C.A. Overturns Order Requiring Minor to Undergo Transfusions

Metropolitan News-Enterprise, California/June 3, 2010

A juvenile court judge cannot order medical treatment for a minor when no dependency proceeding is pending, the Third District Court of Appeal ruled yesterday.

The court reversed an order requiring a teenager-one of Jehovah's Witnesses-with sickle cell anemia to undergo periodic blood transfusions, over religious objections.

While the order expired last year, rendering the appeal technically moot, Presiding Justice Arthur Scotland explained in a footnote, the panel exercised its discretion to consider the case on its merits because it "poses issues of broad public interest that are likely to recur."

The ruling, Scotland acknowledged, upsets an arrangement under which the San Joaquin County Human Services Agency and the Hospital Liaison Committee for Jehovah's Witnesses in Stockton acknowledged the need to protect the due process rights of minors without subjecting them to the "stigma" associated with dependency proceedings.

"The problem is that, although well intended, the 'system' created in San Joaquin County does not comply with the statutory scheme and results in a juvenile court acting without subject matter jurisdiction," the presiding justice explained.

Ex Parte Application

The ruling stems from an ex parte application, filed in October 2008, in which the agency asked the court to order that the physician treating 16-year-old Marcus W., as the appellate court identified him, administer transfusions "as medically necessary."

In support of the application, the agency attached a letter from the doctor reporting that the boy had suffered two strokes "and has developed moya moya disease due to the cerebral ischemia that was caused by the strokes." The doctor explained that transfusions were necessary because drug therapies had failed to raise the minor's level of hemoglobin F to the point required to prevent another stroke.

San Joaquin Superior Court Judge Jose Alva held a hearing, at which counsel for the minor insisted that although California does not explicitly recognize the right of a "mature minor" to make his or her own medical decisions, an order requiring such a minor to undergo a medical procedure over religious objections would violate due process.

Marcus testified that he was a junior in high school, with above average grades, and that he understood the nature of his illness. He said he did not want a transfusion, however, because "it states in the Bible how our God, Jehovah, how he doesn't want us to take blood."

Alva granted the order, but Scotland, writing for the Court of Appeal, said the court lacked fundamental jurisdiction to do so.

'Lack of Jurisdiction'

The presiding justice explained that an order requiring a minor to undergo necessary medical treatment may only be entered pursuant to Welfare and Institutions Code Sec. 369. The statute only applies to a person who has been taken into temporary custody or is the subject of a petition pursuant to the dependency laws.

Scotland rejected the county's argument that emergency medical treatment may be ordered under other legal authority-including the statutes requiring parents to provide their children with necessary medical care-and that while none of those statutes explicitly authorize court orders for care, the court can make such an order by way of its writs jurisdiction.

"We need not decide whether those statutes would authorize the issuance of a writ of mandate, as the Agency contends," he wrote. "We simply point out that a writ of mandate 'will not issue if there is a plain, speedy and adequate remedy in the ordinary course of law'...and that section 369 sets forth a plain, speedy, and adequate remedy for the Agency to obtain a court order compelling the minor to undergo periodic blood transfusions to prevent him from suffering a third stroke and possibly death."

The case is San Joaquin County Human Services Agency v. Marcus W., 10 S.O.S. 3002.

To see more documents/articles regarding this group/organization/subject click here.