Wisconsin Supreme Court avoids "mature minor" ruling

In a decision handed down earlier this month, the Wisconsin Supreme Court avoided ruling on whether so-called “mature minors” should be able to make decisions controlling their own medical care.

Dane County v. Sheila W. started in February of 2012, when a 15-year-old Jehovah’s Witness (identified only as Sheila W. in court documents) was diagnosed with aplastic anemia, a potentially fatal condition that prevented her bone marrow from producing blood cells.  Doctors initially treated the teenager with antibodies, but these eventually proved ineffective, leaving her at risk of cardiac arrest and respiratory failure.  The physician treating her determined that she would die if she did not receive a blood transfusion.

Although their stance on the issue appears to have softened somewhat in recent years, many Jehovah’s Witnesses believe that transfusions are tantamount to “eating blood,” a practice proscribed by the Bible.   Sheila, in keeping with those tenets of Witness doctrine, refused to consent to the transfusions. She informed one physician that she "would rather die” than live with the stigma of having received a transfusion.   In a later proceeding, the teen told Dane County Circuit Judge William Foust that a blood transfusion would be “devastating to me mentally and physically” because it is “my body, my belief, my wishes.  Sheila even went so far as to say that she thought of considered receiving a blood transfusion equivalent to being raped.

Dane County authorities, believing that Sheila’s health to be in serious jeopardy, took emergency custody of the teen on February 29, 2012. The county subsequently filed a petition for protective services, the goal being to obtain temporary physical custody of Sheila and administer the blood transfusions. Early in March, Foust held a hearing in the hospital and determined that Sheila’s parents were seriously endangering her health by refusing to consent to the transfusions. He did not grant custody to the county but rather appointed a temporary guardian, who then authorized the transfusions.

In her appeal, Sheila W. asked the high court to accept the “mature minor" doctrine as part of Wisconsin law. The doctrine permits older minors who can demonstrate sufficient understanding and appreciation of the consequences of their decision to independently make medical treatment decisions involving their own care, without parental consent.

In a 4-3 decision, the Wisconsin Supreme Court refused to address the substance of Sheila W.’s claim, asserting that the case was moot since the order appointing the guardian had long since expired.  The per curiam opinion for the court acknowledged that “this case undoubtedly presents issues of great public importance.”  Yet the majority decided that it would be premature to rule on the matter before the state legislature had weighed and passed a statute dealing with “such substantial social policy issues with far-ranging implications.”  (Unlike Wisconsin, several other states have laws that seem to address the applicability of the “mature minor” doctrine is cases relating to health care.)

The majority opinion drew a vehement dissent from Justice Michael Gableman, who criticized his colleagues for ducking their responsibility.  “Life is about hard choices, particularly for members of a state high court,” he wrote.  “Unfortunately, today the only thing the parties receive for their time and trouble before this court is abdication dressed as modesty.”

The Sheila W. case marked the second time in a month that state high court had ruled in a case involving religious objections to medical treatment.  Earlier in July, the justices upheld the second-degree reckless homicide convictions of Dale and Leilani Neumann, whose daughter Kara had died in 2008 after being treated with prayer in lieu of conventional medicine.