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Prison Wardens Must Not Make “End-of-Life” Medical Decisions without Advance Consent from the Prison

On appeal, Carter Davenport, a prison warden, argued that he was entitled to qualified immunity from claims by the estate of Marquette F. Cummings Jr., a prisoner who was stabbed by a fellow inmate. Estate of Cummings v. Davenport, 2018 WL 4705723 (11th Cir. 2018). After he was stabbed, Cummings was transported to a hospital and died the next day. His estate filed a civil-rights complaint alleging that Davenport violated the Eighth and Fourteenth Amendments to the Constitution by illegally interfering with Cummings's end-of-life medical care with deliberate indifference to his serious medical needs. The district court determined that Davenport failed to establish that his alleged actions, which included the entry of a do-not-resuscitate order and the decision to remove Cummings from artificial life support, fell within the scope of his discretionary authority, his threshold burden for qualified immunity.

Cummings was transferred to the University of Alabama at Birmingham Hospital. Shortly thereafter, Cummings’ mother arrived at the hospital and asked to see her son, but the staff told her she would have to wait at least 90 minutes. At some point, the hospital staff told her that “Cummings had been stabbed in the eye and that, due to his injuries, he was only operating with 10% of normal brain functioning.” On January 7, 2014, Cummings was removed from life support, without his or his mother’s consent. Rather, his transfer papers from prison included an instruction from Davenport that “no heroic measures would be taken to save his life.” Therefore, Dr. Sherry Melton, at Davenport's instruction, entered a do-not-resuscitate order for Cummings. Throughout Cummings’ stay at the hospital, hospital staff “repeatedly conveyed that it was not Cummings’ mother’s call because “the State had legal custody over Cummings and that the decision to let her son die was the Warden's decision.”

Davenport argued that his alleged actions fell within his discretionary authority because, as a prison warden, it was his responsibility to “supervis[e] and control[ ] the care and custody of inmates including their medical care.” Davenport also maintained that no authority clearly established that Davenport's actions were unconstitutional. The district court concluded that a warden must either have an advance directive from the patient or be a court-appointed guardian to make those medical end-of-life decisions. Therefore, Davenport had not met his burden of establishing that the alleged acts were within his discretionary authority, so he could not claim qualified immunity. Accordingly, the Eleventh Circuit affirmed the denial of qualified immunity.

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