JUSTICE

Decisions about life and death

MALCOLM GRAY March 28 1983
JUSTICE

Decisions about life and death

MALCOLM GRAY March 28 1983

Decisions about life and death

JUSTICE

The question was whether a severely retarded boy would receive a potentially life-saving operation or, effectively, be allowed to die. Finally, last Friday afternoon Stephen Dawson, 6, was hurriedly wheeled into Vancouver Children’s Hospital for surgery to repair a pump which drained fluid from his brain. The emergency operation came only hours after a British Columbia Supreme Court judge overturned a previous decision that, in essence, gave Stephen’s parents—not medical authorities—the right to determine the boy’s fate. The distraught parents, Robert and Sharon Dawson, believed that their son—blind, deaf and

suffering from cerebral palsy—had no hope of living a normal life. But Mr. Justice Lloyd McKenzie flatly rejected the parents’ request that Stephen be allowed to die a simple death with dignity. The justice concluded that it was not certain that the boy would die without the operation and he accepted testimony that Stephen might live indefinitely in great pain. “I cannot accept the view that Stephen would be better off dead,” he said. “This would mean that the life of a handicapped child is worth less than the life of a normal child—and worth so much less that it is not worth contemplating,” he added, in a ruling that was the latest chapter in the battle over “the right to die.”

The judge relied heavily on the legal doctrine of parens patriae (father of the

country), which gives the courts wide jurisdiction over the welfare of the child. In fact, he awarded custody of the child to the B.C. superintendent of child welfare. The fact that Stephen’s parents divorced in 1980 and are not married—they now live together—was also a factor in the decision, McKenzie said. In the end, he sided with the evidence of the medical staff who, because the boy had been home only once in four years, had seen him constantly. They testified that he could lead a normal life within the limits of his handicap. For Robert and Sharon Dawson, the second stressful week in court ended when they decided not to appeal McKenzie’s decision

and to allow the operation on their son. “We feel the decision was unfair,” Robert Dawson said. Sharon Dawson also vowed to continue the fight for permanent custody of the boy.

The drama began with the startling decision by Provincial Court Judge Patricia Byrne to rule out an operation to repair a blocked shunt that drained fluid from Stephen’s brain. She ruled that the brain shunt would be an extraordinary surgical intervention and would constitute “cruel and unusual treatment.” Within hours of her ruling, the provincial government, supported by the B.C. Association for the Mentally Retarded, sought custody of the boy.

Before deciding the issue, McKenzie confronted the tangled emotional questions raised by the case. Among the

issues were whether the quality of life, and not simply life itself, should be the chief consideration in medical decisions and whether individuals or the state should have the final say. They are not new questions, but they are ones that have been raised With increasing frequency as medical technology offers new hopes of prolonging life.

The arguments over Stephen Dawson’s fate recalled the case of Karen Anne Quinlan, the 28-year-old New Jersey woman who sank into a coma eight years ago after drinking and taking tranquillizers. After a long battle in the U.S. courts, Quinlan’s parents won a 1976 decision allowing them to discon-

nect life-support systems. But their brain-damaged daughter did not die. Before the court, Quinlan was found to be an adult in a terminal condition. But in the Dawson case the fight was over a child who, his parents believed, had no future. McKenzie’s decision echoed new U.S. federal regulations that became effective this week, requiring hospitals to care for disabled newborns—or lose funding.

The Dawson case turned the nation’s focus on a reality of discreet, private dealings between many doctors and grieving relatives—the practice of letting terminally ill patients die.

1 McKenzie clearly concluded that

2 Stephen Dawson did not fit that 2 category. In contrast, a cancer o therapist who has had to deal z with the question of euthanasia > agreed with the parents’ right to

forgo surgery. “The professional practice of no resuscitation has gone on for decades,” said Dr. William Ibbott, the physician who convinced the Canadian Medical Association to adopt that practice in 1974.

For Stephen Dawson, life’s possibilities narrowed two weeks after he was born prematurely on March 29,1976. He contracted spinal meningitis, a bacterial disease that attacks the membranes surrounding the spinal cord, which left him severely retarded. Throughout the poignant trial, he was an unseen but palpable presence in the courtroom. Even though his right to life-saving medical care was guaranteed, he will probably never comprehend the wrenching debate that made his surgery possible—no matter how long he lives.

MALCOLM GRAY