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HELD: Oregon's Death with Dignity Act, Measure 16, which legalizes physician-assisted suicide for certain terminally ill persons, violates the equal protection clause of the fourteenth amendment to the United States Constitution. Measure 16 fails to withstand even the lowest level of judicial scrutiny because the disparate treatment afforded the class of terminally ill persons does not further any legitimate state interest.
The due process clause of the Fourteenth Amendment protects the right of terminally ill persons to hasten their inevitable death. In prohibiting physicians from prescribing lethal medications by which such patients might hasten death, Michigan's ban on "assisted suicide" unconstitutionally imposes an "undue burden" on the exercise of that right.
This article discusses the 1975 Supreme Court opinion O'Connor v. Donaldson. The article first examines the due process clause of the Fourteenth Amendment, the basis for the O'Connor ruling. It then looks carefully at the Court's conclusions, with particular attention to the Court's reasoning and analysis. The article goes on to look at how the Supreme Court has interpreted O'Connor on subsequent occasions and suggests that the Court has often misconstrued its own decision. The article concludes by offering thoughts and commentary on the O'Connor opinion and its progeny.
City of Revere v. Massachusetts General Hospital presented the United States Supreme Court with its first opportunity to consider whether a state or municipality has a constitutional duty to pay for medical treatment received by an individual in police custody. The Supreme Judicial Court of Massachusetts had held that the city had an eighth amendment duty to pay for an arrestee's treatment. The U.S. Supreme Court reversed, observing that eighth amendment rights and duties are not implicated prior to conviction and that fourteenth amendment due process concerns were met once the arrestee received adequate medical care. No obligation to pay arises, the Court held, absent a specific state law provision requiring such payment. Because arrestees are subject to physical restraints similar to those imposed on convicted prisoners, this Case Comment argues that courts undertaking to determine the scope of a state's duty to provide treatment to arrestees should apply a due process standard which draws upon eighth amendment analysis. The Comment concludes that under such an eighth amendment equivalence approach, no duty to pay arises because the state's failure to pay the health care provider does not reflect "deliberate indifference" towards the recipient of the treatment.
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Exploitation of children in the labor force at the beginning of this century gave rise to a national campaign leading to congressional passage of the Keating-Owen Act in 1916. The act prohibited from interstate commerce goods produced in factories or mines that employed children who either were under fourteen years of age or who were under sixteen years of age and worked more than eight hours a day. Despite its popular support, the Act was declared unconstitutional by the Supreme Court in Hammer v. Dagenhart (1918). The Court's decision involved several major issues: interpretation of the Fifth and Fourteenth Amendments to the Constitution, freedom of contract, police power of the states, and the interstate commerce clause. Review of previous Court decisions suggests that the justices were on less than solid legal ground in reaching their decision. Examination of the historical context of the decision, however, suggests other factors that may have played a more important role than judicial precedents. The debate prompted by Hammer v. Dagenhart has much relevance to such current issues as young agricultural workers, sex discrimination in industry, and the powers of the federal government vis-a-vis states and individual citizens.
In December 1994, the Michigan Supreme Court decided a group of cases comprising constitutional challenges to a Michigan statute against assisted suicide and prosecutions of Dr. Jack Kevorkian for his role in two incidents of suicide. The court rejected arguments that the statute infringed a right of "personal autonomy" under the Fourteenth Amendment to the US Constitution; it noted that, although US Supreme Court opinions indicate that decisions to withdraw or reject life-sustaining treatment are constitutionally protected, a legal difference exists between permitting death to occur by natural means and taking affirmative steps to end life. The Michigan court also decided that Kevorkian could not be charged with murder for supplying only the means by which suicide occurred, but he could be charged with a common law crime of assisting in suicide although the statute outlawing such actions became effective only after the suicides occurred. Because suicide was a crime under the prerevolutionary English Common Law, which forms the foundation of Michigan law, assisting in suicide is also a residual crime under the "savings clause" of the Michigan statutes, which incorporates common law crimes into the law of that state when no superseding statute exists.
Because child endangerment laws and their judicial interpretation are different in each state, healthcare providers should familiarize themselves with the law in their particular jurisdiction. In situations in which parents refuse on religious grounds to consent to medical treatment for their children, health care providers should consult local counsel as to the legal options available.
