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March 27, 2000 Press Conference
Albany, NY
Kathy Faber-Langendoen, MD
The care of Sheila Pouliot is a graphic example of how really harmful
medical decisions can be made when we let the State and Courts make them,
rather than loving families and involved physicians who have taken an oath
to help, and not harm, patients. When the courts and attorney general
became involved in Sheila's medical decisions, because of the state's
insistence on never stopping nutrition and hydration, physicians were
forced to restart intravenous fluids and liquid nutrition through the
feeding tube in her stomach (a "G-tube"). Using the G-tube caused
incessant hiccups, followed by severe vomiting, and the physicians stopped
it. IV fluids were continued per the court-approved treatment plan; they
provided Sheila's only sustenance. However, IV fluids alone were never
meant to sustain people for more than a few days, because they are only
water with a little sugar and salt. They provide no protein, and are
utterly insufficient to sustain life long-term. So, as Sheila continued
to receive hydration alone, she developed severe protein malnutrition.
Her body puffed up with fluids, and her skin began to break down, with raw
open sores as her body devoured itself, starved of protein.
In the end, it was the physicians who pushed with the family to make the
court reconsider what had become a torturous treatment plan. The attorney
general's office argued that the state had an absolute interest in
prolonging life, and resisted any change in the treatment plan that would
have shortened Sheila's life, even if keeping her alive caused great harm.
While Sheila's family spent hours at her bedside, soothing her, stroking
her hair, the attorney general believed he knew what was right 150 miles
away in Albany. Even when a physician hired by the attorney general's
office to review Sheila's case agreed with our recommendations and the
family's wishes, the attorney general persisted in his request that
hydration be continued.
The tragedy is that Sheila's dying became not merely the stuff of family
sorrow and difficult choices, but of a fierce legal battle that pitted the
state against a loving family and caring physicians. The physicians
recognized that there was no way to save Sheila's life, yet were forced to
string it out for months as her body slowly consumed itself. In the end,
Sheila died only after an adversarial and costly court battle, with the
family's difficult choices and Sheila's dying highlighted in newspapers
and the 6:00 news. This is no way to treat people. This was not respect
for Sheila's life; it was the triumph of abstract principle over the
reality of Sheila's suffering. Sheila's suffering finally came to an end
less than a day before the next legal hurdle, which could have forced
restarting IV hydration. These decisions don't belong in the courts.
These decisions don't belong to the attorney general. They belong to the
families who love and care for patients, and to physicians who have sworn
to do no harm.
For more Information, E-mail Family Decision Coalition
For questions about website, E-mail Jack Freer
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