| HOUSTON -- He was born Sept. 25 with lungs too small to support his tiny body.
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# GRAPHIC: Deadly dwarfism (Adobe PDF, 87K)
For nearly six months, Sun Hudson has been hooked up to machines. A ventilator pumps air into his lungs, and he gets nourishment through feeding tubes. Unconscious and sedated for comfort, he does not wiggle or open his eyes.
Now, in a case that could make U.S. legal history, appellate judges in Texas have been asked to determine the baby's fate. Should doctors at Texas Children's Hospital in Houston be allowed to turn off the machines and end the treatment they say is cruel and unethical? Or does Wanda Hudson, whose mental stability has been questioned, have a right to force doctors to keep her son alive, even when the hospital believes his case is hopeless?
Much attention has been focused in recent months on a similar lawsuit in Florida, where 41-year-old Terri Schiavo's husband and parents are fighting over whether she should be kept alive. On Wednesday, a judge in Clearwater extended a stay in that case until Friday.
In Texas, the Hudson case has been playing out with much less media coverage. But in terms of setting legal precedent, it may be more significant.
Medical ethicists and lawyers say that if appeals courts concur with a lower court decision, it would be the first time in the nation's history that a U.S. judge has allowed life support to be removed from a living infant.
In years past, courts have upheld hospitals' decisions to withdraw support from infants, but those rulings were made after the infants had already died.
"No judge has ever ordered the cessation of treatment while the baby is still alive," said John Paris, a Jesuit priest who teaches medical ethics at Boston College and has written extensively on the subject. "Never."
The arguments
Sun was born with a rare form of dwarfism that affects just one of 60,000 babies. The condition, called thanatophoric dysplasia, causes a skeletal malformation that leaves its victims with underdeveloped lungs, ribs too tiny to allow normal breathing and pressure on the spinal cord that disrupts brain signals controlling respiration. Most babies with the condition are stillborn or die within a few hours of birth. There have been a few survivors, however.
Sun was not diagnosed with the condition in utero, as many babies are. He was born at another Houston hospital, but immediately taken to Texas Children's Hospital, where doctors put him on a ventilator, they said, to give themselves time to diagnose what was wrong. After they diagnosed the genetic condition, they said -- and the hospital's ethics committee agreed -- that there was no hope for Sun.
"His chest cavity and lungs will never grow. He is slowly suffocating," doctors said in court papers. "It would be unethical to continue with care that is futile and prolongs Sun's suffering."
But his mother, 33-year-old Hudson, said she doesn't believe in sickness or death, and her son just needs time to grow.
She has interrupted court hearings with rambling outbursts and talked about how she communicates with Sun telepathically. She testified that she spent three days in a psychiatric hospital after his birth because doctors were alarmed that she was calling her child the human embodiment of the sun.
Because of concerns about her mental competence, the hospital is paying her legal fees to guarantee her interests are protected.
The case spotlights the difficulty of deciding when to withdraw or withhold treatment from babies and children with terminal conditions, particularly when doctors and parents disagree.
Texas law allows doctors and hospitals to make some decisions involving life support, but clinicians usually strive to reach consensus with families, said William Winslade, an ethicist at the University of Texas Medical Branch in Galveston. When the relationship between doctors and parents deteriorates and the issue ends up in court, judges often are reluctant to order that treatment be stopped.
Texas law also requires that the hospital's ethics committee support the withdrawal of life support and states that families must be given 10 days from written notice of the hospital's decision to find another facility willing to accept the patient.
Hudson's lawyer, Juan Caballero, said he has not been able to find another facility to take Sun. Texas Children's Hospital said it has contacted 40 hospitals with neonatal intensive-care units, and none is willing to accept the baby.
Before the case went to court, Winslade and other ethicists predicted the hospital would lose. But Harris County Probate Judge William McCulloch ruled in the hospital's favor Feb. 10.
"I am no longer prohibiting the hospital from deciding to remove life support," McCulloch said in his decision. "I am not saying they can or can't, but I am saying they are not restrained."
Caballero appealed, saying his client was the victim of an unfair court procedure.
Last week, Appeals Court Chief Justice Sherry Radack and Justices Laura Carter Higley and Jane Bland suspended McCulloch's ruling until they could consider the mother's appeal.
This week, they said they are still deliberating. Although the court says the case is on an accelerated schedule, there is no indication when an opinion will be issued. | |
