Bouvia v. Superior Court

Elizabeth Bouvia (plaintiff), 28, was a quadriplegic and suffered from severe cerebral palsy. She was bedridden, in continuous pain, and was unable to move except for some slight movement in her fingers and face. She relied on public assistance for medical and other care. On several occasions, Bouvia expressed a desire to die, including an intention to starve herself. While a patient at a Los Angeles County hospital, physicians determined that Bouvia was not consuming enough nutrients and losing significant weight. Her weight hovered around 70 pounds and the medical staff believed her weight loss to be a life-threatening condition. Against her expressed wishes, and against her will, physicians and staff inserted a nasogastric feeding tube into Bouvia to provide nutrition. Thereafter, Bouvia filed a petition to have the feeding tube removed. At a bench trial, the county hospital, its physicians and administrators (collectively, defendants) argued that the state’s interest in preserving Bouvia’s life outweighed her desire to refuse life-saving treatment. They also argued that she is not terminally ill or in an otherwise incurable medical state—conditions which may allow for the discontinuation of live-saving treatment. By removing the feeding tube, Bouvia would essentially be committing suicide via starvation, and the public hospital could not assist her in that course of action. The trial court agreed with the hospital’s medical staff and found Bouvia’s weight loss to be a life-threatening condition. In reaching its decision, the trial court placed significant weight on the amount of time Bouvia could live with sufficient feeding—an additional 15 to 20 years—as well as her motives behind wanting the tube removed.