Life And Death

By Susan Tifft.

Retired schoolteacher Helga Wanglie, 87, has lain in a vegetative state at the Hennepin County Medical Center in Minneapolis since last May. There is no possibility of recovery. Doctors have told Oliver Wanglie, Helga's husband of 53 years, that they want to end life support for a patient whose prospects seem so hopeless. Cost is not an issue: the family's health insurance covers almost all expenses. But Wanglie refuses to permit the demise of his spouse, who, according to him, believed firmly that only God should make such a determination. "She told me that if anything happened to her, she didn't want anything done to shorten her life," says Wanglie, 86. "I promised her I would respect that."

Authorities at Hennepin have failed to persuade the retired attorney to transfer his wife to another facility or file for an injunction that would force the hospital to continue care. Therefore they plan to take a disturbing and unprecedented step: asking a state court to grant the hospital permission to disconnect Helga's life-support systems. "We don't feel the physicians should be forced by the family to provide inappropriate medical care," says Dr. Michael Belzer, Hennepin's medical director.

The Wanglie case is the reverse image of the controversy that surrounded Nancy Cruzan, the 33-year-old Missouri woman whose family fought all the way to the U.S. Supreme Court to win the right to remove the feeding tube that was keeping her alive. Cruzan died last month, 12 days after a Missouri probate court permitted her family to stop nourishment. Before doing so, Judge Charles E. Teel Jr. determined from the testimony of witnesses that the woman would not have wanted to continue living in her comatose condition.

Disposition of the Cruzan case seems to have opened a Pandora's box of right-to-die and right-to-life cases, all putting painful ethical dilemmas before the courts. Three days after Cruzan's death, the state-run Missouri Rehabilitation Center blocked the attempt of St. Louis marketing consultant Pete Busalacchi to move his daughter Christine from Missouri, which severely restricts the disconnecting of feeding tubes from patients judged beyond recovery, to Minnesota, where rules are less strict. In June the U.S. Supreme Court affirmed Missouri's right to require "clear and convincing evidence" of a patient's desire to avoid life-sustaining treatment. But the guidelines do not help Busalacchi: he had never discussed the eventuality with Christine.

The case of an 81-year-old Wisconsin man known only as L.W. is equally agonizing. In May 1989, L.W. suffered a series of heart attacks and strokes that left him irretrievably comatose. The man had lived in mental hospitals since 1951, but even if his previous competence had been unquestionable, he now has no immediate family or close friends who could tell a court whether he wanted life-prolonging care. In June an Eau Claire County Circuit Court judge decided that L.W.'s legal guardian, Paul Lenz, has the right to decide whether to halt life supports. Lenz has appealed to the state supreme court for guidance.

As the welter of life-or-death cases wends through various state courts, only two outcomes seem relatively clear. The first is that a patchwork of state-level decisions will provide no definite guidelines. The second certainty, in the words of Hennepin's Belzer, is that "there are going to be thousands of cases like this in the future."

With reporting by Marc Hequet/Minneapolis and Georgia Pabst/Milwaukee +