Stouffer v. Reid

• Decision Date: 06 February 2009
• Docket Number: No. 243, September Term, 2008.,243, September Term, 2008.
• Citation: 965 A.2d 96,184 Md. App. 268
• Parties: J. Michael STOUFFER, Commissioner of Correction v. Troy REID.
• Court: Court of Special Appeals of Maryland

965 A.2d 96

184 Md. App. 268

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

No. 243, September Term, 2008.

Court of Special Appeals of Maryland.

February 6, 2009.

Laura Mullally (Douglas F. Gansler, Atty. Gen. on the brief), Baltimore, for Appellant.

Stuart O. Simms (Brown, Goldstein & Levy on the brief), Baltimore, for Appellee.

Panel: DAVIS, ZARNOCH, TONI E. CLARKE, (specially assigned), JJ.

DAVIS, Judge.

J. Michael Stouffer, appellant, Commissioner of Correction, filed a Complaint for Declaratory Judgment and Application for Temporary Restraining Order and Preliminary and Permanent Injunction in the Circuit Court for Baltimore City against Troy Reid, appellee, an inmate in appellant's custody. Appellant sought to compel appellee, over appellee's objection, to submit to kidney dialysis and medical treatment. A hearing was held on May 1, 2008 before the circuit court (Nance, J.). At the close of the hearing, the circuit court orally denied appellant's complaint and, on May 6, 2008, filed a Declaratory Judgment, adjudging that appellee could refuse dialysis and medical treatment. Appellant appeals the circuit court's ruling and presents one question for our review, which we have rephrased as follows:

Did the circuit court err in determining that appellant was without legal authority to compel appellee to submit to medical treatment?

For the reasons that follow, we answer appellant's question in the negative. Accordingly, we affirm the judgment of the circuit court.

FACTUAL BACKGROUND

In 1995, appellee was sentenced to a forty-year term of imprisonment. In July 2007, prison medical personnel diagnosed appellee with end-stage renal disease. Thereafter, appellee was prescribed kidney dialysis three times per week. Appellee objected to receiving dialysis and periodically refused to accept dialysis, sometimes going weeks at a time without receiving treatment. In early April 2008, appellee again refused dialysis and, on April 11, 2008, appellant filed a Complaint for Declaratory Judgment and Application for Temporary Restraining Order and Preliminary and Permanent Injunction in the Circuit Court for Baltimore City, seeking to compel appellee to submit to dialysis and medical treatment.¹ The circuit court granted appellee a temporary restraining order (TRO) on April 25, 2008, ordering appellee to submit to dialysis and medical treatment.

At a hearing held on May 1, 2008, the trial judge, in an oral ruling from the bench, denied appellant's request for a permanent injunction and declared that appellee had the right to refuse kidney dialysis and other medical treatment:

[Appellant] 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.... [Appellee] is an inmate within the Department of Correction ... [and is] a charge of [appellant]. [Appellant] has the responsibility of insuring [safety] ... and provid[ing] proper medical treatment and care for ... inmates.

* * *

The testimony submitted by [appellant] ... 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.

* * *

[T]he 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 high blood pressure, that also could lead to stroke.

* * *

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.

In this case ... [what appellant] is saying, [appellee], 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. ... [I]t's been determined by the doctors that you need this treatment.

* * *

[M]y 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 [appellee] is 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 may be harmful to him.

* * *

This Court believes that [appellee] 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 appellant'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 [appellee] to undergo dialysis does not outweigh [appellee's] right to refuse medical care" on the following:

(1) [Appellee] has been diagnosed with, among other medical conditions, end-stage kidney disease, for which he should receive dialysis three times a week. [Appellee] has refused this treatment.

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

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

Appellant timely filed this appeal.

On May 5, 2008, appellant filed an Emergency Motion for Injunctive Relief Pending Appeal, requesting a stay of his April 25, 2008 TRO. On May 6, 2008, we stayed enforcement of the circuit court's order pending the filing and consideration of appellee's response to appellant's motion. Appellee filed a Show Cause Order on July 7, 2008. On July 31, 2008, we denied appellant's May 5 then emergency motion, but ordered that the stay remain in effect until August 15, 2008. On August 14, 2008, the Court of Appeals denied appellant's petition for writ of certiorari and motion for injunction pending appeal.

Additional facts will be discussed as warranted, infra.

LEGAL ANALYSIS

I

Appellant contends that the circuit court erred in determining that he could not compel appellee to submit to kidney dialysis and medical treatment. We disagree.

Our review of the issue raised in this appeal is pursuant to Md. Rule 8-131(c):

(c) Action tried without a jury. When an action has been tried without a jury, the appellate court will review the case on both the law and the evidence. It will not set aside the judgment of the trial court on the evidence unless clearly erroneous, and will give due regard to the opportunity of the trial court to judge the credibility of the witnesses.

"The clearly erroneous standard does not apply to the circuit court's legal conclusions, however, to which we accord no deference and which we review to determine whether they are legally correct." Cattail Assocs. v. Sass, 170 Md.App. 474, 486, 907 A.2d 828 (2006). We will "review the trial court's application of the law to the facts on an abuse of discretion standard." Porter v. Schaffer, 126 Md.App. 237, 259, 728 A.2d 755 (1999).

A.

STATE INTERESTS

The circuit court based its determinations on Mack, supra, 329 Md. 188, 618 A.2d 744, which addresses the qualified common law right of a competent adult to refuse medical care. Following the reasoning of the Court of Appeals in Mack, we will "sketch the path of general reasoning from the basic right to the particular application" sought here...