Bouvia v. Superior Court

Brief Fact Summary. Bouvia (Plaintiff), not terminally ill but forced to eat through intubation, made a request to stop the feeding.

Synopsis of Rule of Law. Even if not terminally ill, a competent adult may refuse force-feeding done to sustain life.

Facts. Elizabeth Bouvia (Plaintiff) suffered from cerebral palsy and arthritis.  She slowly lost the use of her body to the point that she could no longer use her limbs.  She lived off government assistance in a public hospital.  Plaintiff wished to die and refused food.  Medical personnel responded by feeding and hydrating her through a stomach tube inserted through her nose.  She sought an injunction compelling removal of the tube.  The trial court found that Plaintiff could live indefinitely in her state, not being terminally ill, and denied the injunction.  Plaintiff appealed, petitioning for a writ of mandamus.

Issue. Even if not terminally ill, may a competent adult refuse force-feeding done to sustain life?

Held. (Beach, J.)  Yes.  Even if not terminally ill, a competent adult may refuse force-feeding done to sustain life.  A competent adult has the right to refuse any kind of medical treatment, including force-feeding through tubes.  Whether or not a person is terminally ill is not relevant to that person’s rights.  A decision to reject medical treatment belongs to the patient alone, and is not to be second-guessed by judges or doctors.  In this case, Plaintiff is clearly of sound mind, and her desire to stop treatment must be respected.  Writ issued.

Discussion. The court’s position on this issue is so well accepted by now that it is no longer controversial.  The concurrence’s point of view however, is something else.  Medically assisted suicide has generated much controversy, as shown by the events in 1992 surrounding Dr. Jack Kevorkian, a Michigan pathologist who assisted several people who wished to die.  He was prosecuted, but the charges were dismissed when the court found that he broke no law.  The Michigan legislature responded by passing a law criminalizing assisted suicide as of April 1993.  Alternately, the Netherlands passed a euthanasia law about the same time permitting physician-assisted death under strict controls.