Paul Brophy
Encyclopedia
Paul Brophy was a firefighter in Massachusetts
who entered a persistent vegetative state
with no believed chance of recovery. Opposing viewpoints between his family and his doctors on how to deal with his condition sparked an early legal case on the right to die
.
On March 22, 1983, Paul Brophy sustained a basilar artery
aneurysm
rupture with very destructive neurologic consequences. Following the rupture he entered a persistent vegetative state
with no chance of recovery. As he was unable to chew or swallow, a gastric feeding tube was eventually inserted into him to allow for nutrition
and hydration.
Later, when it became obvious that there was no hope for even a modest degree of higher brain function recovery, his family requested that his gastrostomy feedings be terminated, a request based on the fact that Mr. Brophy had verbally indicated that he would not want to exist in such a degraded state. However, the hospital, New England Sinai Hospital, denied the request, leading to a series of legal actions.
While the first court to hear the case agreed that Mr. Brophy would have wanted the gastrostomy tube removed, it refused to authorize its removal, principally because he was not terminally ill. However, when the case went on further to the Supreme Judicial Court of Massachusetts
, transfer of Mr. Brophy to another hospital facility that was agreeable to removal of the gastrostomy tube was authorized.
Mr. Brophy died a number of days later, making him the first American
to die after court-authorized discontinuation of artificially supplied nutrition and hydration to a person in a persistent vegetative state.
argued that death by dehydration symptoms was "cruel and violent" in his opinion on this case because such a death involved:
While this is all true for a person who is healthy, or even relatively healthy, this does not apply to a person who is otherwise dying. The brain damage that occurs when someone is in a persistent vegetative state means the physical experience is vastly different, and these physical changes are not perceived by the person in a PVS.
Massachusetts
The Commonwealth of Massachusetts is a state in the New England region of the northeastern United States of America. It is bordered by Rhode Island and Connecticut to the south, New York to the west, and Vermont and New Hampshire to the north; at its east lies the Atlantic Ocean. As of the 2010...
who entered a persistent vegetative state
Persistent vegetative state
A persistent vegetative state is a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. It is a diagnosis of some uncertainty in that it deals with a syndrome. After four weeks in a vegetative state , the patient is...
with no believed chance of recovery. Opposing viewpoints between his family and his doctors on how to deal with his condition sparked an early legal case on the right to die
Right to die
The right to die is the ethical or institutional entitlement of the individual to commit suicide or to undergo voluntary euthanasia. Possession of this right is often understood to mean that a person with a terminal illness should be allowed to commit suicide or assisted suicide or to decline...
.
On March 22, 1983, Paul Brophy sustained a basilar artery
Basilar artery
In human anatomy, the basilar artery is one of the arteries that supplies the brain with oxygen-rich blood.The two vertebral arteries and the basilar artery are sometimes together called the vertebrobasilar system, which supplies blood to the posterior part of circle of Willis and anastomoses with...
aneurysm
Aneurysm
An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle of the heart...
rupture with very destructive neurologic consequences. Following the rupture he entered a persistent vegetative state
Persistent vegetative state
A persistent vegetative state is a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. It is a diagnosis of some uncertainty in that it deals with a syndrome. After four weeks in a vegetative state , the patient is...
with no chance of recovery. As he was unable to chew or swallow, a gastric feeding tube was eventually inserted into him to allow for nutrition
Nutrition
Nutrition is the provision, to cells and organisms, of the materials necessary to support life. Many common health problems can be prevented or alleviated with a healthy diet....
and hydration.
Later, when it became obvious that there was no hope for even a modest degree of higher brain function recovery, his family requested that his gastrostomy feedings be terminated, a request based on the fact that Mr. Brophy had verbally indicated that he would not want to exist in such a degraded state. However, the hospital, New England Sinai Hospital, denied the request, leading to a series of legal actions.
While the first court to hear the case agreed that Mr. Brophy would have wanted the gastrostomy tube removed, it refused to authorize its removal, principally because he was not terminally ill. However, when the case went on further to the Supreme Judicial Court of Massachusetts
Massachusetts Supreme Judicial Court
The Massachusetts Supreme Judicial Court is the highest court in the Commonwealth of Massachusetts. The SJC has the distinction of being the oldest continuously functioning appellate court in the Western Hemisphere.-History:...
, transfer of Mr. Brophy to another hospital facility that was agreeable to removal of the gastrostomy tube was authorized.
Mr. Brophy died a number of days later, making him the first American
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
to die after court-authorized discontinuation of artificially supplied nutrition and hydration to a person in a persistent vegetative state.
Ethical concerns over death by dehydration
Judge Lynch of the Massachusetts Supreme Judicial CourtMassachusetts Supreme Judicial Court
The Massachusetts Supreme Judicial Court is the highest court in the Commonwealth of Massachusetts. The SJC has the distinction of being the oldest continuously functioning appellate court in the Western Hemisphere.-History:...
argued that death by dehydration symptoms was "cruel and violent" in his opinion on this case because such a death involved:
- The mouth would dry out and become caked or coated with thick material.
- The lips would become parched and cracked.
- The tongue would swell, and might crack.
- The eyes would recede back into their orbits and the cheeks would become hollow.
- The lining of the nose might crack and cause the nose to bleed.
- The skin would hang loose on the body and become dry and scaly.
- The urine would become highly concentrated, leading to burning of the bladder.
- The lining of the stomach would dry out and the sufferer would experience dry heaves and vomiting.
- The body temperature would become very high.
- The brain cells would dry out, causing convulsions.
- The respiratory tract would dry out, and the thick secretions that would result could plug the lungs and cause death.
- At some point within five days to three weeks, the major organs, including the lungs, heart, and brain, would give out and the patient would die.
While this is all true for a person who is healthy, or even relatively healthy, this does not apply to a person who is otherwise dying. The brain damage that occurs when someone is in a persistent vegetative state means the physical experience is vastly different, and these physical changes are not perceived by the person in a PVS.
See also
- EuthanasiaEuthanasiaEuthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering....
- Terri SchiavoTerri SchiavoThe Terri Schiavo case was a legal battle in the United States between the legal guardians and the parents of Teresa Marie "Terri" Schiavo that lasted from 1998 to 2005...