[Source: Transcript of conference video tape, "How Do Families Cope?" Families on the Frontiers of Dying, Philadelphia, PA, May 21, 1998.]

The case of Michael Martin, a 41-year-old Michigan man who suffered head injuries as a result of a 1987 car-train accident, is currently before the Michigan Court of Appeals. Oral arguments are scheduled for 5/6/93.

Michael is conscious, alert, appears happy, plays card games, and loves country-western music. He has communicated through a computer-augmented device that he wants to live.

Mary Martin, his wife and legal guardian who has been in contact with the Hemlock Society, wants to have his food and fluids (provided by gastrostomy tube) withdrawn. She says that, years before the accident, Michael had made statements indicating that he would never want to be maintained as a vegetable. Michael's mother and sister are fighting for his right to live and want Mary removed as his guardian, but have been unable to establish legal standing. According to his sister, Pat Major, "Brain-injured is not brain dead…. This is euthanasia -- get rid of anyone who needs care." [The Detroit News, 10/25/92: 1B]

Mary Martin is currently appealing a 11/12/92 ruling by probate Judge George Grieg which rejected her request (to have Michael starved and dehydrated to death) on the basis that Michael's statements prior to the accident were not written. But the judge indicated that he would have granted the wife's request if Michael were terminally ill or unconscious.

The fact that Michael currently expresses the wish to live was ruled irrelevant by the judge because of Michael's "impaired condition."

Judge Grieg's ruling raises serious questions regarding the autonomy of disabled patients and just how "impaired" a person has to be before he or she no longer has rights and interests.

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Update: the Michael Martin food and fluids case

As previously reported in the Update (5-6/93), the case of 41-year-old Michael Martin, severely disabled as the result of a 1987 car-train accident, is currently before the Michigan Court of Appeals. Michael, who experts say is not in a persistent vegetative state, has indicated that he wants to live. His wife and current legal guardian, Mary Martin, petitioned a Michigan Probate Court to have Michael's gastrostomy tube feeding stopped, claiming that Michael had made statements prior to the accident indicating that he would not want to live as a "vegetable."

The judge would have granted the request if Michael were terminally ill or unconscious. The fact that Michael indicated that he wanted to live was ruled irrelevant by the judge because of Michael's "impaired condition." The judge also refused to give legal standing to Michael's mother and sister, who were attempting to remove his wife as legal guardian.

• failed to issue specific findings based on the evidence as to Michael's current decision-making capacity and his "present level of physician, sensory, emotional, and cognitive functioning.";

• erred when it denied the petition of Michael's mother and sister to have Mary Martin removed as legal guardian without even holding a hearing concerning the "possible bias, prejudice, conflict of interest, or improper motive" on the part of Mary Martin; and

• erred in not granting his mother and sister legal standing.

Probate Judge Grieg has 56 days from the date of the remand order to initiate proceedings to resolve these and other questions. Grieg's new "findings of fact and conclusions of law" must be forwarded to the Court of Appeals within 28 days of the close of those proceedings.

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Better dead than disabled

When last reported in the Update (9-10/93), the case of 41-year-old Michael Martin was before the Michigan Court of Appeals. Michael is severely disabled as a result of a 1987 car-train accident, he is not in a persistent vegetative state; and he has communicated through a computerized device that he wants to continue living. Yet, despite his currently expressed wishes, Mary Martin, his wife and legal guardian, has petitioned the courts to have his food and fluids withheld. Michael's sister and mother have been fighting for his right to live.

On 7/19/93, the MI Court of Appeals remanded the case back to the Probate Court for specifics regarding findings of fact and conclusions of law. The Probate Court had previously ruled against the removal of food and fluids, but also offered the opinion that Michael's expressed wish to live was irrelevant because of his "impaired condition."

Write/lawyer Wesley J. Smith, who has been closely following this case and has written about it for the National Review, posed the question, "Why isn't the benefit of doubt being given to the choice of life in these starvation cases?" "Perhaps," writes Smith, "it is because we are becoming a society that increasingly believes that it is better to be dead than disabled." [Wesley J. Smith, "Better Dead Than Fed?" National Review, 6/27/94]

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The Michigan Supreme Court ruled on 8/22/95 that Mary Martin, wife and legal guardian of severely disabled Michael Martin, could not be permitted to cause Michael's death by having "life-sustaining treatment," namely his food and fluids, withheld. In a 6-1 decision, the Court found that the testimony and affidavit of Mary Martin, claiming that Michael had said several times prior to his injury that he would never want to live "like a vegetable," does not constitute clear and convincing evidence that he would not want to continue living in his present condition.

According to lower court testimony, Michael -- who had suffered a closed head injury in a 1987 car/train accident -- is not in a persistent vegetative state nor terminally ill, can carry out some voluntary motor commands, can recognize faces, and can communicate with other people through head nods. There was also testimony from various health care providers that Michael seems happy with his environment and that he has responded with a "no" head shake when asked if there were ever times when he did not want to go on living.

Yet, in spite of these facts, both a MI probate court and the MI Court of Appeals ruled that nutrition and hydration could be withheld from Michael. One judge held that Michael's response indicating that he wanted to go on living was irrelevant given his impaired condition. Michael's mother, Leeta Martin, and his sister, Patricia Major, in an attempt to save Michael's life, appealed the case to the state Supreme Court. (For more background information, see Update, July-August 1994)

Regarding Mary's contention that Michael's pre-accident statements prove that he would not want to continue living in his present state, the MI Supreme Court cited conflicting testimony from two of Michael's co-workers indicating that, before the accident, Michael expressed the wish not to be kept alive if he was ever in a coma or in a vegetative state. "[O]ur review of the record," the justices wrote, "reveals that virtually all the witnesses agreed that Mr. Martin is not in a vegetative state and is not suffering from the type of incapacitation referenced in his expression of a desire not to continue life-sustaining treatment." [Mary Martin v. Leeta M. Martin and Patricia major, No. 99699, 99700, MI S. Ct., Slip Op., p. 24]

The Court concluded, "Accordingly, we reverse the Court of Appeals determination because [Mary Martin’s] testimony and affidavit do not constitute clear and convincing evidence of Mr. Martin’s preinjury decision to decline life-sustaining medical treatment in the form of a gastrostomy tube that provides hydration and nutritive support." [p. 29]

Note: There is virtually an identical case currently unfolding in Stockton, CA. The wife of Robert Wendland has taken steps to have her husband’s food and fluids withheld. She has done so with the unanimous approval of the hospital ethics committee and Robert’s doctor. Robert, 42, became severely disabled after a car accident, but is conscious, interactive, and improving. Robert’s mother and sister have obtained a restraining order to prevent his death. A court hearing is scheduled for 1/13/95. There will be more on this case in the next Update.