## Facts

- Joelle Rosebush, a minor, suffered a 1987 traffic accident that severed her spinal cord at the C-1 level, causing cardiac arrest and catastrophic, irreversible injury.
- She became permanently ventilator-dependent, completely paralyzed from the neck down, and remained in a persistent vegetative state with no prospect of regaining consciousness or independent respiration.
- Joelle was not “brain dead” because her brain stem functioned; thus she did not meet the statutory definition of death under Michigan’s Determination of Death Act.
- After nearly a year without improvement, Joelle’s parents consulted physicians, clergy, and counsel and decided to withdraw life-sustaining treatment, including mechanical ventilation.
- Nursing home staff reported perceived signs of improvement to the prosecutor, who obtained ex parte injunctive relief preventing transfer and withdrawal of life support.
- Following an evidentiary hearing with medical testimony that the observed movements were involuntary and that Joelle’s condition was irreversible, the circuit court dissolved the injunction and permitted the parents to decide whether to withdraw life support.
- Life support was discontinued; Joelle died shortly thereafter. The prosecutor appealed, and the appellate court reached the merits despite mootness due to the recurring public importance of the issues.

## Issues

1. Whether, under Michigan common law, parents may authorize withdrawal of life-sustaining medical treatment for an incompetent minor in a persistent vegetative state.
2. Whether such a decision generally requires prior judicial approval or should ordinarily be made by the family and treating clinicians absent a dispute or special circumstances.
3. Whether withdrawing life-sustaining treatment from a non-brain-dead patient exposes parents or physicians to criminal liability or violates Michigan’s Determination of Death Act.

## Decision

- The Michigan Court of Appeals affirmed the order allowing the parents to authorize removal of life support.
- The court held that, under the common-law doctrine of informed consent, the right to refuse or discontinue medical treatment extends to life-sustaining treatment.
- Because minors act through parents or guardians for medical decisions, the parents could exercise that right on Joelle’s behalf, guided by her best interests.
- The court rejected the claim that withdrawal was unlawful because Joelle was not brain dead, concluding the Determination of Death Act defines legal death but does not require continued life support until brain death.
- The court held that withdrawal of life-sustaining treatment under accepted medical and legal standards in these circumstances does not constitute criminal conduct.
- Despite mootness, the court decided the appeal because the questions were of public significance and likely to recur while evading review.

## Legal Principles

- Michigan common law recognizes a right, as part of informed consent, to refuse or discontinue medical treatment, including life-sustaining interventions.
- Parents generally speak for their minor children in medical matters and may decide to withhold or withdraw life-prolonging treatment for an incompetent minor, subject to a best-interests assessment.
- Court involvement in end-of-life treatment decisions is generally unnecessary absent disagreement among those directly involved or other reasons warranting judicial oversight.
- Michigan’s Determination of Death Act governs when a person is legally dead; it does not bar withdrawal of life support from a patient who is not brain dead.
- When undertaken consistent with accepted standards, withdrawing life-sustaining treatment from a permanently unconscious patient does not, by itself, impose criminal liability on parents or clinicians.

## Conclusion

The court upheld parental authority to discontinue life-sustaining treatment for an incompetent minor in a persistent vegetative state, treating the decision as part of informed consent and generally reserved to the family and clinical setting, with courts intervening only in exceptional circumstances; the death-determination statute did not require continued ventilation or create criminal exposure for lawful withdrawal.


Rosebush v. Oakland Cnty. Prosecutor, 491 N.W.2d 633 (Mich. Ct. App. 1992)