MISSOULA — One day after a Missoula County District Court judge ordered a hysterectomy for a woman with cancer, the Montana Supreme Court stepped in and halted the surgery to allow an appeal.

Last Tuesday, Judge Karen Townsend found that the woman known as L.K. was not mentally competent and ordered that the surgery should be performed on Thursday.

The next day, a public defender filed an emergency petition on L.K.’s behalf.

“Tomorrow’s impending involuntary removal of L.K.’s reproductive organs both establishes that the district court is proceeding under a mistake of law and is causing a gross injustice and involves constitutional dignity and religious freedom issues of statewide importance,” the public defender’s office wrote on L.K.’s behalf.

The Supreme Court issued an order the same day providing for an expedited appeal within 30 days.

The emergency petition decision described L.K. as a deeply religious woman who wants children, and balked at the hysterectomy on both those grounds.

Her religion wasn’t specified, but a psychiatrist and a physician from the Montana State Hospital termed her religious beliefs — including one that God had cured her — delusional.

The physician testified at a March 1 hearing that without treatment, L.K.’s cancer could kill her within three years. The physician said that L.K.’s “religious delusions” interfered with her ability to make reasoned decisions about her care, and that L.K. didn’t understand that she might die without the surgery, according to the petition.

“L.K. then testified on her own behalf that she did understand that she had been diagnosed with cancer and that she did understand the risks of dying if she did not have the hysterectomy procedure,” the petition said.

She also said that she might change her mind later about following her doctors’ recommendations.

“L.K.’s dignity and bodily integrity are at stake and,” the petition argued, “ ... under the Montana Constitution her dignity is inviolable, including when her life or health is potentially at risk.”

Such cases present thorny issues for legal experts and medical ethicists. Decisions turn on the degree of competence and the severity of the medical issue.

“The more a disease or a problem for an adult is life-threatening, the more likely it is that treatment is compelled if the person is mentally impaired,” said Arthur L. Caplan, who heads the Center for Bioethics at the University of Pennsylvania.

“Normally, we don’t force treatment on adults. Competent adults can refuse even lifesaving treatments on religious terms,” he said. “The challenge is to establish that they truly are incompetent and that they really do comprehend the risk posed to their life.”

Then there are degrees, so to speak, of religion, said John Stone of Creighton University’s Center for Health Policy and Ethics. People with well-established religious objections to medical treatments — say Jehovah’s Witnesses who refuse blood transfusions, even lifesaving ones – generally see those requests honored, he said.

However, courts have forced minors who are Jehovah’s Witnesses to have transfusions, said Stone, who practiced cardiology in Missoula and co-founded the Institute of Medicine and Humanities, a joint program of the University of Montana and St. Patrick Hospital.

Things get more problematic with what he called the “marginal cases — people who are Satan worshippers. People who play with reptiles. ... What the heck do we make of these people who have these weird views?”

Finally, Stone said, there’s the issue of the level of expertise of those who testify as to L.K.’s incompetence.

“What was the range of knowledge of the person who assessed her regarding any of the range of religious views and how that reflects on capacity?” That question, he said, likely will be part of continued legal maneuvers.

Stacey Anderson, a spokeswoman for Planned Parenthood of Montana, said the case raises unsettling questions.

“The primary one is when the court starts ordering any sort of health care, it opens up the door for the slippery slope argument,” she said. “... Government intrusion into very private decisions is troubling.”

Anderson specified that she’s not familiar with this particular case.

“But in other states, when a woman doesn’t comply with what people think is best for her, that’s frequently the route they go — to get someone declared incompetent,” she said.

“And that’s troubling.”

Both Greg Hood, the public defender, and Deputy Missoula County Attorney Cathleen Sohlberg declined to discuss specifics of the case.

The Supreme Court’s order gives the public defender 30 days to appeal the District Court order; then the county attorney’s office will respond.

“L.K. will argue on appeal that the district court erred in determining that she is an incapacitated person with respect to this decision,” according to the motion seeking the Supreme Court stay, “and that the district court’s authorization of an involuntary hysterectomy violated L.K.’s constitutional rights to personal autonomy, dignity and religious freedom.”

Reporter Gwen Florio: 406-523-5268 or gwen.florio@missoulian.com

(15) comments

Longinus
Longinus

Can this woman support herself? Can she support a child?
Who pays her bills? If she can not take care of herself, than why would anyone let her have a child that we the taxpayers will have to support?

miss spelling
miss spelling

I don't think we are at the point where we "let" people have children. Altough your concern for my tax dollars is touching,
your take control attitude is ridiculous.

sealjoy
sealjoy

[quote]Longinus said: "Can this woman support herself? Can she support a child?Who pays her bills? If she can not take care of herself, than why would anyone let her have a child that we the taxpayers will have to support?"[/quote]

If this were the litmus test to which we have to measure in order to have children then all males who make under a certain amount of money should be castrated, and women as well.

My above statement is as ridiculous as Longinus' statement. This is the U.S., forcing someone to save their own life through this surgery is against the constitution. Declaring them incompetent based on their religious beliefs is also against the constitution.

Taxpayer's dollars are not more sacred than individual rights. IF you don't like how it is getting spent, change it. If your vote isn't enough, get involved, do something other than complain about your lot in life.

Where a woman gets her support does not determine if her right to have a child should be taken from her.

Independent
Independent

Forcing a medical procedure for a competent woman is wrong. If she knows the risks leave her alone.

mtbanana
mtbanana

Forcing ANY medical procedure on ANYONE is wrong, IMHO. If this woman is competent enough to understand that she has cancer, grasp the risks and benefits of surgery, and decide she doesn't want the surgery, it should be her decision. Since she is obviously opposed to having the surgery, I feel she understands what is going on at a sufficient level to decide for herself.

