action alert
URGENT: A Catholic hospital in St. Louis, St. John’s Mercy Medical Center – and its ethics committee – convinced the wife of Steven Becker to withdraw tube feedings from her husband. Steven Becker is a 29-year-old father of three little boys who began suffering headaches in February and was rushed to St. John’s, where it was found that fluid was building up in his brain. An emergency brain operation was performed. But Steven did not fully wake up, and now St. John’s maintains that he is in a so-called permanent vegetative state. The hospital says his tube feedings should be stopped so that he dies. According to the family, Steven refused to sign a living will or other advance directive when he was admitted – fully conscious – to St. John’s.
According to the few public court records available, within weeks of Steven’s surgery, St. John’s convinced the wife to “limit treatment to pain meds and tube feedings.” This was even termed “comfort care” at the time.
Several days later, however, the hospital notes say the “wife had met with ethics committee before deciding that, at some point, she wished to withdraw hydration and nutrition in order not to continue providing extraordinary interventions.” Obviously, there is a pattern of incremental coercion apparent here, even though Sister Pat Talone and other ethics committee members have stated that the committee does not make recommendations but rather only provides a forum for families.
However, Steven’s mother and aunts resisted the offers of counseling and meetings apparently offered by St. John’s to induce them to go along with the ethics committee recommendations. Steven’s mom got a lawyer after the neurosurgeon said the decision to withdraw feedings surprised him. The doctor said it was “too soon” because it was just weeks after the surgery. But the very next day, the doctor told her that he changed his mind after talking with the ethics committee.
The decision to withdraw feedings was made in May, but Steven’s mother got a court injunction to continue feedings. The judge then appointed a public guardian to evaluate the situation.
According to the family, Steven was smiling and responsive until the case went to the judge. He was then moved to a room on a locked ward. Antibiotics, beneficial medications, physical therapy, etc. were stopped, even though the tube feedings had to be continued by court order. Steven started to deteriorate, but the guardian only made the hospital restart the antibiotics (which the media has now also dubbed “life support”). Even Steven’s hygiene suffered and the family’s repeated requests for washcloths so they could bathe him themselves were rebuffed and they were forced to bring their own from home.
On August 11, the court-appointed guardian recommended that tube feedings be stopped and said that, despite the absence of a living will or other advance directive, people had come forward to say that Steven would not want to live in a so-called vegetative state (even though at least one neurologist has disputed that diagnosis.)
The mother and aunts had wanted Steven to be transferred from St. John’s and therapy to be resumed. They had found out that Steven was receiving medication that could sedate him. They also wanted an order to allow Steven’s infected brain shunt to be revised. None of this was done. The family visited Steven last night and report that, once again, Steven’s antibiotics have been stopped and they were told that Steven now has pneumonia as well as an infected brain shunt. It seems probable that Steven will not be allowed to live until the next court hearing in September.
St. Louis Archbishop Justin Rigali had issued a statement in July that food and water – even medically assisted – must be provided to all patients who need it and can medically benefit from it. Missouri Right to Life issued a press release about the allegations of medical neglect and asked St. John’s to justify its care of Steven, and last Friday, an editorial in the archdiocesan newspaper said, “in a situation where the health of the patient depends not only upon food and water, but on other forms of care and treatment, the purpose of providing food and water should not be undermined by a neglect of the other forms of care. A patient’s life might depend not only upon basic forms of medical treatment such as antibiotics, but upon simple care designed to minimize infection and bolster physical, mental and physiological functioning” and that health care professionals must avoid “any course of action that leaves a patient susceptible to death through lack of care, contrary voices notwithstanding.”
The media, as well as St. John’s, have ignored all of this and have portrayed this as only a case of “who decides” and what Steven would have wanted if he were in a “vegetative” state.
The implications of this case are obvious and disturbing: A Catholic hospital is ignoring Church teaching and even its own archbishop’s statements without public rebuke or even notice. If anyone becomes incompetent – even if fully conscious – or signs even a protective advance directive, that person cannot be assured that he will not be made to die if an ethics committee or others make a negative judgment on the quality of his life – even in a Catholic hospital. Food and water can even be maintained but such things as antibiotics, insulin, heart medication, etc. can be withdrawn to cause death. Families can be told that a person has no chance of improvement even when there is no evidence of this, thus depriving a person of even a chance of survival. As in the cases of people with strokes and other mental or physical impairments, patients can be sedated into apparent unconsciousness for “comfort” and lead even well-intentioned relatives to withdraw treatment based on false information. (Without the knowledge to know what questions to ask, the ethical situation as it is today puts people of all ages at risk of dying prematurely. Without strong ethics and with a pervasive “right to die” mentality among health care providers, we are all at risk.)
The Steven Becker case is vitally important, not only for his life but also for the precedent it will set for other Catholic hospitals. We are asking for position statements, amicus briefs, phone calls and letters to the Archdiocese, the St. Louis Post-Dispatch and St. John’s, from people who have survived such situations and their families, medical experts, etc. to help. My e-mail address is “>.
