Mother pleads to doctor to restore son's food and water

By Martin Barillas
Monday, August 20, 2012

(Spero News)



A 12-year-old boy, Zach McDaniel (earlier reports claimed his last name was Fernandez), was secretly denied food and water and life-saving treatment while at a hospital in Fort Worth, Texas. His doctor also slipped a "do not resuscitate" order into the boy's chart without the knowledge and consent of his parents.

On August 6, after suffering a gunshot wound to his head as a bystander during a drug-deal gone bad in Abilene, Texas, Zach underwent emergency surgery and then was transferred to Cook Children's Medical Center in Ft. Worth for advanced treatment.

Upon transfer, Zach was admitted to the pediatric intensive care unit. Heavily sedated and connected to a ventilator, doctors painted a grim picture for his parents. Cook medical officials told the boy's parents that part of Zach's brain was removed during his emergency surgery. The doctors told them that his prognosis for survival was poor and encouraged them to sign an organ donation consent form. They nearly did, but then discovered after an EEG that Zach's brain was, in fact, intact. Cook officials said that there must have been miscommunication between the two hospitals.

But on August 13, the hospital convened an "ethics panel", a legal entity where under Texas law medical officials can make a decision that care would be futile to restore the quality of a patient's life. If they decide care would be futile, the hospital can terminate care after 10 days.

Most patients who fall under a "futile care" decision are living with the assistance of ventilators and feeding tubes.

But due to a mistake in procedure, the hospital said the panel didn't technically convene. Informally, though, hospital officials told Zach's parents that they didn't want to treat their son anymore.

Three days later, Zach was able to breathe on his own and no longer needed a ventilator.

On the same day, a family member visited Zach in the hospital and asked the parents why Zach was on palliative care. To the parent's surprise, Zach was not receiving food or water.

When the parents tried to discover why the hospital was denying their son food and water, they found a "do not resuscitate" order in Zach's chart.

According to Texas law, doctors can insert DNR orders into a patient's chart if the doctor considers care to be futile, overruling both the patient's and the family's wishes.

A friend of the mother -- who faced a similar ethics panel decision for a family member at a different hospital -- told her to contact Texas Right to Life to help protect her son's life from the hospital.

Rachel Bohannon, spokesperson for Texas Right to Life, said they advised the mother to confront the doctor. "The hospital broke the law when they withdrew food and water. That can't be done without an ethics committee's approval," she said.

Reluctantly, the doctor removed the DNR order, reinstated food and water, but again told the parents that he didn't want to treat their son.

"She is the legal guardian and medical decision maker. But when care is considered futile, her rights are trumped by the hospital," Bohannon said.

Bohannon said she expects the hospital to reconvene the ethics panel. "This time they'll follow all the rules so that it sticks. When that happens, Zach has 10 days to leave the hospital or risk having his basic medical care taken away."

Zach's family is trying to find a new facility to treat him.

Spero News editor Martin Barillas is a former US diplomat, who also worked as a democracy advocate and election observer in Latin America. He is also a freelance translator.