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Terminally Ill Maryland Prisoner May Refuse Treatment; State’s Highest Court Denies Forced Treatment

The Maryland Court of Appeals held that prison officials cannot force a terminally ill prisoner to undergo kidney dialysis treatment.

In 1995, Troy Reid was sentenced to 40 years in the custody of the Maryland Department of Corrections (DOC). In July 2007, Reid was diagnosed with end-stage renal disease, meaning his “kidneys are no longer able to function or the kidneys completely fail to function, remove waste, or concentrate urine and regulate electrolytes.” He also suffers from high blood pressure and human immunodeficiency virus.

Reid required kidney dialysis treatment – “an artificial process to replace the kidney function of removing waste and unwanted water from the blood” – three times per week. He initially consented to dialysis treatment but later chose to terminate all treatment, “even though he understood the medical consequences of ceasing dialysis (serious bodily injury and even death).”

DOC Commissioner J. Michael Stouffer fought to compel life saving treatment for Reid, seeking an injunction from the Baltimore City Circuit Court. The court denied the injunction and the Commissioner appealed to the Court of Special Appeals. The court granted a temporary injunction requiring continuing dialysis pending appeal. The Commissioner then petitioned Maryland’s highest court, the Court of Appeals, for a writ of certiorari and for an injunction. The Court denied both requests.

The Court of Special Appeals affirmed the circuit court’s denial of an injunction. See: Stouffer v. Reid, 184 Md. App. 268, 965 A.2d 96 (2009). The Commissioner sought a second writ of certiorari. The Court of Appeals granted the petition. See: Stouffer v. Reid, 409 Md. 44, 972 A.2d 859 (2009).

The Court noted that it had recognized in Mack v. Mack, 329 Md. 188, 618 A.2d 744 (1993), that mentally competent adults have a common law right to refuse medical treatment under non-emergency circumstances. It also recognized “that there is considered decisional case law in other jurisdictions holding that a person’s right to refuse treatment is” a constitutional right. Yet, Mack was decided “under the Maryland common-law right of a competent adult to refuse treatment.”

Still, the Court recognized that Mack held that the right is not absolute, but rather may be overridden by countervailing state interests. Therefore, the question for the Court was whether the Commissioner presented sufficient evidence of countervailing state interests overriding Reid’s decision to refuse treatment. “May the Commissioner of Correction administer life-sustaining medical treatment or nutrition to an inmate over the inmate’s objection, where the lack of treatment may cause the inmate’s death or serious injury and threaten prison safety, security, and good order?” asked the certiorari petition.

The Commissioner advanced several state interests, including: preservation of life; maintaining prison security, order, and discipline; maintaining the integrity of the medical profession; and interests of third parties and prevention of suicide, each of which had been rejected by the lower courts. The Commissioner’s arguments that “preservation of life” is a function of the DOC seems at best ironic and at worst hypocritical given that the only state agency officially vested with committing state murder via the death penalty is the DOC.

After an extensive analysis, the Court rejected the Commissioner’s invitation to follow Polk County Sheriff v. Iowa District Court for Polk County, 594 NW 2d 421 (Iowa 1999) and Commissioner of Corrections v. Myers, 399 NE.2d 452 (Mass 1979) and “conclude that the State’s interest in the preservation of life outweighs the inmate’s right to refuse medical treatment.”

Concerning the State’s interest in maintaining prison security and discipline, the Court distinguished Polk and Myers, finding that “the evidence presented was merely speculative” and “did not persuade the court that correctional officials’ conclusions were reasonable and supported by the evidence.”

The Court also rejected the Commissioner’s “claim that the ethical integrity of the medical profession has been impaired by Reid’s refusal to submit to kidney dialysis.”

Finally, the Court rejected the Commissioner’s “interests of innocent third parties” and “the prevention of suicide.” In short, “the Commissioner’s non-specific claim of preservation of life, safety and security was insufficient to demonstrate that Reid’s refusal of medical treatment would cause a disruption or impact safety in the institution, or endanger the ethics of the medical profession,” and “the State has not shown a valid penological interest in compelling Reid to submit to dialysis.”

Reid’s attorney, Stewart Simms, who is a former Public Safety and Correctional Services Secretary, explains that Reid does not need dialysis. Reid has been advised that his decision is risky, says Simms, but he is prepared to accept the consequences. As this issue of PLN goes to press, Reid is alive. See: Stouffer v. Reid, 993 A.2d 104 (2010).

Source: Associated Press

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Related legal case

Stouffer v. Reid