Refusal of Newborn Medical Testing as Probable Cause for Emergency Removal and Termination Affirmance Under § 41-3-609(1)(f), MCA (Matter of R.T.C. & R.J.C.)

Refusal of Newborn Medical Testing as Probable Cause for Emergency Removal and Termination Affirmance Under § 41-3-609(1)(f), MCA (Matter of R.T.C. & R.J.C.)

Introduction

In In the Matter of: R.T.C. and R.J.C., Youths in Need of Care, DA 25-0243, the Montana Supreme Court affirmed the Ninth Judicial District Court’s termination of both parents’ rights to two children under § 41-3-609(1)(f), MCA. The case arose from two births—March 2023 (R.T.C.) and August 2024 (R.J.C.)—each followed by neonatal respiratory complications, suspected withdrawal, and parental resistance to drug testing and aspects of medical care.

The appeals primarily challenged (1) whether there was probable cause at the show cause/EPS stages to justify removal, and (2) whether termination was lawful given alleged defects in treatment plans, counsel performance, self-representation, and the District Court’s failure to consider guardianship as an alternative.

Important procedural note: The Court issued a memorandum opinion under its Internal Operating Rules and expressly stated it “shall not be cited and does not serve as precedent.” Even so, the decision illustrates how the Court applies settled Montana child-protection standards to recurring fact patterns.

Summary of the Opinion

The Supreme Court affirmed termination as to both children and both parents. It held:

  • Probable cause supported removal for both newborns—based not only on drug exposure/withdrawal indicators, but also on the parents’ refusal to consent to testing and medical measures requested to diagnose and treat respiratory distress.
  • The parents’ failure to complete treatment plans was overwhelming on this record, supporting termination under § 41-3-609(1)(f), MCA.
  • The treatment plans were appropriate, especially given drug-risk concerns in the home; later objections did not undermine the plans’ original propriety.
  • Father did not establish ineffective assistance of counsel because he did not show prejudice.
  • The District Court did not err by allowing Father to represent himself after warnings; his waiver of counsel was upheld.
  • The “guardianship instead of termination” argument was waived because it was not raised in the District Court.

Analysis

Precedents Cited

Although the Court emphasized the case was “controlled by settled law,” it anchored its review standards and key doctrinal points in several prior decisions:

Standards of review in termination cases

  • In re A.B., 2020 MT 64 and In re D.F., 2007 MT 147: cited for the framework that termination decisions are reviewed for abuse of discretion, while underlying findings are reviewed for clear error. This matters because many appellate arguments here invited reweighing evidence (e.g., whether removal was “necessary”); the Court instead asked whether the District Court’s findings were clearly erroneous or its ultimate termination decision exceeded the bounds of reason.
  • In re A.M.G., 2022 MT 175: cited for viewing evidence “in the light most favorable to the prevailing party.” This reinforced deference to the Department and the District Court on contested inferences—particularly about risk created by refusing neonatal testing and about the parents’ pattern of noncompliance.

Ineffective assistance of counsel in termination proceedings

  • State v. Ward, 2020 MT 36: cited for the proposition that ineffective assistance claims are mixed questions of fact and law reviewed de novo.
  • In re A.D.B., 2013 MT 167: central to Father’s IAC claim. The Court quoted In re A.D.B. for two points: (1) the Montana Constitution’s Due Process Clause affords parents the right to effective assistance of counsel in termination proceedings; and (2) such claims “cannot succeed” without a showing of prejudice. The Court’s rejection of Father’s IAC arguments turned primarily on this prejudice requirement.

Issue preservation/waiver on appeal

  • In re T.E., 2002 MT 195: cited for the “consistently held” rule that the Supreme Court will not consider issues raised for the first time on appeal.
  • In re D.H., 2001 MT 200: applied as a close analogue—there, as here, parents argued for the first time on appeal that the trial court should have ordered a less restrictive alternative to termination. The Court again declined to reach the merits due to non-preservation.

