The fundamental right to self-determination is subject only to state’s compelling and overriding interest. Everyone has the right to be free from intrusion or coercion whether by the government or by society at large. A very important component of self-determination is the right to make choices regarding one’s health, including the right to refuse or stop unwanted medical treatment.
The Florida Supreme Court held in the case of Wons in 1989 that a competent practicing Jehovah’s Witness could exercise her constitutional right to refuse emergency blood transfusion, even if such refusal would result in death. In addition, the state Supreme Court also held in 1989, in the matter of Satz, that an individual suffering from a terminal condition was entitled to remove a mechanical respirator even if such removal would result in the person’s death. Further, the United States Supreme Court found in the case involving Cruzan in 1990, that a competent individual has the constitutional right to refuse medical treatment regardless of his or her medical condition.
So, the right of the competent individual to determine whether to accept treatment or to stop treatment is established in Florida law. This article explains why every person should have a surrogate healthcare decision-maker and, in addition to introducing the concept of the right to self-determination, this first installment also briefly examines the limits of this right in Florida.
WHAT ARE THE LIMITS OF THE RIGHT OF SELF-DETERMINATION
In Florida, a person’s fundamental right of self-determination is subject only to the state’s compelling and overriding interest. The state has a duty to preserve life, protect innocent third parties, prevent suicide and maintain the ethical integrity of the medical profession. These four duties of the state must be balanced against an individual’s right to refuse or stop medical treatment.
However, though state’s duty to preserve life limits the right of self-determination when the issue is the preservation of life where the affliction is curable. However the state’s duty does NOT limit the right of self-determination when the issue is the extension of life in a person afflicted with an incurable. So, the state’s interest to preserve life do not override an individual’s right to refuse or stop medical treatment for an incurable condition. This constraint on the state’s duty extends to the decision of the guardian, surrogate and proxies.
Therefore, when it is determined that an individual is suffering from an affliction from which there is no cure, the state’s interest are insufficient to override the decision of the individual, her guardians, proxies or surrogates including family members and friends. However, the right of self-determination does not extend to suicide and does not extend to harm to innocent third parties. In these matters, the duty of the state supersedes.
In the next installment in this series we would explore whether the right of self-determination is limited by the incapacity of an individual.