legally incompetent person

On the night of January 11, 1983, Nancy Beth Cruzan lost control of her car as she traveled down Elm Road in Jasper County, Missouri. The vehicle overturned, and Cruzan was discovered lying face down in a ditch without detectable respiratory or cardiac function. Paramedics were able to restore her breathing and heartbeat at the accident site, and she was transported to a hospital in an unconscious state. An attending neurosurgeon diagnosed her as having sustained probable cerebral contusions compounded by significant anoxia. The Missouri trial court found that permanent brain damage generally results after six minutes in an anoxic state, and it was estimated that Cruzan was deprived of oxygen from twelve to fourteen minutes. She remained in a coma for approximately three weeks and then progressed to an unconscious state in which she was able to orally ingest some nutrition. Surgeons implanted a gastrostomy feeding and hydration tube in Cruzan with the consent of her then husband. Subsequent rehabilitative efforts proved unavailing. She now lies in a Missouri state hospital in what is commonly referred to as a persistent vegetative state in which a person exhibits motor reflexes but evinces no indications of significant cognitive function. The State of Missouri is bearing the cost of her care. After it had become apparent that Nancy Cruzan had virtually no chance of regaining her mental faculties, her parents Lester and Joyce Cruzan, who serve as coguardians, asked hospital employees to terminate the artificial nutrition and hydration procedures. All agree that such a removal would cause her death. The employees refused to honor the request without court approval. The parents then sought and received authorization from the state trial court for termination. The trial court found that a person in Nancy's condition had a fundamental right under the State and Federal Constitutions to refuse or direct the withdrawal of death prolonging procedures. The court also found that Nancy's expressed thoughts at age twenty-five in conversation with a housemate friend suggested that given her present condition she would not wish to continue on with her nutrition and hydration. The Supreme Court of Missouri reversed by a divided vote. The court recognized a right to refuse treatment embodied in the common-law doctrine of informed consent but expressed skepticism about the application of that doctrine in the circumstances of this case. The court found that Cruzan's statements to her roommate regarding her desire to live or die under those conditions were unreliable for determining her intent and thus insufficient to support the coguardians' claim to exercise substituted judgment on Nancy's behalf. It rejected the argument that Cruzan's parents were entitled to order the termination of her medical treatment, concluding that no person can assume that choice for an incompetent in the absence of the formalities required under Missouri's Living Will statutes or the clear and convincing inherently reliable evidence absent here. The Supreme Court granted certiorari to consider the question whether Cruzan has a right under the United States Constitution which would require the hospital to withdraw life-sustaining treatment from her under these circumstances.

In order to combat child pornography, Ohio enacted Revised Code Annotated section 2907.323(A)(3). The statute prohibits any person from possessing or viewing material or a performance that shows a minor who is not the person's child or ward in a state of nudity, unless certain exceptions for bona fide purposes or parental consent apply. Columbus, Ohio police officers conducted a valid search of petitioner Clyde Osborne's home and found four photographs. Each photograph depicts a nude male adolescent posed in a sexually explicit position. Osborne was convicted of violating the statute and sentenced to six months in prison. An intermediate appellate court affirmed Osborne's conviction. The Supreme Court of Ohio likewise affirmed. Relying on its construction of the statute, the Ohio Supreme Court rejected Osborne's claim that the First Amendment prohibits states from proscribing private possession of child pornography. The court also found that the statute, as narrowed to require a lewd exhibition or graphic focus on the genitals, is not unconstitutionally overbroad. The court held that scienter is an essential element of the offense. Osborne objected that the trial judge had not required the government to prove lewd exhibition and scienter as elements of the crime. The Ohio Supreme Court rejected these contentions because Osborne had failed to object to the jury instructions at trial and the court did not believe the failures amounted to plain error. The Ohio Supreme Court denied a motion for rehearing and granted a stay pending appeal. The United States Supreme Court noted probable jurisdiction in June 1989.

