Bartling v. Superior Court, 163 Cal. App. 3d 186, 209 Cal. Rptr. 220 (Cal. Ct. App. 1984)
Bartling v. Superior Court is a foundational California decision on patient autonomy and the right to refuse life-sustaining medical treatment.
Does a competent adult patient have the right to refuse life-sustaining medical treatment—specifically, withdrawal from a mechanical ventilator—even if death will foreseeably result and the patient is not terminally ill under the Natural Death Act?
Under California law, a competent adult has both a common-law right to bodily autonomy and informed consent—and a state constitutional right to privacy—that encompasses the right to refuse any medical treatment, including life-sustaining interventions, notwithstanding that death may result. This right is not limited by the Natural Death Act's terminal-illness provisions, which do not preempt or restrict broader common-law and constitutional rights. Withdrawal of unwanted treatment at a competent patient's direction does not constitute suicide or homicide, and physicians and hospitals honoring such refusals incur no civil or criminal liability. Providers who conscientiously object need not participate but must allow transfer or otherwise not obstruct the patient's lawful choice.
Yes. The Court of Appeal granted relief, directing the trial court to permit withdrawal of the ventilator in accordance with Bartling's competent, informed refusal. The court held that the Natural Death Act does not cabin a competent adult's broader constitutional and common-law right to decline life-sustaining treatment, and that honoring such a refusal is lawful and noncriminal.
Bartling is a cornerstone of California's right-to-refuse-treatment jurisprudence. It clarifies that a competent adult may decline life-sustaining care irrespective of terminal status, grounding that right in both common law and the state constitutional right to privacy. The case distinguishes withdrawal of treatment from suicide and reassures providers that honoring informed refusals is lawful. It also foreshadows later cases—like Bouvia (force-feeding) and Wendland (standards for incompetent patients)—by establishing the baseline autonomy principle and the framework for balancing state interests. For students, Bartling synthesizes bioethics, tort (battery/informed consent), and constitutional privacy into a coherent doctrine that still guides end-of-life decision-making.