Robert Wendland Dies of Pneumonia; Court Rejects Wife's Euthanasia Request
By Liz Townsend
Robert Wendland, the disabled California man at the center of a court case that had the potential to widen the threat of involuntary euthanasia, died July 17 of pneumonia, according to the Los Angeles Times.
After his death, the California Supreme Court ruled that his wife did not have the right to order the removal of his feeding tube, since Wendland was not in a coma or terminally ill and had not left instructions that he would want to die if incapacitated, the Times reported.
Justice Kathryn Mickle Werdegar, in the court's unanimous August 9 decision, 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."
"It is going to save a lot of lives," Janie Hickock Siess, attorney for Robert Wendland's mother Florence, told the Times. "I just wish Robert were here for this."
Siess was in tears after learning Wendland had died, according to the Times. 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.
Siess also told the newspaper that Florence Wendland would seek the release of her son's medical records and an autopsy to determine his exact cause of death. Robert Wendland's wife told reporters that she would oppose an autopsy, according to the Times.
Wendland, 49, was injured in a car accident on September 29, 1993. He woke from a coma in January 1995, and had shown some limited improvement since then, although he remained profoundly disabled, unable to speak or walk on his own.
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.
Wendland required a feeding tube to deliver food and fluids needed to survive. However, his wife began the court case in 1995 when she asked for his feeding tube to be removed, asserting that Wendland "would have wanted to die in his condition," according to the Times. She was opposed by Wendland's mother Florence and his sister, Rebekah Vinson, who "insisted that he would have opted for life," the Times reported.
Mrs. Wendland 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.
Mrs. Wendland ordered that Robert's mother should not be told the details of her son's medical condition while he was suffering from pneumonia, the Times reported. According to the newspaper, the Superior Court in Stockton and the 3rd District Court of Appeal rejected Florence Wendland's emergency petitions to find out the details of his condition and to have Robert examined by a doctor of her choice.
Florence Wendland was by her son's side July 17 when he took his last breath. Mrs. Wendland refused to allow his sister Rebekah to visit him in his last days, the Times reported.
Mrs. Wendland expressed a sense of relief after her husband's death, insisting that she lost her husband and their three children lost their father "that day in September 1993 when he was so terribly hurt in that accident," the Times reported.
"Today his right to live free of tubes and medicines that could not really make him better has finally been made real," Mrs. Wendland said in a statement, according to the San Francisco Chronicle. "But it had taken way too long for this to happen."
In her statement, she also condemned Florence Wendland and other family members who opposed removing Robert's feeding tube as "relatives he did not love and with whom he did not share any kind of meaningful personal relationship," the Times reported. "I think it is tragic, ridiculous, and ultimately disgusting that the law permitted these strangers to interfere in a decision that naturally and morally belongs to his close family."
Florence Wendland, on the other hand, did not release a statement after her son's death. "It's her son. She's distraught," Siess told KCRA.
The case that the California Supreme Court decided centered on the decision-making powers of guardians of incompetent patients. The state Court of Appeals ruled on February 24, 2000, that California law allowed guardians to make life-ending decisions as long as they act in good faith based on medical advice.
According to the 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. "[T]he court is merely to satisfy itself that the conservator has considered the conservatee's best interest," the appeals court wrote.
The court expressly included people who are disabled but not terminally ill or in a persistent vegetative state (PVS) in its ruling. If the state Supreme Court had allowed the appeals court ruling to stand, the door would have been open for guardians to remove lifesaving treatment from patients.
"It meant that the person making the decision is the most important factor, not the wishes of the patient or even the patient's best interests," Tom Marzen of the National Legal Center for the Medically Dependent and Disabled told NRL News. "It placed the burden on a nonguardian to prove that the conservator is acting in bad faith or with evil intent, which is normally extremely difficult."
With the Supreme Court's reversal of this decision, conservators of conscious disabled patients have to meet a higher threshold of proof to remove a feeding tube. Justice Werdegar wrote that Mrs. Wendland "offered no basis" for starving her husband to death "other than her own subjective judgement that the conservatee did not enjoy a satisfactory quality of life and legally insufficient evidence to the effect that he would have wished to die."
Florence Wendland was in "complete joy" over the Supreme Court's decision, Siess told the 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."