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Haleigh Poutre and ‘Ethical’ Dehydration

Haleigh Poutre and ‘Ethical’ Dehydration. March 15, 2006. Haleigh Poutre. 11 years old, beaten nearly to death in September 2005 by her adoptive mother and stepfather

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Haleigh Poutre and ‘Ethical’ Dehydration

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  1. Haleigh Poutre and ‘Ethical’ Dehydration March 15, 2006

  2. Haleigh Poutre • 11 years old, beaten nearly to death in September 2005 by her adoptive mother and stepfather • Within a week, doctors at Baystate Medical Center in Massachusetts diagnosed her as "virtually brain dead" from an irreversible coma

  3. The courts decide • Once court-appointed guardian Harry Spence was told of the diagnosis (he never visited her), he sought court permission to remove her respirator and feeding tube • The court agreed and was affirmed by the Massachusetts supreme court despite pleas from the stepfather

  4. “Brain dead”?? • When Spence finally visited her, she was conscious and responsive • Spence called off the dehydration • Haleigh is now breathing and eating solid food on her own (though still on a feeding tube) while receiving therapy at Francisan Hospital for Children in Brighton

  5. Wesley J. Smith • Attorney and consultant for the International Task Force on Euthanasia and Assisted Suicide, special consultant to the Center for Bioethics and Culture • Has filed amicus briefs opposing the legalization of assisted suicide and on other bioethical issues in federal and state courts

  6. …and he’s coming here! • WJS will be speaking on March 29 in the Campus Center Little Theater at 7:30pm • “Bioethics: Creating a Disposable Caste of People?”

  7. Euthanasia • “The intentional killing by act or omission of a dependent human being for his or her alleged benefit” • By action: performing an action, i.e., lethal injection, providing drugs in lethal amounts • By omission: not providing necessary and ordinary care

  8. Dehydration? • Artificial nutrition and hydration (ANH) is defined in law and medical ethics as ordinary medical treatment that can be refused, like antibiotics or surgery • Thus, removing ANH is an "ethical" way to end the lives of disabled patients like HP and Terri Schiavo even though it’s euthanasia by omission

  9. How did this happen? • In the 1980s, the bioethics movement launched a campaign to change the classification of ANH from humane care to medical treatment • In March 1986, the American Medical Association Council on Ethical and Judicial Affairs legitimized dehydration

  10. AMA Statement • Said terminating life-support treatment was ethical even if: • "...death is not imminent but a patient's coma is beyond doubt irreversible...life-prolonging medical treatment includes medication and artificially or technologically supplied respiration, nutrition and hydration."

  11. Cruzan v. Director, Missouri Department of Health • In 1983, Nancy Cruzan woke up in a persistent vegetative state (PVS) after a car accident • 4 years later, her family decided to remove her feeding tube • The Missouri supreme court ruled there wasn’t enough evidence that she didn’t want to be kept alive

  12. To the Supreme Court • In 1990, the Supreme Court affirmed the Missouri law allowing removal of ANH given “clear and convincing evidence” • Yet it agreed that ANH is medical treatment • Soon all 50 states permitted withdrawal of ANH based on the Court’s ruling • Afterward, three close friends of Cruzan said that she didn’t want to stay alive; the Missouri court allowed removal and she died 11 days later

  13. Once and again • In 1994, the AMA released another statement that broadened who may be dehydrated: • “Even if the patient is not terminally ill or permanently unconscious, it is not unethical to discontinue all means of life-sustaining medical treatment…” • Terri Schiavo’s feeding tube was removed based on testimony that she was in a PVS

  14. The Danger • Terri Schiavo’s death was not unique—look at Haleigh Poutre • WJS points out that Haleigh isn’t safe from dehydration even though she is conscious • Disabled people’s lives may become liabilities as long as ANH is considered medical treatment and third parties can decide to withdraw it

  15. References • American Medical Association, “E-2.20 Withholding or Withdrawing Life-Sustaining Medical Treatment” http://www.ama-assn.org/ama/pub/category/8457.html • http://en.wikipedia.org/wiki/Nancy_Cruzan • http://www.nrlc.org/euthanasia/index.html • Wesley J. Smith, “Like Terri Schiavo, Haleigh Poutre Not Safe When Others Decide Her Fate” http://www.lifenews.com/bio1305.html

  16. Euthanasia by Action • Indirect: providing treatment with known side effect of early death • Direct: actively inducing death (i.e., lethal injection) • Assisted suicide: providing means to patient in order to kill him/herself (i.e., providing drugs in excessive amounts—Oregon)

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