Amicus Curiae Brief

In the matter of Christine Busalacchi, nurses and nursing organizations in Missouri and Arkansas submitted an amicus curiae (friend of the court) brief to the Missouri Supreme Court. Busalacchi suffered serious injuries in an automobile accident that left her in a persistent vegetative state (PVS) and dependent on a feeding tube for nutrition. Her father sought to have the feeding tube removed, which would result in Busalacchi's death.

The nurses, some of whom were providing care to Busalacchi, objected, citing two bases for their motion: Their interests in the welfare of Busalacchi and similarly situated patients, and the harm that would result to the nurses from being forced to assist in her death. This paper will examine that brief, explicating the nurses' reasoning and the decision I would have reached if I had been a justice on the Missouri Supreme Court.

The nurses began by dismissing the argument that withdrawing food and water is not causing a patient to die, only allowing that patient to die. They point to Nancy Cruzan, a patient who died 11 days after food and water were withdrawn. Her death certificate listed the cause of death as "dehydration." Denying food and water to Busalacchi will similarly cause her death.

The nurses then differentiated between terminal patients and "non-dying patients" (NDP). Withdrawing treatment from a terminally ill patient simply hastens death, and such an action is not at all controversial. Indeed, withdrawing treatment f

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) and make the last moments of life as comfortable as possible. But Busalacchi is not dying. Withdrawing food and water will not only cause her death, but it will make her last moments of life extremely uncomfortable. Amici follow with a comparison to Nazi Germany, where nurses collaborated in Hitler's euthanasia campaign against mentally retarded children. Nurses "do not wish to be indicted in a 21st Century Missouri Nuremberg." In addition, the court would be asking many nurses to violate their deeply held religious beliefs. Simply transferring the patient to another facility or other caregivers does not make the action any more moral or ethical. In addition, the autonomy of nurses is threatened by this case. The nursing care of individual patients is solely under the discretion of nurses. A doctor only becomes involved if the patient needs medical care. In this situation, however, the guardian could give an order to the nurses that a physician could never give, i.e., starve and dehydrate that patient. Busalacchi survived initially because of medical treatment. She survives now because of nursing care, not medical treatment, and to deny her that care is to cause her death and irreparably harm the public's confidence

Category: Government - A