Court-ordered surgery?

A 17-year-old man under suspicion for attempted murder is refusing to have a 9-mm bullet removed from his forehead. Prosecutors claim that the bullet, which is lodged just under the skin, could prove that the man was involved in a shootout with a used car-lot owner after taking part in a gang-related robbery of the lot.

Prosecutors say it will prove that Bush, 17, tried to kill the owner of a used-car lot after a robbery in July. And they have obtained a search warrant to extract the slug.

But Bush and his lawyer are fighting the removal, in a legal and medical oddity that raises questions about patient privacy and how far the government can go to solve crimes without running afoul of the constitutional protection against unreasonable searches and seizures.

Prosecutor Ramon Rodriguez said gang members who took part in the robbery identified Bush as one of those involved. When he was questioned about a week later, Bush admitted taking part in the robbery but not the shooting, police said.

"The officers noticed the guy looks like hell. One of his eyes is black and he has a big old knot on his forehead," Rodriguez said. "He tells police he got hurt playing basketball."

A few days later, Bush went to the hospital and told doctors he had been hit by a stray bullet as he sat on a couch in an apartment.

A judge took the unusual step of issuing a search warrant to retrieve the bullet from Bush's head in October. But a Beaumont doctor determined that small pieces of bone were growing around the slug, and he did not have the proper tools in the emergency room to do it. The doctor said that removal would require surgery under general anesthesia and that no operating rooms were available.

The police are now having a hard time finding a doctor or hospital willing to perform the operation, which all agree is practically risk-free, but which the young man's attorney is warning will set a "dangerous precedent" regarding the government's discretion in searching suspects' bodies--literally.

I think this is a really interesting case, and I will be the first to state that I have no legal background whatsoever and therefore can only speculate as to the constitutional issues at stake, but I'd like to put forth a few ideas and see what people who know more than I have to say.

As regards the "unreasonable search and seizure" protection invoked by the man and his defense, there can be no doubt that investigators' desire to examine the bullet is reasonable. The young man has admitted involvement in the robbery that led to the shootout, has a bullet in his forehead of the correct size to have been involved, and has given two very different stories as to how it got there. Warrants for the bullet were issued on two separate occasions. So the unreasonable aspects of the search apply to the question of whether it is unreasonable for the government to have the right to order a nonessential medical procedure for the purposes of garnering evidence.

As a society, we allow law enforcement officials certain rights of search as regards our bodies. With a court order, we can be forced to give up samples of our blood for DNA and type analysis, or other bodily fluids for drugs analysis etc. Therefore, the precedent for removing evidence from our bodies is there. All sides in this case have agreed that the risks involved in removing the bullet are about as minimal as they come, hardly greater than DNA sampling. So presumably, the hang-up here is the relative invasiveness of the procedure, in that it does involve anesthesia and surgery.

Myself, I think he did try to shoot the car lot owner, but I don't think the prosecution should have the right to force the surgery. I'll admit, though, that it's not as easy as I thought it would be to come to that conclusion. Perhaps this is due to the low-risk nature of the procedure: the bullet is just under the skin, making it really easy to remove. If the bullet were somewhere inside his brain or his body cavity (assuming that its remaining there did not pose a risk to his life), I would certainly feel that the heightened risk presented by its removal meant that the young man's constitutional presumption of innocence would have to hold, and that the prosecution was out of luck. But it is hard not to feel that society's interest in removing criminals from the streets trumps one guy's right to keep a bullet in his head.

Now, I say this as someone who doesn't generally buy the "slippery slope" argument that if you allow the government to remove something under the skin, it's only a matter of time before they are allowed all sorts of rights to mandate invasive procedures in the interest of society. I think that's a weak argument that has not been borne out by experience, but it is a fact that the legal system runs on precedents, and that this would set a precedent regarding the government's jurisdiction over our persons. Mostly I just think that a person's sovereignty over their own body is absolute, and that in the same way that I believe the government should have no say in women's reproductive decisions, they should have no authority in choices of medical procedure, especially nonessential ones.

The second part of this case that I find interesting regards the medical profession, which has its own code of ethics regarding patient rights and the absolute responsibility of physicians to care for those rights above the rights of the government to criminal evidence. I think it's telling that the police are having difficulty finding someone willing to do this surgery against the patient's wishes. I welcome input from those of you studying or practicing medicine.

On a more amusing note, I'd just like to point out that, if successful, this kid is going to walk around for the rest of his life with a bullet in his forehead. When he gets out of prison for the robbery, he's going to have some fun with the heightened airport security if he ever wants to fly anywhere. "Sir, have you emptied your pockets of metal objects?" "Well...."