Dehydration at Ottawa’s Bruyére Centre
On May 11, 1989, John Gauthier, 26, died of cancer in Ottawa’s Civic Hospital. Prior to that he had spent nearly three months in the palliative care unit of the Elizabeth Bruyére Health Centre. The Centre is named after a religious sister and is run by the Sisters of Charity.
John’s parents, Roger and Irene Gauthier, are very upset. They charge that the care unit deprived their son of “food and water.” This, they say, violated their son’s human rights. Food and water are ordinary means of sustaining life. They may never be cut off in any hospital anywhere and certainly not in an institution under Catholic auspices.
The Gauthier’s have witnesses who heard Dr. John Scott, head of palliative care at the center, stating that the unit has “an unwritten policy” of dehydrating the dying to hasten their demise.
At one point, the Gauthier’s say, the hospital staff gave their son three days to live, but when the young man received intravenous hydration as family and friends demanded, his condition improved remarkably. John Gauthier was removed from the Bruyére Centre and lived not three days, or three weeks, but three months, dying finally at the Ottawa Civic Hospital.
This story of the Bruyére Centre was related in detail in a report written by registered nurse Sylvia MacEachern and published in the Human Life International newsletter (July/August 1989). The report relates how John Gauthier’s condition suddenly appeared to deteriorate rapidly within a couple of days. According to witnesses, the young man was administered medication orally by a nurse at the center.
The patient told several witnesses that “he didn’t want the medication or need it.” This medication apparently, was meant to supplement the morphine he was receiving. The young man’s lips were cracked and parched in appearance and his tongue was dry and giving rise to thick secretions. His feet were badly swollen and he lost contact with those around him and became delirious.
John’s mother Irene, became increasingly alarmed that her son was not getting intravenous water. His father, Roger, asked an Ottawa Catholic priests, Rev. Robert Bedard, about the Catholic Church’s position on giving water to the dying. Mr. Gauthier was told he should object if his request for hydration was refused.
Bruyére Centre physicians
Roger Gauthier approached Dr. Anne-Marie Hamilton and asked for intravenous fluids, but was told that it was not hospital policy. A meeting was then arranged with Dr. Andre Pepin, the palliative care physician. According to the HLI report, Dr. Pepin said “that the body has enough water. It will not prolong John’s life. It’s not necessary at this last stage. John is losing his memory. He’ll die in two of three days. “it’s best if he goes that way.”
Dr. Pepin also spoke about John Gauthier’s “qualify of life,” implying , one would assume, that it wasn’t worth sustaining.
When John’s father (and legal guardian) threatened to remove his son from the Centre unless hydration was provided, the hospital relented and the young man was given intravenous fluids. Within three days his condition changed. He became coherent, the swelling of his feet gradually disappeared and he began to eat and drink again.
A few weeks later, however, the Bruyére Centre again removed hydration due to the fact that John as taking nourishment orally. The IV was discontinued without his parents being advised.
Another meeting with hospital staff was arranged, and there was more “quality of life” terminology presented to the Gauthier’s. It was at this meeting after some questioning by Ottawa Catholic priest, Father D. Parsons, that Dr. Scott stated that the Bruyére had indirectly adopted an unwritten dehydration policy.
The Gauthier’s removed their son from the Bruyére Centre, placing him in the care of a physician. Taking daily doses of prescribed morphine, he lived at home for another month, receiving visitors, eating his favorite foods, watching TV and even shopping occasionally with his parents. Approximately two weeks before he died he asked to be put into the Ottawa Civic Hospital to be with his father who was undergoing quadruple bypass heart surgery.
John remained coherent until his death on May 11, 199.
In a letter dated April 12, 1990, the Gauthier’s presented the evidence to the new Archbishop of Ottawa, Marcel Gervais, and asked him to investigate. The Archbishop promised them he would. Early this month, September 1991, I presented a letter to Archbishop Gervias on behalf of The Interim, requesting a response to the evidence the Gauthier’s had provided a year and a half earlier.
In a return letter dated September 13, 1991, Archbishop Gervais stated that he had investigated the hospital’s Palliative Care Unit, had questioned their personnel, and was “satisfied that the stated policies, to which the institution is adhering, are completely in keeping with Catholic moral principles.”
The Bishop also stated that with Mr. and Mrs. Gauthier’s written and signed release, the hospital might be permitted to speak in more specific terms about the John Gauthier case.”
So far there have been no results. When provided with the written release, the hospital refused to speak to me about the Gauthier case. However, in a letter to the Gauthier’s, the hospital states that only they, the parents, in the presence of two hospital witnesses, will be allowed to see the dead man’s medical record.
The hospital’s director, Dr. Michel Bilodeau, also states that copying of the medical records will not be permitted. This decision, the letter explains was made at a meeting of the hospital’s board of directors.
The Gauthier’s having no medical background and no experience in reading medical records, are seeking legal advice regarding the availability of records.
Health care ethics guide
I contacted hospital director Michel Bilodeau by telephone about the Bruyére Centre’s dehydration policy. He referred me to section 83 of the recently published Health Care Ethics Guide published by the Catholic Health Association of Canada (CHAC). Section 83 states that for person “in the final stages of a terminal illness it is morally permissible to forego treatment, including artificially supplied nutrition and hydration, that secures only a precarious and burdensome prolongation of life.”
It should be noted here that nutrition and hydration are not considered to be “artificial means” by the vast majority of ethicists in American states, even those with “living will” legislation. (The Economist, July 20/91)
Moreover, the Vatican’s 1980 Declaration on Euthanasia states that death must be “imminent” before forms of treatment that “only secure a precarious and burdensome prolongation of life” can be refused. Rita Marker, director of the International Anti-Euthanasia Task Force, has stated that intravenous food and water should never be refused unless the body is “shutting down” and the person is “truly imminently dying (within 24 to 48 hours, not weeks or months).”
The Interim contacted Richard Haughian, a spokesman and ethicist for the Catholic Health Association, asked him how widely the term “final phase of a terminal illness” could be interpreted.
Mr. Haughian stated he had no problem with the term and did not feel it needed to be defined more precisely. He stated that the ethics guide prohibits assisted suicide and was not intended to be “interpreted irresponsibly.”
Mr. Haughian’s preference for imprecise language will be well known to many Catholic pro-lifer from his little article “Dialogue About Abortion” in the Living With Christ Sunday misalette of June 10, 1990. Despite the huge number of abortions of convenience in North America each year, “a woman does not decide lightly to have an abortion,” Mr. Haughian stated. He also described both the pro-abortion and the pro-life positions as “extreme.” He suggested that pro-lifers should make the social structure of society more just (more daycare, better education, more economic power for women, etc.) before battling to end abortion.
What disturbs John Gauthier’s parents the most is the fact that what happened to their son occurred in a Catholic hospital. It should disturb all Catholics.
In the editorial of the June 1991 issue of Bioethics Research Notes, the following warning appeared: “Perhaps one of the most ironic aspects of the recent story of the euthanasia movement is that the involvement of individuals and groups under Catholic auspices as been crucial to its success. Rita Marker, director of the International Anti-Euthanasia Task Force, points out that, in the U.S., non-opposition or even outright support form Catholic individuals and groups has served to silence others with the remark, ‘even the Catholic Church approves of it.’”
(But the Catholic Church does not approve of the withholding of food and water at any time. See the U.S. Bishops’ recent statement on euthanasia elsewhere in this issue. Editor.