Medically Incompetent Doctors Should Not Diagnose Disorders of Consciousness: The Sad Case of Haleigh Poutre

Politics, ideologies, or other motivations can similarly skew medical findings in the other direction, as the botched case of Haleigh Poutre reveals. This Massachusetts case, which followed on the heels of Terri’s death, involved an eleven-year-old girl who had been the subject of repeated battering and had entered what doctors believed to be a vegetative state. In fact only eight days after she had entered the hospital in a condition of unconsciousness, her doctors declared her vegetative state to be permanent. The state of Massachusetts, through its Department of Social Services, won temporary custody of Haleigh and sought to remove her from all life support. Although not the explicit motive for the state’s petition, if Haleigh died, her step-father, accused of beating Haleigh, could have been charged with murder. The department’s petition was successful in lower court and affirmed by the state supreme court. But the day after the court’s decision, it became apparent that Haleigh was not permanently unconscious; in fact, she was not even unconscious at that moment! Two years later, she has recovered some speech and also communicates through a keyboard; ABC News reported that she might be well enough to testify against her stepfather.

Louis Shephard, It it happened to me: making life and death decisions after Terri Schiavo, p. 33

What makes the bolded sentence so outrageous is that according to conventional medical guidelines a “persistent” vegetative state should be declared 1 month after injury and a “permanent*” vegetative state should be declared 3 months after non-traumatic brain damage and 12 months after traumatic brain damage.

*Many experts recommend abandoning the term “permanent” because it implies a greater degree of epistemic certainty than is warranted. What “PVS” really means is that there is the odds are stacked against recovery because of statistical patterns of patients with similar brain injuries. However, the fact that most DOC patients recover 3-12 months after injury indicates that the most accurate approach is merely to describe the VS state and then specify how long they have been in the state rather than trying to categorically predict their chances of recovery.

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Filed under Consciousness, Neuroethics

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