Health Law

Conservatorship of Wendland — Study Notes

Conservatorship of Wendland, 26 Cal. 4th 519, 28 P.3d 151 (Cal. 2001) (Supreme Court of California)

Study notes for Conservatorship of Wendland: professor notes, cold call prep, exam angles, and memory aids.

A conservator may not withdraw artificial nutrition and hydration from a conscious, incompetent conservatee without clear and convincing evidence that the decision reflects the conservatee's wishes.
Professor Notes

This case underscores the critical importance of clear and convincing evidence regarding a conservatee's wishes when it comes to the withdrawal of artificial nutrition and hydration. The court emphasized that personal autonomy and the right to make decisions about one's own medical care remain paramount, even when the individual is deemed incompetent. While the conservator acted with presumed good intentions, the court made clear that any withdrawal of life-sustaining treatment must align with the conservatee's prior wishes or intentions; mere conjecture is insufficient. This case also sets a high evidentiary standard to protect vulnerable individuals who cannot advocate for themselves, balancing family desires and ethical dilemmas in health law decisions.

Cold Call Prep
  1. 1Discuss the evidentiary standard that must be met for a conservator to withdraw life support.
  2. 2What are the implications of this ruling for future cases involving conservatorship and medical decision-making?
  3. 3How does this case reflect the balance between personal autonomy and state interest in health care decisions?
  4. 4What considerations should conservators make when determining a conservatee's wishes?
  5. 5Can you explain the significance of the court's distinction between a persistent vegetative state and a minimally conscious state in this case?
Mnemonic Device

COVI - Clear evidence of wishes required for withdrawal of liquids.

Distinguish From
CaseDistinction
Cruzan v. Director, Missouri Department of HealthIn Cruzan, the U.S. Supreme Court required clear evidence of a patient's wishes for the withdrawal of life-sustaining treatment, leaning heavily on constitutional rights of privacy but distinguishable as it addressed case law on living wills and advance directives.
Green v. CongerThe focus in Green involved the rights of the family to make medical decisions without a conservatorship context, while Wendland specifically pertains to the judicial standards enforced for conservatorship under California law.
Policy Arguments

For the Rule

The rule reinforces the importance of honoring an individual's autonomy and previously stated wishes regarding medical treatment, even in cases where they cannot express those wishes directly due to incapacity.

Against the Rule

Critics argue that the evidentiary burden may hinder timely decision-making for patients in critical health situations, possibly prolonging suffering or leading to unnecessary interventions.

Class Discussion Points
  • Consider the impact of this decision on families making medical decisions for incapacitated loved ones.
  • How do varying state laws on conservatorships affect outcomes in similar cases?
  • What safeguards are in place to ensure that a conservatee's wishes are accurately represented in court?
Exam Angle

Students should focus on the standard of clear and convincing evidence and its implications for conservatorship cases involving medical decisions. Expect questions that explore ethical considerations in health law decisions, especially concerning conscious yet incompetent patients.

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