Monday, June 13, 2005

Pettis v. Smith and Braddock In the Louisiana Court of Appeal

The Louisiana Court of Appeals has ruled in Pettis v. Smith and Braddock (published in the current Issues in Law & Medicine)--essentially stating that it is permissible to stop artificial feeding in someone despite their living will not giving explicit permission to do such.
"HOLDING: Tube feeding may be withheld or withdrawn from a person in a persistent semi-conscious state even though her living will did not explicitly decline tube feeding, and there is no clear and convincing evidence of her intention to decline tube feeding."
The court affirmed that artificial nutrition/hydration are life sustaining medical interventions (and not comfort measures). It also affirmed that since Louisiana didn't establish in its living will law a 'clear and convincing' criteria for withdrawal of care, that that standard of evidence was not needed (per the Cruzan case in which the federal Supreme Court stated that states may--but not must--require this level of evidence).
Overall this ruling seems to (thankfully) affirm the status-quo about end of life decision making. Especially in these post-Schiavo times I personally am heartened to see the long established standard that artificial (IV, feeding tube) nutrition and hydration are life sustaining medical interventions, and can therefore, under certain circumstances be legally and ethically discontinued. It goes without saying that end of life decision making should be in the hands of patients, their loved ones, and their doctors, & not legislatures or the courts.

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