Baby's fate to be decided in Waco

Austin AMERICAN-STATESMAN ^ | Friday, November 15, 2002 | Mary Ann Roser

[Station 51]

A baby boy on life-support in Austin will return today or Saturday to Waco, where a hospital has the power to stop care and let the child die -- even against the mother's wishes.

Under the state's 1999 Advance Directives Act, a hospital can stop providing life-support to a patient if its ethics committee determines that continued care would be futile.

The hospital must help the patient's family find another facility before withdrawing care, but if no place is available, the hospital could stop treatment after 10 days of the ethics committee's written decision. Only a judge could grant more time if the family pursues legal action.

In the case of this baby, doctors at Children's Hospital of Austin, Hillcrest Baptist Medical Center in Waco and Cook Children's Medical Center in Fort Worth all have concluded that 2 1/2-month-old Telvin Jackson of Waco should be removed from a ventilator because of irreversible structural damage to his brain.

However, Hillcrest does not appear eager to exercise its authority under the state law.

"If this child is returned to Hillcrest, the hospital will do its best to provide care to the child until the parents or CPS (Child Protective Services), under a valid court order, direct the hospital or the baby's doctors to discontinue care," said Waco attorney Roy Barrett, who represents Hillcrest.

Texas Child Protective Services has temporary custody of Telvin and three other sons of Mary Jackson, 39, because she tested positive for cocaine at the hospital after Telvin was born. Jackson denied using the drug, and subsequent tests were negative.

Hillcrest sent Telvin to Austin last week for a consultation, and doctors at Children's agreed that additional care and medical procedures, including a feeding tube and a breathing hole in the neck, would be futile, said Aaron Reed, a spokesman for Child Protective Services.

"Each of the surgical teams that we requested to evaluate those procedures have declined to perform them," Reed said Thursday.

His agency supports the decision to end life-support, saying it considers continuing care a violation of the child's body. But a Waco judge ruled that Child Protective Services would have to go to another court and win guardianship to terminate life-support.

Telvin was born Aug. 30 in a car because his mother couldn't get to the hospital in time. For reasons Reed does not know, the baby was without oxygen for about 30 minutes and arrived at the hospital "technically dead."

Doctors said the baby's brain has turned to liquid and his body is decomposing. However, he has not been declared brain dead because of involuntary gasping sounds, indicating some brain stem activity.

Brain death is not required to terminate care, said Tom Mayo, an associate professor of law at Southern Methodist University who also helped write the Advance Directives Act. The standard is whether treatment is useless.

"There is a general ethical principle that physicians are not required to provide futile treatments," Mayo said. "Obviously, we always hope to have the relevant family members in agreement on that."

Jackson did not return calls requesting an interview Thursday. Her former attorney, Cindy Tisdale of Waco, said Jackson still hopes someone can help her baby.

The baby's father, Melvin Washington, 42, of Waco, said, "I think she feels as long as he has a heartbeat, she wouldn't want him to be off the machine."

He has mixed feelings about it.

"If he's living, I don't want to take his life," he said. "I hate to see him suffer, though."

Doctors don't think the baby can sense pain.

Greg Hooser, an Austin lawyer who helped draft the law, said that if the baby is taken off life-support, doctors and nurses still could provide drugs and nourishment until the body shuts down on its own.

"You're letting nature take its course, as painlessly as possible," he said.

[McLynnan]

This poor baby never had a chance.

Valerie, local ping. I haven't had time to read the local paper all week, were you aware of this?

[Blood of Tyrants]

I truly feel sorry for the parents but God would have let the poor child die and come back to heaven.

[ikka]

His agency supports the decision to end life-support, saying it considers continuing care a violation of the child's body

So keeping the child alive is a violation, but withdrawing support and having the child die is not?

[dead]

What a sad story. I think it's time to let him go.

[Catspaw]

I think it's time to let this child go, too. He has suffered enough.

I wonder if the mother is saying no because the police might upgrade any possible charges against her.

[Station 51]

Under the state's 1999 Advance Directives Act, a hospital can stop providing life-support to a patient if its ethics committee determines that continued care would be futile.

Sadly, it appears that this is a law George W. Bush signed. Why.

[willyone]

I can not even imagine having to make a decision like this. What a sad event.

[dead]

That's a really good point, though the article is unclear about whether she actually was on cocaine or if that accusation has been dropped. A false positive on a cocaine test is certainly possible.

[Catspaw]

This is a horrendous decision, but given the state of the child, I'd let him go.

Doctors said the baby's brain has turned to liquid and his body is decomposing. However, he has not been declared brain dead because of involuntary gasping sounds, indicating some brain stem activity.

[TXBubba]

If he's living, I don't want to take his life," he said. "I hate to see him suffer, though."

I don't think you would be taking his life at this point. If the brain has turned to liquid and the body is decomposing then this baby died a long time ago. It's body functions have only been kept moving by the machines. Although I can't imagine the grief on the part of the mother I also can't imagine not loving the child enough to let it go.

[TXBubba]

This was discussed on our local radio shows this week. Apparently at least 3 ethics committees have been approached with the question. All of them said to removed the life support. It's not like one group is alone in it's conclusions.

[TXBubba]

Another point discussed on the radio was the need of other critically ill infants to use the facilities.

[Scoutmaster]

Why would George W. Bush sign this law?

Often, relatives of someone who is, for all intent and purposes, dead, refuse to have them removed from life support. As a healthcare attorney who represents hospitals, I see this on a weekly basis. We're not talking patients who could be removed from machines and who would live, but be severly disabled and in a vegetative state. We're not talking patients who might awake from a coma.

We're talking patients who are dead -- with a machine keeping a heart beating and oxygen coursing through the body, which is slowly wasting away.

There are cases where you can tell the soul has left the body -- people look different dead than they do in a coma. There's something visible about the life force.

When a family member can't come to grips with death, and wants to keep someone hooked up to machines at a cost of thousands of dollars a day (which they will never pay), someone has to decide that enough is enough. I sit through meetings where patients like this are discussed, and often twenty or more healthcare personnel from a myriad of medical specialties solemnly discuss the matter. It's obscene to keep a body hooked up to machines and allowed to wither away when the soul is gone, the brain is dead, and some "loved one" can't come to terms with that.

[ValerieUSA]

I did hear about this case. It's a tragedy that should have been resolved with the baby's death and burial long ago, so the parents could grieve and recover. They are torturing themselves. Removing the baby from life support is not murder - it isn't a sin - it is an act of faith in God and in His loving care for the little ones returning to His arms.

[McLynnan]

I agree, and Hillcrest's reluctance to let this baby go can only be because they fear legal action. I can't imagine why these parents want to put the baby and themselves through this since there is obviously no hope this child will improve.