The heartbreaking case of Vincent Lambert has produced a consequential plea for urgent action by the United Nations Committee on the Rights of Persons with Disabilities. This unexpected yet welcome development is the latest chapter in a French version of the Terry Schiavo case that riveted national attention in the United States in 2005.
Vincent Lambert, 42, was critically injured in a motorcycle accident in 2008. He sustained severe brain damage and has been diagnosed as being in persistent vegetative state (PVS), a condition that presumes no self-awareness and no conscious response to external stimuli. He requires assisted nutrition and hydration (ANH) in order to survive but he does not require a ventilator.
Adding to the tragic circumstances is an intra-family dispute that pits his wife and some siblings against his parents and other siblings. The former want ANH withdrawn, asserting that he would not want it. The later insist that euthanasia must be rejected and ANH provided. The conflict is possible because Vincent never prepared what L.I.F.E. provides: an advance medical directive, or an appointment of health care representative. Even our short form directive would eliminate doubt as to the patient’s wishes and provide the necessary foundation to protect life.
PVS is not a terminal illness. Nor is it a state of permanently unconscious. Patients in PVS experience waking and sleeping cycles, typically do not require a ventilator, and frequently open and close their eyes. Disputes and uncertainty persist as to the precise nature of the condition as well as the accuracy of diagnosis. But what is undisputed is that PVS is not a terminal condition.
A 2016 French law applicable to terminally ill patients allows physicians to withdraw life sustaining treatment – including ANH – in purportedly hopeless cases while administering powerful sedatives until the patient dies from the lack of food and fluids.
The European Court of Human Rights and France’s top administrative body had upheld the doctors’ earlier decision to stop Lambert’s life support. His parents filed a petition with the UN Committee on the Rights of Persons with Disabilities and, according to news reports, a French court ordered that his feeding be resumed until the UN body resolves the petition filed in that forum.
In the media storm that surrounds the case there has emerged a strong statement from the Vatican. Consistent with a statement from Pope John Paul II in 2004 and a ruling on the issues from the Congregation for the Doctrine of the Faith in 2007 [link is in the bioethics library], the most recent Vatican statement affirms the essential norm that ANH is ordinary and proportionate care that must be provided to a PVS patient “as long as the person is able to receive nutrition and hydration, provided this does not cause intolerable suffering or prove damaging to the patient.” It continues by stating that its “suspension … represents … a form of abandonment” and describes ANH in the specific context as “an inescapable duty.”
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