Justice John Paul Stevens — The Practice of Medicine and the Rule of Law | Health Care Reform Center

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by George J. Annas, J.D., M.P.H. in the New England Journal of Medicine

Although it’s not a thought that has leapt to the minds of commentators, U.S. Supreme Court Justice John Paul Stevens will be missed by physicians and patients. Stevens believes that the Constitution prohibits government from interfering in personal decision making, including medical decisions that belong in the hands of physicians and their patients, not politicians and regulators; it was for this reason that he was Justice Harry Blackmun’s staunchest ally in upholding the Roe v. Wade abortion-rights decision.

One clear articulation of this belief can be found in Stevens’s 1991 dissent in Rust v. Sullivan, in which the Court upheld the “gag” rule prohibiting government-funded physicians from discussing abortion with patients. In his dissent, Stevens wrote, “Roe v. Wade and its progeny are not so much about a medical procedure as they are about a woman’s fundamental right to self-determination . . . free from governmental domination.”1 Similarly, in a 1990 dissent in Washington v. Harper, Stevens objected to what he saw as an abuse of medicine: the drugging of a prisoner for security reasons rather than health reasons. Stevens carefully examined the medical facts, including the side effects of the drug in a patient like the prisoner, Harper, who already had dystonia and akathesia from previous forced medication with psychotropic drugs.1 Close attention to both statutory language and the facts of the case before him are hallmarks of Stevens’s approach to adjudication. And by paying close attention to the facts of cases, he learned about medical practice on the job.
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