A Right to Live

32 A RIGHT TO LIVE (Haven Bradford Gow) Illionois state legislators are weighing a proposal that would permit surrogate decision-makers, such as family, court-appointed guardians, etc., the right to okay the withdrawal of medical care and treatment — including artifical feeding —?- from a patient who is unable to make the decision. A coalition of anti-abortion and pro-family groups have organized to fight passage of the proposal, saying that the legislation would permit euthanasia. According to Nicholas Stojakovich, a spokesman for the coalition, the proposed legislation, in its present form, takes a quantum leap forward in legalizing euthanasia in Illinois. This bill, if passed, will allow the intentional starvation of both terminally and non-terminally ill patients. The proposed legislation says that, if two physicians certify that the patient is incompetent to decide on medical care and treatment, a surrogate decision-maker can make the decision for him. Medical care and treatment can be1 withheld if two of the following three factors are present: The patient is in a terminal state; he or she is in a vegetative state; and if it can be established that continued medical treatment would impose an extraordinary financial or personal burden with only minimal health benefits to the patient. In this connection, a prestigious task force approved by the American Academy of Neurology and four other medical organizations has acknowledged that diagnoses of persistent vegetative state (PVS) are inherently uncertain in the light of present medical scholarship. The case of Nancy Cruzan, a PVS patient, has made national news and currently is being weighed by the U.S. Supreme Court. In their briefs-in the Cruzan case, the American Medical Association and other- medical associations argued that PVS can be diagnosed, and that it has a negligible chance of recovery. However, a study by 8 neurologists and other specialists that appeared in the March 8 New England Journal of Medicine pointed out that, contrary to claims made by the AMA in its brief in the Nancy Cruzan case, it remains an open question whether PVS patients can recover. An article in the April 1990 Respect Life Report, published by the REVIEW OF RELIGIONS 33 National Conference of Catholic Bishops of the United States, revealed some startling and inspiring cases of persons who have recovered from PVS: In November 1989, ayounggirlfrom the state of Washington lay in a coma for 19 days, largely unresponsive to talk and touch. Doctors predicted she would likely be comatose for years. Hours after the diagnosis, the girl awoke. A Wisconsin man in his mid-40s lay in a coma for two years and then remained in what was diagnosed as a ‘vegetative state’for eight years more. Because it was determined he could feel pain, doctors administered Valium to prepare him for dental work. The man fell asleep, then woke up. To the doctors’ astonishment, he could talk, walk, feed himself and answer questions lucidly. Doctors don’t know why the drug had this effect, but they are working on devising appropriate doses of drugs to keep the man lucid for long periods of time. Inl989, Timmy, alO-year-oldDelawareboy, was operated on for a brain tumour. Following surgery he lay vacant-eyed and helpless in a ‘vegetative state’. Because he could not chew or swallow, he was fed through a stomach tube, and he drew breath through a hole in his trachea. The child’s prognosis was not encouraging, but for reasons unknown, Timmy began to recover ten months after surgery. Today he is undergoing speech and physical therapy The chief of rehabilitation in the hospital where Timmy receives therapy put it: ‘Just when you think there’s no such thing as a miracle, Timmy comes along.’ Dr. Eugene Diamond, professor of pediatrics at Loyola University Medical School in May wood, IE., points out that the American Medical Association’s judicial Counsel has recommended that food and drink could be discontinued for those in persistent vegetative state. The AMA statement, says Dr. Diamond: suggests that the diagnosis be ‘insured’ and the coma irreversible ‘beyond doubt’. These are degrees of certitude not achievable in the real world of bedside medicine. Persons in persistent vegetative states are neither dead nor dying. Whenfeeding tubes are removed, they die of starvation and not of any underlying disease. Subsequently AMA attorneys have intervened in cases throughout the country on behalf of starvation of patients, most recently in the Longeway case in Illinois. The AMA has shown no interest in the quandry created (continued on page 36)