WA court: Fasting inmate can't refuse force-feeding

OLYMPIA — Prisoners don't have a right to refuse force-feeding merely to maintain a fast or hunger strike that would eventually kill them, the state Supreme Court ruled today.

The court's 8-1 ruling rejects the arguments of prison inmate Charles R. McNabb, who claimed Washington's strong constitutional privacy protections gave him a right to starve himself to death while behind bars.

McNabb, 53, was sentenced to more than 14 years in prison after pleading guilty to arson and assault for a 2003 fire at his estranged wife's home. McNabb stopped eating solid food in February 2004, reportedly out of remorse for injuries his teenage stepdaughter suffered in the fire.

After nearly six months of fasting that McNabb hoped would kill him, state prison officials intervened, force-feeding McNabb by inserting a tube through his nose. McNabb agreed to eat on his own after several days of tube feeding, but he challenged the state prison system's force-feeding policy in court.

Today, the court ruled that McNabb did not have a constitutional right to starve himself to death, saying that an otherwise healthy prisoner's circumstances are far different from those contemplated under a state law that allows gravely ill people to refuse life-sustaining treatment.

The court's majority was split, however, over whether a prisoner has even a limited right to refuse food and hydration without a "terminal or incurable illness, or a severe and permanent mental and physical deterioration."

Four justices, led by Mary Fairhurst, said a prisoner has a limited right to refuse forced feeding, subject to a five-part test.

The justices created the new standard by combining two existing legal tests: one balancing inmates' rights with the need for effective prison administration, and another that determines whether a Washingtonian's desire to refuse life-sustaining treatment conflicts with a compelling state interest.

After weighing those factors, the four lead justices concluded that "the state's interests in orderly administration of the prison system, preservation of life, prevention of suicide, and maintenance of the ethical integrity of the medical profession outweigh McNabb's limited right" to refuse food and water.

Four other justices, however, agreed only with the results of the lead opinion. They said the lead ruling's recognition of a limited food-refusal right for inmates strays too far from existing law that lays out a right to refuse treatment only in cases of a grave medical condition.

"The lead opinion... expands the constitutional privacy right by granting to an otherwise healthy and competent individual the right to refuse nutrition and hydration, subject only to compelling state interests that might outweigh the right," wrote the concurring justices, led by Barbara Madsen.

The lone dissenting justice, Richard Sanders, supported McNabb's argument that he has a privacy right to refuse feeding, and said the court was incorrectly casting the privacy question as a right to commit suicide.

State officials said McNabb, who was at a state prison near Spokane when the case was launched, is now serving time in Monroe and could be released in 2015.