Bowen v. American Hospital Association

476 U.S. 610 (1986)

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Nature of the Case

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Facts

Various organizations were opposed to the final rules adopted by DHHS on January 12, 1984, for the care of handicapped infants. These final rules were formulated after parents of an infant with Down's syndrome and other handicaps refused to consent to surgery to remove an obstruction that prevented feeding. The hospital lost the judicial proceedings to force the surgery, and the local Child Protection Committee found no reason to disagree with the court's findings. The child died six days after birth. This prompted an immediate response by the President of the United States and DHHS that handicaps such as Down's syndrome were protected by federal regulations. The new rules required conspicuous posting of those rules in places of immediate access throughout hospitals with a hotline number to report suspected violations. Various organizations disputed the issuance of this directive. DHHS took a step back and did the proposed rule like it was supposed to be done with a period of notice and comment. Those new rules required CPS to take active measures to prevent instances of medical neglect of handicapped infants. The Final Rules did not contain a recognition of the fact that hospitals and physicians lacked authority to perform treatment to which parents have not given their consent. Suit was taken to declare these regulations invalid and enjoin their enforcement. The District Court agreed and declared the regulations invalid. The Court of Appeals affirmed based on its own prior case law involving University Hospital; the hospital had not refused to perform the procedures because the child was handicapped but because consent was refused by the parents. The Supreme Court granted certiorari.