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
If that's your take on what I'm saying then I'm wasting my time talking to you.
Remind me to never check into a hospital, since doctors aren't saving lives anymore I might as well stay home and die for free.
I believe that you are correct about Reeve, but I conceded the point merely because I didn't know and didn't want to go research the issue. Thank you for your correction.
lol I hate to laugh at a time like this.
uh... didn't?
However, aside from the confusion that typo could cause... many doctors have said "so and so doesn't have a chance" in order to justify removing feeding tubes etc, and only because there were those that opposed them did the person have a chance to actually recover and prove them wrong. There has to be a more concrete definition of 'doesn't have a chance.'
Following that statute, they could clean out every hospital in the state!
yep. Maybe that's their goal.
I have observed your posts for some time. In my opinion, anyone who talks to you is wasting their time.
BTW this isn't the first case of its kind.
http://www.affirminglife.org/issues/doe.asp
No kidding.
You nailed it, partner. Medical resources are not infinite; they have to be allocated somehow. If "nobody" has to pay, "nobody" is going to be interested in how much it costs.
Of course, Children's Hospital had to pay. Since they were paying, it should be their call as to whether it was time to stop postponing the inevitable.
By the way, this sort of thing happens often. This is a "first" only because such a stupid case made its way into a court.
If bleeding-heart conservatives want to extend the lives of hopeless cases, then they should contribute thier own money and build their own hospitals. I don't think there's any law against it.
Personally, I think it's a tragic misallocation of resources to provide a neonatal ICU slot for an indisputably hopeless case when thousands of infants and young children die daily for want of cheap, basic care.
In my opinion, that's why parents should not make the decision. It's up to the spouse.
If the polls are correct, overwhelmingly the American people agree with you. Every subgroup, including Republicans, evangelical Christians, and self-described conservatives (narrowly) agree that it should be the husband's decision. Even larger majorities say Congress should not have gotten involved.
Has the ugly parade of death begun?
Heaven help us!
"So they could have done the same thing to Terri legally."
Exactly the point I brought up in a "Terri" thread for which I got soundly thrashed. Not to mention that was signed by Gov. Bush, but hey, lets not let facts and history get in the way.
If you (the "generic" you, not you specifically Terriergal) don't like the law, change the law, but it's not an "activist judge" if they are following the law the legislature passed, that is their job.
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