6/18/2004
Do Aiden Stein's Parents Have the Right to Keep Him on Life Support?
by Ginger Skinner
On March 15, 2004, five-month-old Aiden Stein was rushed to the hospital by his father when he discovered that his son was not breathing. At Akron Children’s Hospital, doctors diagnosed Aiden with Shaken Baby Syndrome after finding that severe skull and brain injuries had left him blind, deaf and unaware of his surroundings. As a result of these injuries, Aiden has been in a coma since March 15 and, according to his doctors, will remain in a permanent vegetative state.
After reviewing Aiden’s medical condition, the ethics committee at Akron Children’s Hospital recommended that Aiden be removed from life support. The committee further reasoned that because Aiden’s unmarried 21-year-old parents, Matt Stein and Arica Heimlich, were believed to be involved in his injuries and may be charged with murder if the baby dies, their decision to keep Aiden on life support should not be deferred to. As a result of this determination, an application for guardianship has been filed in the Summit County Court of Common Pleas.
A hearing to appoint a guardian was held on April 12. On the second day of the hearing, Aiden’s parents consented to the appointment of a guardian to make medical decisions. However, they stipulated that this guardian was not to make the decision to withdraw life support. After four days, Judge Bill Spicer gave Child Services Division temporary custody of Aiden and appointed a guardian, Ellen Kaforey, to make all medical decisions for the child, including termination of life support. And even though no charges have been brought against either parent, Judge Spicer stated that the parents were unfit to make a decision regarding termination of life support because of the possibility of a murder charge against Stein.
A few factors seemed to inform the lower court’s decision to appoint a guardian. In past case law, Judge Spicer has supported the withdrawal of nutrition and hydration once a court has determined that a person is in a persistent vegetative state. Spicer has consistently shown that he considers the withdrawal of nutrition and hydration a brief and relatively painless death and certainly better than years of “torturous deterioration and body deformation.”
This case was further complicated when the unmarried parents were treated as one party. Attorney Edward Markovich represented both parents, causing Judge Spicer to determine their rights as a parental unit, not as a father and mother with separate issues. Katherine Federle, a law professor at Ohio State University and director of the law school’s Justice for Children Project, disagreed with the approach. “The cleanest way for the court to look at it is to start from the premise that the mother has constitutional rights,” she said. “I don’t know how we override her wishes.”
Additionally, if the mother’s parental constitutional rights had been asserted from the beginning, it is much more likely that she would still be able to decide the fate of her baby. However, because the parents are being represented by the same attorney, they are likely not able to advance their legal arguments most effectively. For Markovich to strongly advance the mother’s interests, he may have to hinder those of the father who is suspected of causing the injuries. If Heimlich were represented independently, her attorney could likely blame the injuries on Stein, thus presenting a far better argument for allowing Heimlich to continue making medical decisions for her son. Further, because the mother is not a suspect at this point, it is less likely that she would face murder charges in the event of Aiden’s death. This reduces her conflict of interest regarding the removal of life support. However, because these issues were never addressed, both parents have lost their parental rights and a state-appointed guardian will likely determine the fate of their child.
The appointment of Aiden’s guardian was affirmed on June 9 by the Court of Appeals, with most of the decision seemingly rebuking the parents’ counsel. With a shake of the head, the court dismissed the parents’ constitutional parental rights argument because of their failure to even present such an argument to Judge Spicer at the lower court level. The court also found that it did not need to address whether the Ohio statute pertaining to removal of life support applied to minors because the parents never raised this issue, either. In addition, the parents failed to assert that a guardian, while being allowed to make medical decisions, is not granted the authority to remove life support. Because the parents failed to present these arguments at the proper time, they lost the right to make the decision regarding the life and death of their child. (Attorney Markovich was contacted for comment but did not return the call.)
Presiding Judge Donna Carr concurred only in affirming the appointment of the guardian and wrote separately to question Judge Spicer’s refusal to apply Ohio’s modified version of the Uniform Rights of the Terminally Ill Act. Under the Act, twelve months must lapse from the time Aiden entered into a coma before life support could be terminated. Because this Act does not mention minors, however, Judge Spicer concluded that it did not apply. Judge Carr was skeptical of this logic. “One could take a view contrary to that of the probate court,” wrote Judge Carr, “that, by failing to make any provisions for minors in R.C. 2133.08, the legislature did not intend that these types of decisions would be made at all in the case of a minor or that the decision would be made by the minor’s parents.”
Judge Carr also took issue with Judge Spicer’s assumption that the guardian has authority to end a child’s life. Again, Judge Spicer had relied on the absence of language, in this case the Act’s failure to address whether the guardian could decide life-support issues, to determine that the guardian had that power. “If the legislature had intended ‘medical treatment’ to encompass the removal of life-sustaining treatment,” Judge Carr wrote, “it certainly could have made that clear when it codified the Uniform Act.” Carr asserted that her opinion was strengthened by the legislature’s refusal to lay out specific standards to guide that decision-making process. She pointed out that the Uniform Rights of the Terminally Ill Act includes a detailed process for making the decision to remove life support. “Where the legislature did explicitly authorize the power to make decisions regarding the removal of life-sustaining treatment,” she stated, “it did not do so with merely a blanket requirement that the decision be made in the patient’s best interest.” Judge Carr then argued for the Ohio General Assembly to enact statutes that would proscribe the decision-making process in this important area.
Regardless, the same day as the Appellate affirmation of the lower court’s ruling, Aiden’s guardian ordered the removal of his ventilator. Although it was scheduled to be removed two days later at noon, on June 11, the Ohio Supreme Court granted an emergency stay to Aiden’s parents, allowing the seven-month-old to remain on life support. The parties were then given 45 days to present arguments to try to convince the Ohio Supreme Court to hear the case. However, if the Ohio Supreme Court does not agree to hear the case, life support will be removed.
Related links:
2003 Year-in-Review Case Report
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