Thursday, March 14, 2019

EPC granted intervention standing in withholding of food and fluids court case

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition was granted intervention in a Ontario court case concerning the withdrawal of fluids and food against the wishes of the substitute decision maker in a case known as the Cement case.

The Cement case concerns a 62 year-old woman (Connie) with Downs Syndrome and dementia who was raised in a family whereby her father was an Orthodox Jewish Rabbi.

In September 2018 Connie entered an ICU in an Ontario hospital. She was having difficulty breathing due to problems with aspiration, she had a tracheotomy and feeding tubes inserted.

Connie now breathes on her own, but due to her dementia she continues to be fed by feeding tube. 

The doctors at the hospital have proposed a "treatment plan" based on providing only comfort measures. The doctors want to withhold fluids and food, and deny ventilator support, if needed, and provide no medical treatment, even if the treatment would be beneficial. 

The doctors have stated that the "treatment plan" is in Connie's "best interests."

Connie's substitute decision makers, family members, have refused to accept the "treatment plan."

The Cement case will soon go before the Consent and Capacity Board.

The Euthanasia Prevention Coalition (EPC) was granted intervention standing based on our position that fluid and food are not medical treatment but rather a basic necessary of life.

We agree with the position of the substitute decision maker that Connie is tolerating and benefiting from tube feeding.

Further to that, tube feeding is beneficial in her condition, it is not contra-indicated and to discontinue tube-feeding will cause her to die and do so in a way that is contrary to her religious beliefs.

The doctors are arguing that because of her life-long disability and since her dementia has been progressing for many years, that the wishes of Connie are unknown.

The EPC agrees with the position of the substitute decision maker that the denial of basic care, such as food and fluid is a form of disability discrimination.

To kill a woman with Down Syndrome and dementia by dehydrating her to death is never in her "best interests" and is the highest form of disability discrimination because her life is seen as having no value.

Child with feeding tube.
We would all agree that to deny a child, who cannot eat on her own, food and fluids by bottle or other means is not denying the child medical treatment but rather denying the child a basic necessary of life.

Fluids and food provided by a feeding tube is not medical treatment but rather normal care. It is simply the way that Connie, in her medical condition, eats and drinks.

The Euthanasia Prevention Coalition will need significant financial support to intervene in the Cement case. (Donation link). More information on this case will follow.
  • Texas bill is model legislation to prevent death by dehydration (Link).


Freela said...

To die of thirst is a horrible way to die, no matter what the reasons for choosing death. It is cruel and easily qualifies as torture.

Nancy said...

Thank you, Thank You, Thank You to the Euthanasia Prevention Coalition for protecting this Dear Woman and the rights of her Alternate Decision Maker. This situation is surely shocking, although unfortunately too familiar!

elizsend said...

Discontinuation of tube feeding is not a case of euthanasia. Withholding oral feeding and drinking is euthanasia.
Unless the physicians want to ACTIVELY end this girl's life the coalition should not be involved.
In fact you are muddying the water and making it difficult for an average person to understand what euthanasia is. (THE ACTIVE TAKING OF A HUMAN LIFE) Also we should be supporting natural death but a supported and kind natural death. This may mean discontinuation of tube feeding, and intravenous feeding but NOT ORAL FEEDING if desired by the dying person.

Alex Schadenberg said...

They order that the physicians are seeking is to withdraw all fluids and food and all other treatments. Her death would occur by dehydration. This would be a case of euthanasia by dehydration and it is a case we should be involved with. In her current state, oral feeding is not an option but she is benefiting from tube feeding.

By the way, ethically your wrong about discontinuing tube feeding but not oral feeding. There are many circumstances whereby tube feeding is necessary and beneficial.

Nancy said...

This subject is complicated. If there is an alternate decision maker who wants tube feeding and life maintained, their decision should be respected.If the patient is mentally incapacitated at the time the decision is being made to end or maintain life, then euthanasia should definitely not be an option. In other words, if the patient made a declaration in the past, while competent, to elect euthanasia in the future, but then became mentally incompetent at the present,their past choice of euthanasia should no longer be an option. I oppose euthanasia completely, but that is beside my points.

elizsend said...

At the end of his life Pope John Paul 2 had end stage Parkinson's Disease. He choose not to prolong his life by tube feeding fluids and food. We all should learn and understand why he choose this route.
As Christians we must be cognizant of God's will in our lives. Sometimes we are being called home.

Alex Schadenberg said...

As a person is nearing death, there is no obligation to accept feeding tubes. But in this case, the power of attorney, the family and the faith community all support tube feeding. Withdrawing tube feeding is not withdrawing treatment, but withdrawing basic care.