On Sept. 17, the United States will celebrate Constitution and Citizenship Day to recognize the signing of the U.S. Constitution in 1787.
In 1952, President Truman signed a bill that created “Citizenship Day” on Sept. 17 of each year. In 2004, Sen. Robert Byrd of West Virginia entered an amendment to the Consolidated Appropriations Act of 2005 that changed the name of the Sept. 17 holiday to “Constitution Day and Citizenship Day.” The amendment directs all educational institutions receiving federal funding to provide educational programming on the U.S. Constitution on or around Sept. 17 of every year.
The U.S. Constitution greatly influences Americans’ daily lives, including individuals’ rights regarding health care. The U.S. Supreme Court has afforded Americans substantive due process protection under the 5th and 14th amendments over the last 25 years for fundamental rights such as liberty and the right to privacy in health care matters.
For example, in Cruzan v. Director, Missouri Department of Health (decided June 25, 1990), the U.S. Supreme Court reviewed the principle that a person has a constitutionally protected liberty interest in refusing unwanted medical treatment, including lifesaving hydration and nutrition. The Court affirmed the Supreme Court of Missouri’s holding that clear and convincing evidence of an incompetent patient’s desire to have life sustaining treatment withdrawn is required. In the absence of such evidence, Cruzan’s parents lacked authority to effectuate such a request.
Shortly thereafter, Congress passed The Federal Patient Self Determination Act requiring health care providers to have written policies and procedures concerning advance directives. The Terry Schiavo case again highlighted similar constitutional issues of liberty and the separation of powers between the executive, legislative and judicial branches of government.
Many U.S. Supreme Court Opinions have cited a “zone of privacy” from governmental intrusion created by several fundamental constitutional guarantees (i.e. Griswold v. Connecticut & Roe v. Wade)
In 2001, the U.S. Supreme Court reviewed the issue of a pregnant woman’s right to confidential medical care in Ferguson v. City of Charleston. By a 6-3 vote, the U.S. Supreme Court held that the Medical University of South Carolina’s policy of testing pregnant women seeking obstetrical care for evidence of cocaine use is unconstitutional under the Fourth Amendment in the absence of consent, when the immediate purpose of the policy was to obtain evidence for the police for criminal prosecution, not to help the pregnant women or their fetuses.
Since the word “privacy” is not found in the text of the Constitution, the interpretation of the substance and extent of individuals’ privacy rights in health care matters has always been controversial, and is emerging as a central issue in the confirmation hearings for chief justice nominee John Roberts.
The Constitution provides a framework to interpret many fundamental health care issues. To learn more about the Constitution, Constitution and Citizenship Day, and the U.S. Supreme Court, see the following links: