Posted on 03/21/2005 5:14:06 PM PST by ambrose
Hospital ends life support of baby
1st U.S. case of its kind is against mom's wish, in accordance with law
10:52 PM CST on Tuesday, March 15, 2005
By BRUCE NICHOLS / The Dallas Morning NEws
HOUSTON — In what medical ethicists say is a first in the United States, a hospital acting under state law, with the concurrence of a judge, disconnected a critically ill baby from life support Tuesday over his mother's objections.
The baby, Sun Hudson, who'd been on a mechanical ventilator since his birth Sept. 25, died quickly afterward, his mother said.
"I held him ... I talked to him. I told him I love him," said the child's mother, Wanda Hudson. Then doctors took the mechanical breathing tube out, the child took a couple of breaths, struggled briefly in her arms and it was over, Ms. Hudson said.
She never shed a tear and explained why she wasn't showing emotion. "I was prepared for this," she said.
Doctors did not join her in meeting reporters, but Texas Children's Hospital issued a statement that it was "deeply saddened." The baby died of the effects of thanatophoric dysplasia, a form of dwarfism that impairs lung and chest cavity development and is "a lethal and incurable genetic deformity."
The death ended a court battle that began in mid-November when Ms. Hudson, a 33-year-old unemployed dental assistant, opposed doctors when they decided continuing life support was futile, unethical and medically inappropriate. Probate Judge William McCulloch cleared the way for removal of mechanical ventilation from the baby Monday.
There have been other cases elsewhere in which courts intervened, but the Hudson case was the first to reach the end stage, said Dr. John Paris, a bioethicist at Boston College.
"It's a first in the United States," he said. "It's not a first in the world. There was a similar case in England."
The hospital acted under a Texas law passed in 1999 that allows attending physicians, in consultation with a hospital bioethics committee, to discontinue life support when a patient's condition is hopeless. The law gives a parent or guardian 10 days to find another hospital or institution. After that, the hospital is free to act.
Texas Children's officials, and Ms. Hudson's lawyer, Mario Caballero, called dozens of institutions and none was willing to take the child, officials said.
Ending life support
With modern technology keeping more and more people alive who would have died in the past, the question of whether to end artificial life support increasingly arises, said Joan Krause, an expert on health care law at the University of Houston.
But parents and guardians usually go along with doctors' decisions. "The vast majority of cases end quietly," she said.
In the Hudson case, the hospital encouraged the mother to go to court and agreed to pay her lawyer after concern arose about her mental state. She said "the sun that shines in the sky," not a man, fathered her child and would decide its fate. She repeated her belief Tuesday.
Push came to shove Nov. 18, when the hospital's bioethics committee endorsed the recommendation of attending physician Peter Hainey to end life support. The hospital agreed to several extensions of the 10 days to seek alternative care but in January began pushing for a resolution.
Judge McCulloch in February lifted a restraining order barring the hospital from removing life support, but the 1st Court of Appeals stayed his order then sent the case back for correction of a procedural error. When that was done, the judge renewed his order, and Ms. Hudson's lawyer did not pursue his appeal further.
Mr. Caballero said he was a solo practitioner without the resources to go forward.
"I only have two arms and two legs," he said. He expressed disappointment that groups interested in right-to-life issues did not come forward to help him.
First state with law
The law under which the hospital acted was a compromise passed with the participation from the right-to-life lobby, Ms. Krause said. Their main focus has been opposing an artificial end to life through abortion, not an end to artificial support for life, although they've intervened in some cases, analysts said.
Texas was the first state to enact such a law, followed by California, Dr. Paris said.
"Texas is way ahead of everybody else," he said. "Judges don't want to issue these rulings. They want somebody else to do it."
The Texas law has not been tested before the highest courts.
Judge McCulloch took pains at a hearing to explain that he wasn't ordering the hospital to end life support, merely ruling that under the law, the hospital had done its duty, acted properly and was free to remove mechanical ventilation.
Ms. Hudson said her son had grown to more than 17 pounds while on life support, and that he "opened his eyes, moved his tongue" and moved around when she held him at the end.
"That was not the body," she said, expressing faith that she would see her son again. "As long as the sun's shining in the sky, my son's still here."
Hospital officials disputed her account, saying the baby has always been sedated and unresponsive.
Ms. Hudson said she'd made no funeral plans and would not attend if one were held. She said her parents, who did not talk to the news media and disapproved "of my talking about the sun," might be present.
Ms. Hudson said she's not angry but wants an autopsy and warned, "This is not over." She did not clarify what she meant. She complained that Texas Children's officials briefly put her in a psychiatric unit. Hospital officials denied it.
Ms. Hudson's lawyer, Mr. Caballero, is also involved in another Houston case, that of 68-year-old Spiro Nikolouzos, a retired electrical engineer. St. Luke's Episcopal Hospital wants to remove him from life support, but the patient's wife, Jannette, has gone to court to force continued care.
E-mail bnichols@dallasnews.com
Sure, from Waaaaay back in post 4
http://www.capitol.state.tx.us/statutes/docs/HS/content/htm/hs.002.00.000166.00.htm
However that is not the law in Floriduh I believe.... and there are still all those other laws that have been broken both by Michael and Greer.
I think you guys are talking about two different Governor Bush-es.
see post above - then-gov George Bush, not Jeb Bush.
"WHAT IN THE HELL LAW ARE YOU RAVING ABOUT???????"
hey, I just reread what you posted a little bit back and you seem to know already know this law (yes, it's Texas not Florida, I know, I was just pointing out the irony). So if you were not asking about this one which one are you asking for?
"I think you guys are talking about two different Governor Bush-es."
Yes, correct, I should have been more clear, my bad.
The only daily deaths of children in the thousands are in abortion clinics. You just lost any credibility you may have had on this subject.
Of course we do ultimately do put a value on life. We like to think that we don't, but we do every day. If a dying child could live one extra day at a cost of the entire GNP of the world, that cost could not reasonably be spent. Just as there are reasonable limits put on the dispensation of resources in all of heath care.
If there is only one surgeon available in the ER a a given moment, and two cases arrive, one that has a 1% chance of survival after surgery and another that has a 99% chance of survival after surgery... it would be *wrong* to allocate the surgeon to the 1% case at the expense of the 99% case.
Thousands of lives are taken on the highways every year, and yet we continue to allow cars to exist, because we are *willing* to accept the casualties in trade for the benefit of convenient travel.
Many soldiers' lives are expended in defense of liberty and freedom. This is a cost we are willing to bear because we believe that there are good and rightful things worth fighting and dying for.
Life has a price, and we willingly pay it every day. But this does not mean that we willingly waste it when there is an alternative. In Terri's case, there is an alternative.
OK, just what are you saying that Bush is responsible for? HINT: not much!!!!
A neonatal ICU plus neonatologist, other professional fees, and expenses, etc. is going to cost closer to $10K/day than to $1000 per day.
Of course, mom didn't have to pay anything.
BTW, I don't have anything against government-paid neonatal care for the indigent. (Oh, I suppose I'd prefer voluntary charity to government Medicaid, but that battle was decided long ago in favor of the liberals.) It's just that the payer should make the call on when it's ethical to pull the plug.
Yes, I know all about Texas. I know nothing about Florida. George Bush is totally clean in Texas, although I think that we have a lousy death culture law that he could help us out on. What else are you saying????
Well hopefully that clears up some misunderstandings here. :-)
Relax, I wasn't attacking anyone.
I posted a link to the law that was referd to in the article. Terrrigal noticed how this law HAD IT BEEN IN FLORIDA (which it was not) directly related to the Terri case (not Terrigal, the other terri). I pointed out the irony of this being a law signed by now President Bush, who is now arguing AGAINST a situation covered in a law he previously signed.
Thats it, interesting, ironic and completely meaning less in the case of Florida, but this thread is about Texas and this law is directly referenced in the article so here IT IS appropriate.
" The only daily deaths of children in the thousands are in abortion clinics. You just lost any credibility you may have had on this subject."
Nonsense. Thousands of children die daily from diarreal diseases, measles, pneumonia, cholera, malaria, etc., which are inexpensively preventable or treatable. The number is inherently imprecise, but it's around 25,000 dead kids/day. The cost of preventing the majority of these deaths is about $100 per child through age 10.
http://www.child-survival.org/stateof.html
http://www.childinfo.org/cmr/revis/db2.htm
Note that this does not include HIV/AIDS, which is much more expensive and problematic, just the diseases that affluent nations have conquered for the past 60-100 years.
Thanatophoric Dysplasia is a disease that is terminal in the period shortly after birth. This has nothing to do with "psychos" being terminated.
http://www.emedicine.com/PED/topic2233.htm
It's called a belief in the sanctity of life.
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