Dehydrating Brain Injured People to Death Still an Important Political Issue

By Wesley J. Smith, J.D., Special Consultant to the CBC

It is oft said that a society is judged by how it treats its weakest members. (Humans only. Animals are not members of the moral community. Their proper care is an important ethical issue, but irrelevant to this post.) And there are no weaker among us than those who experience profound cognitive disability.

Former Governor Mitt Romney is taking some heat for the scandalous attempt made during his governorship, by Massachusetts bureaucrats, to dehydrate a then unconscious 11 year-old child abuse victim, named Haleigh Poutre, to death. (I covered her case extensively. Had not dotting all the bureaucratic “it’s taken several months, Poutre would be dead today instead of in school!) From the Politico story:

In 2005, aides to then-Massachusetts Gov. Romney pressed vigorously in court for a pull-the-plug order on a severely-beaten 11-year-old girl who appeared to be brain dead, only to rescind the request when the child unexpectedly emerged from a vegetative coma.

Well, that’s an unfair description. As I recall the circumstance, those pushing for the dehydration were bureaucrats from the state social welfare agency, not personal aides of Romney, as Politico implies, pushed by doctors’ who declared her not worth maintaining within days of her savage beating. But, back to Politico:

On Jan. 16, 2008, the state’s highest court sided with Romney’s DSS and gave permission for the removal of a respirator and feeding tube. But a day after the decision, Haleigh regained consciousness and began responding to simple commands, to the astonishment of doctors at Baystate hospital in Springfield.

A few days later, Romney, who had remained mum on the case up until that point, was pressed by reporters to articulate a broader position on end-of-life, but demurred, telling them: “My concern is with this young girl and her current status,” he told the Boston Globe. “In light of reported improvements in her medical condition, it should be clear to everyone that no action should be taken to end this girl’s life.” In the months that followed, Romney tapped a three-member panel to examine the Poutre case and offer recommendations. Their findings: Errors were made by caseworkers and state officials, in the future, would seek outside medical advice and conduct more thorough physical examinations prior to proceeding with any end-of-life requests of people in their care.

Romney implemented the suggestions and told reporters, “The process of deciding to remove life support for a child In state custody has been inadequate,” adding, “We must implement a far more comprehensive and robust process.”

To be sure, but that begs an important question: Should tube-supplied hydration and nutrition ever be ordered removed by the state when it is medically appropriate, in other words, when it maintains life as opposed to those times at the verge of death when the body cannot assimilate sustenance. I say no. Anyone who dehydrated a dog would go to jail. Were Osama bin Laden dehydrated to death over two weeks, instead of shot in the head, President Obama would be up on charges in the Hague. And the symbolism of deciding that a human being isn’t worth feeding is just too denigrating. Yet, in America we routinely dehydrate the cognitively disabled, and it is shrugged off as medical ethics.

Dehydration raises a lot of issues and emotionality — and hence most politicians prefer to avoid it. But events happen occasionally that force them to take a stand.

I recall when Congress rushed to pass “Terri’s Law,” which attempted to prevent Terri Schiavo’s dehydration based on the perceived need for the federal judiciary to independently investigate what were considered — and I think were — highly irregular state court proceedings in that case. (The federal judge assigned to the case effectively refused comply with the law, and Terrie died slowly over 14 days, bleeding in her eyes at the end from hyper dryness.) That law was later criticized harshly by Democrats — but only after polls showed it was unpopular.

Yet, when they could have stopped the legislation from becoming law, they didn’t. Indeed, it would only have taken one U.S. Senator to prevent Terri’s Law from passing. Both (then) Senators Barack Obama and Hillary Clinton acquiesced in the unanimous consent of the Senate. So, did Harry Reid and every other Democratic senator. (Obama later said it was his worst mistake as a Senator — when running against Clinton and after it was clear that Senator McCain would be the Republican nominee. Such courage to say he did something “wrong” when his opponents had done the same thing.)

Dehydration remains an important ethical issue in the country precisely because it is a proper measure of our morality as a people. And, it is one that can cut both ways politically. A society is judged by how it treats the least among us.