By Dave Andrusko
I have just begun reading Justice Baker’s 75-page decision which, thankfully, came to the correct conclusion. A 51-year-old woman identified only as “M” will not be starved and dehydrated to death. I will analyze the decision in more detail tomorrow.
The key issue is whether the Court (in this instance known as the Court of Protection) would extend the logic of non-feeding currently applied to patients in a so-called “persistent vegetative state” to someone diagnosed as being in a “minimally conscious state.”
Alex Schadenberg, of the Euthanasia Prevention Coalition, blogged on the case earlier today. Quoting from the decision,
“I accept the evidence of the carers, who have far greater experience of living with M in recent years than do members of her family whose visits have become less frequent as time has gone by.”
“M does have positive experiences and …although her life is extremely restricted, it is not without pleasures, albeit small ones.”
As Mr. Schadenberg concluded, “Therefore ‘M’ will not die by dehydration because it was determined that she had a ‘quality of life’”– which is a very thin reed to lean on.
Again, from a preliminary examination, the good news is that Justice Baker relied on the testimony of the staff, who see “M” everyday rather than the sister who visits her only occasionally and medical “experts.” The obvious bad news is that assessments about a patient’s “quality of life” is both subjective and open to being swayed by attitude towards patients who have cognitive disabilities and/or who are unable to communicate.
England has already established the precedent that is acceptable to starve and dehydrate patients to death if they are diagnosed to be in a PVS—the Bland case. The issue raised in the case of M, who is being cared for somewhere in the north of England, is whether someone diagnosed as being in a “minimally conscious state,” a less severe condition, can also have their food and fluids removed.
The Official Solicitor, a lawyer appointed to represent M, strongly opposed the request of her sister to have M’s “artificial nutrition and hydration” withdrawn. As the trial began he said that M is “otherwise clinically stable” “has signs of awareness,” and “may be able to communicate using a switch,” according to the Belfast Telegraph.
M’s medical diagnosis was bungled in 2003 after coming down with viral encephalitis. In a coma for several weeks, she was thought to be in a PVS, but later was discovered to be in a minimally conscious state.
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