December 10, 2010 | Posted By Bruce White, DO, JD

Student Jacob M. Appel, M.D. ( called the Winter Term Bioethics and Law class’ attention to this recent ABC News feature found here [accessed December 6, 2010].

Dan Crews is 27 years old. He has been a quadriplegic since age 3, as the result of a car accident. He cannot breathe without the aid of a ventilator, but he can speak and eat with assistance. He asked to be removed from the life-sustaining breathing machine, but the Wisconsin hospital refused because the psychiatrist service is of the opinion that he is depressed and thus incapable of making the decision to remove the ventilator.

From the story it appears that he has been asking to be removed from the ventilator since May 2009! The patient is reported to have said that “[h]e doubts the hospital will reverse its decision – ever.”

As from Gilbert & Sullivan’s The Mikado, here’s a howdy do? Or, perhaps a Catch-22 conundrum in the fashion of Joseph Heller’s World War Two satire?

Of course other physicians and courts – faced with similar fact patterns – have discontinued the life-sustaining medical intervention. See Bouvia v. Superior Court, 225 Cal.Rptr. 297 (2d Cal.App. 1986) (artificial feeding); State v. McAfee, 385 S.E.2d 651 (Ga. 1989) (ventilator); McKay v. Bergstedt, 801 P.2d 617 (Nev. 1990) (ventilator); and State v. Ruane, 912 S.W.2d 766 (Tenn.Crim.App. 1995) (Donald Willis, the victim-patient, was maintained on a ventilator).

Wonder if Mr. Crews has sufficient decision making capacity to discharge his physician(s) or ask to be transferred to another facility? Or ask his lawyer to file a lawsuit alleging battery?

Another case in which the patient “begged” his medical team to leave him alone and thus “allowed to die” is the nationally known Dax Cowart case. Information about this patient may be found at this link [accessed December 6, 2010].

0 comments | Topics: Bioethics in the Media , Doctor-Patient Relationships , End of Life Care , Patient Autonomy

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