Nancy Valko, RN
URGENT: A Catholic hospital in St. Louis, St. John’s Mercy Medical Center – and its ethics committee – convinced the wife of Steven Becker to withdraw tube feedings from her husband. Steven Becker is a 29-year-old father of three little boys who began suffering headaches in February and was rushed to St. John’s, where it was found that fluid was building up in his brain. An emergency brain operation was performed. But Steven did not fully wake up, and now St. John’s maintains that he is in a so-called permanent vegetative state. The hospital says his tube feedings should be stopped so that he dies. According to the family, Steven refused to sign a living will or other advance directive when he was admitted – fully conscious – to St. John’s.
According to the few public court records available, within weeks of Steven’s surgery, St. John’s convinced the wife to “limit treatment to pain meds and tube feedings.” This was even termed “comfort care” at the time.
Several days later, however, the hospital notes say the “wife had met with ethics committee before deciding that, at some point, she wished to withdraw hydration and nutrition in order not to continue providing extraordinary interventions.” Obviously, there is a pattern of incremental coercion apparent here, even though Sister Pat Talone and other ethics committee members have stated that the committee does not make recommendations but rather only provides a forum for families.
However, Steven’s mother and aunts resisted the offers of counseling and meetings apparently offered by St. John’s to induce them to go along with the ethics committee recommendations. Steven’s mom got a lawyer after the neurosurgeon said the decision to withdraw feedings surprised him. The doctor said it was “too soon” because it was just weeks after the surgery. But the very next day, the doctor told her that he changed his mind after talking with the ethics committee.
The decision to withdraw feedings was made in May, but Steven’s mother got a court injunction to continue feedings. The judge then appointed a public guardian to evaluate the situation.
According to the family, Steven was smiling and responsive until the case went to the judge. He was then moved to a room on a locked ward. Antibiotics, beneficial medications, physical therapy, etc. were stopped, even though the tube feedings had to be continued by court order. Steven started to deteriorate, but the guardian only made the hospital restart the antibiotics (which the media has now also dubbed “life support”). Even Steven’s hygiene suffered and the family’s repeated requests for washcloths so they could bathe him themselves were rebuffed and they were forced to bring their own from home.
On August 11, the court-appointed guardian recommended that tube feedings be stopped and said that, despite the absence of a living will or other advance directive, people had come forward to say that Steven would not want to live in a so-called vegetative state (even though at least one neurologist has disputed that diagnosis.)
The mother and aunts had wanted Steven to be transferred from St. John’s and therapy to be resumed. They had found out that Steven was receiving medication that could sedate him. They also wanted an order to allow Steven’s infected brain shunt to be revised. None of this was done. The family visited Steven last night and report that, once again, Steven’s antibiotics have been stopped and they were told that Steven now has pneumonia as well as an infected brain shunt. It seems probable that Steven will not be allowed to live until the next court hearing in September.
St. Louis Archbishop Justin Rigali had issued a statement in July that food and water – even medically assisted – must be provided to all patients who need it and can medically benefit from it. Missouri Right to Life issued a press release about the allegations of medical neglect and asked St. John’s to justify its care of Steven, and last Friday, an editorial in the archdiocesan newspaper said, “in a situation where the health of the patient depends not only upon food and water, but on other forms of care and treatment, the purpose of providing food and water should not be undermined by a neglect of the other forms of care. A patient’s life might depend not only upon basic forms of medical treatment such as antibiotics, but upon simple care designed to minimize infection and bolster physical, mental and physiological functioning” and that health care professionals must avoid “any course of action that leaves a patient susceptible to death through lack of care, contrary voices notwithstanding.”
The media, as well as St. John’s, have ignored all of this and have portrayed this as only a case of “who decides” and what Steven would have wanted if he were in a “vegetative” state.
The implications of this case are obvious and disturbing: A Catholic hospital is ignoring Church teaching and even its own archbishop’s statements without public rebuke or even notice. If anyone becomes incompetent – even if fully conscious – or signs even a protective advance directive, that person cannot be assured that he will not be made to die if an ethics committee or others make a negative judgment on the quality of his life – even in a Catholic hospital. Food and water can even be maintained but such things as antibiotics, insulin, heart medication, etc. can be withdrawn to cause death. Families can be told that a person has no chance of improvement even when there is no evidence of this, thus depriving a person of even a chance of survival. As in the cases of people with strokes and other mental or physical impairments, patients can be sedated into apparent unconsciousness for “comfort” and lead even well-intentioned relatives to withdraw treatment based on false information. (Without the knowledge to know what questions to ask, the ethical situation as it is today puts people of all ages at risk of dying prematurely. Without strong ethics and with a pervasive “right to die” mentality among health care providers, we are all at risk.)
The Steven Becker case is vitally important, not only for his life but also for the precedent it will set for other Catholic hospitals. We are asking for position statements, amicus briefs, phone calls and letters to the Archdiocese, the St. Louis Post-Dispatch and St. John’s, from people who have survived such situations and their families, medical experts, etc. to help. My e-mail address is “>.
Nancy Valko, RN