On Wednesday February 7, the administrative court in Marseilles issued a court order to continue health care for one-year old baby Marwa, who had been put in an induced coma at the Timone hospital.
After an aggressive enterovirus attacked her nervous system, Marwa was first taken to Lenval hospital in Nice before being transported by emergency helicopter to Timone hospital in Marseilles on September 25, 2016.
Considering the baby’s neurological lesions to be irremediable, the doctors made a collective and unanimous decision on November 4, 2016 to stop her treatment and switch off the life-supporting respirator. The parents disagreed and filed suit at the Marseilles administrative court on November 9. On November 15, the court suspended the doctor’s decision (Marseilles Hospital’s Public Assistance) and ordered for appropriate care to be reinitiated, as well as medical consultations by 2 neurologists, and for a neuro-pediatrician to reevaluate her condition after a 2-month time lapse.
Following the expert evaluation, the administrative court issued a new decision on February 7: whereby the decision to stop treatment was “premature because it had been taken too soon to unequivocally ascertain the child’s strength and that the therapy in progress was ineffective”. The expert report qualified the prognosis as « exceptionally poor” although noting that “some signs of improvement had been observed”.
The court did not take into account Barrister Olivier Grimaldi’s arguments, the hospital’s lawyer, who described continuing care as a risk of “coercive medical excesses”. Rather the opposite, the court judged that « the fact that an individual is in an irreversible condition of losing autonomy, requiring a respirator or artificial feeding does not characterize, in and of itself, that pursuing treatment is unjustified under the label of therapeutic obstinacy.”
Following the verdict, the Marseilles Hospital’s Public Assistance lawyers published a press release Thursday February 9, announcing they would file an appeal with the State Council objecting the continuation of Marwa’s care.
The parents launched a petition in November which already has over 170,000 signatures on the website www.change.org requesting their daughter be given « a chance to live ».
Alliance VITA’s position :
The legal battle surrounding Marwa’s case constitutes a new tragedy for an especially complex medical issue, since the doctor and the family have different positions on whether or not therapy is promising. The administrative judge in Marseilles, (using language that recall the 2014 debates in the Vincent Lambert case) underlines an important fact: A comatose individual needing a respirator or artificial feeding does not necessarily represent excessive medical obstinacy that should be discontinued. Diagnosing someone as “being kept alive artificially” and thus authorizing the doctor to “unplug” the patient, ensuring imminent death, must be evaluated cautiously on a case-by-case basis and only as a last resort.
