Court and the End of Life - Can Doctors Be Held Liable?

Barber v. Superior Court of the State of California

Historically, physicians have been free from prosecution for terminating life support. A precedent was set in 1983, however, when two doctors were charged with murder and conspiracy to commit murder after agreeing to requests from a patient's family to discontinue life support (Barber v. Superior Court of the State of California, 195 Cal.Rptr. 484 [Cal.App. 2 Dist. 1983]). The two physicians were Drs. Neil Barber and Robert Nejdl.

Clarence Herbert suffered cardio-respiratory arrest following surgery. He was revived and placed on a respirator. Three days later his doctors diagnosed him as deeply comatose. The prognosis was that he would likely never recover. The family requested in writing that Herbert's respirator and other life-sustaining equipment be removed. The doctors complied, but Herbert continued to breathe on his own. After two days the family asked the doctors to remove the intravenous tubes that provided nutrition and hydration. The request was honored. From that point until his death, Mr. Herbert received care that provided a clean and hygienic environment and allowed for preservation of his dignity.

A superior court judge ruled that because the doctors' behavior intentionally shortened the patient's life, they had committed murder. The Court of Appeals, however, found that a patient's right to refuse treatment, and a surrogate's right to refuse treatment for an incompetent, superseded any liability that could be attributed to the physicians.

In ruling that the physicians' compliance with the request of Herbert's family did not constitute murder, the Court of Appeals stated that "cessation of 'heroic' life support measures is not an affirmative act but rather a withdrawal or omission of further treatment." In addition, artificial nutrition and hydration also constituted a medical treatment.