Due process in the "voluntary" civil commitment of juvenile wards.
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The US Supreme Court's decision in Planned Parenthood of Southeastern Pennsylvania v Casey both protects a woman's liberty to choose to terminate her pregnancy and permits the state to make it more difficult for her to exercise her choice. In their opinion on the case, Justices O'Connor, Kennedy, and Souter eloquently defend constitutional protection of the right to make intimate decisions like continuing or ending a pregnancy. At the same time, they permit the state to try to persuade pregnant women not to have abortions and to make abortion harder to obtain and more costly, as long as the state's methods do not create an "undue burden" on the decision. Any restriction on abortion is a burden; whether it is "undue" (and therefore unconstitutional) depends on one's circumstances. The Court appears to view the difference between an undue burden and mere inconvenience from the perspective of privilege. The restrictions that were upheld may not significantly affect middle-class access to abortion, but they could prove insurmountable for many less privileged women.
In its Cruzan v. Director, Missouri Department of Health, decision the U.S. Supreme Court addressed only states' authority in the refusal of medical treatment. But the case itself drew national attention to the issue, and physicians and healthcare facilities should expect to see living wills and durable powers of attorney increase as a result. Legal concerns will also arise as a result of misconceptions regarding the law. The Court was careful to qualify and limit its support of the Missouri Supreme Court's decision. As opposed to the latter's nearly outright denial of an individual's right to refuse medical treatment, the U.S. Supreme Court's majority opinion asserted that a competent person has a "constitutionally protected liberty interest in refusing unwanted medical treatment." And although the Court upheld Missouri's requirement that there be "clear and convincing evidence" of an incompetent patient's previously expressed wishes before treatment can be discontinued, it did not make such evidence mandatory for states with different law. Finally, in a separate concurring opinion Justice Sandra Day O'Connor asserted that a patient-designated proxy could be an acceptable "source of evidence" of a patient's intent. If the proxy does in fact have some constitutional status, this status should motivate state courts and legislatures to recognize the practice.
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