 64, 70-72 (1981); In re Guardianship of Hamlin, 102 Wash.2d 810, 689 P.2d 1372, 1376 (1984) (en banc); In re Guardianship of L.W., supra note 10, at 73-74; David W. Meyers, Medico-Legal Implications of Death and Dying § 11.6, at 274 (1981). Courts have identified three methods by which to determine whether an incompetent's right to refuse or terminate artificial life-support systems should be exercised: