The story of Haleigh Poutre continues.  A rising tide of criticism is emerging on the web, mostly from conservative bloggers, arguing a number of points about how Haleigh’s case has been handled.  I want to respond to some of them.

    First, there are the assertions that the State of Massachusetts, through the agency of the Department of Social Services (DSS), is trying to, or wants to, "kill" Haleigh.  In some cases, this is wildly overblown rhetoric.  In others, like this statement from Massachusetts Citizens for Life, the point is a bit more subtle:

“It’s disturbing. The SJC
is saying the state has a right to euthanize a severely disabled ward
of the state,” said Peg Whitbread, president of Massachusetts Citizens
for Life. “We are talking about a human being here.”

    Taking someone off a respirator is not euthanasia; it is discontinuing heroic measures.  There is a fairly clear distinction drawn in medical ethics between "allowing to die" and "killing."  In Catholic ethics this distinction long recognized feeding tubes as "extraordinary means" and understood removing a feeding tube as "allowing to die."  This only began to change with John Paul II’s last minute intervention in the Schiavo case, where he asserted that removing a feeding tube was denying ordinary care. 

    It would seem, then, that removing a respirator is clearly not a matter of euthanasia, which we could define here as taking active steps to end a life.  And whether removing a feeding tube should be considered a matter of "allowing to die" or more active euthanasia is, at least, debatable. Personally, I see a clear difference between the two, but I could also accept that, under certain circumstances, removing a feeding tube is "allowing to die."

    Bottom line: let’s avoid the scare headlines of "killing" Haleigh.  No one is killing her; they are trying to determine under what conditions she should be allowed to die or whether her medical condition will change to a degree that she can continue to live.

     A second line of criticism is that the DSS was rushing to judgment on Haleigh.  This is from today’s Boston Globe:

The state Department of Social Services sought a legal order to
withdraw life support from a brain-damaged girl, who is now showing
some signs of improvement, within three weeks after she was
hospitalized following a brutal beating, court records show.

    Was that too fast?  In light of her recent improvement it now appears that it may have been.  But we should resist the immediate jump to assumptions of bad faith.  Again, DSS is not in the business of killing children.  Last October they were faced with a terrible situation: a young girl brutally beaten to a hair’s breath of her life, with a serious brain stem injury and on a respirator.  The prognosis then looked very bleak.  Moreover, there was no family to step forward to undertake her care.  So, she faced a possible future of artificial medical intervention and social isolation.  Given what they knew then, starting the process (and this is a key point: the respirator could not just be snapped off at any moment) of taking her off the machines was reasonable.  Perhaps they knew there would be some sort of legal challenge and were thinking to start the process then, understanding that the final decision to remove the respirator could not come for some months. 

    When judging DSS actions in this case, I think we should also look at how they have responded to the unexpected improvement in Haleigh’s condition (and I also think we need to mute our expectations here: what improvement there is still leaves her in a grave condition).   As the situation has changed, i.e. that she can breath on her own, DSS’s position has also changed:

DSS said Wednesday it had suspended plans to take Haleigh off life
support. DSS lawyers are scheduled to appear before a judge today to
provide new test results that show, among other things, that she is
breathing on her own and responding more to stimulation.

    The important point here is that DSS has sought, and received from the court, the authority to make the final decision for Haleigh, they have not, and have now suspended for a time, any implementation of that authority.  For all of the DSS-bashers out there, here is a question: who else should have that authority?

    A third, and final, issue is the culpability of DSS in not recognizing the on-going abuse that Haleigh suffered before the near-fatal beating.  This is obviously a problem, as poingnatly illustrated by the horrible death of 7-year-old Nixzmary Brown in New York last week.  But for those conservatives who want to argue that this is just another example of how government cannot carry out social policy, let’s keep one thing in mind: tax cuts at both the national and state level have gutted the ability of state agencies to carry out these sorts of responsibilities.  Notice:

Representative Shirley Owens-Hicks, a Mattapan Democrat, said the
agency clearly failed to keep Haleigh safe, though she also
acknowledges that the agency, with nearly 40,000 children in its
caseload and nearly 10,000 in its custody, faces tremendous challenges
in caring for so many vulnerable children.

    State agencies are overwhelmed with abused children.  It is a national shame and a national crisis.  But what political leaders are talking about it, much less doing anything about it?  If right-to-life advocates are serious, then they should be pressing state and federal government to massively increase the resources available to respond to the epidemic of child abuse in the US.  Put up or shut up.  There is a compelling state interest to intervene more effectively and earlier in such cases, and the government should responsibly manage its finances to allow for sufficient funds to go to this priority.  So, let’s tell the Republican leadership in DC to do the right thing…