The constitutional right to privacy encompasses the freedom of the terminally ill person who is competent to decide to choose whether or not to decline medical treatment[i]. A patient’s right to refuse medical treatment is primarily protected by the common law and by the federal and state constitutional right of privacy[ii]. Generally, the right to self determination outweighs any countervailing state interests and competent persons can refuse medical treatment even at the risk of death[iii].
However, it is to be noted that the state has a legitimate interest in asserting its parens patriae powers over the mentally and physically incompetent who fails to provide care and cannot safeguard or take care of themselves[iv]. Therefore, the constitutional right to privacy is paramount to a state interest unless that interest outweighs the individual’s constitutional right. Thus, the right to refuse medical treatment can be overridden by countervailing compelling state interests[v].
In the absence of countervailing state interests, a person has the right to have life sustaining treatment withheld if s/he is:
- In an advanced stage of a terminal and incurable illness,
- Suffering severe and permanent mental and physical deterioration.
Similarly, an adult who is incurably and terminally ill possesses a constitutional right of privacy to refuse treatment that only results in prolonging his/her dying process in the absence of any countervailing state interests[vi].
The state can intervene if the interests of the state outweigh the interests of the patient in refusing medical treatment. Under this circumstance, courts generally consider four state interests[vii]:
- Preservation of life;
- Prevention of suicide;
- Protection of third parties;
- Ethical integrity of the medical profession.
However, these interests will not override a patient’s refusal of artificially administered food and water normally[viii].
[i] Leach v. Akron General Medical Center, 68 Ohio Misc. 1 (Ohio C.P. 1980)
[ii] In re Farrell, 108 N.J. 335 (N.J. 1987)
[iii] In re Duran, 2001 PA Super 52 (Pa. Super. Ct. 2001)
[iv] In re Eichner on behalf of Fox, 73 A.D.2d 431 (N.Y. App. Div. 2d Dep’t 1980)
[v] In re Eichner on behalf of Fox, 73 A.D.2d 431 (N.Y. App. Div. 2d Dep’t 1980)
[vi] In re Guardianship of Grant, 109 Wn.2d 545 (Wash. 1987)
[viii] In re Estate of Longeway, 133 Ill. 2d 33 (Ill. 1989)