California Supreme Court Rules on ‘Right-to-Die’ Case

In a right-to-die case expected to have "national repercussions," the California Supreme Court ruled 6-0 yesterday that family members cannot withdraw life-sustaining medical treatment from a conscious but severely brain-damaged loved one unless they provide "clear and convincing" evidence that they are acting on the patient's wishes, the San Francisco Chronicle reports (Chiang, San Francisco Chronicle, 8/10). The ruling stems from the case of Robert Wendland, a Stockton, Calif. man who was severely brain-damaged in an auto accident in 1993 that left him unable to "talk, walk, eat or express his wishes." Saying that he would not have to wanted to be kept alive under such circumstances, Wendland's wife wanted to remove his feeding tube, while his mother wanted to keep him alive. Wendland died of pneumonia before the court heard his case. The decision still allows life support to be removed in cases where the patient is unconscious even if they have not clearly stated their wishes. But the Los Angeles Times reports that Wendland did not fall into that category because he was considered "minimally conscious, capable of responding to simple commands but unable to communicate."

The ruling, issued by Justice Kathryn Werdegar, stated that unless patients in cases similar to Wendland's have left "specific written instructions or designated a surrogate decision maker, their legal conservators may not remove life-sustaining tubes without 'clear and convincing' evidence that they would have wanted to die or that death would be in their best interest" Werdegar cited a new California law that, she said, "gives competent adults extremely broad power to direct all aspects of their health care in the event they become incapacitated" (Dolan, Los Angeles Times, 8/10). Werdegar wrote, "Only the decision to withdraw life sustaining treatment, because of its effect on a conscious conservatee's fundamental rights, justifies imposing a high standard of proof. The decision to treat is reversible. The decision to withdraw treatment is not" (San Francisco Chronicle, 8/10).