Haleigh Poutre: Proof It’s Not Over Until It’s Over In PVS Cases

I have written about Haleigh Poutre nationally and several times here at SHS (here, here, here as examples), but this bears repetition until it finally sinks in. Scenario: Child badly beaten. Within a week or so Haleigh’s doctors write her off as in a persistent vegetative state. She will never awaken, they say. Best to dehydrate.

The State of Massachusetts goes meekly along—even though it is supposed to take at least 3 months to be able to diagnose a PVS. The Social Services people petition the Supreme Court of MA for permission to dehydrate and remove breathing assistance, and the rubber stamp is given. But then, just before forcing a little girl who has already been terribly abused by those who were supposed to love her, and being written off by state bureaucrats and judges who were supposed to protect her, she shows signs of awareness and at the last second, the dehydration is cancelled.

NOW, she can apparently communicate and may testify in court against her abusers. From the story:

More than two years after Haleigh Poutre was so brutally beaten she was left in a coma from which she was never expected to revive, the 14-year-old girl may be well enough to testify against the man accused of abusing her. Haleigh, who was once thought to be so irreversibly brain damaged that doctors planned to remove her from life support, has spent the last two years recovering at the Franciscan Hospital for Children near Boston. She began breathing on her own and showing other signs of brain activity in January 2006, just days before doctors planned to remove her ventilator. Now, she is reportedly able to communicate and recall her alleged attack...

Haleigh is now in rehabilitation at the Franciscan Hospital for Children near Boston, though her level of recovery is not clear. Wendy Murphy, Avrett’s attorney, said Haleigh is enrolled at the day school at the hospital.

Haleigh is in school, but if the bureucratic process needed to dehydrate her had moved a little bit faster, she would be dead!

This case involves many lessons, that we never seem to learn. One is that doctors should turn away from the quality of life ethic that is infecting our medical ethics and skewing prognoses and advice about the care of people with profound cognitive impairments. This can lead, as in this case, to a rush to judgment about PVS and chances for improvement.

Second, we should quit writing off people, even when diagnosed properly with PVS, primarily because they possess equal moral worth. Moreover, the diagnosis is often mistaken or people wake up—such as Jesse Ramirez whose wife wanted him dehydrated, but whose family fought for his life. Eventually he walked out of the hospital on his own two legs and I had the honor of shaking his hand.

Utilitarian ethics, duty to die, futile care theory, dehydration—it isn’t safe today to be profoundly disabled or terminally ill. Indeed, increasingly such helpless people are being treated as if they were less than fully human.

But will we learn? No. Cases like this will not cause a dent in the mindset.