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Washington Force-Feeding Interests Outweigh Prisoner's Privacy Rights

The En Banc Washington State Supreme Court held that the State's interests in force feeding a prisoner outweighed his constitutional right to refuse artificial means of nutrition and hydration.

In July 2004, Charles R. McNabb was transferred from the Spokane County Jail to the Airway Heights Corrections Center (AHCC). At that time, he had not voluntarily eaten in over five months.

"AHCC staff began to force-feed McNabb by nasogastric tube one or two days after he arrived because he refused food and drink." After several days of force-feeding, McNabb agreed to eat and has not been force-fed since.

McNabb brought suit in state court alleging that the Department of Corrections (DOC) force-feeding policy violated his right to privacy under the Washington Constitution and his common law right to be free from bodily invasion.

"The trial court found that McNabb did not have a right to refuse artificial means of nutrition and hydration while in state custody." The Washington Court of Appeals affirmed, holding "that although DOC's force-feeding policy might violate McNabb's privacy right to refuse artificial means of nutrition and hydration, the State's interests outweigh his right." See: McNabb v. Department of Corrections, 127 Wn.App. 854, 113 Pad 592 (2005).

The En Banc Washington Supreme Court affirmed. First, the Court rejected McNabb's argument that the Washington Constitution affords a fundamental right which is "far stronger than any in federal law." The right granted "in this context is coextensive with, but not greater than, the protection granted under the federal constitution," the Court held.

Next, the Court rejected McNabb's contention "that he has an absolute right to refuse artificial means of nutrition and hydration ... even if refusal would result in his death." The Court found that "the question ... is an issue of first impression for this court."

Ultimately, the Court concluded, "in accord with holdings from other jurisdictions," that "McNabb retains a limited right of privacy, including the right to refuse artificial means of nutrition and hydration subject to the goals and policies of the prison system."

Turning to DOC's force-feeding policy, the Court rejected DOC's contention that Turner v. Salley, 482 US 78. 107 SCt 2254 (1987) is dispositive. "Turner does not resolve the present dispute since it merely provided the framework for determining whether a prison regulation was reasonable on its face," the Court held. "The present claim does not involve a facial challenge to a prison policy. McNabb contests the constitutionality of the policy as applied to him. Therefore, the factors outlined in Turner do not assist the court with balancing the competing interests of McNabb and DOC." Even so, "the twin principles set forth in Turner do inform the disposition of this case by identifying an additional state interest that should be considered."

"Consonant with Turner and the majority view amongst (its) sister states," the Court concluded "that the unique demands of prison administration warrant judicial deference to prison administrative decisions." It held "that this principle should be considered in addition to the four established compelling state interests adopted by" In re Welfare of Colyer, 99 Wn2d 114, 660 P2d 738 (1983) "when determining whether the right of an incarcerated individual to refuse artificial means of nutrition and hydration outweigh the State's interests."

Weighing all the relevant factors, the Court concluded "that the State's interests in
applying DOC's force-feeding policy to McNabb outweigh his right to refuse artificial means of nutrition and hydration." Those interests included: "a compelling interest in maintaining security and orderly administration in its prison system;" "a strong interest in the preservation of life where medical treatment will in fact save the patient's life;" "a compelling interest in the prevention of suicide;" and "a compelling interest in the maintenance of the ethical integrity of the medical profession."

Under the conditions presented, the Court found that "DOC's application of the force-feeding policy was necessary and effective." See: McNabb v. Department of Corrections, 180 P. 3d 1257, 163 Wash. 2d 393 (2008).

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McNabb v. Department of Corrections

McNabb v. Department of Corrections