DUE PROCESS FOR A SAD RESULT:

Hospital ends life support of baby: 1st U.S. case of its kind is against mom's wish, in accordance with law (BRUCE NICHOLS, March 15, 2005, The Dallas Morning News)

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. [...]

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.

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.

At least two things differentiate this from the Schiavo case: first, Sun Hudson was on life support, not just receiving sustenance; second, procedural safeguards were built into this law -- perhaps thanks to the participation of pro-life advocates and the need for George Bush's signature? -- and the hospital seems to have behaved in exemplary fashion. Still, killing a child against the wishes of the parent seems a potentially dangerous precedent and was hopefully just a function of Ms Hudson's apparent estrangement from reality.

Posted by Orrin Judd at March 22, 2005 11:52 PM