A Texas hospital deemed further treatments for Michael Hickson to be futile — a decision his wife opposed but others signed off on
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| Michael Hickson, 46, surrounded by his children at the nursing home where he had lived. Hickson died June 11 of complications from covid-19. (Family photo) |
Hickson’s
sister, a physician, agreed. So did the agency acting as his legal
guardian. But his wife, Melissa Hickson, was horrified. She worried
doctors were placing less value on her husband’s life because he was a
black man who was disabled. After going into cardiac arrest in 2017 and
suffering complications, he had been left quadriplegic and
brain-damaged.
The
disagreements over Michael Hickson’s care — amplified by an audio
recording, widely shared on social media, of his wife pleading with a
doctor to continue treatment — provide a rare window into fraught
end-of-life decisions that are being made across the country as the
novel coronavirus
continues its rampage. The case puts a spotlight on issues of race,
disability and family, including the different ways individuals, even
within the same family, assess what makes a life worth living.
In
the days after Hickson’s June 11 death, the audio recording shared by
his wife has created a furor among disability rights activists across
the United States who have rallied around his wife. Their outrage has
been echoed by Catholic organizations and antiabortion groups, which
have argued that stopping treatment was tantamount to failing to
recognize the inherent value of a human life.
DeVry
Anderson, chief medical officer at St. David’s South Austin Medical
Center, where Hickson was treated, described his case as a “very sad and
complex situation.” He said the decision to withdraw care was not a
matter of hospital capacity, Hickson’s disabilities or cognitive
abilities, or his race.
“This was a man who was very, very ill,” Anderson said in a written statement.
“Some
people want the public to believe that we took the position that Mr.
Hickson’s life wasn’t worth being saved, and that is absolutely wrong,”
he added. “It wasn’t medically possible to save him.”
Hickson’s
sister, Renee Hickson, a fellow at George Washington University
Hospital in the District, said doctors worked very hard to save her
brother’s life, but his decline was precipitous. She does not believe
any of their decisions were based on his disabilities or his race.
“There
is only so much medically that we can do,” she said. “And they did that
for all of those days, and there was nothing more to do.”
In
the recording between Melissa Hickson and the doctor in charge of her
husband’s case, she expresses confusion as to how the decision to stop
treatment was made and tries to change his mind. Under Texas law, such
recordings are allowed as long as one party consents.
“So as of right now, his quality of life — he doesn’t have much of one,” the doctor explains.
“What do you mean?” she asks. “Because he’s paralyzed with a brain injury, he doesn’t have quality of life?”
“Correct,”
the doctor responds. The hospital declined an interview on behalf of
the doctor, who is not identified in the recording.
The
debate over Hickson’s care has hit a nerve as crisis protocols
activated by health officials in some jurisdictions would allow
hospitals to ration treatments in certain circumstances, as coronavirus
cases surge. Disability rights activists, among others, express alarm
that disadvantaged groups — the disabled, members of minority groups,
the poor — might get lower priority.
“I’ve
been stewing on this for a few days as I try to come up with the right
words to explain to you how much of an underlying fear this scenario is
for much of the disabled community,” tweeted
Steven Spohn, a popular gamer who has spinal muscular atrophy. “We live
our entire lives in fear that one day a doctor will decide we just
aren’t worth it.”
The
Department of Health and Human Services’ Office for Civil Rights
responded to such concerns this spring by probing some of the plans,
issuing guidance affirming the need for nondiscrimination protections
and threatening action against violators.
Devan
Stahl, a bioethics expert at Baylor University, said research shows
that people with disabilities often have a higher assessment of their
quality of life than others do, including some doctors. That can
adversely affect their medical care, Stahl said, and this bias has long
been a source of controversy when it comes to medical futility laws in
some states, such as Texas, that allow hospitals to override a patient
or family’s wishes if they feel a treatment is not of benefit.
Stahl
added that Hickson’s doctors may have been correct that he would not
benefit from additional life-sustaining interventions, but it is
“unfortunate that the physician stressed the quality-of-life judgment
the way he did.”
“These are difficult things to say, and I want to be empathetic to
physicians making hard choices,” Stahl said. “But I don’t think many are
trained well enough to have these really sensitive conversations.”
Full Article & Source:
Quadriplegic man’s death from covid-19 spotlights questions of disability, race and family
