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Two cases put spotlight on end-of-life decisions

Haleigh Poutre's end-of-life case has been compared to the well-publicized saga involving Terri Schiavo, a brain-damaged Florida woman from Florida who was on life support for 15 years before dying March 31 at age 41. Following are questions and answers about similarities and differences in the cases.

Q. How do the two patients compare medically?

A. Schiavo suffered brain damage in 1990 after her heart stopped from a chemical imbalance, possibly caused by an eating disorder.

She was in a persistent vegetative state, which means she was awake but unconscious. She could breathe on her own, but could not feed herself or communicate. She was kept alive only by a feeding tube and died 13 days after the tube was removed.

Haleigh was allegedly brutally beaten last fall by her adoptive mother and stepfather. According to court records, the 11-year-old girl is "virtually brain dead" and in an "irreversible coma," suggesting she has suffered more brain damage than Schiavo. She has yet to show she can breathe on her own for extended periods of time. She has severe injury to her brain stem, which controls the body's vital functions. Doctors predict she will not live for more than a couple of months longer, even if she remains attached to a feeding tube.

Q. How do the two cases compare legally and politically?

A. Schiavo's case was taken up at the highest legislative and judicial levels of both state and federal governments. President Bush and his brother, Governor Jeb Bush of Florida, intervened to keep her feeding tube attached. Schiavo also had family members appealing to keep her alive, and they sought a range of political, legal, and religious groups to help their cause.

Haleigh's case has so far remained within the state court system.

Haleigh has no family members passionately arguing to keep her alive. Her stepfather, who has been accused in her beating, has appealed to keep her life-support systems going, but the courts have said he has no legal standing.

Q. Why did the cases end up in court?

A. Schiavo was old enough to have a healthcare proxy spelling out who would make decisions for her if she became incapacitated.

But she did not designate in writing anyone to make decisions for her, leaving her husband, who said it would have been her wish to remove the feeding tube, and her parents fighting the legal battle.

Without any legal parents to speak for her, Haleigh was placed in the custody of the state Department of Social Services. All end-of-life medical care for children in state custody must be reviewed by the courts.

PATRICIA WEN AND ALICE DEMBNER

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