In 1984, Teofilo Medina, Jr., stole a gun from a pawnshop in Santa Ana, California. Over the following weeks, he committed multiple armed robberies of gas stations, a drive-in dairy, and a market, during which he murdered three employees and shot at two passersby. He was apprehended less than a month after the crime spree began and charged with three counts of first-degree murder and other offenses. Before trial, Medina's counsel moved for a competency hearing under California Penal Code section 1368, expressing uncertainty about Medina's ability to participate in the proceedings. The trial court granted the motion, and a six-day hearing was held before a jury. During the hearing, the jury heard conflicting testimony from multiple psychiatrists and psychologists regarding Medina's mental condition, including diagnoses of paranoid schizophrenia and depression, as well as observations of his verbal and physical outbursts, such as overturning the counsel table. The trial court instructed the jury that Medina was presumed mentally competent and bore the burden of proving his incompetence by a preponderance of the evidence under California Penal Code section 1369(f). The jury found Medina competent to stand trial. At the conclusion of the guilt phase, petitioner was found guilty of all three counts of first-degree murder and lesser offenses. A sanity hearing was held, and the jury found that petitioner was sane at the time of the offenses. At the penalty phase, the jury found that the murders were premeditated and deliberate and returned a verdict of death. On direct appeal, the California Supreme Court affirmed the conviction and sentence. Medina later filed a habeas corpus petition in the California Supreme Court, which appointed a referee for an evidentiary hearing; the referee found Medina had been competent, and the court adopted those findings. Medina then sought federal habeas relief in the United States District Court for the Central District of California, which was denied, and the Ninth Circuit affirmed. The Supreme Court granted certiorari to address the constitutionality of the state statute allocating the burden of proof on competency to the defendant.

In August 1976 Walter Harper was sentenced to prison for robbery and incarcerated at the Washington State Penitentiary, where he spent most of his time in the mental health unit and consented to antipsychotic medication. In 1980 Harper was paroled on the condition that he participate in psychiatric treatment, which he received at Harborview Medical Center and later at Western State Hospital under a civil commitment order. His parole was revoked in December 1981 after he assaulted two nurses at a hospital in Seattle. Upon his return to prison, respondent was sent to the Special Offender Center, a 144-bed correctional institute established by the Washington Department of Corrections to diagnose and treat convicted felons with serious mental disorders. At the Center, Harper was diagnosed with a manic-depressive disorder and initially consented to treatment, including antipsychotic drugs, but in November 1982 he refused further medication. The treating psychiatrist then invoked SOC Policy 600.30 to administer the drugs involuntarily after a committee hearing found that Harper suffered from a mental disorder and posed a likelihood of serious harm to others. Harper was involuntarily medicated for about one year beginning November 23, 1982, then transferred to the Washington State Reformatory in November 1983 where he took no medication and his condition deteriorated, prompting his retransfer to the Center and another involuntary medication approval. He continued receiving the drugs subject to periodic reviews until his transfer to the Washington State Penitentiary in June 1986. In February 1985 Harper filed suit in state court under 42 U.S.C. § 1983 against the State and individual defendants, alleging that the failure to provide a judicial hearing before involuntary administration of antipsychotic medication violated due process and other constitutional provisions. After a bench trial in March 1987 the trial court upheld the policy's procedures as satisfying due process, but the Washington Supreme Court reversed, holding that a judicial hearing with full adversarial protections and proof by clear, cogent, and convincing evidence was required. The United States Supreme Court granted certiorari in 1989 to review the constitutional questions presented by the state court's decision.

On February 6, 1963, petitioner, a citizen of Ohio, filed her complaint in the District Court for the District of Massachusetts, claiming damages in excess of $10,000 for personal injuries resulting from an automobile accident in South Carolina, allegedly caused by the negligence of one Louise Plumer Osgood, a Massachusetts citizen deceased at the time of the filing of the complaint. Respondent, Mrs. Osgood's executor and also a Massachusetts citizen, was named as defendant. On February 8, service was made by leaving copies of the summons and the complaint with respondent's wife at his residence, concededly in compliance with Rule 4 (d) (1). Respondent filed his answer on February 26, alleging, inter alia, that the action could not be maintained because it had been brought contrary to and in violation of the provisions of Massachusetts General Laws Chapter 197, Section 9. On October 17, 1963, the District Court granted respondent's motion for summary judgment. On appeal, the Court of Appeals for the First Circuit affirmed. The Supreme Court granted certiorari because of the threat to the goal of uniformity of federal procedure posed by the decision below.