Elizabeth Bouvia was an intelligent young woman living with severe quadriplegic cerebral palsy, very limited muscle control, and constant pain from arthritis and contractures. In 1985, after separation from her husband, Elizabeth voluntarily entered Riverside General Hospital in California as a psychiatric patient. She requested nursing care and pain medication as she ceased eating in order to starve herself. Her physicians refused to comply with her request. Bouvia asked that the court prevent the hospital from force feeding her or from discharging her. The court determined that she was competent and believed that her decision to end her life by refusing food and water was rational given her extreme difficulties. The court did not feel, however, that she had the right to end her life with the assistance of society. The court therefore denied Bouvia’s request to keep the hospital from discharging her or, if she remained a patient, from feeding her by force. The case is remarkable on many levels, but especially for the issue of pain management. Ultimately, a physician approached Elizabeth with the promise of providing aggressive pain management; Elizabeth accepted the physician’s care. This new option apparently altered her determination to end her life. [Source: 179 Cal. App. 3d. 1127 (1986), and 60 Minutes.]
Principles & Concepts: human dignity, autonomy, respect for autonomy, informed consent, beneficence, institutional & professional integrity, common good, justice.
