## Facts

- Five-year-old William Matthew Bowman suffered massive physical injuries inflicted by a nonfamily caregiver and was hospitalized.
- The Department of Social and Health Services filed a dependency petition when Matthew’s parents could not initially be located.
- A shelter-care order authorized the Department to transfer Matthew to a specialty hospital and to consent to necessary medical and surgical care; after the parents were located, the order was amended to share authority for routine care and to authorize necessary emergency care.
- Physicians concluded Matthew had suffered an irreversible loss of brain function while mechanical systems maintained respiration and circulation.
- At a hearing on whether to dismiss the dependency petition, the guardian ad litem opposed dismissal on the theory that it would permit termination of life support.
- The trial court ruled that Matthew was legally dead as of the hearing date because of irreversible loss of brain activity, and it temporarily enjoined discontinuation of life support pending appellate review.
- By the time of appellate review, all bodily functions had ceased, but the court reached the merits due to the public importance of the questions presented.

## Issues

1. Whether the standard for determining when death occurs is defined by law or by medicine.
2. If defined by law, whether Washington should adopt a brain-death standard.
3. If brain death is the standard, what role medicine plays in specifying criteria for determining whether the standard is met.
4. Whether the appeal should be decided despite mootness because the child’s bodily functions had ceased before appellate review.

## Decision

- The Washington Supreme Court affirmed the trial court.
- The court held that the legal standard of death is defined by law, not by the medical profession.
- The court adopted brain death as a legal standard in Washington.
- The court held that the medical profession determines the applicable diagnostic criteria for brain death in accordance with accepted medical standards.
- The court decided the case despite mootness because the issues were of continuing public importance and likely to recur yet evade review.

## Legal Principles

- The definition of death is a legal standard that must be uniform for legal consequences such as status, responsibility, and inheritance.
- Washington recognizes death upon irreversible cessation of brain function (brain death), not solely upon cardiopulmonary cessation.
- Courts should not fix specific medical tests for brain death in case law; physicians apply accepted medical standards to determine whether the legal standard is satisfied.
- A court may resolve an otherwise moot case when it presents questions of significant public interest likely to recur and evade timely review.

## Conclusion

The court affirmed that Matthew Bowman was legally dead upon irreversible loss of brain function, adopted brain death as part of Washington’s legal definition of death, and assigned to the medical profession the task of applying accepted diagnostic criteria to determine when that legal standard is met.


In re Welfare of Bowman, 617 P.2d 731 (Wash. 1980)