Rosebush, Joelle

When Joelle Rosebush was 11 years old, she was involved in a traffic accident that severed her spinal cord at the C-1 level and caused her to go into cardiac arrest. The spinal cord injury left Joelle completely paralyzed from the neck down and unable to breathe without a respirator. The lack of oxygen to her brain during the cardiac arrest destroyed most of Joelle’s cerebral brain function and left her in a persistent vegetative state. More than a year after her accident, Joelle’s parents requested that she be transferred from the nursing home where she had been living to Childrens Hospital for termination of life support measures (ventilator, feeding tube). Staff at the nursing home sought and obtained a temporary restraining order, and later a preliminary injunction, that prevented the transfer and termination of life support. A Michigan trial court which later heard the case dissolved the preliminary injunction and authorized Joelle’s parents to make treatment decisions for Joelle, including termination of life support.

The Oakland County Prosecutor appealed the trial court’s decision to grant Joelle’s parents the authority to make such a decision. After hearing the case, the Court of Appeals stated that an individual’s right to withhold or withdraw life-sustaining medical treatment is an aspect of the common law doctrine of informed consent, which applies to any and all forms of medical treatment, including life-sustaining or life-prolonging medical treatment. The court also confirmed that an individual does not lose the right to accept or decline medical treatment on account of being incompetent or a minor. In such cases where an individual lacks the capacity to make treatment decisions, another individual acting as that person’s surrogate may exercise this right on the patient’s behalf. Specifically, as to minors such as Joelle, the court held that parents speak for their minor children in matters of medical treatment, including decisions to forego, i.e., withdraw or withhold, life-sustaining measures. Accordingly, the court upheld Joelle’s parents’ right to withdraw support measures that were keeping Joelle alive. [Source: In re Joelle Rosebush, 195 Mich. App. 675 (1992).]

Principles & Concepts: informed consent, substituted judgment, best interests, autonomy, proportionate/ disproportionate means.

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