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http://www.changingworldviews.com/GuestCommentaries/wesleysmitharticle6.htm

MANY DEHYDRATION CASES have involved such casual statements. The most disturbing of these was that of Marjorie Nighbert, which, ironically, also occurred in Florida. Marjorie was a successful Ohio businesswoman who was visiting her family in Alabama when she was felled by a stroke that left her disabled but not terminally ill. After being stabilized, she was moved to a nursing home in Florida where, it was hoped, she could be rehabilitated to relearn how to chew and swallow without danger of aspiration. To ensure she was nourished, she was provided a feeding tube.

This presented an excruciating quandary for her brother Maynard, who had a general power of attorney from Marjorie (not power of attorney for health care), as a consequence of which he became her surrogate medical decision-maker. Marjorie had once told her brother that she didn't want a feeding tube if she were terminally ill. Despite the fact that she was not dying, however, Maynard believed that if she were unable to be weaned off the tube, she would have wanted to die rather than live using the tube for nourishment. When she did not improve, he ordered the tube removed.

As she was slowly dehydrating to death, Marjorie began to ask the staff for food and water. In response to her pleas, members of the nursing staff surreptitiously gave her small amounts. One distraught staffer eventually blew the whistle, leading to a state investigation and a temporary restraining order requiring that Marjorie be nourished

Circuit Court Judge Jere Tolton received the case and appointed attorney William F. Stone to represent Nighbert and to conduct a 24-hour inquiry, the sole issue being whether Marjorie was competent to rescind her power of attorney and make her own decisions. After the rushed investigation, Stone was forced to report to the judge that she was not competent at that time. She had, after all been intentionally malnourished for several weeks. Stone particularly noted that he had been unable to determine whether she was competent when the dehydration commenced.

With Stone's report in hand, the judge ruled that the dehydration should be completed, apparently on the theory that Marjorie did not have the competence to request the medical treatment of food and water. Before an appalled Stone could appeal, Nighbert died on April 6, 1995.

Society's approach to the so-called "right to die" has become far too casual. None of us should be made to die because of statements made in casual conversations or due to misconstrued oral directives. The time has come for the best legal minds in the country to draft model legislation that will tighten existing laws so as to give every reasonable legal benefit of the doubt to life rather than, as too often happens now, to slow death by dehydration.

http://www.americamagazine.org/articles/ParisFinn.htm

ONCE AGAIN A "RIGHT TO DIE" case has captured national attention. What brought the issue to the fore this time were actions by some members of the family of Hugh Finn and by Governor James S. Gilmore 3rd of Virginia, who sought to block the removal of a feeding tube from Mr. Finn, who was being cared for in a nursing home in Virginia.

The facts in the case are relatively straightforward. Hugh Finn, a popular, 44-year-old news anchorperson in Louisville, Ky., ruptured his aorta in 1995 in a traffic accident. The resulting anoxic damage to his brain left him, like Karen Ann Quinlan and Nancy Cruzan, irreversibly comatose. Though he was incapable of any conscious activity, a feeding tube inserted through his abdomen supplied the nutrition and fluids necessary to sustain life.

Mr. Finn, a Catholic who had reported on the earlier cases, had drafted a written statement opposing such life-prolonging measures for himself, but at the time of his accident he had not yet signed it. His wife, with the support of her husband's sister, but over the objections of her husband's parents and his six brothers, requested that the physician remove the feeding tube and allow her husband to die. The relatives opposing that decision brought suit to block the removal of the feeding tube.

Once again issues raised in the landmark Paul Brophy and Nancy Cruzan cases were argued: that removal of life-sustaining medical technology is not allowing to die, it is killing; that the action itself, not the patient's condition, would cause the death; that food and water are not medical treatments, they are basic care; that if treated the patient could survive another 30 years; that failure to provide that care is murder.

Those arguments had been heard and rejected by every court of final jurisdiction that has reviewed "right to die" cases since Quinlan in 1976 and Brophy in 1983 first occasioned consideration of these questions. They took on renewed strength, however, when presented at a televised news conference by a state governor claiming he had a duty to intervene to protect the interests of the most vulnerable of the state's citizens.

A Prince William Circuit Court judge and subsequently the Virginia Supreme Court rejected the Governor's argument that removing the feeding tube that had sustained the severely brain damaged Hugh Finn for three and a half years would constitute euthanasia. In an emergency ruling, the Virginia Supreme Court upheld the trial court's finding that the withdrawal of nutrition and fluids from a patient in Hugh Finn's condition merely permitted the natural process of dying; it was not an illegal "mercy killing."

The politicization of the case was compounded when a local state representative, Delegate Robert B. Marshall, claimed that disconnecting the feeding tube would not only be illegal, "it would be against the teachings of the Catholic faith." "To me, the law doesn't allow it," he said. "He's not on life-support. He's not on a respirator. He's not brain dead. To me it is active euthanasia." That view was supported by the Rev. Paul de Laudurantaye, the secretary of education for the Diocese of Arlington, Va., who observed, "Mr. Finn has not yet reached the point where death is imminent. To withdraw [food and water] now would be homicide, for it is the adoption, by choice, of a proposal to kill him by starvation and dehydration. Such killing can never be morally right and ought never be permitted." On the other hand, the archbishop of Mrs. Finn's diocese, Thomas C. Kelly, O.P., of Louisville, wrote her a letter of support, assuring her that her decision fell within the framework of Catholic moral teaching. ...

Hugh Finn died at a nursing home on Oct. 9, 1998, eight days after his wife had his feeding tube removed. But that was not the end of the story. The local coroner then had the body taken to a funeral home so he could perform an autopsy. Since there was no question concerning the cause of death, the circuit court ordered the body returned to the family. That ruling finally allowed the family to lay Hugh Finn's body to rest in peace.