Right to Refuse Treatment

In Massachusetts, as in most states, a free person generally has the right to refuse medical treatment even when it is necessary to save his or her life. Shine v. Vega, 429 Mass. 456 (1999). See also, Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990) (“a competent person has a constitutionally protected liberty interest in refusing unwanted medical treatment”). As a general rule, prison staff will respect your right to refuse medication or treatment that the doctor has recommended. If you choose to reject the recommended treatment, medical staff should meet with you to explain the risks and benefits, but in most situations the final decision is up to you.

In rare instances, such as when prison officials fear that a prolonged hunger strike or refusal of treatment has created a substantial risk of death or serious injury, the DOC may file an emergency petition in the Superior Court seeking a judge’s approval for force-feeding or forced medical treatment. The Judge can override your decision not to accept treatment because the right of a prisoner to refuse medical care can be outweighed by the State’s interest in preserving life and in protecting institutional security. For example, in Commissioner of Correction v. Myers, 379 Mass. 255 (1979), the court ruled that the DOC could force a prisoner to have kidney dialysis treatment because it was necessary to save his life and because the prisoner was “attempting to manipulate his placement within the prison system by refusing life-saving treatment.” (A copy of the Myers decision is enclosed). Even without getting a court order, the DOC can discipline a prisoner for refusing to submit to certain diagnostic tests that are necessary to ensure the health of the prison population, such as the skin test for tuberculosis. See Langton v. Commissioner of Correction, 34 Mass. App. Ct. 564 (1993).

Please note that if the DOC chooses to file an "emergency" motion for involuntary treatment, the court is not required to give you a hearing, although some judges will do so. If you believe that the prison may label your situation an "emergency" and seek a hearing to impose medical treatment on you, you may want to send a letter to the court asking for the right to speak at the hearing or to present your position. You should also send a copy of this letter to the General Counsel for the DOC.

Mental Health Treatment

If you are refusing medication or treatment for a mental disorder, the prison may ask the district court to transfer you to a mental institution, such as Bridgewater State Hospital, for a 30 day evaluation period. See G.L. c. 123, § 18(a). You will not have a hearing before this transfer takes place. Once in the Hospital, you can be medicated against your will for a very short period of time, but only if there is a serious risk of immediate harm to yourself or others. See Rogers v. Commissioner, Dep’t of Mental Health, 390 Mass. 489 (1983). If the Hospital wants to make you take medication when there is no longer an emergency, or if it wants you to stay in the Hospital for more than 30 days, it must obtain permission of the court. The court will appoint a lawyer to represent you at that hearing and you will have the right to attend the hearing and explain why you do not want to take medication or remain in the hospital.