Court halts family’s efforts to remove man from life support
INTERVENTION BY LAWYER WAS ‘DEVASTATING’: ANESTHETIST
Fernando Ferreira had been in hospital for three days when his family made the heartwrenching decision. The 53-year-old had suffered a cardiac arrest, causing what doctors believed was irreparable brain damage and leaving him unconscious. Now his common- law wife had agreed to have Ferreira taken off life support and his organs donated for transplant when he died.
But just before that was to happen, an apparently unprecedented court ruling put a sudden halt to the process.
Georgiana Masgras, a lawyer who had represented Ferreira in an unrelated car- accident case and who worried the family was acting rashly, had convinced a judge to order a stop to the plan.
The surprise ruling on July 8, a Saturday, sparked a flurry of legal activity as doctors at St. Mary’s General Hospital in Kitchener, Ont., warned that the delay could render their patient’s organs unusable. Finally, that Sunday, another judge agreed to overturn the original injunction.
The strange sequence of events was “devastating” for Ferreira’s relatives, said anesthetist Dr. Chris Hinkewich, who oversaw his treatment.
“They gathered on Saturday (some coming from the United States) to say goodbye to a loved one,” he said in an affidavit.
“Instead, they have been stuck in limbo as a result of the actions of Ms. Masgras and as a result of the order,” the physician said. “They are confused, tired and do not understand how someone with no connection to their family can intervene in such a manner. They are also very upset that the opportunity for organ donation may be lost.”
Lawyers for the hospital and the doctors involved said they could not comment on whether the organs were, in fact, successfully harvested, or any other aspect of the case. Ferreira’s wife, Kim, also declined to comment, saying it was “not a good time.”
Canadian courts have seen a series of bitter disputes over end- of- life care in the last decade or so, but most involved clashes between family members and medical staff — or among family members — about when to stop treatment.
Lawyer Mark Handelman, one of the country’s leading experts in the area, said he has never heard of an unrelated third-party intervening in that way.
“It’s hugely unfortunate for everybody involved,” he said. “They ( family members) have come to grips with the situation and made what they believe to be the right decision, and now there’s an interloper.”
Masgras herself, however, vigorously defended her actions, even as she admitted they were unusual.
She cited the evidence of Omar Irshidat, owner of the rehabilitation clinic that treated Ferreira after his accident last December. Irshidat said in an affidavit his client told him repeatedly he never wanted to die like his friend Peter, who had terminal cancer and was cut off food in his final days, a relatively common palliativecare practice designed to reduce discomfort.
“I was making a case for Mr. Ferreira to remain alive because I’m his lawyer and as an officer of the court I do think that it’s my duty to ensure that all his options are being properly explored,” Masgras told the Post. “Because there are i rreparable consequences … There shouldn’t be any rush. We’re talking about somebody’s life.”
Irshidat also mentioned a psychology report done as part of the rehab process that noted Ferreira’s relationship with his wife had deteriorated since the accident. Masgras questioned whether the woman was the most appropriate substitute decision-maker.
But Handelman said provincial law makes it clear that a spouse automatically as- sumes that role, with other relatives filling in according to a set hierarchy if there is no living partner. That situation would change only if Ontario’s Consent and Capacity Board awarded power of attorney to someone else, the lawyer said.
In this case, 25 loved ones had gathered at the hospital, all agreeing on what to do.
The legal dispute aside, it was a tragic end to a trying year for Ferreira. The immigrant from Portugal — on workers’ compensation since an accident on his brick-laying job 20 years ago — suffered from acute pain and severe depression in the wake of the car crash, said the psychologist’s report.
He was admitted to St. Mary’s on July 3. According to patient records filed in court, he had been out “gambling” the night before and got in an argument with his wife. The next morning she found him lying on the floor, but breathing. When he hadn’t gotten up later, the family called an ambulance, the chart said.
His heart had stopped and though it started again, he had suffered brain damage from lack of oxygen, said Hinkewich’s affidavit.
On the evening of July 6, informed that Ferreira was being kept alive by “multiple forms of life support” and had a “guarded” prognosis — though staff judged that brain death was unlikely to occur — the family agreed to the withdrawal of those supports, the document says.
The act was to take place on July 8, by which time Hinkewich felt “there was no prospect” Ferreira would ever recover. But then staff and relatives discovered that the night before, Justice Harrison Arrell of Ontario’s Superior Court had issued an order that the hospital was “forbidden from withdrawing Mr. Ferreira’s life support.”
Lawyers convinced Justice Frank Marrocco of the same court to hear an appeal the next day by teleconference. As the hearing unfolded, they learned that Ferreira had already become brain dead.
Regardless, the new judge said the wife was clearly the substitute decision maker, while other family members and medical staff had unanimously supported taking Ferreira off life support.
THEY HAVE BEEN STUCK IN LIMBO AS A RESULT OF THE ACTIONS.