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New York Attorney General Eliot L. Spitzer and an assistant are protected by qualified immunity for intervening in the medical treatment of a terminally ill woman, the 2nd U.S. Circuit Court of Appeals ruled Monday. Spitzer and Assistant Attorney General Winthrop H. Thurlow had been sued by the estate of Sheila Pouliot for opposing the efforts of doctors and the patient’s family to terminate medical care for Pouliot, who died in 2000 after a lifetime of suffering. Thurlow had sought to ensure that Pouliot’s life would continue to be supported, but doctors and family members said feeding Pouliot would require invasive procedures that would only increase and prolong her pain. Thurlow had advised officials at a Syracuse, N.Y., hospital that the administration of artificial nutrition, hydration and antibiotics was required, and that no third party could direct the withdrawal of life-extending measures from Pouliot, who from birth had never been competent to make decisions on her own medical treatment. A state court eventually determined it was in Pouliot’s best interest to have hydration terminated, a decision that was upheld in the Appellate Division on March 3, 2000, three days before Pouliot died. The administratrix of Pouliot’s estate, Alice Blouin, brought suit under 42 U.S.C. � 1983 charging several constitutional violations as well as state law claims. Northern District of New York Judge Howard G. Munson found that the attorney general’s office could not invoke absolute immunity because its “actions began prior to the commencement of any judicial proceeding and they were not pursuant to any statutory obligation.” Moreover, Munson said, the office’s “initial actions,” providing legal advice to the State University of New York Upstate Medical Center at Syracuse, “are neither part of a prosecutor’s traditional functions nor are they closely associated with the judicial process.” But Judge Munson nevertheless found that Spitzer and Thurlow were protected by qualified immunity because the plaintiff “has failed to allege a violation of a clearly established right.” On the appeal in Blouin v. Spitzer, 02-7997, Spitzer and Thurlow claimed absolute immunity was proper in a case under � 1983 because their actions concerned “functions and conduct as government advocates representing their state clients.” But 2nd Circuit Judge Barrington D. Parker Jr., writing for the court, said, “We are not persuaded that absolute immunity extends this far under federal law.” Judge Parker then turned to qualified immunity, which he said “shields a government official acting in an official capacity from suit for damages under �1983 unless the official ‘violated clearly established rights of which an objectively reasonable official would have known.’” LIBERTY INTEREST Parker said the “central and strongest” argument advanced by Blouin was that Pouliot’s liberty interest under the 14th Amendment had been violated. But even that argument fell short, the judge said. “While Blouin is right to assert that the Constitution supports a right to reject life-sustaining medical treatment as a function of the fundamental right to bodily integrity under the Due Process Clause … it does not follow from this, as Blouin argues, that an incompetent person whose death is imminent has a constitutional right to have a surrogate make critical medical decisions, including a decision to withdraw life support,” Judge Parker said. “While the former proposition finds support in case law, the latter does not and, as a consequence, is not ‘clearly established.’” Parker said the U.S. Supreme Court, in case law beginning with Cruzan v. Dir., Mo Dep’t of Health, 497 U.S. 261 (1990), “has explicitly refused to recognize any personal right to assisted suicide and has noted that the personal autonomy rationale employed here does not create new substantive rights entitled to protection under the Due Process Clause.” The Cruzan case, he said, “rests solely on the patient’s capacity to express her intention regarding the course of her medical treatment; a capacity that Nancy Cruzan once possessed but that Sheila Pouliot never did.” “In sum, Blouin has not demonstrated that clearly established federal law barred the defendants from effectuating the state’s interest in prolonging the life of one of its citizens, whatever its quality,” Judge Parker said. Judges Rosemary S. Pooler and Robert D. Sack joined in the opinion. James T. Snyder and James E. Reid of Greene & Reid represented Blouin. Assistant Solicitor General Robert M. Goldfarb, Deputy Solicitor General Daniel Smirlock and Senior Counsel Peter H. Schiff represented New York state.

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