The wife of a recently passed quadriplegic Texas man with brain damage claims that her husband died after a local hospital and court-appointed guardian agreed to stop life-saving treatment against her wishes. The hospital contends that it was not medically possible to save her husband.
The death of 46-year-old Michael Hickson at St. David's South Austin Medical Center on June 11 has raised questions about what “quality of life” means and has raised concerns from disability rights activists even though Hickson’s family members had differing opinions of their loved one’s outlook.
Melissa Hickson, Michael’s wife, has turned to the internet and media to raise attention over what she believes to have been an unjust course of action taken by the hospital with approval of a court-appointed legal guardian, Family Eldercare.
Michael Hickson, who became quadriplegic after going into cardiac arrest in 2017 and suffered brain damage, was living in an Austin nursing home when he contracted COVID-19 in May. He was sent to the hospital on June 2 when he developed a fever and breathing troubles.
While at the hospital, Hickson developed other life-threatening complications that ultimately resulted in “multi-system organ failure,” according to a statement from St. David’s Chief Medical Officer Dr. DeVry Anderson.
Hickson suffered from pneumonia in both lungs, a urinary tract infection and sepsis.
Melissa Hickson recorded a June 5 call with a doctor at the medical center. Hickson said she was told that additional measures to treat her husband’s ailments would not help improve his “quality of life.”
"Will it affect his quality, will it improve his quality of life?" the doctor asked in the recording. "And the answer is no."
She pushed back, asking the doctor why treatment wouldn’t improve his quality of life.
"Being able to live isn’t improving the quality of life?” she asked.
The doctor is heard in the recording telling Hickson that there is “no improvement with being intubated, with a bunch of lines and tubes in your body, and being on a ventilator for more than two weeks."
"As of right now, his quality of life — he doesn’t have much of one," the doctor is heard saying.
Hickson again pushed back, asking the doctor: “What do you mean?” She asked if it was “because her husband is paralyzed with a brain injury,” to which, the doctor responded by saying, “Correct.”
Hickson posted a video on YouTube, claiming that her husband was “murdered.” She voiced her outrage that the hospital staff and Family Eldercare employees decided to put her husband in hospice care. She claimed that her pleading with them to change their decision did no good.
“The reason that he (the doctor) would not treat my husband any further was because he was disabled,” she said. “That disability caused him to believe that my husband had poor quality of health.”
Reports of the recorded conversation with the doctor have driven much concern from disability rights and pro-life activists who contend that the doctor’s remarks show a level of disregard for human life.
In a statement, Anderson, the hospital’s CMO, shot down the narrative that rose last week, stressing that “misinformation” has spread regarding Hickson’s case.
Anderson said that while he doesn’t normally divulge the private details of the hospital’s patients, he felt “troubled by the untruths” surrounding the circumstances of Hickson’s death.
“Some people want the public to believe that we took the position that Mr. Hickson’s life wasn’t worth being saved, and that is absolutely wrong. It wasn’t medically possible to save him,” Anderson stressed. “My colleagues and I went into healthcare to preserve human life. When a patient passes, it’s a loss for everyone involved. We all feel it and mourn that loss, and our hearts always go out to the patient’s family and loved ones. This situation is no different.”
Anderson explained that the decision made in Hickson’s case had nothing to do with hospital capacity, his disabilities or the color of his skin, adding that the hospital treats all patients equally.
“This was a man who was very, very ill and in multi-system organ failure,” Anderson added. “His legal guardian and his doctors worked together, consulting pulmonary and critical care specialists, to determine a care plan that was best for him.”
When Hickson was transferred to the facility, he had pneumonia in both lungs, a urinary tract infection and sepsis. Other complications also arose near the end of his life, such as aspiration of food.
According to Anderson, aspiration means that Hickson was “regurgitating the nutrients going into his body through his feeding tube, and they were going into his airways, causing his respiratory condition to worsen.”
“Aspiration has the potential to be fatal, especially for a patient in a weakened physical state, like Mr. Hickson, and this was the reason his tube feedings were discontinued,” he explained.
“To act within the bounds of the law, my staff at the hospital communicated with Mr. Hickson’s court-appointed guardian, an organization called Family Eldercare.”
Although it is not common for guardianship to be taken away from family members, a court may do so if they think it is in the patient’s best interest, Anderson explained.
In Hickson’s case, a Travis County judge appointed temporary guardian status to Family Eldercare until it can be determined whether Melissa Hickson or Hickson’s sister, a physician, would be appointed Hickson’s guardian.
The Washington Post reports that court documents filed in February by a county investigator found that during an earlier hospitalization, a hospital manager complained that Melissa Hickson had rejected the facility’s efforts to transfer him out of the hospital, which resulted in Hickson being kept in the hospital for months longer than he should have. The hospital manager also commented that Hickson had “unrealistic expectations” when it comes to the level of care her husband required.
Michael Hickson’s sister, Renee Hickson, a fellow at George Washington University Hospital in Washington, D.C., agreed with the doctor’s assessment of her brother’s condition in June.
She told the newspaper that the doctors worked hard to save her brother’s life. However, she said her brother’s condition worsened suddenly. She disagreed with the notion that the doctor’s decisions were based on race or disability.
In a statement on Hickson’s passing, Family Eldercare stressed that “end of life decisions when families are in disagreement can be especially difficult.”
“As court-appointed Guardian, we consulted with Mr. Hickson’s spouse, family, and the medical community on the medical complexity of his case. Mr. Hickson’s spouse, family, and the medical community were in agreement with the decision not to intubate Mr. Hickson.”
Family Eldercare argued that “in consultation with Mr. Hickson’s family and medical providers,” it agreed with the recommendation for hospice care for Hickson to receive end-of-life comfort, nutrition and medications.
Some activists and medical professionals, however, are not pleased by the reports of Hickson’s death.
Dr. Monica Verduzco-Gutierrez, chair the Department of Physical Medicine and Rehabilitation at the University of Texas Health Science Center in San Antonio, issued a Twitter thread to voice her displeasure.
“As a Brain Injury Medicine physician, I have fought for patients like this every day of my career in #Physiatry,” Verduzco-Gutierrez wrote. “Begging doctors who don’t know the outcome data or ‘wouldn’t want to live that way’ to give a chance at treatment, rehab, & life.”
She argued that Hickson “may of had more quality of life than any of us.”
Steven Spohn, a disability rights advocate, award-winning author and COO of AbleGamers Charity, warned on Twitter that Hickson’s case shows how much of an “an underlying fear this scenario is for much of the disabled community.”
“We live our entire lives in fear that one day a doctor will decide we just aren't worth it,” Spohn wrote.
“In the YouTube video, the doctor can be heard saying ‘he will have lines and tubes coming out of his body... That's not a quality-of-life.’ I have tubes coming out of my body. I happen to like my life. Without those tubes I'd be dead.”
Spohn wrote that his definition of “quality of life” is apparently “vastly different” than how the doctor defines the term.
Disability rights advocates protested along the street outside St. David's campus on Saturday. Advocates with the Texas Americans with Disabilities Action Planning Team.
“I’m a quadriplegic just like Michael was,” demonstrator Bob Kafka told the Austin American-Statesman. “I want to make sure I’m treated equally.”