Stouffer v. Reid

993 A.2d 104

413 Md. 491

J. Michael STOUFFER, Commissioner of Correction v. Troy REID.

No. 54, September Term, 2009.

Court of Appeals of Maryland.

April 19, 2010.

Michael O. Doyle, Assistant Attorney General (Douglas F. Gansler, Attorney General of Maryland, and Laura Mullally, Assistant Attorney General, Baltimore), on brief, for petitioner.

Stuart O. Simms (Brown, Goldstein & Levy, LLP, Baltimore), on brief, for respondent.

Carmen M. Shepard, Buc & Beardsley, LLP, Washington, DC, and C. Matthew Hill, Public Justice Center, Baltimore, brief of Public Justice Center, Maryland Disability Law Center, American Civil Liberties Union of Maryland, D.C. Prisoners' Project of the Washington Lawyers' Committee for Civil Rights and Urban Affairs, and On Our Own of Maryland, Inc., as Amici Curiae for respondent.

Argued before BELL, C.J., HARRELL, BATTAGLIA, GREENE, ADKINS, BARBERA and JOHN C. ELDRIDGE (Retired, specially assigned), JJ.

GREENE, J.

The respondent, Troy Reid ("Reid"), an adult male, was committed to the custody of the Commissioner of Correction in 1995 to serve a forty year sentence. Reid's medical history while in the institution revealed a diagnosis of high blood pressure, human immunodeficiency virus and end-stage renal disease.¹ In July 2007, prison medical personnel diagnosed Reid with end-stage renal disease and prescribed the application of kidney dialysis three times per week.² Initially, Reid consented to the dialysis treatment; however, even though he understood the medical consequences of ceasing dialysis (serious bodily injury and even death), he eventually requested that all treatment be terminated. As a result of his refusal to submit to kidney dialysis in April 2008, the petitioner, J. Michael Stouffer, Commissioner of Correction ("Commissioner"), filed a complaint in the Circuit Court for Baltimore City seeking declaratory and injunctive relief to compel Reid to submit to kidney dialysis and medical treatment that medical professionals had determined was necessary.

This case presents the question of whether the Commissioner presented sufficient evidence to override a competent adult inmate's right to object to life-sustaining medical treatment.³ We shall hold that, under the circumstances of the present case, the Commissioner's non-specific claim of preservation of life, safety, and security was insufficient to demonstrate that Reid's refusal of medical treatment would cause a disruption or impact safety in the institution, or endanger the ethics of the medical profession.

Following a hearing in the Circuit Court for Baltimore City, the court denied the Commissioner's request for an injunction. The Commissioner noted a timely appeal to the Court of Special Appeals. Pending the appeal, the Commissioner obtained a temporary injunction permitting Reid's physicians to continue providing Reid with dialysis and other necessary medical treatment. Prior to expiration of the temporary injunction, the Commissioner filed a petition for a writ of certiorari and a motion for injunction pending appeal, which this Court denied. Subsequently, the Court of Special Appeals affirmed the judgment of the Circuit Court denying the Commissioner's request for an order requiring that Reid submit to kidney dialysis. Stouffer v. Reid, 184 Md.App. 268, 965 A.2d 96 (2009). The Commissioner filed an additional petition for a writ of certiorari, which we granted. Stouffer v. Reid, 409 Md. 44, 972 A.2d 859 (2009).

FACTS

The underlying facts are not in dispute. We shall adopt the facts as found by the Circuit Court judge at the hearing held on May 1, 2008, and as subsequently adopted by the Court of Special Appeals in its opinion in Stouffer, 184 Md.App. at 273-76, 965 A.2d at 99-100:

The trial judge, in an oral ruling from the bench, denied the Commissioner's request for an permanent injunction and declared that Reid had the right to refuse kidney dialysis and other medical treatment:

The Commissioner is the head of the Department of Correction. He... has the responsibility of maintaining the operation of the correctional institutions in the State of Maryland.... Reid is an inmate within the Department of Correction ... and is a charge of the Commissioner. The Commissioner has the responsibility of insuring safety ... and providing proper medical treatment and care for ... inmates.