And WHERE do the folks at MSH get off on saying her religious beliefs are "delusional"? Some atheists would argue that ALL religion is delusion. When a court can reject someone's religious beliefs as delusion and use that to justify forcing a permanently life-altering medical procedure on them, this country is in trouble.

Even mentally ill people are entitled to their religious beliefs.

Longinus
Longinus

If you can't feed em, Don't breed em.

ClancyCoot
ClancyCoot

After reading the news article a little more closely, it appears this woman is a ward of the state. How long she has been in the state hospital and what her mental illness was is not mentioned. So, it seems there will be no winners in this case. She wins, she dies sooner. If she loses, she lives longer but for how long and at the hospital? It would be nice to have a few more details, otherwise all our comments are pure speculation.

JJ2014
JJ2014

The following summaries of nearly 1500 JEHOVAH'S WITNESSES MEDICAL and other COURT CASES will provide the BEST and MOST ACCURATE info about Jehovah's Witnesses, their beliefs, and how they ACTUALLY practice such day to day.


The following website summarizes over 900 court cases and lawsuits affecting children of Jehovah's Witness Parents, including 400 cases where the JW Parents refused to consent to life-saving blood transfusions for their dying children:

DIVORCE, BLOOD TRANSFUSIONS, AND OTHER LEGAL ISSUES AFFECTING CHILDREN OF JEHOVAH'S WITNESSES

jwdivorces.bravehost.com

The following website summarizes over 500 Jehovah's Witnesses Employment related lawsuits, etc, including DOZENS of court cases in which JW Employees refused blood transfusions, and/or other cases involving Worker's Comp, medical, health, and disability issues:

EMPLOYMENT ISSUES UNIQUE TO JEHOVAH'S WITNESS EMPLOYEES

jwemployees.bravehost.com

Curmudgeon
Curmudgeon

If the state Supreme Court is STRUGGLING with a complex and difficult case like this, what makes some of the commenters below, who have only read a news story, and who don't even know L.K., think they are qualified to pass judgment on the case?

Go look up "hubris".

jlarsen
jlarsen

If this woman were a minor, whose treatment was being withheld because of the parent's beliefs, I would say the state should intervene. She isn't, she's an informed adult who should be able to make her own decision regarding her treatment. The state should not intervene.

If she shrugs of the surgery, for whatever reason, including her belief that God has cured her, that's her choice. If she dies, she dies. Of course the religious right doesn't believe in a patient's right to die, so I'm surprised the churches and the GOP haven't gotten involved with trying to prevent her from making her choice. The fact that God is her reason for abstaining from treatment probably has them confused.

jlarsen
jlarsen

[quote]Longinus said: "Can this woman support herself? Can she support a child?Who pays her bills? If she can not take care of herself, than why would anyone let her have a child that we the taxpayers will have to support?"[/quote]

You missed the entire point of the article and the controversy surrounding it.

jlarsen
jlarsen

[quote]Longinus said: "If you can't feed em, Don't breed em."[/quote]

This article has nothing to do with reproduction, please read the article, and not just the headline before posting your ignorance again.

jlarsen
jlarsen

[quote]ClancyCoot said: "After reading the news article a little more closely, it appears this woman is a ward of the state. How long she has been in the state hospital and what her mental illness was is not mentioned. So, it seems there will be no winners in this case. She wins, she dies sooner. If she loses, she lives longer but for how long and at the hospital? It would be nice to have a few more details, otherwise all our comments are pure speculation."[/quote]

Just re-read the article. Nowhere does it state that this woman is a ward of the state. It might allude to it by the fact that they do not give her real name, and that one of the doctors quoted works at the state hospital, but it doesn't specifically say that she is a ward of the state or a resident of the hospital.

Assuming she is, couldn't she be in the state hospital for drug abuse related rehabilitation? If so, then there's no evidence that she is mentally incompetent. The article lists her religious beliefs as the sole determining factor in their decision that she is incompetent and doesn't mention anywhere that that she is being treated for any other symptoms of mental illness.

I think the supreme court made the correct move in halting her forced treatment until she has sufficient chance to appeal.

You are correct though, it would be nice to have a few more details. If she is in fact a ward of the state, and suffering from a more serious mental illness (other than one religious "delusion"), such as would make her incompetent - that would change things completely.

helenros
helenros

I find it disturbing how quickly people leap to eugenics as a cure for poverty and mental illness. I may choose not to reproduce due to my economic situation, but involuntary sterilization by castration? That is what the court is proposing here, and it doesn't appear the woman has committed a crime. She's entitled to her religious beliefs, even if they are wrong and kooky. She is an adult and has the right to refuse medical treatment, even if she dies.

jlarsen
jlarsen

[quote]helenros said: "I find it disturbing how quickly people leap to eugenics as a cure for poverty and mental illness. I may choose not to reproduce due to my economic situation, but involuntary sterilization by castration? That is what the court is proposing here, and it doesn't appear the woman has committed a crime. She's entitled to her religious beliefs, even if they are wrong and kooky. She is an adult and has the right to refuse medical treatment, even if she dies."[/quote]

I agree that an informed adult has the right to refuse medical treatment, even if it means that they will die. But this is not about eugenics, nor is it about "forced sterilization." She is refusing a life saving operation, and some think it is because she is mentally incompetent. It is just coincidence that her cancer happens to be in her reproductive organs.

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
PLEASE TURN OFF YOUR CAPS LOCK.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.