## Facts

- Samantha Burton, about 25 weeks pregnant, went to a hospital after premature rupture of membranes and signs of premature labor.
- Physicians recommended continued hospitalization and bed rest; Burton refused prolonged hospitalization, citing personal and family concerns, and sought to leave.
- Burton’s obstetrician would not discharge her and sought state involvement rather than allowing her to obtain a second opinion.
- The State Attorney initiated a judicial proceeding to compel treatment.
- The trial court conducted an emergency telephone hearing while Burton was in her hospital bed; she had no attorney and no independent medical expert testified on her behalf.
- The court ordered Burton to submit to “any and all medical treatments” deemed necessary by her attending obstetrician, including hospital detention for bed rest, intravenous medications, and anticipated surgical delivery.
- Two days after the order, Burton underwent a cesarean section; the fetus was delivered dead.

## Issues

1. Whether a court may compel a competent pregnant woman to undergo medical confinement and treatment, including surgery, over her objection for the asserted benefit of the fetus.
2. What constitutional standard applies when the State seeks to override a pregnant woman’s refusal of medical treatment based on fetal welfare, including whether fetal viability must be proven.

## Decision

- The District Court of Appeal reversed the order compelling Burton to submit to medical confinement and treatment.
- The court held the appeal was reviewable despite mootness because the dispute was capable of repetition yet evading review.
- The court rejected the trial court’s use of a generalized “best interests of the child” approach to override Burton’s refusal.
- The court held that strict scrutiny governed and that the State failed to meet its burden, including failing to establish fetal viability and the necessity and tailoring of the compelled interventions.

## Legal Principles

- A competent person’s decisions about medical treatment implicate fundamental privacy and liberty rights under the Florida Constitution.
- State interference with those rights is subject to strict scrutiny, requiring a compelling state interest and narrowly tailored, least-restrictive means.
- In pregnancy-related compelled-treatment cases, the State must prove fetal viability; viability is not established solely by gestational age.
- Family-law “best interests of the child” standards for disputes involving born children do not supply the constitutional test for compelled medical treatment of a competent pregnant woman.
- Emergency proceedings compelling serious bodily intrusions require careful protection of the individual’s rights; conclusory assertions of fetal benefit are insufficient.

## Conclusion

The court set aside an order forcing a competent pregnant woman to accept confinement and medical treatment, holding that any such state action must satisfy strict scrutiny and be supported by proof of fetal viability and a narrowly tailored justification, not a generalized fetal “best interests” rationale.


Burton v. State, 49 So. 3d 263 (Fla. Dist. Ct. App. 2010)