Bizio v. Dorsey, 21 N.Y.3d 95 (2013)
When an inmate’s prolonged hunger strike creates a substantial risk of death or serious permanent injury, the state’s interest in preserving life and maintaining institutional order outweighs the inmate’s qualified right to refuse medical treatment.
Summary
Leroy Dorsey, a state inmate, engaged in a hunger strike to obtain a transfer and highlight alleged mistreatment. When his health deteriorated, the Department of Corrections and Community Supervision (DOCCS) sought a court order to force-feed him via a nasogastric tube. The New York Court of Appeals held that the state’s interest in preserving life and preventing institutional instability outweighed Dorsey’s right to refuse medical treatment, justifying the forced feeding. The Court emphasized that Dorsey’s actions created the life-threatening condition, distinguishing it from cases involving pre-existing illnesses or injuries.
Facts
Leroy Dorsey, an inmate, began a hunger strike at Great Meadow Correctional Facility to secure a transfer and draw attention to claims of abuse.
Dorsey had previously engaged in hunger strikes with similar motivations.
Medical staff repeatedly warned Dorsey that his refusal to eat was causing potentially irreversible organ damage and would lead to death.
Dorsey only ingested small amounts of liquids, insufficient to sustain his health.
After a month, Dorsey had lost 11.6% of his body weight.
Procedural History
DOCCS petitioned the court for an order permitting medical staff to insert a nasogastric tube to provide nutrition and hydration.
Supreme Court granted DOCCS’ application, allowing force-feeding unless Dorsey consumed a nutritional supplement and solid food voluntarily.
Dorsey resumed eating but appealed the order.
The Appellate Division deemed the case moot because the hunger strike had ceased but addressed the core issue of the State’s right to force-feed, ruling in favor of DOCCS.
The New York Court of Appeals granted Dorsey leave to appeal.
Issue(s)
1. Whether the inmate’s claim that the force-feeding order violated his constitutional right to refuse medical treatment was preserved for review.
2. Whether the State had the right to secure a force-feeding order when an inmate, not intending to die, was engaging in a hunger strike to bring attention to grievances and obtain a transfer.
Holding
1. Yes, because it was clear from his posture that he viewed the insertion of a nasogastric feeding tube as an unconstitutional invasion of his bodily integrity.
2. Yes, because when “an inmate’s refusal to eat has placed that inmate at risk of serious injury and death . . . the State’s interest in protecting the health and welfare of persons in its custody outweighs an individual inmate’s right to make personal choices about what nourishment to accept” (91 AD3d at 1053).
Court’s Reasoning
The Court addressed the preservation of the constitutional claim, noting DOCCS initiated the proceedings, relying on Matter of Von Holden v Chapman, which involved similar constitutional objections. The Court found that despite Dorsey’s initial reference to the Eighth Amendment, the hearing court understood the argument as based on the right to avoid unwanted medical intervention, given DOCCS’s reliance on Von Holden.
The Court emphasized the State’s interest in preserving life, preventing suicide, and maintaining order within correctional facilities, especially when an inmate’s actions create a life-threatening condition.
Distinguishing from Rivers v Katz and Matter of Fosmire v Nicoleau, the Court highlighted that Dorsey’s condition was self-inflicted, triggering the State’s interest in preventing suicide. The Court stated, “Whatever his purported intent, by refusing to eat for a prolonged period of time despite repeated warnings concerning the imminent physiological damage that behavior was causing, Dorsey knowingly inflicted injury on himself that, if continued, would result in his death.”
The Court applied the Turner v Safley standard, which states that prison regulations impinging on constitutional rights are valid if reasonably related to legitimate penological interests. The Court determined that DOCCS’s actions were reasonably related to preserving life, preventing suicide, and maintaining institutional order, all legitimate penological objectives.
The Court noted that Dorsey’s claim that he sought a transfer and brought attention to alleged mistreatment by DOCCS undermined his interest in continuing the hunger strike, as he had other available means to pursue those objectives. His stated intent did not negate the risks associated with his self-inflicted starvation.