August 14, 2001
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ROBERT WENDLAND: RIP [PART TWO OF TWO]
On Monday we began the week with the sad news that Robert Wendland had died of pneumonia July 17. Severely injured in a 1993 automobile accident, Mr. Wendland became the focus of a national debate whether it would become permissible to starve and dehydrate people who are conscious but very much limited.
In l995 Wendland awoke from a two-year-long coma. With the aid of therapy (according to a February 2000 appeals court decision), Wendland was occasionally able to "grasp and release a ball, operate an electric wheelchair with a 'joystick,' move himself in a manual wheelchair with his left hand or foot, balance himself momentarily in a 'standing frame' while grabbing and pulling 'thera-putty,' draw the letter 'R,' and choose and replace requested color blocks out of several color choices" with the assistance and encouragement of physical therapists.
He was not terminally ill or in a so-called persistent vegetative state (PVS).
Courts in Michigan and Wisconsin had addressed similar cases and in both instances insisted there be “clear and convincing” evidence the patient would want his/her food and fluids stopped.
But Mr. Wendland died before the Court rendered its opinion. Nonetheless, given the potential effect on hundreds of thousands, if not millions of other severely disabled people, the state High Court delivered its judgment August 9.
Robert Wendland’s wife did not have the right to order the removal of his feeding tube, the justices ruled unanimously, since Wendland was not in a coma or terminally ill and had not left instructions that he would want to die if incapacitated.
Justice Kathryn Mickle Werdegar wrote that life support for a patient in Wendland's condition may not be stopped "absent clear and convincing evidence that the conservator's decision is in accordance with either the conservatee's own wishes or best interest."
"The decision to treat is reversible," Werdegar wrote. "The decision to withdraw treatment is not."
A tearful Janie Hickok Siess told the Los Angeles Times, "It is going to save a lot of lives. Siess, attorney for Florence Wendland, added, "I just wish Robert were here for this."
At the time of his death, she was working on a petition to the California Supreme Court to demand information about his medical condition and to have another doctor examine him. "I was filing papers with the court, but I wasn't fast enough," she told the Times.
Robert Wendland’s wife told the Times that doctors at Lodi Memorial Hospital informed her July 2 that her husband had an infection. One of his lungs collapsed July 8, and doctors were not able to drain all the fluid from it, according to the Times.
He was diagnosed with pneumonia, and was given antibiotics. When they did not work, Mrs. Wendland "made the decision that aggressive treatment was not in his interest, and he was kept comfortable," Lawrence Nelson, Mrs. Wendland's lawyer, told the Times.
Fortunately, at the end Robert Wendland was not alone. Florence Wendland was by her son's side when he took his last breath. Mrs. Wendland refused to allow his sister Rebekah to visit him in his last days, the Times reported.
We can be thankful the California Supreme Court rejected the appeals court decision, which held last year that California law allowed guardians of incompetent patients to make life-ending decisions as long as they act in good faith based on medical advice.
According to that February 2000 decision, courts were not even allowed to independently evaluate the expressed wishes of the patient before the disability or even the best interests of the patient, as long as the guardian had taken them into consideration.
The court expressly included people who are disabled but not terminally ill or in a persistent vegetative state (PVS) in its ruling.
Florence Wendland was in "complete joy" over the Supreme Court's decision, Siess told the San Francisco Chronicle. "If someone is in Robert's condition, their feeding tube cannot be pulled without the strictest scrutiny of that decision," Siess added.
Although the court decision came after her son's death, Florence Wendland's six-year fight to prevent his starvation and dehydration gives promise to other disabled patients whose guardians may be seeking their deaths. "As we mourn the loss of Robert," said Wesley J. Smith, author of Culture of Death: The Assault on Medical Ethics in America, "we can only send our most sincere condolences to Robert's mother, who stayed with him to the end, his sisters and brother, who were allied with her to save his life, and all of those who believed fervently in Robert's right to live his life fully as a disabled man."