Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Wednesday, March 04, 2015

Quality of Life = Living Death

"I recognize the terribly difficult situation in which Mrs. Bentley's family find themselves and I appreciate the disappointment they must feel in being unable to comply with what they believe to have been her wishes and what they believe still to be her wishes."
"It is a grave thing, however, to ask or instruct caregivers to stand by and watch a patient starve to death."
Justice Mary Newbury, B.C. Court of Appeal

"Essentially, she's very rigid."
"She doesn't communicate in any way. ... She sits with her eyes closed and curled up in a fetal position with stiff muscles and her hands in a claw-like position."
Kieran Bridge, veteran health lawyer, Vancouver

"I direct that I be allowed to die and not be kept alive by artificial means or ‘heroic measures. [Care workers are to dispense] no nourishment or liquids."
"[If unable to recognize family members] I ask that I be euthanized."
Margot Bentley, Maplewood Home resident, Abbotsford, B.C.

John Morstad for the National Post
John Morstad for the National Post Margot Bentley's living will.
Margot Bentley is an 83-year-old, suffering late-stage Alzheimer's disease. She was diagnosed  with that dread disease in 1999. And she was moved to Maplewood Home in Abbotsford, British Columbia in 2009. John Bentley, Margot Bentley's husband, and her daughter Katherine Hammond filed a suit against the care home's decision to feed the woman, in direct contradiction to the living will that Margot Bentley had written two decades earlier.

In that will she was resolute that she had no wish to be kept alive by artificial means if her health became so critically impacted that there was no potential for recovery. Margot Bentley's experience with the impact of conditions such as hers had taken place during her time spent in the nursing profession. She had witnessed patients in vegetative states resulting from Alzheimer's disease and firmly informed her family not to permit her to reach that state.

The family argued in court that their wife and mother was being fed to sustain life without her consent and against her legal directions as specified in the document she had signed in 1991. The B.C. Court of Appeal released a unanimous ruling concluding caregivers at the Maplewood Home were not in fact feeding Mrs. Bentley against her will, and that being the case, care should continue.

Justice Newbury had reached the conclusion that although the woman was unable to speak or to recognize family members she remained capable of deciding whether to accept or refuse food. Mr. Bridge, the lawyer representing the family, explained that caregivers were accustomed to "prodding" Mrs. Bentley with a spoon repeatedly until she opens her mouth to accept food; an obviously autonomic response.

That, he stated, constituted battery, and as such defined as unlawful and unprompted forceful physical contact. The Appeal Court, however, was dismissive of that interpretation, instead accepted evidence that care home workers would not force the woman to accept either food or drink if Mrs. Bentley kept her mouth closed. Ms. Hammond described her mother's life: "lifted into and out of bed with a hoist, virtually motionless in a wheelchair, kept alive only through regular spoon-feeding."
John Morstad for the National Post
John Morstad for the National Post   Katherine Hammond with a picture of her mother, Margot Bentley.

"She’s not taking it [spoon-feeding] by choice, that’s clear [the feeding process being a reflex reaction]."
"She doesn’t have the ability to make choice and if she had the ability to make choice, she would refuse; she’d clamp her mouth shut and nobody would try to feed her.""I’ve spoken with a fair number of health professionals about this case, and everybody is dismayed, to say the least; we’re shocked that this is happening."
Dr. Andrew Edelson, Mrs. Bentley's personal physician

Dr. Edelson pointed out, in addition, that ordinarily under such circumstances there would be no question that Mrs. Bentley's living will specifications would have been respected; she would have been permitted to die with dignity. The metropolitan Vancouver area has many seniors who have taken the precautionary step of drawing up explicit end-of-life and do-not-resuscitate orders, which are then respected.

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