2-3.
THE RIGHT TO PRIVACY
In some cases, medical care is refused on the basis of the constitutional right to
privacy. Unwanted infringements of bodily integrity have been recognized to violate the
right to privacy, unless state interests outweigh that right. In re Quinlan (N.J., 1976), the
right to privacy was recognized as the basis for refusal to continue the life support
system. The right to privacy has been the basis for allowing refusals in situations where
the patient is neither terminally ill nor comatose. In the 1990 case of Nancy Cruzan, a
young woman who had been in a persistent vegetative state for 7 years, the
constitutional right to liberty was cited as the interest protected by the court, when they
ruled that each state could set its own standards for allowing patient refusal.
2-4.
FREEDOM OF RELIGION
Freedom of religion is another basis for refusal in a few situations. However, this
First Amendment protection applies primarily to freedom of belief, not freedom of action,
so the state may restrain religious action. Another reason that this freedom has limited
relevance in refusal of treatment situations is because most religions merely permit
refusal. Thus, legally required treatment does not necessarily violate religious tenets.
The only cases in which freedom of religion has been pivotal have involved Jehovah's
Witnesses' refusing blood transfusions or Christian Scientists' refusing all treatment.
Although more recently, there have been a few cases pertaining to religious sects that
believe in "faith healing," in which the right to refuse was upheld.
Refusing the blood transfusion.
vs.
Accepting the blood transfusion.
Prolonged life on earth; eternal
Eternal live without damnation.
vs.
damnation in the hereafter.
HIGHER VALUE PLACED ON ETERNAL LIFE
Respect for the patient's autonomy.
vs. The patient's objective best interest.
Respect for the patient's right to refuse. vs. Preserving and prolonging life.
HIGHER VALUE PLACED ON PROLONGED LIFE AND CURING DISEASE
Figure 2-2.
Determining what is in the best interests of anyone other than oneself is
difficult. In the case of a Jehovah's Witness, the best medical outcome
is not the same as the outcome the patient might prefer. And the law,
in some instances, recognizes the patient's right to refuse on religious
grounds.
MD0067
2-4