THE RIGHT TO
REFUSE TREATMENT
A CONSTITUTIONAL
PROTECTION
RIGHT TO PRIVACY
• AMENDMENTS 1, 4, 5, 9, 14
• FIRST IDENTIFIED IN GRISWOLD V.
CONNECTICUT (1965)
• CENTERPIECE OF ROE V. WADE
(1973)
• FIRST USED IN CASES OF DYING IN
IN RE QUINLAN (1976)
RIGHT TO PRIVACY
U.S. CONSTITUTION: AMENDMENT I
• AMENDMENT I
– CONGRESS SHALL MAKE NO LAW
RESPECTING AN ESTABLISHMENT OF
RELIGION, OR PROHIBITING THE FREE
EXERCISE THEREOF; OR ABRIDGNING
THE FREEDOM OF SPEECH, OR OF
THE PRESS; OR THE RIGHT OF THE
PEOPLE PEACEABLY TO ASSEMBLE,
AND TO PETITION THE GOVERNMENT
FOR A REDRESS OF GRIEVANCES.
RIGHT TO PRIVACY
U.S. CONSTITUTION: AMENDMENT IV
• AMENDMENT IV
– THE RIGHT OF THE PEOPLE TO BE SECURE
IN THEIR PERSONS, HOUSES, PAPERS, AND
EFFECTS, AGAINST UNREASONABLE
SEARCHES AND SIEZURES, SHALL NOT BE
VIOLATED, AND NO WARRANTS SHALL ISSUE,
BUT UPON PROBABLE CAUSE, SUPPORTED
BY OATH OR AFFIRMATION, AND
PARTICULARLY DESCRIBING THE PLACE TO
BE SEARCHED, AND THE PERSONS OR
THINGS TO BE SIEZED.
RIGHT TO PRIVACY
U.S CONSTITUTION: AMENDMENT V
• AMENDMENT V
– NO PERSON SHALL BE HELD TO ANSWER FOR A
CAPITAL, OR OTHERWISE INFAMOUS CRIME, UNLESS
ON A PRESENTMENT OR INDICTMENT OF A GRAND
JURY, EXCEPT IN CASES ARISING IN THE LAND OR
NAVAL FORCES, OR IN THE MILITIA, WHEN IN ACTUAL
SERVICE IN TIME OF WAR OR PUBLIC DANGER; NOR
SHALL ANY PERSON BE SUBJECT FOR THE SAME
OFFENSE TO BE TWICE PUT IN JEOPARTY OF LIFE OR
LIMB NOT SHALL BE COMPELLED IN ANY CRIMINAL
CASE TO BE A WITNESS AGAINST HIMSELF, NOR BE
DEPRIVED OF LIFE, LIBERTY, OR PROPERTY,
WITHOUT DUE PROCESS OF LAW; NOR SHALL
PRIVATE PROPERTY BE TAKEN FOR PUBLIC USE,
WITHOUT JUST COMPENSATION.
RIGHT TO PRIVACY
U.S. CONSTITUTION: AMENDMENT IX
• AMENDMENT IX
– THE ENUMERATION IN THE
CONSTITUTION, OF CERTAIN RIGHTS,
SHALL NOT BE CONSTRUED TO DENY
OR DISPARAGE OTHERS RETAINED BY
THE PEOPLE.
RIGHT TO PRIVACY
U.S. CONSTITUTION: AMENDMENT XIV; 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 ABRIDGES 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.
CRUZAN V. DIRECTOR, MISSOURI
DEPARTMENT OF HEALTH (1990)
• LIBERTY RIGHT
• 14TH AMENDMENT ONLY
• REITERATED IN VACCO V. QUILL
(1997)
PATIENT SELFDETERMINATION ACT (1990)
• RIGHT TO REFUSE TREATMENT IS
ENDORSED AND RECOGNIZED --NOT CONFERRED
• RIGHT TO REFUSE TREATMENT IS
FOUNDATION STONE.
VACCO V. QUILL (1997)
• LIBERTY RIGHT GROUNDED IN 14TH
AMENDMENT
• REITERATES CRUZAN
• “EVERYONE, REGARDLESS OF
PHYSICAL CONDITION, IS ENTITLED,
IF COMPETENT, TO REFUSE
UNWANTED LIFESAVING MEDICAL
TREATMENT; NO ONE IS
PERMITTED TO ASSIST A SUICIDE.”
CONCERNS OF THE COURTS
• PERSERVATION OF LIFE [QUINLAN ]
• PREVENTION OF SUICIDE [BOUVIA ]
• PROTECTION OF THIRD PARTIES
[OSBOURNE ]
• INTEGRITY OF THE MEDICAL
PROFESSION [BROPHY ]
CONCERNS IN MEDICAL
PRACTICE
• BEST INTERESTS OF PATIENTS
• STANDARDS OF ORDINARY
MEDICAL PRACTICE
– INTEGRITY OF MEDICAL PROFESSION
• EFFECTIVE COMMUNICATION
• FEAR OF LIABILITY EXPOSURE