Legal News

Court-Ordered Hysterectomy Put on Hold . . . For Now

By Ashby Jones

When and under what circumstances does a judge have the right to order medical treatment for an adult who doesn’t want it?

Courts in Montana are currently wrestling with the question in a case with a highly unusual set of facts.

A trial-court judge in Missoula last Tuesday ordered a woman to undergo a radical hysterectomy last Thursday in order to treat her cervical cancer. The woman, identified only by her initials, L.K., appealed the order, arguing she is a deeply religious woman who wants children and shouldn’t be made to submit to a radical hysterectomy.

On Monday, the Montana Supreme Court delayed the lower-court’s order to give time to allow the woman to file an appeal. Click here for the AP story; here for the Missoulian story; here for L.K.’s motion, courtesy of the Missoulian; here for a post by UCLA law professor Eugene Volokh at the Volokh Conspiracy.

The backstory goes like this: Last September, after L.K.’s cancer diagnosis, a doctor sent a letter to the Missoula County attorney’s office expressing concerns that L.K. might not be able to make medical decisions on her own. A petition to appoint a temporary medical guardian was filed in November. On Feb. 11, the temporary medical guardian signed a consent form for L.K. to have the radical hysterectomy. According to the AP story:

During a status hearing on March 1, a psychiatrist from the Montana State Hospital testified that the woman was having religious delusions that God had cured her and that those delusions prevented her from making fully informed decisions about her medical care.

A state hospital physician testified that the woman’s cancer was in stage 1 and that without treatment, there was an 85 percent chance it could kill her within three years. The physician also testified that it was possible, although not probable, for L.K. to have a child at her age. The court record does not include her age.

L.K. testified that she did understand she had been diagnosed with cancer and did understand the risks of dying without treatment. Her attorney argued that what the state characterized as delusions are actually L.K.’s deeply held religious beliefs.

A day after Townsend made her ruling, L.K.’s public defender filed an emergency petition with the Supreme Court arguing Townsend’s ruling violates L.K.’s religious freedom, bodily integrity and constitutional right to dignity. Greg Hood argued his client faced irreversible harm if the surgery went on as scheduled.

According to Volokh, the case raises some thorny — and not entirely well-settled — points of law:

Note that it's well-settled that sane people have a right to refuse medical treatment, even if they are nearly certain to die as a result. They may do so for secular reasons, religious reasons, or a mix of both. The question in this case, I take it, is whether a mistaken belief about the facts (as opposed to a belief about moral or religious obligations, or about how much one values life, dignity, absence of pain, and so on) - whether or not founded on religion - can be so deluded that it suggests that the person isn't sane enough to make the decision.

LBers, any thoughts?

Full post as published by Law Blog - WSJ.com on March 07, 2011 (boomark / email).