AN
FRANCISCO, Aug. 9 — In September 1993, Robert Wendland of
nearby Stockton crashed his pickup truck, an accident that
left him brain-damaged and unable to walk, talk, eat or drink,
or in any way communicate his wishes. Two years later his
wife, Rose, asked doctors to remove the feeding tubes that
kept him alive, saying he had told her not long before the
crash that he would never want to live in so helpless a
condition.
But Mr. Wendland's mother and
sister objected, noting among other things that he was
conscious, if minimally so, and not comatose. They carried
their case all the way to the California Supreme Court.
Today the justices ruled in
their favor, finding that families have no right to stop life
support for conscious patients who are not terminally ill, and
who have not left explicit instructions allowing them to do so
or formally appointed anyone to make health care decisions in
the event of incapacity.
Although Mr. Wendland, still
attached to feeding tubes, died of pneumonia last month at the
age of 49, the court had retained the closely watched case to
clarify law regarding the right of families to disconnect life
support systems.
In its 6-to-0 decision today,
the court said that "absent clear and convincing
evidence" that Rose Wendland's decision was in accordance
with her husband's own wishes or best interest, it would not
have allowed the removal of life support.
Courts have previously allowed
the removal of life support in cases where a patient is
terminally ill or in a permanent comalike state, most famously
a quarter-century ago in the precedent-setting case of Karen
Ann Quinlan in New Jersey. But the law has been unclear as to
how families can proceed when patients are conscious but
unable to express their wishes.
The justices emphasized the
narrow scope of their ruling, saying it affected only cases
involving patients who are conscious, who would die without
life support, and who have not left formal directions for
health care or legally appointed anyone to make such decisions
should they ever be unable to make them.
"Our conclusion,"
Justice Kathryn Mickle Werdegar wrote for the court,
"does not affect permanently unconscious patients,
including those who are comatose or in a persistent vegetative
state."
Jon Eisenberg, an Oakland
lawyer representing more than 40 medical ethicists who had
urged the court to uphold Rose Wendland's wishes, said the
ruling meant that "if you want to have a say in your
end-of-life decision making, you'd better put it in an
advance, written directive." He added, "The problem
here is, I don't know how you do that in a manner that covers
all of the possibilities."
Janie Hickok Siess, a lawyer
for Mr. Wendland's mother, Florence Wendland, and for his
sister, Rebekah Vinson, called the ruling "a total win
for us," in that it "found that Rose Wendland did
not have sufficient evidence to justify pulling the feeding
tube."