"On its merits, this case raises troubling questions: Did
private health-care providers acting under color of state law
violate a patient’s constitutional rights when, without a court
order, they forcibly held her in a hospital for a month;
subjected her to medical, including psychiatric and prenatal,
treatment; did not allow her to contact a lawyer; and then,
after her daughter was born, allowed her to leave in so fragile
a condition that she died outside near the hospital that night?
But we cannot answer those questions today. The district
court’s denial of the health-care providers’ good-faith
defense to § 1983 liability is not immediately appealable
under the collateral order doctrine, so there is no decision
within our jurisdiction to review. That conclusion eliminates
any basis for our jurisdiction over the cross-appeal brought
by the patient’s survivors. We accordingly dismiss these
appeals."
The opinion seems definitely correct; it's not a final judgment, and the federal defense at issue is not akin to qualified immunity, so yeah, no appellate jurisdiction. On that (dispositive) point, I wholeheartedly agree.
I had a slightly different reaction than Judge Berzon, though, on the merits.
From the introduction, I thought that I would be heavily sympathetic to the plaintiff. And, in truth, I kinda am. After reading the entirety of the facts, I might have added the word "allegedly" to that introductory paragraph, but overall, it accurately summarizes what plaintiff claims to have transpired.
At the same time, I find it somewhat difficult to reconcile any potential outrage at the hospital's (alleged) initial conduct with any potential outrage at the final result. From Judge Berzon's introduction, I definitely felt like the hospital was not giving the patient very much autonomy. I learned later in the opinion that the hospital (through its psychiatrist) did file a petition to involuntarily hold the plaintiff in the hospital, but the hospital held here there in the interim while the petition was pending. Clearly the better option would have been to get a TRO and a court order for that interim period so, yes, there's a real issue about whether the hospital was justified in holding the plaintiff in the hospital, and treating her there, against her wishes.
But that initial sentiment is somewhat contradicted by the final result -- one that Judge Berzon's opinion distinctly mentions, but that didn't really hit home until the subsequent recitation of the ultimate facts.
Pursuant to the pending petition, the hospital held her there, and treated her, until her child was born, even though he continuously objected and demanded to leave. Once the child was born, however, the hospital finally relented, and granted her the autonomy that she so desperately sought. Two days after the c-section, they told her that if she really wanted to leave, it was 100% against their medical advice, but at that point, if she was absolutely set on declining medical treatment, it was her choice, and when she insisted on leaving, they then dropped the petition and -- again, totally AMA -- let her leave.
Which is when she promptly dropped dead on a porch not far from the entrance to the hospital.
There's a lingering sentiment in me that says you can't have it both ways. You can't complain about not being allowed to leave the hospital and then simultaneously complain about dropping dead after they finally relent and release you. It's one or the other. And the fact that she did, in fact, drop dead shortly after leaving the hospital seems to me a strong argument for not letting her leave the hospital, especially during that period in which she had an about-to-be born child inside of her.
Admittedly, those are all issue that relate to the merits, and a jury will ultimately get to decide whether what the hospital did was justified or not. And, again, the much better practice would have been to get all of this blessed by a judge in advance as part of the involuntary commitment petition.
But it nonetheless seems difficult to me for one to argue that you should have been left to leave the hospital when, upon actually being released, you promptly (and presumably involuntarily) ceased to exist.
