Law

At risk of death

A Texan rejects plans to operate on his daughter

TOM FENNELL October 7 1996
Law

At risk of death

A Texan rejects plans to operate on his daughter

TOM FENNELL October 7 1996

At risk of death

A Texan rejects plans to operate on his daughter

Ten-year-old Rachel Stout was writhing in agony when her aunt, Jane Gainey, visited her home in Fort Worth, Tex., in July. Gainey pleaded with Rachel’s father, Steve Stout, to take Rachel to a hospital. When he relented several days later, doctors in a Dallas hospital quickly determined that drastic measures were in order: Rachel needed an immediate operation to remove her severely ulcerated colon before it could rupture and possibly kill her. But Stout would not grant his permission, and on Sept. 1, as state officials sought a court order to allow the surgery, he spirited Rachel to Toronto and into the hands of a controversial naturopath. Last week,

Rachel was back in a hospital, in Toronto, undergoing treatment for an infection and again being advised to have her colon removed.

But her father—portrayed either as a hazard to his daughter or a courageous defender of the freedom of choice—was carrying on his fight in the courts. There, he was ordered to return Rachel to Fort Worth this week, where the Texas courts will determine whether he can seek an alternative treatment.

Stout, an engineer, flew his daughter to Toronto because he had heard of naturopath Dr. Ravi Devgan through practitioners of holistic medicine in Texas.

They arrived to discover that Devgan, who was convicted earlier this year of defrauding two patients, was serving a 90-day prison sentence on weekends. Between sessions in jail, Devgan treated Rachel with laser light acupuncture and doses of acemannin, a derivative of aloe vera, a natural substance commonly used to soothe sunburns, among other things. But then an infection developed from an intravenous tube that was still in her body when she left the Dallas hospital, and Stout sought help at

the Hospital for Sick Children on Sept. 9.

The Toronto surgeons, like their colleagues in Texas, determined that Rachel’s colon had to be removed by a process under which a new one would later be rebuilt from her intestines. The Children’s Aid Society, alerted by a children’s welfare agency in

Texas, obtained a court order giving it protective custody of the girl. But in Ontario family court, Stout persuaded Judge David Main to accept a plan that would transfer Rachel back into the custody of child care officials in Texas. There, Stout will seek to have Rachel obtain alternative treatment at the famed Mayo Clinic in Rochester, Minn. “Steve is a hero in Rachel’s eyes,” her mother, Pat Stout, said in Texas, “because he has respected her desire to keep her colon.”

Stout also emerged as a hero to practitioners of alternative medicine in Texas who believe that the government has no right to intervene in what they maintain should be purely a family decision. At the Texas custody hearing, dozens of specialists in alternative treatments testified that alternatives to surgery do exist for ulcerative colitis—including Devgan’s laser and aloe vera potions. But Rachel’s doctors countered that she had not responded to non-surgical treatments in the past. Rachel’s plight also divided members of the Stout family. Gainey testified that Rachel was living in “absolute squalor” when she visited her and was barely able to stand. “I truly felt that she was going to die,” she said. While Rachel’s case is sensational, there

is plenty of legal precedent. Kristina Reitmeier, chief legal counsel for the Children’s Aid Society, said that the Supreme Court of Canada has consistently upheld the right of the state to intervene on behalf of children who are endangered. It has also ruled that individual rights outlined in the Charter of Rights and Freedoms do not supersede the rights of the state to protect a child. The U.S. Supreme Court has followed a similar line. “It happens all the time,” says Jack Sampson, who teaches family law at the University of Texas. “The facts of Rachel’s case are just a little more colorful than normal.” Still, doctors face growing challenges over the question of consent. Christine Harrison, director of bioethics at the Hospital for Sick Children, says that people feel empowered to take control of their own health. The Que^ bee Superior Court helped I legitimize that trend in JanuS ary, 1992, when it ruled that I a Quebec woman known as Nancy B, who was suffering from Guillain-Barré syniiü drome, a rare neurological disorder, had the right to disconnect her life-support

system. And many parents reject treatments prescribed for their children. “But ethically there has to be a higher standard when we’re deciding for other people,” says Harrison. “I can make bad decisions for myself, but I have to be more careful in my decision-making for other people.” That is exactly what courts in Texas and Ontario are asking of Steve Stout.

TOM FENNELL