home *** CD-ROM | disk | FTP | other *** search
- <text id=93TT0381>
- <title>
- Oct. 11, 1993: An Education In Death
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1993
- Oct. 11, 1993 How Life Began
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- ETHICS, Page 60
- An Education In Death
- </hdr>
- <body>
- <p>A New England school bridles at honoring a mother's request
- that her daughter not be saved if she's dying
- </p>
- <p>By DAVID VAN BIEMA--Reported by Massimo Calabresi/Lewiston
- </p>
- <p> In the sun-dappled Norman Rockwell vision of America, the concept
- of in loco parentis might be best embodied by a freckled kid
- handing a teacher a note from home. "I can't be at school with
- my child," the letter might read, "so please take care of him.
- If he gets stung by a bee, here's the medication to give him.
- Don't make him eat onions at lunch, since he has a food allergy.
- I give over my authority to you. Please do for him as I would
- do."
- </p>
- <p> After a fashion, that was also the nature of the letter that
- went out on July 29 to the Lewiston, Maine, school about Corey
- Brown, a pupil at the system's Farwell School. But there was
- nothing Rockwellian about it. The note, written on behalf of
- Corey's mother Linda Lafrance by Corey's pediatrician, Richard
- J. Marsh, read, "I am writing...to ask you to honor the
- medical order to `Do Not Resuscitate.' " That is, it explained,
- should Corey's lungs cease to work, do for Corey as Lafrance
- would do: let her die.
- </p>
- <p> In the furor that followed, Lewiston learned that Corey, 12,
- suffers from spastic cerebral palsy and progressive scoliosis.
- As these conditions have worsened, ever more frequent cases
- of pneumonia related to them have threatened her with possible
- pulmonary arrest. Her doctor says the scoliosis will eventually
- kill her by slowly constricting her vital organs. The doctor's
- note was alerting the teachers that Lafrance preferred the quicker,
- less painful death, and hoped they would too.
- </p>
- <p> "Do not resuscitate" notices, or DNRs, are a form of passive
- euthanasia well known and almost always honored by hospitals.
- But DNRs issued to schools are far less routine, and the ethics
- and law surrounding them are largely uncharted territory. The
- reaction on the part of Corey's teachers was horror. "This turns
- my insides upside down," said Crystal Ward, the head of the
- local teachers' union. Says Pat Lemaire, a longtime kindergarten
- instructor: "A school is not a place where we make those kinds
- of decisions. It's not our training--and frankly, I don't
- want it to be my training." Yet Lafrance maintained her request,
- backed by Dr. Marsh. Says he: "I live in a world that sometimes
- deals with `Do not resuscitate.' "
- </p>
- <p> In good New England fashion, Lewiston held an open-school committee
- meeting last week to address the question. The teachers were
- worried that no one would be able to tell if one of Corey's
- seizures was minor (help her) or had shut down her lungs (let
- her alone). But she is already watched at school by a registered
- nurse assistant, who could be expected to make the call. Other
- problems were far more tangled. Under federal law, says Yale
- Law School professor Robert A. Burt, schools must educate children
- with disabilities to "the maximum extent appropriate," along
- with their non-handicapped peers. Moreover, many state statutes
- hold that they must accede to parents' wishes "unless they can
- demonstrate that they are abusive or against the best interests
- of the child," a position that the school district has declined
- to use in its defense. "On the other hand," continues Burt,
- "the school might argue that the kind of burden implementing
- these orders imposes on school personnel makes them inappropriate
- in a mainstream setting." If the case went to court, he suggests,
- the district might end up providing Corey with home tutoring.
- </p>
- <p> That is an option her mother rejects. The Lafrance living room
- looks even smaller than it really is, crowded with a hospital
- bed, IV stands and automatic drip feeders for Corey, who sits
- in a wheelchair between two recliners that face the TV. She
- is a terribly frail girl, legs in braces and arms hanging limp
- from her shoulders. She cannot speak; but she can smile or cry,
- and has made it abundantly clear that along with cotton candy
- and the color purple, she enjoys the regular music and art classes
- she attends at Farwell, as well as the Bingo games held for
- disabled students. To deprive her of these few joys would be
- cruel, says Lafrance, 39. "It's not like I want her to die in
- the classroom among all those people," says Lafrance. She points
- out that Corey could be taken to the nurse's office to spare
- her classmates' feelings. Then hurt breaches her Yankee reserve,
- and her voice breaks. " I'd rather have her go like that than
- have her spine crush her to death."
- </p>
- <p> The school committee delivered its decision after last Monday's
- session. For now, Corey's teachers will not be expected to comply
- with the DNR order. But by unanimous vote, the board pledged
- to re-examine the larger policy guiding that ruling, which was
- framed years ago to address relatively simple questions of first
- aid, and to take up the issue again within two months. People
- are making an effort to be conciliatory. Says Dr. Gordon Smith
- of the Maine Medical Association, who knows both the issue and
- the players: "It's a small state, and generally we're able to
- work these things out rather than leave it up to a judge."
- </p>
-
- </body>
- </article>
- </text>
-
-