Saint John Paul the Great argued that the common good “is that point where rights and duties converge and reinforce one another.” Political philosopher Francis Lieber—whose Lieber Code of 1863 laid the groundwork for the Hague Conventions—similarly claimed that “The very condition of right is obligation; the only reasonableness of obligations consists in rights.” 

That rights and duties correspond should be plainly obvious. The right of a manufacturer to produce and sell goods in commerce corresponds to a legal duty to provide adequate warnings, be truthful in advertising, and not sell defective products, among other duties. The right to sit on a jury corresponds to a duty to be fair and impartial, to apply the law as given by the judge, etc.

Perhaps nowhere is the intersection of rights and duties more evident than in the home, where the apex of individual freedom lies. Indeed, American courts agree with “the ancient adage that a man’s house is his castle to the point that the poorest man may in his cottage bid defiance to all the forces of the Crown.” But a man’s rights in his own home are not unlimited. He may not turn his home into a public nuisance, or a den of thieves, and he may not abuse or neglect those in his charge. 

As to that last point, there exists a thin, gray line: where do my rights as a parent to rear my children as I deem fit collide with my duty (and the duty of the state) to protect and care for those same children?

Matter of Child of M.E.P., a recent decision from the Minnesota Court of Appeals, illustrates this tension. In that case, a 5-year-old child was diagnosed with leukemia, and his parents initially complied with the doctor’s recommended course of treatment, including chemotherapy. But the parents objected to the second phase of chemotherapy based on concerns about the efficacy of the chemotherapy, the severity of its side effects, and a preference for natural remedies. The treating doctor made a child-protection report with the county, and the district court filed an order granting the county interim legal custody, authorizing placement of the child in his grandmother’s home, and ordering the county to “follow the treatment course recommended by Minnesota Children’s Hospital.” 

The parents appealed, arguing, among other things, that the district court’s orders violated their constitutional rights under the Fourteenth Amendment to the care, custody, and control of their son. The court of appeals observed that a “parent’s right to make medical decisions on behalf of a child co-exists with a ‘high duty to recognize symptoms of illness and to seek and follow medical advice.’” Although parents have the dominant role in the care and treatment of their children, it is not unfettered; the state has some “constitutional control over parental discretion in dealing with children when their physical or mental health is jeopardized.” 

Of course, where that thin, gray line exists in a given case is the key question. The court of appeals noted that the issue before it—whether a parent has a Fourteenth Amendment due process right (as distinct from a First Amendment free exercise right) to reject a physician’s treatment recommendation for a child’s life-threatening illness—was novel in Minnesota and had only been addressed by one other case, Massachusetts’ Custody of a Minor, which also involved treatment for life-threatening leukemia. After reviewing Custody of a Minor, the Minnesota Court of Appeals determined that “a parent’s right to make medical decisions on behalf of a child must be balanced against the state’s interest in ensuring child welfare and that the proper balancing of such rights and interests in a particular case depends on the facts of the case.”

Given the child’s aggressive form of cancer, his odds of survival if he completes the chemotherapy treatment plan (93 percent) versus his odds of survival if he does not (less than 20 percent), and testimony from multiple doctors that chemotherapy is necessary to save the child’s life, the court of appeals concluded that the “parents’ constitutional rights to the care, custody, and control of K.K.P. must yield to the state’s interest in protecting K.K.P.’s best interests.” 

That rights and duties correspond is the very backbone of American jurisprudence. But at which point a right must cede to a duty is not always clear. Although it doesn’t draw a bright line, Matter of Child of M.E.P. does provide important guidance regarding the intersection between parents’ right to the care, custody, and control of their child, and the state’s duty to protect the child’s best interests. Based on the importance of the issue at stake, and its novel nature, it will not be surprising if the Minnesota Supreme Court accepts further review. 

Note from the Editor: The Federalist Society takes no positions on particular legal and public policy matters. Any expressions of opinion are those of the author. We welcome responses to the views presented here. To join the debate, please email us at [email protected].