Readers Join Debate on Medical Ethics

I am the “consulting neurologist” mentioned in the story (“One Family Takes a Painful Stand,” Aug. 5). I would like to respond . . . to the glossing over and gross simplification of a very complex question: Should a physician deny food and water to a child who has brain function that is present but significantly impaired, and thus consign him or her to die of starvation and/or dehydration, only two days after the brain injury occurred? My answer to this question was no.

I firmly believe that denial of fluid and nutrition from a patient, be it adult or child, is not a decision lightly reached, to be rushed into before one has had an opportunity to let time declare the reversibility or irreversibility of brain injury.

The degree of mental and physical handicap or the eventuality of permanent coma that results from a severe brain injury cannot be determined within two days, two weeks or even two months of an acute brain injury, particularly in a child where the brain is more resistant to permanent damage that an adult.

My role here was to make an informed and thoughtful a judgment as was possible for this child’s benefit, to be his advocate in a charged and volatile atmosphere, and to give him every chance to declare himself.

That is exactly what happened in this tragic case.

DR. O. CARTER SNEAD III, Chief of Neurology, Childrens Hospital Los Angeles

Editor’s note: Childrens Hospital, citing confidentiality, did not provide the reporter with Dr. Snead’s name at the time the story was written.