When Nichole Stewart-Graves checked into the Southwest Washington Medical Center in Vancouver, she was 35-weeks pregnant and in labor. Although at first it appeared that the delivery would be easy, complications set in and her son, Liam, was born by Caesarean section while her husband Todd waited in the postoperative unit. Liam had no heartbeat at birth.

Dr. Katherine Vaughn worked for 24 minutes to resuscitate Liam, and her efforts were ultimately successful. As a result of the extended period of oxygen deprivation, Liam suffers from severe cerebral palsy, mental retardation, and a seizure disorder. He is fed through a tube, and his conditions are permanent.

Liam’s parents sued, arguing that they should have been asked to consent to the extended resuscitation effort. The trial judge dismissed the lawsuit, both as to Liam’s parents claims of “wrongful birth” and failure to secure informed consent, and as to Liam’s own claims for “wrongful life.” The state Supreme Court then reviewed the decision, and affirmed the reasoning and the result.

An earlier Washington case had dealt with the concept of “wrongful birth.” In that case, a woman with a seizure disorder had asked her physicians whether Dilantin, the drug they prescribed for her, would cause any problems with her planned pregnancy. After she was assured that it would not she and her husband had two children, both of whom suffered from disabilities. They sued, arguing that if they had been properly informed about the risks they would never have chosen to have children.

In Liam’s case the Washington Supreme Court ruled that the issues were different. When the alleged mistake was made, Liam had already been born—and so his parent’s right to complete information before they chose to conceive a child was not implicated.

Furthermore, ruled the high court, Dr. Vaughn was not required to get Liam’s parent’s consent before initiating or continuing the resuscitation effort. Dr. Vaughn was responding to a medical emergency, and she could not be required to stop the proceedings, discuss the alternatives with Mr. Graves (his wife was unconscious, having been anesthetized for the surgery) and ask him to approve continuation of the resuscitation.

One expert medical witness had asserted that Dr. Vaughn’s resuscitation fell below the standard of care, since the medical literature agreed that if Liam survived at all after about ten minutes of resuscitation, he would certainly be severely disabled. The court rejected that view, ruling that it would not accept “the premise that death is preferable to a severely disabled life as a matter of medical judgment.” Stewart-Graves v. Vaughn, November 8, 2007.

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