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Wednesday, February 08, 2006

Haleigh: 8 Days And A Request To Kill Her

The Republican filed asking for the release of DSS court filings in the case of Haleigh Poutre. DSS released a redacted version, so it is now official:
The legal brief filed by the state Department of Social Services also showed that the agency sought an order to remove the Westfield girl from life support five days after gaining custody of her on Sept. 13.
In the brief, DSS referred to Poutre as having "the least amount of brain function that a person can have and still be considered alive." The agency further stated that, within a week of her hospitalization on Sept. 11, the girl was diagnosed as having a stroke of "the entire right side and most of the left side of her brain. As a result of both brain injuries, the child has no hope of any meaningful recovery," according to the brief filed by DSS General Counsel Virginia A. Peel.
What's even more significant than this is that the initial request asked for permission to remove Haleigh from ventilation and to withdraw the feeding tube. Out of two doctors consulted, one did not agree with the withdrawal of the feeding tube. Obviously they knew she might be able to breathe on her own. This decision does appear to have been made under the theory that Haleigh had major brain damage and should be shuffled off as quickly as possible.

The press is still calling Haleigh "vegetative", even though she has been reported as following people with her eyes and following commands. That's what the head of DSS said he observed when he visited her, according to Spence she could see him and was able to pick up specified toys with her hand. That is clearly not a vegetative child.

See the Mass Supreme Court ruling. This is a description of the testimony provided at a September 30th evidentiary hearing (only caused by Strickland's attempt to stop the death order):
The physician testified that, "short of developing the technique for a complete brain transplant, there is no hope that medical treatment will be discovered in the foreseeable future which could reverse [Sharlene's] condition." Sharlene's treating physician, the associate director of Baystate's PICU, testified that Sharlene's brain is operating at a primitive level, and that the child cannot see, hear, feel, or respond.(13)

Both physicians supported the issuance of an order that Sharlene not be resuscitated on the occurrence of cardiac or respiratory failure. With respect to the withdrawal of her life support, however, their opinions differed. Sharlene's treating physician recommended both the removal of the ventilator and her feeding tube. The director of the PICU, on the other hand, recommended removal of the ventilator only and expressed opposition to the removal of her feeding tube. The physicians agreed that, with the feeding tube, Sharlene's death would likely occur anytime from several weeks up to two months. Without the feeding tube, Sharlene's death would likely occur in a substantially shorter period of time. The director of the PICU testified that the removal of life support in this case would not be contrary to prevailing medical ethics.

On October 5, the judge entered a written decision, in which he made findings of fact and concluded that "[Sharlene's] dignity and quality of life would be most respected by withdrawing both the ventilator and the feeding tube along with the issuance of a [DNR] order, with great sadness I so issue this day." The judge also ordered that his written decision not be released to anyone except Sharlene's counsel, her GAL, the department, and Baystate.
What's so odd about this is that they knew back in September that Haleigh could breathe somewhat on her own - that was the reason for asking for the feeding tube to be withdrawn. They knew the brain stem injury was partial and the doctors even testified that she might live for several months breathing on her own in the September 30th hearing. The MA SC wrote in their decision:
The order is the product of careful consideration by an experienced judge who heard from all interested parties, who received a comprehensive and thoughtful GAL report, and who entered specific findings on the appropriate factors he considered. See Guardianship of Doe, supra at 524.(16) Counsel for Sharlene did not oppose the order, nor did Sharlene's existing family members. 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. No provision of medical ethics is violated by the order. As the GAL report notes: "To all extent and purpose [Sharlene] has already left this world consciously and subconsciously and the only real remaining question is under what circumstances she'll be allowed to leave it physically."
Except for one small detail. This order was handed down on the 17th, and the birth mother had already noticed that Haleigh was moving and responding after she had been weaned off the ventilator and probably withdrawn from sedation. Haleigh arrived at the hospital almost dead on September 11th. DSS filed asking that she be dehydrated to death within 8 or 9 days. Four months passed, and no attempt at medical reevaluation was made.

Legally, Haleigh's position is highly equivocal. DSS still has the authority to dehydrate her to death.

Related Post:

When in Doubt, Remove Life Support Quickly

This is what Peter Singer's world looks like.

Nice, isn't it?
Yes, this is the Singerian theory of how to deal with an ill child.

No, I don't find it nice. We give the governor of PA a heart-lung transplant, but this kid doesn't merit food and water? Gina's right.
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