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Terri Schiavo case redux

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A French court has ordered a Reims hospital to provide nutrition and hydration to 38-year old quadriplegic Vincent Lambert, who has been in a state of minimal consciousness (en état de conscience minimale) for five years following a motorcycle accident.

Last Thursday a tribunal administratif overruled the wishes of the hospital, Lambert's wife and some of his siblings who wanted to cut off intravenous feeding. The court sided with his parents and his other siblings, who as observant Catholics, objected to euthanizing him. Le Monde reports the Lambert case will reopen the contentious debate about euthanasia, the value of life and human dignity in France.

Have we not heard this before?

The Lambert case has a number of parallels with Terri Schiavo saga in America: a spouse ready to move on vs. Catholic parents not ready to let go; no clear statement of the patient's wishes, conflicting medical terminology of persistent vegetative state v. minimal consciousness; political intervention by Congress and partisan debates in the French parliament; and a high profile role played by Catholic bishops. While it is early days yet, the most striking difference is the different decisions reached by the courts.

In Florida the courts came down on the side of death, even though the presumption of the law is in favor of life, while in France they have chosen life, even though euthanasia is legal. The hospital authorities can now appeal against the decision before France's Constitutional Council. The French press reports the Lambert case comes amidst a growing social and political debate over legalizing assisted suicide and euthanasia. President Francois Hollande this week entered into the fray, saying he favored the legalization of euthanasia, but covered his bases by saying it was appropriate only under strict government scrutiny.

A 2005 law permits passive euthanasia, where a person causes death by withholding or withdrawing treatment necessary to maintain life. According to Aujourd’hui en France the court ruled against death as Lambert's condition was not terminal.

Le tribunal a notamment «jugé que la poursuite du traitement n'était ni inutile, ni disproportionnée et n'avait pas pour objectif le seul maintien artificiel de la vie et a donc suspendu la décision d'interrompre le traitement». La juridiction a par ailleurs estimé que «c'est à tort que le CHU de Reims avait considéré que M. Lambert pouvait être regardé comme ayant manifesté sa volonté d'interrompre ce traitement».

The court's ruling "held that continuing treatment was neither unnecessary nor disproportionate and was not intended only for the artificial preservation of life and accordingly suspended the decision to stop treatment." The court further held that "it is wrong for [the hospital] to have decided that Mr. Lambert could have been regarded as having expressed a desire to discontinue treatment."

Le Figaro explained the court in Chalons-en-Champagne ruled against ending Lambert’s life as he was neither "sick nor at the end of life ... ", « ni malade ni en fin de vie ».

The French newspapers I have seen have done an excellent job is covering this story. The Aujourd’hui en France story quotes doctors and family members on both sides of the debate, a spokesman for the French Episcopal Conference, and the politician who introduced the 2005 euthanasia law to parliament.

Le Figaro and Le Monde are equally even handed in the sourcing of their stories and in the description of Lambert's condition and the court ruling.

How different the French reporting on Vincent Lambert has been so far compared to the job the American press did with the Terri Schiavo case. It will be fascinating to see if the New York Times and other outlets on this side of the Atlantic pick up the story, and whether they use the phrase "brain dead" -- a legal not medical term the French press have so far avoided.