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Tuesday, May 16, 2006

Maine's Haleigh Poutre?

I was too depressed to blog about this on Mother's Day weekend, but here goes. In Maine, a six-week old infant was brought to the hospital last year. Doctors diagnosed shaken-baby syndrome, and the father has been charged, but not brought to trial. Four days after the child's injury, a Maine court granted Maine's child protective agency custody of the child and a DNR order. (DNR orders commonly imply a right of doctors not to treat medical conditions that may become fatal. It's not explicit, but it is the practice in many cases.) Neither the mother nor the father agreed with the DNR, and they have gone to court.

The basis of the DNR order appeared to be that the child was diagnosed with irreversible brain injury:
Janice Stuver, an attorney for DHHS, told the court Tuesday that the DNR order was requested because resuscitating Matthew would be "painful and inhumane." The parents' refusal to consent to the order was "contrary to the welfare of the child," she argued.
In Maine, Doctors at Eastern Maine Medical Center, who have said Matthew W. suffers from "shaken-baby syndrome," believe it's impossible for him to recover and "be alert, interactive or playful," according to court documents.
Four days? They are not giving things much time these days, are they? The father has not been convicted of anything - only accused, and such accusations have been proven false before. Protective agencies should opt for protection of an injured child in cases like this, but parental rights should not be terminated without court proceedings, surely? And what of the mother, who is not accused? Does she have no rights?

And on what basis did the agency decide that it would be better if this child died four days after the injury? A prediction of disability only, it would seem. Maine isn't seeking to actively kill this child by depriving him of food and water, but they did reach the conclusion, after four days, that it would be better if a six week-old baby died, and they received the legal right to implement that decision over the objections of the parents.

Isn't this extraordinarily disturbing? Four days? An infant? Isn't this something of a rush to judgment? We know no other facts in this case, but Haleigh Poutre's doctors said she had the "the least amount of brain function that a person can have and still be considered alive," and also that her brain was "operating at a primitive level, and that the child cannot see, hear, feel, or respond". They also said that only a "brain transplant" could reverse her condition. In their decision allowing Massachusetts to starve and dehydrate Haleigh to death, the Massachusetts Supreme Court wrote:
The medical evidence is incontrovertible -- the child is in a persistent vegetative state and there is no medical treatment in the foreseeable future that can restore her cognitive abilities.
Except, of course, that two weeks after the Supreme Court wrote that Haleigh Poutre could react, could follow instructions, could pick out one specific stuffed animal from another, and was assuredly not in a "persistent vegetative state". And in the wake of that revelation, many doctors commented that a week was not a reliable time period in which to assess recovery chances from a coma or a PVS. Imagine that.

It certainly seems as if the prevailing theory in the northeast is that brain injuries in abused children qualify these children for the morgue ASAP. It's impossible to be certain that a child will never respond in a week, but it is quite possible to predict that the child will likely experience significant disability. The prevailing opinion seems to be that it is better for a child to die than live with disability, and if the parents object then they are acting "contrary to the welfare of the child".

If that's the case then any parent who chooses to keep a disabled child alive is ignoring the child's welfare, and ignoring the child's welfare is grounds for terminating parental rights. This is past the stage of slippery slopes and moving rapidly toward a societal consensus that ill or disabled people would be better off dead so we'd best hustle them off in the name of mercy. That consensus already appears to rule in the UK, and I'm not willing to lie down and let it take hold here.

I'm probably going to convert Catholic, because I'm having a terrible time walking into churches that support this type of thing. I'm sure I'll be one of the most unsatisfactory Catholics around and certainly no credit to the Catholic church, but at least I won't be supporting theologians who argue that brain-damaged people no longer are an image of God, and therefore are not human. The official Catholic position (there is plenty of dissent) is more scientific, more rational and more morally realistic, and it is John Paul II's gift of life to a weary world about to commit the same old error with the same old and horrific results:
...it is not enough to reaffirm the general principle according to which the value of a man's life cannot be made subordinate to any judgment of its quality…it is necessary to promote the taking of positive actions as a stand against pressures to withdraw hydration and nutrition as a way to put an end to the lives of these patients
Lose hold of the principle that the value of an individual's life cannot be made subordinate to any judgment of its quality, and we will promptly recognize that those who will spend the rest of their lives in prison might as well be dead.... Once you accept that a person's right to life is dependent upon another person's (or society's) opinion of the quality of that life, you have provided the foundation for mass murder, and I refuse to participate in this in any way.