* * * *

The testimony submitted by the Commissioner ... is that failure to abide by that medical treatment ... would negatively impact this inmate. It would impact his heart, his heartbeat, the regularity of his heartbeat, that may cause a heart attack; is that it would cause fluid to build up in the body that is not being taken out of the body under normal means and that fluid may build up in his leg, in his face, in his lungs, and in his lungs could cause respiratory failure and that respiratory failure could lead to heart attack or death.

* * * *

The inmate also has high blood pressure and that failure to receive the treatment in question may impact negatively to his high blood pressure. The impact could lead to the heightening of his blood pressure, that also could lead to stroke.1

1. In addition to end-stage renal failure, Reid suffers from human immunodeficiency virus (HIV), high blood pressure and anemia.

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Maryland is clear that a mentally competent adult may refuse medical care, even though the refusal may result in his or her death, and that unless there are compelling State interests which override the person's interest in their body's integrity, as the Mack2 case says, is that the Court should recognize it.

2. Mack v. Mack, 329 Md. 188, 618 A.2d 744 (1993), articulates four countervailing State interests, which we shall discuss, infra.

In this case ... what the Commissioner is saying, Reid, is that he recognizes that you are a competent individual and he recognizes that you have not been a troubling impact overall while in this facility. That is clearly what is being said here is that you have not disrupted the system; is that it is, in fact, raising the question of concern (a) for your health and trying to make sure that you receive the medical treatment that he and the medical providers say are necessary.... It's been determined by the doctors that you need this treatment.

* * * *

My concern is as to whether or not the countervailing State interest in this case, as identified by the Court of Appeals, does apply. One of the countervailing factors is preserving your life.

The other is around the safety and the safety of others and whether or not it's there. Well, I'm not hearing that you're doing this to cause something to happen and ... that it will simply pass.... The Court's question of Reid is he trying to kill himself and he said, no, that's not the case, and so prevention of suicide is not it.

The maintenance of ethical integrity of the medical profession or the medical treatment is the last point of the balancing ... and the medical profession has made it clear is that they believe this is needed.

* * * *

I don't like playing Russian roulette with anyone's life.... However, on this date, the Court is satisfied that the inmate is aware that he has been advised that the medical treatment that's being offered to him is appropriate and necessary, and that refusal to receive that medical treatment maybe harmful to him.

This Court believes that Reid is competent, but ill-informed in his own wisdom. However, the Court denies the request at this time. The motion for permanent injunction is denied.

In a written order issued on May 2, 2008, the trial court denied the Commissioner's request for a permanent injunction and issued a declaratory judgment on May 6, 2008, memorializing the May 1, 2008 oral ruling. The trial court based its declaratory judgment that "the state interests in forcing Reid to undergo dialysis does not outweigh Reid's right to refuse medical care on the following:

(1) Reid has been diagnosed with, among other medical conditions, endstage kidney disease, for which he should receive dialysis three times a week. Reid has refused this treatment.

(2) There has been no argument or suggestion that Reid is not a competent adult.

(3) The Commissioner, in his responsibility to oversee and maintain the proper medical care of prisoners, has petitioned this court requesting permanent injunctive relief.

(4) Citing Mack v. Mack, supra, the court concluded that a patient has a right to refuse treatment, but this right is not absolute. This right must be balanced against the state interests of the preservation of life, protection of innocent third parties interests, suicide prevention, and the maintenance of the ethical integrity of the medical profession.

(5) Reid is not contemplating suicide, nor is there evidence that his refusal has caused any disruption in the operation of the prison system, nor is there any indication that he seeks to cause a disturbance.

(6) The Commissioner showed proper concern for the negative impact Reid's choice could have upon the prison community, but there has been no evidence presented that Reid has made any attempt to disrupt the order of the prison, nor is there any evidence suggesting the actions of Reid would cause disruption to the prison community, and no evidence has been presented showing that Reid's choice has harmed the integrity of the medical profession.

Additional facts will be presented as necessary for purposes of our discussion.

DISCUSSION

The Commissioner contends that he is entitled to compel Reid to submit to kidney dialysis and medical treatment because the State's legitimate interest in the orderly and safe operation of the state prison system outweighs Reid's right to refuse medical treatment. According to the Commissioner, both the Court of Special Appeals and the Circuit Court "failed to give appropriate deference to the Commissioner and Assistant Commissioner regarding the impact of Reid's refusal to receive life-sustaining medical treatment." The...