In the Interests of DJ addresses whether surgery should be performed on a child in foster care over the objections of the natural mother. The child suffers from familial cateracts, and while glasses can correct his vision to 20/70 in his left eye and 20/40 in his right. He's having some problems in school for reasons that may or may not be related to vision - the record is apparently unclear. Regardless, both the State and his foster parent wished to have cateract surgery performed, contending the need to provide an education for DJ and asserting that the cateracts are interfering with his school performance. His non-custodial mother, identified as "Heather," objected to the surgery, but gave no reason beyond the fact that as the natural parent she should have the right to make medical decisions that are not life-threatening. The surgery carries the risk of "blindness, glaucoma, scarring, and retinal detachment. Death resulting from the anesthesia is also a possible risk." The benefits include "better vision and depth perception, reduced glare, and improved ability to participate in sports and outdoor activities." The juvenile court found the risks involved with the surgery minute, and ordered the surgery on the left eye to proceed, with the surgery on the right eye to also be performed if recommended by the attending ophthalmologist.
The Court of Appeals did not feel that Heather had a unilateral right as a natural parent to make non-threatening medical decisions for her son when he was outside her custody, citing an earlier case in which it upheld a decision for a tonsillectomy on foster kids over the objections of their non-custodial father, as it was in the children's best interest. However, it felt there was a significant question as to the wisdom of surgery, and whether it was in DJ's best interests:
"Neither ophthalmologist actually recommended D.J. have surgery. One stated she did not have a complete medical history and that a treating physician would need more information to make a recommendation as to surgery. She also stated that either decision, to have the surgery or not have the surgery, would be reasonable. . . .
The other doctor stated he could conclude with reasonable medical certainty that D.J.’s eyesight will worsen with time. He could not say whether D.J.’s sight would improve with surgery at this time, but if surgery was postponed until D.J. was fifteen or sixteen, there may be less of a chance his sight would improve . . .Ultimately, he thought D.J. would benefit from surgery, but stated that he would need to conduct a further examination to make a recommendation. He also stated he felt great caution needed to be taken.
Though we are not against the surgery, we hesitate to override a parent’s wishes without, at the very least, a medical recommendation. Therefore, given the physicians’ uncertainty and their unwillingness to offer an opinion without further examination, we must reverse the decision of the juvenile court which authorized surgery. However, in keeping with the best interests of the child and the interest of judicial economy, we remand to the juvenile court for further medical examination of the child and possible rehearing on the matter. We do not retain jurisdiction."
It should also be noted that the surgery carried no guarantees it would actually improve DJ's eyesight. Also, I found this quote from the second doctor rather telling:
"In this particular case, if, you know, when I saw [D.J.] for the first time, actually, it was—I think it was a foster mom who actually brought the patient in, and the foster mom, I had the impression that he or she didn’t even know that [D.J.] had the cataracts. If [D.J.] presented to me with his biological mother or father and if they said, doctor, I do not wish to take the risk, and I would like to observe, that would be reasonable, yes."
All in all, it seems like the best result was reached, given the ambiguities of the situation.
State v. Petra involves a reading of sentencing statutes. Iowa Code section 901.10 permits the modification of the sentencing scheme of sections 124.413 and 124.401 (drug possession charges) under certain circumstances:
1. A court sentencing a person for the person’s first conviction under section . . . 124.413 . . . may, at its discretion, sentence the person to a term less than provided by the statute if mitigating circumstances exist and those circumstances are stated specifically in the record.
2. Notwithstanding subsection 1, if the sentence under section 124.413 involves an amphetamine or methamphetamine offense under section 124.401, subsection 1, paragraph “a” or “b”, the court shall not grant any reduction of sentence unless the defendant pleads guilty. If the defendant pleads guilty, the court may, at its discretion, reduce the mandatory minimum sentence by up to one-third. If the defendant additionally cooperates in the prosecution of other persons involved in the sale or use of controlled substances, and if the prosecutor requests an additional reduction in the defendant’s sentence because of such cooperation,
In this case, the defendant had cooperated by acting as an informant, but it was not a first offense. The defendant still wanted the reduction of one-third the sentence, based on the "notwithstanding subsection 1" language. The argument was that clause completely negated all of subsection 1, including the requirement that the sentencing be in conjunction with a first offense. The Court disagreed:
Reading section 901.10 as a whole, as we must, we cannot agree with Petra’s tortured interpretation of the statute. The word “notwithstanding,” in the context of subsection two, means “despite.” Iowa Dist. Ct., 630 N.W.2d at 782. “Thus, in spite of what is allowed in subsection 1 concerning ‘reduction of sentence,’ subsection 2 sets up additional requirements for defendants convicted of a methamphetamine offense before such defendants may receive a ‘reduction in sentence.’” Id. (emphasis added). Thus, subsection 2 provides additional conditions for sentence reduction when a first-time offender commits certain methamphetamine and amphetamine offenses. It does not, as Petra suggests, remove the requirement that the crime be a first offense. In addition, a common sense reading of the plain language of subsection 2 leads us to conclude it applies only when the first-time offender commits an amphetamine or methamphetamine offense under sections 124.401(1)(a) or (b).
Petra was not a first-time offender and pled guilty to a violation of section 124.401(1)(c). Therefore, the district court correctly concluded the provisions of section 901.10 were not applicable to reduce the mandatory minimum sentence.
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