Hospital Euthanasia: Compassion or Murder?
Johnson, Sally, Insight on the News
As far as his guardian and his doctors were concerned, the time had come to let Ronald Comeau die. The 30-year-old drifter, hospitalized since suffering severe brain damage three months earlier, was being kept alive with feeding and water tubes. According to doctors at the Southwestern Vermont Medical Center who decided to remove the tubes, the situation was hopeless. Ronald Comeau, they said, was in a "persistent vegetative state."
To most people, the words conjure a patient lying still, eyes closed, dead but for his breathing. But videotapes of the emaciated Comeau aired on the evening news in late November clearly showed Comeau in his hospital bed with eyes wide open, pointing, grimacing and hugging a stuffed animal. His mouth seemed at times to be laughing, at other times to be silently screaming. He semed, in short, to be very much alive.
"I was amazed," said one Vermont woman who saw the tape. "That's not at all what I expected to see. I had to wonder what they were doing down there at that hospital."
So did Comeau's family. Alerted by a story about Comeau in their hometown newspaper, his brothers hastened to Bennington to see if the patient was indeed the sibling they hadn't seen in many years. "I was expecting to see a tomato with a bunch of tubes coming out of him" says Renald Comeau, Ronald's older brother. "When we walked in the room, he opened his eyes, smiled, cried, shook hands with everyone. We were elated. And then we began to wonder what was going on."
The story of how Ronald Comeau almost came to die is seen as a cautionary tale by the right-to-life proponents who intervened in his case, setting in motion a court struggle -- still unresolved -- that went to the Vermont Supreme Court. They say it is a taste of things to come in a resource-conscious society in which costs will outweigh compassion in medical decisions, As a result, they have asked the Vermont Legislature to pass laws that would ensure that such a case never happens again.
"We want to make it difficult, if not impossible, for the government to practice involuntary euthanasia," says Mike McHugh, a fundamentalist pastor who stepped in to stop the process.
But the hospital staff and the man, Joseph Schaaf, who made the decision to pull the tubes, say their actions were motivated solely by compassion for Comeau and that their decision was correct in the context in which it was made. "I tried to do for that man what I would do for my son or my brother or even myself," says Schaaf, Comeau's court-appointed guardian. "I am 68 years old, and I wouldn't want to live like that. He seemed without hope of any substantial recovery. better to let him die."
To anti-euthanasia activists, Comeau's story is an unusually visible example of a common practice in hospitals and nursing homes. "The removal of food and fluids from non-dying patients happens every day," says Rita Marker, director of the International Anti-Euthanasia Task Force.
"Over the last 10 years, there has been a redefinition of food and fluids provided through a tube as medical treatment. Therefore, when you withdraw medical treatment from a nonrecovering patient, you remove the feeding tube. What's unusual about this situation is that someone brought it to the public's attention and, as a result, Mr. Comeau is still alive."
But Arthur Caplan, director of the Center for Biomedical Ethics at the University of Minnesota, says the notion of food and fluids as medical treatment is well established and has been reaffirmed again and again by courts, including the U.S. Supreme Court in the Nancy Cruzan case. "Food and water outside the hospital sounds different," he concedes, "but withholding food and fluids doesn't predict death with any more certainty than withholding insulin from a diabetic or antibiotics when the patient has an infection. There's also a common perception that it is a terrible way to die, but it's not if managed humanely. …