John Paul II did not say that an individual must accept artificial feeding, if he or she felt it was against his or her conscience. John Paul II only said that we must not deprive others of food and water in order to end their lives, and this is the minimum standard to which a society must adhere if it wishes to remain civilized.

I'm sure I'll be one of the most unsatisfactory Catholics around and certainly no credit to the Catholic church, but at least I won't be supporting theologians who argue that brain-damaged people no longer are an image of God, and therefore are not human.

Convert over, M-o-M. We "Romish Papists" have got a lot of "unsatisfactory Catholics" already, and you make more sense than most of them. (Not just "Mary Fanboys" -- my own archbishop isn't much of a credit to the Church himself.)

Plus, you have something you don't see much of any more -- feistiness, specifically the kind of feistiness that sticks up for what is right instead of for the latest fashion or tangent.

We've got an unbroken 2000-year historical trace, and a lot of precedent and thought built up over all those centuries. Even with the post-Vatican II shakeups of the late Twentieth, there's still a lot of Christian stability there. The Church was around long before that "Bible Christian Fellowship" down in the storefront (Nero Caesar was the first big-name politician we pissed off), and will be around long after they schism & infight themselves out of existence.

The Headless Unicorn Guy
Yes, the thought thing is impressive, because I've been reading some of the encyclicals, etc. The rationalism and careful reasoning is impressive.
PS: When Nero got pissed off, he got pissed off. Didn't he crucify a bunch of Christians and set them alight on the streets of Rome?
PPS: I have tremendous respect for some of those storefront churches, but it is in times like these in which the lack of organization and a theological tradition shows its weakness. They are not able to muster the resources to analyze a problem like this or attempt to deal with it.

And you are right about the schisming.
Right here in Georgia, there was a similar case. Six month old Dylan Bortz suffered a fall at home. His mom was holding him in a 'bouncy seat' (cloth over metal frame), his big brother (2 or 3 years) caromed through the kitchen into her. She dropped Dylan. Her mother (acquaintance of mine) witnessed the fall. The injury appeared to be a minor bonk (no LOC, child was comforted with a boo boo bunny and hugs). Four days later, Dylan didn't wake up from a nap. He went to N. Fulton Medical Center, and then to CMA/Scottish Rite. DFCS took emergency custody and made the decision to turn off the vent. They also scheduled a mandatory meeting regarding Jackson's custody for the same time (as the vent was turned off.) When the parents tried to have the meeting time changed, so they could be with their son as he was dying, they were labeled "uncooperative." This label probably was part of the decision to put Jackson into foster care.

End result: autopsy result showed that Dylan probably died of the skull fracture, but showed no sign of any abuse. (I'm betting, though, that the death certificate says "Lack of Oxygen to the Brain")According to my sister, the orthopaedic nurse, skull fractures are notoriously hard to diagnose, even in adults.

The situation has been resolved now; Jackson is home. And so is Dylan.

That said, we did turn off the machines on my mom 2 days after her ruptured aneurysm (coded on the steps to the hospital where her new gortex heart valve was waiting) but that was anything but a borderline case. Her pupils were blown, there was minimal brainstem response & that was fading, she had stated (loudly & to anyone who would listen, as well as some who wouldn't) that she didn't want to be on machines & that she did want to donate her organs. My sister is planning on tattooing "DNR" on her chest. But if you are guessing, if you're dealing with kids, I firmly believe that the moral decision is to err on the side of life.
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