Convicted child sex offender Warren Jeffs has fasted his way into a condition which has prompted the state of Texas to induce a coma. Lindsay Whitehurst wrote in this morning’s Salt Lake Tribune:

A fast has landed convicted polygamous sect leader Warren Jeffs in a Texas hospital in critical condition, a prison official said Monday.

“Jeffs has not been eating/taking in fluids as he should,” spokesman Jason Clark said in a press release. “He indicated he was not on a hunger strike but fasting.”

This is not the first time, Jeffs has fasted his way to medical problems:

This is at least the fourth time that prison fasts and other self-imposed health problems have put Jeffs in a hospital during the five years he has been behind bars. Monday marked the five-year anniversary of his arrest on a Nevada highway.

Other unspecified medical problems also required hospitalization, said Clark, who declined to say how long the fast lasted before Jeffs was taken Sunday night to the East Texas Medical Center in Tyler.

Jeffs is in a medically induced coma after a three-day fast, said Sam Brower, a private detective who has spent seven years investigating Jeffs and is the author of the forthcoming Prophet’s Prey, about Jeffs and the sect he leads. Though Clark declined to speak further, an unnamed Texas prison official confirmed Jeffs’ condition to the Associated Press.

While awaiting trial on accomplice-to-rape charges in Utah, Jeffs was hospitalized due to both lack of food and ulcers on his knees from long periods spent praying. His failing health was part of a downward spiral that culminated with a renunciation of his role as FLDS prophet and a suicide attempt in January 2007. He recovered and later recanted.

After a Utah jury convicted him of presiding over a marriage between an unwilling 14-year-old girl and her 19-year-old cousin, Jeffs spent time at the Utah State Prison infirmary on at least one other occasion due to fasting.

After he was sent to Arizona to face similar charges in early 2008, Jeffs was force-fed with a feeding tube several times and jailers used soft restraints to limit his time spent on his knees praying.

A story in today’s Chicago Tribune quotes Jeffs’ sister in law Sherie Jeffs that he should be force fed:

“Jeffs has not been eating/taking in fluids as he should. He indicated he was not on a hunger strike but fasting,” said Texas Dept. of Criminal Justice spokesman Jason Clark in an e-mail to Fox 13. “The inmate also has other medical conditions that have risen to the level of needing hospitalization.”

Prison officials said they could not elaborate on Jeffs’ medical problems. The FLDS leader was hospitalized in Tyler, Texas on Sunday. Medical officials say Jeffs is expected to survive.

Here in Utah, ex-members of the FLDS Church reacted with a mixture of anger and resignation about news of Jeffs’ physical condition. Some feared that if he were to die, he would become a martyr.

“I think that’s what he’s trying to do, is become a martyr in their eyes and further exalt himself as far as they’re concerned. Not necessarily with a bang, but this is precisely what he wants and this is how he wants it to end,” said Sherie Jeffs, who is Jeffs’ sister-in-law.

Two of Jeffs’ children testified against their uncle in Texas that they had been sexually abused as children by the FLDS leader. She said Texas officials should force feed Warren Jeffs, if necessary, to keep him alive.

“I think he needs to stay alive and be able to ponder in that cell for many many years what he’s done to people’s lives, and children’s lives, how many families he’s destroyed,” she told Fox 13.

Which brings up an interesting question, should the state have the right to force feed prisoner’s?  There is not always a definitive answer from state to state, or even at the federal level.  In Cruzan v Missouri Department of Health (1990) 497 U.S. 261, The United States Supreme Court essentially heldthat in certain circumstances a state may have sufficient interest in forcing a patient (it did not address the question of an incarcerated prisoner) to accept medical treatment:

Petitioner Nancy Beth Cruzan was rendered incompetent as a result of severe injuries sustained during an automobile accident. Copetitioners Lester and Joyce Cruzan, Nancy’s parents and coguardians, sought a court order directing the withdrawal of their daughter’s artificial feeding and hydration equipment after it became apparent that she had virtually no chance of recovering her cognitive faculties. The Supreme Court of Missouri held that because there was no clear and convincing evidence of Nancy’s desire to have life-sustaining treatment withdrawn under such circumstances, her parents lacked authority to effectuate such a request. We granted certiorari, 492 U. S. 917 (1989), and now affirm.

In sum, we conclude that a State may apply a clear and convincing evidence standard in proceedings where a guardian seeks to discontinue nutrition and hydration of a person diagnosed to be in a persistent vegetative state. We note that many courts which have adopted some sort of substituted judgment procedure in situations like this, whether they limit consideration of evidence to the prior expressed wishes of the incompetent individual, or whether they allow more general proof of what the individual’s decision would have been, require a clear and convincing standard of proof for such evidence. See, e. g., Longeway, 133 Ill. 2d, at 50-51, 549 N. E. 2d, at 300McConnell, 209 Conn., at 707-710, 553 A. 2d, at 604-605;O’Connor, 72 N. Y. 2d, at 529-530, 531 N. E. 2d, at 613In re Gardner, 534 A. 2d 947, 952-953 (Me. 1987)In re Jobes, 108 N. J., at 412-413, 529 A. 2d, 285*285 at 443Leach v. Akron General Medical Center, 68 Ohio Misc. 1, 11, 426 N. E. 2d 809, 815 (1980).

In California, our state’s supreme court has actually answered the question about whether an inmate can be forced to undergo life sustaining treatment.  In Thor v Superior Court (1993) 5 Cal. 4th 725, the court held:

Here, we must determine whether the right to “exercise of control over [one's] body” is sufficiently broad to permit an individual to decline life-sustaining treatment, even if to do so will cause or hasten death. Drawing upon the wisdom and insight of the courts preceding us into this sensitive territory, we approach our undertaking with caution and humility, fully appreciative of the profound considerations, both philosophical and personal, at issue. After due deliberation, we hold that under California law a competent, informed adult has a fundamental right of self-determination to refuse or demand the withdrawal of medical treatment of any form irrespective of the personal consequences. Under the facts of this case, we further conclude that in the absence of evidence demonstrating a threat to institutional security or public safety, prison officials, including medical personnel, have no affirmative duty to administer such treatment and may not deny a person incarcerated in state prison this freedom of choice. (Pen. Code, § 2600.)

Other state court’s have found similar rights–full opinion here.

On the other hand, as Sheri Jeff’s quoted above, some may feel that criminals forfeit certain rights upon conviction, including the 14th Amendment liberty interests allowing them to refuse medical treatment.  Their argument is that the state has an overriding interest in forcing the inmate to live and endure the physical incarceration punishment meted out by the criminal justice system.

Probably the most striking juxtaposition on whether a state should keep an inmate alive, played out in Utah with the Gary Gilmore story.  Gilmore was convicted of capital murder. While incarcerated he attempted suicide, twice.  Utah went to great lengths to save his life, only to end it shortly thereafter.

So, do prisoner’s have a liberty interest sufficient to overcome the state’s interest in keeping them alive?  Or, should the state have the absolute right over inmates to force them to undergo medical treatment sufficient to save their lives and serve  out their criminal sentences?