A quadriplegic Texas man with brain damage died last month after he was diagnosed with COVID-19, and his wife alleges the hospital and his court-appointed guardian made the decision to stop his treatment even though she wished it to continue. The hospital contends it was medically impossible to save him.
The death of 46-year-old Michael Hickson at St. David's South Austin Medical Center has now become a focal point for disability rights activists, but has also raised the question about what does "quality of life" really mean?
Hickson had been a quadriplegic after suffering a heart attack which resulted in brain damage in 2017, according to The Christian Post. He was living in an Austin nursing home when he came down with the coronavirus in May. Hickson was sent to the hospital on June 2 where his health worsened and had a number of complications.
In a statement, St. David's Chief Medical Officer Dr. DeVry Anderson explained, "Hickson was very, very ill when he arrived at our hospital. He was transferred to us from another facility with pneumonia in both lungs, a urinary tract infection, and sepsis. He also had COVID-19. Despite aggressive treatment and one-to-one care, Mr. Hickson went into multi-system organ failure."
Hickson's wife, Melissa, recorded a telephone conversation with a doctor at the hospital.
"But um, at this point with - the decision is, do we want to be extremely aggressive with his care or do we want, do we feel like this will be futile?" the doctor said. "And the big question of futility is one we always question. And the issue is, will this help him improve his quality of life? Will this help him improve anything? Will it ultimately change the outcome? And the thought is, the answer is no to all of those."
Melissa then asked the doctor, "What would make say no to all of those?"
"Cause as of right now, his quality of life, he doesn't have much of one," the doctor responded.
"What do you mean? Because he's paralyzed with a brain injury, he doesn't have quality of life?" Melissa asked.
"Correct," the doctor replied.
After Hickson's death, Melissa Hickson posted a video to YouTube in which she claimed the doctor would not treat him because he was disabled.
"The reason that he (the doctor) would not treat my husband any further was because he was disabled," she said. "That disability caused him to believe that my husband had poor quality of health."
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"Whenever you say quality of life, that is completely subjective, and is about whether I think this person deserves to live or not live," Schwartz said. "And frankly, those decisions are best left to the patient and their family."
But Dr. Anderson said Hickson's disability played no part in the hospital's decision to stop treating him.
"Every clinical decision that was made for him was done as part of a multidisciplinary team that included his caregiver, who was his surrogate family, according to the law," Anderson said.
Anderson contends that there has been a lot misinformation about Hickson's case.
"Some people want the public to believe that we took the position that Mr. Hickson's life wasn't worth being saved, and that is absolutely wrong. It wasn't medically possible to save him," he said. "My colleagues and I went into healthcare to preserve human life. When a patient passes, it's a loss for everyone involved. We all feel it and mourn that loss, and our hearts always go out to the patient's family and loved ones. This situation is no different."
Family Eldercare was the court-appointed guardian of Hickson. "As court-appointed Guardian, we consulted with Mr. Hickson's spouse, family, and the medical community on the medical complexity of his case. Mr. Hickson's spouse, family, and the medical community were in agreement with the decision not to intubate Mr. Hickson," the organization said in a statement.
Some disability rights activists and medical professionals took to social media to voice their concerns about Hickson's case. Most notable was the statement by Dr. Monica Verduzco-Gutierrez, professor & chair of Rehabilitation Medicine at the Department of Physical Medicine and Rehabilitation at the University of Texas Health Science Center in San Antonio.
Dr. Verduzco-Gutierrez in a two-tweet thread wrote:
"As a Brain Injury Medicine physician, I have fought for patients like this every day of my career in #Physiatry. Begging doctors who don't know the outcome data or 'wouldn't want to live that way' to give a chance at treatment, rehab, & life."
"He could communicate, see his five kids, laugh, sing... all as a quadriplegic with a brain injury. He may of had more quality of life than any of us."
As a Brain Injury Medicine physician, I have fought for patients like this every day of my career in #Physiatry
Begging doctors who don't know the outcome data or "wouldn't want to live that way" to give a chance at treatment, rehab, & life.
— Monica Verduzco-Gutierrez, MD (@MVGutierrezMD) June 28, 2020