The California Supreme Court rules that a conservator did not meet the high standards of proof required to withdraw life-sustaining treatment from her conscious but incompetent conservatee. Wendland v. Wendland (Sup. Ct. Cal., S087265, Aug. 9, 2001)
In 1993, Robert Wendland was involved in an automobile accident that left him severely brain damaged and cognitively impaired. Although conscious and sometimes able to respond to simple commands, Mr. Wendland was wholly dependent on others for his care and unable to speak or otherwise communicate consistently. He received life-sustaining nutrition and hydration through a feeding tube. The court appointed Mr. Wendland''s wife, Rose, as conservator of his person. Mrs. Wendland sought authorization from the court to remove the feeding tube, thereby allowing Mr. Wendland to die. She cited section 2355 of California''s Probate Code, which provides that if a conservatee has been adjudicated to lack the capacity to give informed consent for medical treatment, "the conservator has the exclusive authority to give consent for such medical treatment to be performed on the conservatee as the conservator in good faith based on medical advice determines to be necessary and the conservator may require the conservatee to receive such medical treatment, whether or not the conservatee objects . . ." Mrs. Wendland also testified to several comments her husband had made prior to his accident concerning his wish not to be subjected to life-sustaining treatment. Mr. Wendland''s counsel supported Mrs. Wendland''s position. Mr. Wendland''s mother and sister objected, claiming that section 2355 is inapplicable in this case.
The trial court prohibited Mrs. Wendland from having her husband''s feeding tube removed, concluding that although Mr. Wendland had a right to refuse the feeding tube, Mrs. Wendland had failed to show by clear and convincing evidence that her husband, if competent, would want the feeding tube removed, or that withdrawal of the tube was in his best interests. Mrs. Wendland appealed, arguing the trial court imposed too high a burden on her. The California Court of Appeal for the Third District reversed, ruling that the court's role is "limited to determining whether the conservator''s decision complies with section 2355, i.e., that the conservator has acted in ''good faith'' and decided ''based upon medical advice,'' that treatment is ''necessary,'' after consideration of the conservatee''s prior wishes and best interests. Thus, the conservator is not required to prove that the conservatee, while competent, expressed a desire to die in these circumstances." Wendland v. Wendland (Cal. App. 3 Dist., No. C029439, 2000 WL 215540, Feb. 24, 2000)
In a 47-page opinion, The California Supreme Court overturns the Appeals Court ruling and concludes the Superior Court correctly required Mrs. Wendland to prove, by clear and convincing evidence, either that the her husband wished to refuse life-sustaining treatment or that to withhold such treatment would have been in his best interest. The court agrees with the Superior Court that such evidence was lacking and that permission to withdraw the feeding tube was therefore properly denied. However, the court stresses that "our decision today affects only a narrow class of persons: conscious conservatees who have not left formal directions for health care and whose conservators propose to withhold life-sustaining treatment for the purpose of causing their conservatees' deaths. Our conclusion does not affect permanently unconscious patients, including those who are comatose or in a persistent vegetative state . . . persons who have left legally cognizable instructions for health care . . . persons who have designated agents or other surrogates for health care . . . or conservatees for whom conservators have made medical decisions other than those intended to bring about the death of a conscious conservatee."
Note: Mr. Wendland died while the California Supreme Court was deliberating on this case. The court chose to rule because the case "raises important issues".
For the full-text of this decision, go to: https://www.courtinfo.ca.gov/opinions/documents/S087265.PDF
Subscribe to the Knowledge Bank.
