Barbara Bush, End-of-Life Decisions, and the Legal and Medical Challenges

As the First Lady of the United States from 1989 to 1993 and the matriarch of a prominent political family, Barbara Bush was known for her hospitality and faith, promoting literary, and for being the wife of one president and the mother of another. And in the days leading up to her death this week at the age of 92, she sparked an important conversation about end-of-life decisions.

What is Comfort Care?

Barbara Bush’s family announced a few days before her death that she planned to pursue comfort care for her declining health. Comfort care is a type of treatment that focuses on a patient’s comfort and symptom relief, instead of active treatment. For example, a cancer patient might decide to stop undergoing chemotherapy, but still take medication to ease their symptoms. Comfort care does not aim to speed up the dying process by denying treatment. Instead, it allows patients to die a death that is as natural as possible.

People with terminal, debilitating conditions sometimes choose comfort care because of the pain, financial strains, and stress of aggressive treatment. For people with conditions that affect their quality of life, including their ability to care for themselves, comfort care is a way for them to retain their dignity. For many, it gives them control over their body, their illness, and their death.

When someone is terminally ill, comfort care gives them the option of dying without complications. But because the medical field is full of the potential for medical malpractice and legal disputes, end-of-life care has the potential to be anything but simple.

Legal Complications Over End-of-Life Choices

One way that end-of-life decisions can be complicated is when a person is unable to make their own medical choices. For example, if someone is in a coma, the decision to continue treatment may fall on the person’s family members. This opens up the potential for clashes over whether to continue life-preserving measures, like a breathing tube. This kind of debate famously played out in Pinellas County in the early 2000s when a woman in a persistent vegetative state became the center of a right-to-die battle between her husband and her parents.

Generally, however, these kinds of issues only occur when a patient has not explicitly expressed their end-of-life desires. If a patient is terminally ill, it’s likely that they have discussed their plan with their family and other caretakers.

Negligence, Error, and Malpractice

Even at the end of a person’s life, their well being can still be hindered or harmed by medical malpractice. For example, if a patient stops treatment but contracts an unrelated infection due to an error, it may cause them unnecessary  suffering. In other cases, a doctor could fail to provide an end-of-life patient with the same care and respect that they would provide to a patient undergoing treatment.

If a patient makes their end-of-life desires clear and a doctor fails to respect those wishes, it can have a devastating impact on the patient during this critical time. Even if a patient is close to death, they still deserve care, dignity, and respect from their medical providers.

A Personal Choice

Comfort care and other types of end-of-life decisions have huge impact on how a person dies. For Barbara Bush, who was reportedly displaying her signature wit until her death, comfort care was the best choice. For others, end-of-life care can be a more complex and difficult topic, filled with conflict and tough decisions. Ultimately, the best course of action depends on an individual and their personal desires.


The attorneys at Perenich, Caulfield, Avril & Noyes represent those involved in car accidents, motorcycle accidents, bicycle accidents, pedestrian accidents, and other types of personal injury matters. Our firm is one of the oldest personal injury law firms in Tampa Bay. There are no attorneys’ fees or costs unless we prevail for you. Call our office 24 hours a day at 727-796-8282 or simply click here to schedule a free case consultation.


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