Saturday, April 09, 2005

Killing the Sick

Grizzly Mama writes of the case of Mae Magouirk, an 81-year-old Georgia woman whose grandaughter has ordered her feeding tube removed. As in the Terri Schiavo case, the family is not in agreement as to whether the patient's case is hopeless or not. Magouirk's closest living relatives are A. Byron McLeod (brother), 64, of Anniston, Ga. and Ruth Mullinax (sister), 74, of Birmingham, Ala, followed by the granddaughter, Beth Gaddy, 36, an elementary school teacher. Ruth Mullinax's son, Ken Mullinax (nephew) is also opposed to the dehydration. Mae Magouirk's husband and son are deceased.

Fortunately, in this case the patient has a living will that lays out specific conditions for removing a feeding tube, so there is no controversy, right? Wrong:
WorldNetDaily: Granddaughter yanks grandma's feeding tube: "Two weeks ago, Magouirk's aorta had a dissection, and she was hospitalized in the local LaGrange Hospital. Her aortic problem was determined to be severe, and she was admitted to the intensive care unit. At the time of her admission she was lucid and had never been diagnosed with dementia.

Claiming that she held Magouirk's power of attorney, Gaddy had her transferred to Hospice-LaGrange, a 16-bed unit owned by the same family that owns the hospital. Once at the hospice, Gaddy stated that she did not want her grandmother fed or given water.

'Grandmama is old and I think it is time she went home to Jesus,' Gaddy told Magouirk's brother and nephew, McLeod and Ken Mullinax. 'She has glaucoma and now this heart problem, and who would want to live with disabilities like these?' [...]

[The hospice's in-house legal counsel, Carol] Todd explained that Gaddy had only a financial power of attorney, not a medical power of attorney, and Magouirk's living will carefully provided that a feeding tube and fluids should only be discontinued if she was comatose or in a 'vegetative state' – and she was neither.
We note that the hospice's legal counsel apparently did not list "terminal illness" as a condition for removing the feeding tube. Even so the risk of death from the aortic dissection is the rationale for hastening the process. At The Daily Kos jbane adds:
"Aortic Dissection is a catastophic event. 33% of patients die in 24 hours, 50% within 48 hours. The two week mortality rate approaches 75%. The prognosis is very poor. Since she is 85 I am sure they are reluctant to perform any operation.

The reports do not indicate what the state of her brain is, but she must be unconscious or they wouldn't be arguing about her. One report says she is being medically sedated so she can't respond and can therefore be allowed to die by dehydration.

In this case she had a power of attorney, but it isn't clear whether this condition is covered."[emphasis added]
First of all, just contemplate the bolded sentence from Kos. So if you think the patient might object to being killed, just sedate them so they can't speak? According to the WorldNetDaily article, Magouirk is 81, not 85. It's also quite clear from the hospice legal cousel's statement that the financial power of attorney does not apply to medical decisions. Moreover, she has a living will that covers the situation.

Aortic dissection is indeed a very dangerous condition, particularly at the onset:
THE MERCK MANUAL, Sec. 16, Ch. 211, Diseases Of The Aorta And Its Branches: "The long-term survival of treated patients who have survived the acute episode is about 60% at 5 yr and 40% at 10 yr. In contrast, 75% of untreated patients die within 2 wk. About 1/3 of late deaths are due to complications of the dissection; the other 2/3 are due to other diseases."
So if it doesn't kill you right away, you may live another 10 years or more. Treatment may consist of drugs or surgery and drugs. Since it's been two weeks since the start of the dehydration/starvation "therapy," Magouirk has obviously already lasted longer than 75% of untreated patients.

The overall health and vigor of people of Magouirk's age varies widely. Our own mother is quite healthy and self-sufficient at age 80. Until the aortic problem just a short time ago, Magouirk herself was well enough to live independently. Of course health status can change quickly for the worse in the elderly. Still don't count them out prematurely. We have personally seen near-miraculous recoveries from apparently hopeless illness and/or invasive surgery at advanced ages in our father, grandfather, and both grandmothers. We've also seen first hand that patients in ICU often become a bit "loopy" with "hospital psychosis," but this is reversible.

So now Mae Magouirk continues to exercise her "right" to slowly die of dehydration/starvation against her own wishes as expressed in the provisions of her living will and against the wishes of most of her family. To those who believe this is a humane, painless way of "letting" someone die, why not push for it as a method of capital punishment, too?

UPDATE 7:30PM: Monica of Grizzly Mama pointed us back to an update on WorldNetDaily: 'Grandma' airlifted to medical center: "Mae Magouirk, the 81-year-old Georgia widow over whose medical care a family tug-of-war reminiscent of the Terri Schiavo case has been raging, has been transported from the hospice in LaGrange, Ga., to the University of Alabama-Birmingham Medical Center, according to her nephew, where 'she is receiving food, fluids, cardiac care and neurological help.'"

This article also has some very good things to say about the granddaughter, Beth Gaddy, and the attorney for the brother and sister also agrees that everyone wants what is best for Mrs. Magouirk. They just disagree on what those are.

This page is from the original Don't Let Me Stop You blog. We have moved to a new site: Visit DLMSY on WordPress.

Return to main page of Don't Let Me Stop You