Legal Reasoning

1) Probable cause for removal: drug exposure plus refusal of medical testing/care

The parents’ primary early-stage attack was that there was “no probable cause” at the show cause/EPS stage because the children were not in immediate or apparent danger such that removal was necessary. The Court rejected that framing and focused on the concrete, contemporaneous risk factors recognized by the District Court:

  • For R.T.C., the record included Mother’s earlier pregnancy drug test (January 2023) and neonatal indicators consistent with in-utero drug exposure (respiratory issues, NICU care, withdrawal symptoms). The Court treated these as sufficient for probable cause that the newborn was abused or neglected and required emergency protection.
  • For R.J.C., the Court emphasized an additional and independent ground: even “without the drug test evidence,” probable cause existed because the parents denied consent for requested testing and medical care while the newborn had respiratory issues, thereby placing the child “in danger.”

A key analytic move is the Court’s acceptance that refusing medically indicated diagnostic testing for a newborn in distress can itself support a probable-cause finding of danger—especially when paired with a known history (R.T.C.’s birth circumstances) and the parents’ documented failure to engage in substance-use monitoring and treatment.

2) Timing of challenges to drug-test evidence

Mother argued her hospital drug tests should not be used because she refused consent. The Supreme Court did not resolve the issue as a decisive evidentiary question; instead it treated it as largely non-dispositive and procedurally late: the parents did not press exclusion until the EPS hearing for R.J.C., after R.T.C. had already been adjudicated YINC and treatment plans ordered. Importantly, the Court reasoned that even if the contested birth-related tests were excluded, other evidence remained: (i) an earlier pregnancy drug test, and (ii) both infants’ clinical symptoms consistent with withdrawal and the need for NICU care.

3) Termination under § 41-3-609(1)(f), MCA: treatment plan noncompliance and ongoing unfitness

The Court stated termination under § 41-3-609(1)(f), MCA, is “controlled by settled law,” and it treated the record as an archetypal noncompliance case. It highlighted that neither parent “seriously disputes” failing to complete treatment plans and described pervasive failures:

  • inconsistent visits;
  • refusal of drug testing;
  • failure to implement parenting skills;
  • failure to obtain mental health evaluations;
  • failure to maintain consistent contact with the Department.

The Court also credited the District Court’s finding that to the extent visitation was limited, it was “occasioned by Father’s conduct” (noncompliance with the supervised-visit provider’s terms), blunting any argument that the Department thwarted reunification.

4) Treatment plan “appropriateness”: the effect of stipulation and the relevance of substance-risk in the home

Both parents attacked treatment plan appropriateness on appeal, but the Court emphasized process and context:

  • Stipulation/initial approval: Mother did not object at all; Father objected only to an alcohol prohibition and obtained relief when the District Court struck it. When asked for further objections, both said there were none. This record undercut later broad challenges.
  • Father’s later objection to drug testing: Father argued testing was unnecessary because nothing suggested he had a drug problem. The Court pointed to the child’s drug exposure, the shared household, and Father’s later admission of drug use in substance-use evaluation as confirming the testing requirement’s rational connection to child safety.
  • Mother’s “domestic violence” critique: The Court rejected the claim that the plan was inappropriate for not including domestic violence tasks, reasoning those issues arose more than a year after plans were ordered and that Mother’s longstanding noncompliance made additional tasks reasonably viewable as futile.

The throughline is that “appropriateness” is assessed against the risks prompting state intervention. Here, the Court framed substance exposure and concealment/avoidance of detection as core safety concerns, making drug testing and treatment compliance central rather than collateral.

5) Ineffective assistance of counsel: no prejudice from counsel’s conduct at the termination hearing

Father argued counsel was ineffective for not objecting to the treatment plan and for not advocating at R.T.C.’s termination hearing, where Father did not appear. Applying In re A.D.B., the Court rejected these claims for lack of prejudice:

  • On treatment plan objections, Father had already litigated appropriateness with prior counsel; the District Court had re-reviewed the plan and reaffirmed it. The third attorney had no new basis to relitigate.
  • On the termination hearing, the District Court found Father had notice and his absence was his own doing. The Supreme Court agreed Father did not identify what admissible evidence or meaningful opposition counsel could have presented without Father’s participation.

