At the Other End of the Spectrum -- Part Two of Two

In Part One, I had the opportunity to celebrate my oldest daughter's 23rd birthday and to talk about how fatherhood has fundamentally shaped the way I see the abortion issue and made me a better--though hugely imperfect--man. Part Two discusses a topic that is as depressing and maddening as Part One was elating and satisfactory.

In the February issue of National Right to Life News, which is arriving this week in most people's homes, we discuss the near-starvation death of little Haleigh Poutre. On September 19, the Massachusetts State Department of Human Services asked a judge for permission to withdraw her life support, including a ventilator and a feeding tube, only "six days after the agency took custody of Haleigh and eight days after she was brought to a Westfield hospital after a beating, allegedly by her adoptive mother and stepfather," according to the Boston Globe's Patricia Wen. Juvenile Court Judge James G. Collins gave the agency the go-ahead October 5.

Fortunately, on January 18, Haleigh (who, supposedly, was "in a vegetative state," and "had suffered a severe brain injury, and probably would never think or feel again") began to breath on her own and show 'increased responsiveness." This came less than 24 hours after the Supreme Judicial Court had backed the lower court's death order.

"A week later, DSS Commissioner Harry Spence witnessed her picking up a duck and a Curious George doll on command and tracking some of his movements with her eyes," Wen reports. "On Jan. 26, DSS transferred Haleigh to the Franciscan Hospital for Children in Brighton, where she is receiving physical, speech, and occupational therapy."

The irony is that the only reason she had remained on life support was because of "her stepfather's appeals, which delayed the process long enough that Haleigh's condition began to improve," the Globe reported yesterday.

There are any number of hugely important issues raised by the manner in which Haleigh's fate was almost sealed. For example,

"Haleigh's highly publicized case shows how easily a child's death can be fast-tracked in a court system that may not be equipped to deal with such complex end-of-life cases, said some lawyers and specialists in juvenile law who have followed the case," according to Wen.

"Too often, they say, lawyers and judges are not inclined to question the medical expertise of physicians or the judgments of DSS lawyers with whom they work frequently."

But that is one step removed from the initial troubling question. While the two doctors who testified in her case "agreed on many points," they "disagreed over whether all life support should be ended."

Dr. Stephen Lieberman opposed the removal of the 11-year-old girl's feeding tube while Dr. Christine McKiernan, "the unit's associate director and Haleigh's attending physician, recommended the withdrawal of both her ventilator and feeding tube to allow for a swifter death," Wen reports.

"At a Sept. 30 hearing at Baystate [Medical Center in Springfield Massachusetts], both doctors gave a bleak prognosis for Haleigh," according to Wen. "Lieberman said that the significant injury to Haleigh's brain stem had caused 'irreparable brain damage' and that 'there was no chance of recovering cognitive or sensate functioning,' according to the Supreme Judicial Court opinion." But he did not recommend that her feeding tube be removed.

Evidently, Lieberman believed, "with proper care," Haleigh "could live for many years in a nursing home." According to an attorney for the stepfather, Lieberman "said he did not believe that the removal of her ventilator would kill her."

But the Supreme Judicial Court misunderstood Dr. Lieberman, Wen writes. In its ruling, "the court said Lieberman believed Haleigh's death was near, even if she was kept on a feeding tube."

The larger point of the story clearly is the need for outsiders to be able to offer an independent evaluation. Lieberman's and McKiernan's assessments drove the case. Wen reports that the court appointed two people to represent Haleigh, but neither sought additional medical opinions, according to court reports.

"[S]ome child welfare lawyers not involved in Haleigh's case questioned why another medical opinion was not sought for the girl -- particularly from someone outside Baystate who would not worry about contradicting a colleague," Wen reports. "Deborah Sirotkin Butler of Arlington, a family lawyer for nearly 20 years who has represented children in DSS custody, said she would have obtained an opinion from a doctor 'outside the hospital and county, maybe even the state.'"

Adding weight to this recommendation is that, "The speedy decision to end Haleigh's life defies what many neurologists say is the prevailing view for children with traumatic brain injuries," Wen reports. Youngsters fare much, much better than "adults with similar traumas."

As for the future, "Haleigh's case -- including how DSS possibly missed repeated signs of abuse -- is being investigated by both a legislative committee and by a panel appointed by Governor Mitt Romney," Wen reports. "Spence said he looks forward to the results."

You can read Patricia Wen's excellent story in its entirety at www.boston.com/news/local/massachusetts/articles/2006/02/12/haleigh_case_rolled_on_despite_dissent/?page=ful

If you have comments, please send them to Dave Andrusko at dandrusko@nrlc.org.

Part 1