An Oregon man wants healthcare workers at his wife’s assisted-living facility to stop offering her snacks—the extra calories have boosted the Alzheimer’s patient’s wispy weight far enough from the edge of death to worry him once again.
Former librarian Nora Harris, diagnosed with Alzheimer’s disease in 2009, signed an advance directive that put her husband in charge of her medical decisions. The 64-year-old woman can no longer communicate coherently or feed herself.
Her husband Bill lost a court battle last year to force workers at Fern Gardens in Medford, Ore., to stop spoon-feeding her. He said her advance directive stipulates she wouldn’t have wanted her life to be prolonged and would prefer to die under such circumstances.
On two occasions her weight dropped low enough to require hospice care, but snacks provided by healthcare workers have allowed her to rebound from 90 pounds to about 103 pounds.
Her husband may take Fern Gardens to court again to force the staff to stop feeding her.
“I want her to pass,” Bill Harris told USA Today. “I want her to end her suffering. It’s not a right-to-life issue. It’s a right-to-die issue.”
The renewed interest in the Harris case comes several months after Oregon lawmakers nixed a bill that pro-life advocates said would have allowed the dehydration and starvation of dementia, Alzheimer’s, and mentally ill patients.
Under current Oregon law, healthcare workers at nursing homes and assisted-living facilities must offer food to patients by cup or spoon. Patients can refuse the food, but they must be given the opportunity to eat.
Eric Foster, Nora Harris’ court-appointed attorney, previously countered Bill Harris’ claims in court, saying that Nora’s advance directive doesn’t mention spoon or cup feeding, only “artificial nutrition and hydration and all other forms of health care.” He noted that by opening her mouth and accepting food, “she has expressed her desire to satisfy her hunger by eating with and without help from the staff at Fern Gardens.”
Bill Harris said his wife isn’t choosing to eat, claiming she’s just opening her mouth involuntarily. But Alex Schadenberg, director of the Euthanasia Prevention Coalition, told me if a patient is still able to open his or her mouth for food and water, they are making a cognitive choice, even if they have a mental disability.
“To actually know she’s not choosing to eat, can you actually tell me you know that for sure?” he asked. “You can’t tell me you know that for sure. It’s not possible.”
Schadenberg also pointed out that generally accepted healthcare ethical standards—as well as the Oregon law—don’t categorize spoon or cup feeding as a form of medical treatment.
“If it is seen as medical treatment, then we can basically dehydrate everyone to death, because true treatment is always optional,” he said. “I can’t force you to accept treatment, just like doctors can’t be forced to do treatment.”
A case similar to the Harris’ played out two years ago in Canada, where the British Columbia Supreme Court ruled against a man seeking to prevent his wife’s nursing home from spoon-feeding her. That court ruled that spoon-feeding is “personal care, not health care.”
Safeguards for spoon-feeding exist for now, but Schadenberg noted that medical ethics continue to shift.
“All these ethics have changed over time,” he said. “The concept of denying somebody tube-feeding because they might have a head injury or they might be in a coma, not too long ago it was considered just brutal and unacceptable. … It’s all a matter of time.”
Despite the temptation for doctors, caregivers, and insurance companies to offer a cheap, easy end to the life of a terminally ill or disabled person, Schadenberg said it’s important to steer away from “the radical secular humanist idea that all humans are not equal.” Disabled or terminally people, he said, “are no less human. They are no different than you and I, even though they have a physical reality that may be very difficult to accept. We are all equal.”