Legal Background
The legal right to refuse medical care began in 1891 when the U.S. Supreme Court ruled they could not order the plaintiff in an injury case to undergo a surgical examination prior to trial and against her will (Union Pacific Railway Co. v. Botsford, 1891). In the written opinion, Justice Gray stated, “No right is held more sacred or is more carefully guarded by the common law than the right of every individual to the possession and control of his own person, free from all restraint or interference of others unless by clear and unquestionable authority of law” (Union Pacific Railway Co. v. Botsford, 1891, p. 251). The right of self-determination was first used in a medical case in 1914 when Justice Benjamin Cardozo incorporated autonomy with regard to patient consent for medical procedures (Brown, 2003). Justice Cardoza stated, “Every human being of adult years and sound mind has a right to determine what shall be done with his own body” (Cardoza, 1914, p. 115).
The medical community was not morally or legally prepared to handle the modern challenges of the rapidly increasing number of scientific advancements and technological developments in medicine. The developments from the previous 50 - 70 years have increased conversations regarding patient’s rights, mechanically sustaining life, and documenting autonomous decisions. While federal law generally defers to state law in health care decision-making, guidelines do exist on the federal level to guide state laws. Here are a few of the most relevant laws.
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