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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 March 15, 2006
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
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
“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
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
…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?”
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
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
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
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."
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
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
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
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
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
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)