The opinion’s footnote also illustrates the Court’s practical approach to prejudice: Father’s proposed “medical negligence” theory about meconium ingestion failed not only for lack of expert support, but because it did not rebut the central child-protection concern— prenatal drug exposure and the parents’ efforts to block testing needed for medical treatment.

6) Self-representation: waiver upheld after warnings

Father claimed the District Court erred by letting him proceed pro se, contending his waiver of counsel was not knowing, voluntary, and intelligent. The Supreme Court recounted two representation hearings where the court and counsel discussed the disadvantages, including counsel’s statement that Father did not understand legal requirements and evidence relevance and that self-representation was ill-advised. The District Court characterized it as a “fool’s errand.” Despite this, Father insisted.

While the Supreme Court noted it “generally caution[s] against” self-representation in termination cases and acknowledged it might have chosen differently, it found no reversible error on this record.

7) Guardianship as an alternative: forfeiture by failure to raise below

Father argued the District Court should have considered guardianship in lieu of termination. The Supreme Court did not reach the substantive merits; it held the issue was not preserved and therefore could not be considered, citing In re T.E. and In re D.H..

Impact

Although noncitable, the opinion signals several practical implications consistent with Montana’s “settled law” approach:

  • Probable cause can rest on medical decision-making during neonatal crisis: The Court treated refusal to permit testing needed to diagnose/treat a newborn’s respiratory distress as an independent danger indicator—especially when it fits a pattern of concealment around substance exposure.
  • Litigation timing matters: Delayed evidentiary challenges (e.g., to drug test results) may not undo an already established adjudication-and-plan posture, particularly where other evidence supports removal and ongoing risk.
  • Treatment plan objections should be made early and specifically: The Court relied heavily on the hearing record showing stipulation and limited objection, and it treated later objections as weak where the plan’s nexus to safety was obvious.
  • IAC claims require a concrete showing of prejudice: The opinion underscores that generalized dissatisfaction with counsel or speculative alternate theories will not succeed without identifying what counsel could have done that likely would have changed the outcome.
  • Guardianship/less restrictive alternatives must be requested in the District Court: The waiver holding is a clear reminder that appellate courts will not invent unrequested alternatives to termination.

Complex Concepts Simplified

  • Youth in Need of Care (YINC): A legal finding that a child has been abused, neglected, or is otherwise in need of state protection and court oversight.
  • EPS / Emergency Protective Services: Immediate, short-term intervention (often including removal) to protect a child when there is urgent risk.
  • Show cause / probable cause in this context: The court’s early-stage determination that there is sufficient reason to believe the child is in danger and state intervention (including removal) is justified.
  • Treatment plan: Court-ordered tasks (e.g., evaluations, testing, counseling, parenting education) designed to remedy the conditions that made the child unsafe; failure can lead to termination.
  • Termination under § 41-3-609(1)(f), MCA: A statutory ground permitting termination when a parent does not successfully complete an appropriate treatment plan and the condition is unlikely to change within a reasonable time.
  • Ineffective assistance of counsel (IAC): A due-process claim that a parent’s lawyer performed deficiently; the parent must also show prejudice—i.e., that the deficiency likely affected the outcome.
  • Pro se representation: Representing oneself without a lawyer; courts must ensure the waiver of counsel is knowing and voluntary, but a competent adult can insist on self-representation even if it is unwise.
  • Issue preservation: To argue an issue on appeal (like guardianship as an alternative), it generally must have been raised in the trial court first.

Conclusion

The Court affirmed termination because the record supported (1) probable cause for emergency intervention at both births, including risk demonstrated by refusal of medically indicated testing and care; (2) the appropriateness of substance-focused treatment plans aimed at addressing the home’s safety risks; (3) sweeping noncompliance by both parents; and (4) the absence of reversible procedural error (no preserved guardianship request, no demonstrated IAC prejudice, and an adequately warned decision to proceed pro se).

While explicitly nonprecedential, the decision encapsulates Montana’s settled approach: deference to trial-court factfinding, insistence on timely and specific objections, and a child-safety lens that treats obstruction of necessary neonatal medical care as powerful evidence of immediate danger and parental unfitness.

Case Details

Year: 2025
Court: Supreme Court of Montana

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