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Jeanne Smits, Paris correspondent

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New hope for France’s ‘Terri Schiavo’

Jeanne Smits, Paris correspondent

There’s hope for Vincent Lambert, also known as France’s “Terri Schiavo.”

At the end of July the doctor who has been pushing to stop giving Lambert food and liquids in order to “let him die” announced that he is leaving the Reims hospital where Lambert has been under his care since 2009. Dr. Eric Kariger had served there as head of the geriatric and palliative care department.

While the legal battle over Vincent Lambert’s life will continue, if Kariger’s successor should want to go down the same path, he will probably have to restart the decision procedure from scratch.

Jérôme Triomphe, the lawyer who is representing Lambert’s parents, is confident. “This is a real game-changer”, he told LifeSiteNews today. “The law makes Kariger solely and personally responsible for an end of life decision concerning his patient. It’s a moral responsibility, of course, but it is also a personal legal responsibility that cannot be taken up by any other person.”

Lambert’s parents now have more hope of obtaining their son’s transfer to a specialized center for brain-damaged patients.

But whichever the outcome, France has woken up to the fact that doctors can make personal life-ending decisions for patients who are not capable of expressing their own will.

This point was confirmed in June by France’s highest administrative court, the Council of State. It decided that lower courts had wrongly annulled the decision to deprive the tetraplegic and brain-damaged young man of food and water in order to “let him die.”

All of the 17 senior civil servants composing the assembly of the “Conseil d’Etat” voted that France’s end of life legislation – the “Leonetti law” – passed in 2005 is applicable and should allow withholding of food and fluids even when a gravely handicapped patient is not terminally ill.

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Lambert has been totally dependent and unable to communicate consistently since a motor accident left him badly injured eight years ago. He has been fed through a feeding tube since then. But he has occasionally been allowed to leave the hospital to spend time at his parents’ home. Lately, attempts to spoon-feed him have suggested that he could again learn to swallow on his own.

Immediately after the Council’s ruling was made public, Lambert’s parents appealed to the European Court of Human Rights. Hours later, it published a press release saying it had requested the French government to suspend execution of the ruling. This fairly rare procedure is used when the execution of a judicial decision would have irreparable or irreversible consequences.

The European Court has announced that it will give the case priority, treating it as early as December. In the meantime, it has formally asked a series of questions of the French government and the legal counsels of Vincent Lambert’s parents, who are fighting for his life, and the Reims hospital that has consistently upheld Kariger’s decision.

Most importantly, it is considering whether the withdrawal of food and liquids would constitute a violation of article 3 of European Convention of Human Rights that prohibits “torture” and “inhuman or degrading treatment or punishment.”

It is also tackling the central question: are artificial nutrition and hydration medical treatments or ordinary care?

Thus far in the legal process, judges have decided that artificial nutrition and hydration are to be considered as medical treatments that can be stopped even if a patient is in no way in a terminal condition. Judges who have decided in favor of Lambert did so on the grounds that he is not dying and that it is impossible to know what he would have wanted.

The first time Lambert was “saved” by the administrative court of Châlons-en-Champagne, in May 2013, he had not received any food and only minimal hydration for 30 days. The doctor who had decided, with Lambert’s wife Rachel, to enter into an “end of life procedure” was criticized for not having consulted his patient’s family and not having conformed to the legal process as set out by the Leonetti law.

However, Dr. Eric Kariger was quick to open a new “end of life procedure,” taking care to keep his patient’s parents and family informed but refusing to take their opposition into account. He made a number of statements to the press, including criticisms of those who wanted the young man’s life to be protected as Catholic fundamentalists.

Kariger was overruled a second time by an administrative appeals court at the end of last year, on the grounds that Lambert, 38, was in a minimally conscious state and should not be put to death because his wife affirms he would have wanted to die.

At a first hearing in February, the State Council seemed fully conscious of the gravity of deciding on Vincent Lambert’s right to live, and decided to order a panel of medical experts to look into the patient’s present condition.

This took place during the spring. His present state, the experts agreed, “suggests” that he is no longer minimally conscious but in a “permanent vegetative state”. Their findings also suggest that he has no hope of recovery or even of seeing an improvement of his condition, they said. Lambert has received no rehabilitative treatment for the last year.

But the experts were careful to add that the young man’s present attitudes or reactions couldn't be interpreted as indicating his will not to live.

Nevertheless, the Council of State decided in June that the testimony of Lambert’s wife, Rachel, that he would not have wanted to be kept alive, was sufficient to justify an end of life procedure. While Lambert has been severly brain-damaged since 2008, his wife only “remembered” his statements about end of life care in 2012, when Kariger first spoke of the possibility of withdrawing food and fluids.

The State Council noted that the simple fact of being in a persistent vegetative state is not sufficient to allow withdrawal of food and fluids. However, the ruling also upholds a patient’s "right” to obtain an end of life procedure in the case of a “living will,” or when clear indications have been given to a designated support person, or when family or close friends are prepared to testify to his or her past remarks on the subject.

This in itself gives wide scope to the promoters of what they call “passive” euthanasia, in which “letting” a person die of hunger and thirst, albeit under heavy sedation as has been planned for Vincent Lambert, is considered as therapeutic.

Defenders of Lambert and his parents argue that there is a difference between stopping extreme medical treatment when a person is beyond help, and withholding the basic care of food and hydration.

The whole question of the Vincent Lambert case is the definition of food and hydration: do they belong to the sphere of medical treatment, or to that of ordinary nursing? That is the point on which the European Court is going to rule, making it a landmark case, whatever the outcome for Lambert. 



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