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Anthony J Hilder on February 3, 2025

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Anthony J Hilder

Amdt14.S1.6.5.1 Right to Refuse Medical Treatment and Substantive Due Process https://constitution.congress.gov/browse/essay/amdt5-4-5-2-5-1/ALDE_00000903/ Fourteenth Amendment, Section 1: ... View MoreAmdt14.S1.6.5.1 Right to Refuse Medical Treatment and Substantive Due Process https://constitution.congress.gov/browse/essay/amdt5-4-5-2-5-1/ALDE_00000903/ Fourteenth Amendment, Section 1: All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws. In multiple decisions, the Supreme Court has recognized that the Due Process Clause subsumes a constitutionally protected right to refuse medical care.1 The Court has maintained, however, that this right must be balanced against relevant state interests, including protection of public health, safety, and human life.2 In Jacobson v. Massachusetts, the Court upheld a Massachusetts law allowing local public health officials to require vaccination against smallpox.3 While the petitioner in Jacobson argued that the compulsory vaccination law infringed upon his right "to care for his own body and health in such way as to him seems best," the Court explained that the state’s interest in protecting communities against the spread of disease was "of paramount necessity."4 The Supreme Court has also addressed the scope of an incarcerated individual’s right to reject antipsychotic medication.5 For instance, in Washington v. Harper, the Court considered an inmate petitioner’s constitutional challenge to a state prison policy that, under certain conditions, permitted involuntary psychotropic drug treatment for inmates with mental illness.6 While acknowledging the petitioner’s "significant liberty interest" in refusing these drugs under the Fourteenth Amendment’s Due Process Clause, the Court’s majority nevertheless concluded that the policy was constitutional.7 Relying on a "standard of reasonableness" articulated in earlier cases involving prisoner rights, the Court explained that the policy conformed with substantive due process requirements, as the state had a legitimate interest in prison safety and security, and the state’s forced medication policy was a rational means of advancing these penological interests.8 The Court further held, in light of the requirements of a prison setting, the Due Process Clause "permits the State to treat a prison inmate who has a serious mental illness with antipsychotic drugs against his will, if the inmate is dangerous to himself or others and the treatment is in the inmate’s medical interest."9 In Cruzan v. Director, Missouri Department of Health, the Court considered whether an incompetent individual has a constitutional right to decline lifesaving nutrition and hydration.10 The case involved the substantive due process rights of a woman in a persistent vegetative state and her parents’ request to terminate use of the feeding and hydration equipment that kept her alive.11 At issue before the Court was whether it was constitutional for Missouri to require the family members to provide "clear and convincing evidence" of the woman’s desire to withdraw life support before honoring the family’s request.12 Although a majority of Supreme Court Justices signaled that the Due Process Clause protects a competent person’s right to refuse life-sustaining medical interventions, the Court, in a 5-4 decision, upheld the state’s imposition of evidentiary requirements under the circumstances presented in the case.13 In its majority opinion, the Court emphasized the legitimacy of the state’s interest in preserving human life and concluded that Missouri was not required to follow the family’s judgment or "anyone but the patient" in making this health care treatment decision.14

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February 3, 2025