Comatose Man, Unfed 8 Days, Dies of Pneumonia

Paul E. Brophy, the comatose firefighter whose case tested the legal limits of a patient’s right to death with dignity, died Thursday at the hospital that granted his wife’s request that he no longer be fed artificially.

Brophy, 49, was pronounced dead at 12:55 p.m. at Emerson Hospital in Concord, where he was taken after another hospital refused to remove feeding tubes that had kept him alive for 3 1/2 years. His death occurred after eight days without food, but he died of pneumonia and would have even if fed, his doctor said.

The decision to withhold food from Brophy was authorized by the Massachusetts Supreme Court at the urging of Brophy’s wife, Patricia, a registered nurse who argued that she was following Brophy’s own clear wishes.

A court-appointed attorney appealed the ruling that halted feedings to the U.S. Supreme Court, but three justices refused to consider it.

The Brophy case drew wide attention because it isolated the legal question of whether it is proper to withhold food and water from a “hopelessly ill” patient when death is not imminent.

Despite the profound brain damage caused by a burst blood vessel, Brophy’s other major organs functioned and he did not need a respirator or other mechanical assistance. But, because he could not eat on his own, he was fed through a surgically implanted tube in his stomach.

Called ‘Medical Treatment’

On Sept. 11, the highest court in Massachusetts ruled that such feedings are a form of “medical treatment” and that any medical patient has the right to refuse all medical treatment.

In Brophy’s circumstances, where the patient suffered an immediate and enduring loss of consciousness, the court applied the “substituted judgment” standard and held that Brophy himself would reject the tube feedings if he were able to speak.

Brophy, of Easton, Mass., had been healthy in March, 1983, when he suffered the aneurysm that destroyed large sections of his brain.

In late 1984, Brophy’s wife asked doctors at New England Sinai Hospital to clamp or remove the feeding tube. When the hospital refused on ethical grounds, she went to court. Brophy later was transferred.

His wife argued that Brophy himself had often returned home from accident scenes, where he aided victims, and said he would never want to be kept alive “as a vegetable.”