Bowen v. American Hospital Association

Parents of an infant with Down’s syndrome refused consent for their child’s life-saving surgery, and the hospital filed suit to override the parents’ decision. The parents prevailed, and the infant died. In response to this incident and directives from the United States president, the secretary of the Department of Health and Human Services (secretary) (defendant) issued final rules establishing procedures for disabled infants’ healthcare. Among other procedures, the rules required hospitals to post informational notices stating that disabled infants could not have medical treatment withheld based only on their disabilities. The contact information for the state child protective services (CPS) agency had to be included on the notice. The rules also mandated that CPS agencies establish procedures to prevent unlawful medical neglect of disabled infants. The CPS procedures had to include requirements for hospitals to report to the agencies, a review process for those reports, a process for on-site investigations of neglect, and a process for taking legal action resulting from the findings. The rules did not acknowledge that hospitals did not have authority to treat infants without parental consent. During the creation of the secretary’s rules, the American Hospital Association (association) and other organizations (defendants) filed suit in federal court for violations of the Administrative Procedure Act. After the final rules were issued, the association amended its complaint, and the case was consolidated with a lawsuit by the American Medical Association. The secretary defended the rules, claiming that they were authorized by the Rehabilitation Act. The lower courts ruled against the secretary, and the secretary appealed to the United States Supreme Court.