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In his epochmaking article, Birnbaum proposed that courts should recognize a right to treatment of institutionalized psychiatric patients based on the substantive due process. His proposal was adopted in Rouse v. Cameron as a statutory right. Wyatt v. Stickney decision was the first to hold that there was a constitutionally based right to treatment for involuntarily committed patients. The Supreme Court, though reluctantly, held in Youngberg v. Romeo that the institutionalized mentally retarded were entitled to minimally adequate training, which was drawn in the Fourteenth Amendment.
Suchrara writes [1977: 296] that "a child's right to humane treatment must be considered not an option on the part of adults, but an obligation." The use of videotaped interviews as admissible judicial evidence is an important step toward Suchrara's goal; videotaped testimony attempts to balance the emotional, psychological, and developmental needs of the child with the civil liberties afforded to alleged perpetrators. The Texas State Legislature, with the passage of Senate Bill 836, broadened the civil rights of children to include the notion of humane treatment in civil and criminal investigations and proceedings. The Texas law establishes explicit guidelines to enhance the child's dignity in a traumatic and personal experience. Furthermore, the law protects the civil rights of the accused guaranteed by the sixth and fourteenth amendments to the U.S. Constitution. The successful implementation of the videotape law, however, depends on the skills and expertise of the social worker. The practitioner must possess specialized training in the dynamics of child sexual abuse and an extensive understanding of related law and legal processes. This expertise is built on a foundation of knowledge and skills required for effective interviewing, counseling, and an exhaustive understanding of human behavior theory. Given the complexity and interplay of law, rights, and human behavior, the social worker requires ongoing training in these areas in order that the interests of all concerned parties be protected. The Texas State Legislature provides an opportunity for the social welfare and legal communities to determine jointly how and to what extent the rights of a victim and an alleged perpetrator may be protected. The law is in hand; the success of its implementation now rests with the practitioners.
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It is scientifically indisputable that excessive use of alcohol or drugs during pregnancy causes defects in the children who are subsequently born to the abusing mothers. In the United States any legislative intervention by a state during the pregnancy would affect the rights of both the mother and the foetus. In order to remain within the bounds of constitutionality any maternal health legislation would have to strike a clear balance between the mother's rights to reproductive and familial privacy and bodily integrity guaranteed by the Fourteenth Amendment and the state's right to protect the foetus. This balance is currently achieved in terms of the framework set out by the Supreme Court in Roe v Wade 410 US 113 (1973). Although South African legislation cannot as yet be tested for its constitutionality the basic problem of balancing the rights of the mother, the foetus and the state remain the same. South Africa enjoys an advantage which the United States of America does not, viz the common-law remedies presented by the Aquilian action and the actio injuriarum. Only a person can be the bearer of rights and can thus invoke an action to protect those rights. It is thus necessary to determine whether the nasciturus fiction as enunciated in D 1.5.7 would enable a foetus (via a curator ad litem) to enforce rights against its mother. It is submitted that an extension of certain principles in the decisions of our Supreme Court in Christian League of Southern Africa v Rall 1981 (2) SA 821 (O), Wood v Ondangwa Tribal Authority 1975 (2) SA 294 (A) and Clark v Hurst NO 1992 (4) SA 630 (D) coupled to the nasciturus fiction are indicative of the fact that a foetus may enjoy protection against drug abuse by its mother prior to its birth.
In recent years, many states have attempted to address the cost and access problems that face their health care systems. Such efforts, however, are significantly impeded by a variety of federalism doctrines that limit the ability of states to regulate the health care market. This Article surveys some of those federalism barriers, including the constitutional restraints imposed by the Commerce Clause, the Privileges and Immunities Clause, and the Fourteenth Amendment, and the statutory hurdles created by ERISA, the Social Security Act, and the Americans with Disabilities Act of 1990. This Article concludes that the restraints that these doctrines and statutes place on states reflect not only federalism concerns, but also deeper ambivalence about governmental regulation of the health care market. Only when that ambivalence is resolved can a proper division of labor between the states and federal government be determined.