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Helga Wanglie Revisited: Medical Futility and the Limits of Autonomy

Published online by Cambridge University Press:  29 July 2009

David H. Johnson
David H. Johnson
Affiliation:
University of New Mexico School of Law
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Extract

There is little to indicate from, her circumstances that events would propel Helga Wanglie, an 86-year-old Minneapolis woman, into the center of public controversy. We know little of her life prior to the events that removed her from the world of conscious, sentient beings. By the time of her death on 4 July 1991, Mrs. Wanglie had become the focus of a nationwide public and professional debate on the rights of a patient in a persistent vegetative state (PVS) to receive aggressive medical treatment when such treatment is felt by the patient's doctors not to be in the patient's best interests.

Type
Special Section: Medical Futility: Demands, Duties, and Dilemmas
Information
Cambridge Quarterly of Healthcare Ethics , Volume 2 , Issue 2 , Spring 1993 , pp. 161 - 170
Copyright
Copyright © Cambridge University Press 1993

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References

Notes

1. For the facts of the Wanglie case I have relied on two sources. Miles, SH. Informed demand for “non-beneficial” medical treatment. New England Journal of Medicine 1991;325:512.CrossRefGoogle ScholarPubMedCranford, RE. Helga Wanglie's ventilator. Hastings Center Report 1991;21(4):23.Google Scholar

2. Ackerman, F. The significance of a wish. Hastings Center Report 1991;21(4):27–28.CrossRefGoogle ScholarPubMed

3. See note 2. Ackerman, . 1991;21(4):29.Google Scholar

4. Angell, M. The case of Helga Wanglie. New England Journal of Medicine 1991;325:511.CrossRefGoogle ScholarPubMed

5. Schloendorff v. New York Hospital 1914: 211 NY 125.Google Scholar

6. Tomlinson, T, Brody, H. Futility and the ethics of resuscitation. Journal of the American Medical Association 1990;264:1276–9.CrossRefGoogle Scholar

7. Veatch, RM, Spicer, CM. Medically futile care: the role of the physician in setting limits. American Journal of Law and Medicine 1992;18:15–23.Google Scholar

8. Task Force on Ethics of the Society of Critical Care Medicine. Consensus report on the ethics of foregoing life-sustaining treatments of the critically ill. Critical Care Medicine 1990;18:1437.Google ScholarPubMed Quoted in: Rie, MA. The limits of a wish. Hastings Center Report 1991;21(4):24–25.CrossRefGoogle ScholarPubMed

9. Lantos, JD, Singer, JD, Walker, RM, et al. The illusion of futility in clinical practice. American Journal of Medicine 1989;87:81.CrossRefGoogle ScholarPubMed

10. See note 1. Cranford, . 1991;21(4):23.Google Scholar

11. See note 1. Miles, . 1991;325:513.Google Scholar

12. See note 1. Miles, . 1991;325:513.Google Scholar

13. This was Helga Wanglie's statement at the beginning of her saga.

14. See note 9. Lantos, et al. 1989;87:81.Google Scholar

15. See note 9. Lantos, et al. 1989;87:82.Google Scholar

16. See note 9. Lantos, et al. 1989;87:83.Google Scholar

17. See note 9. Lantos, et al. 1989;87:82.Google Scholar

18. For a comprehensive review of the pitfalls of decision making under conditions of uncertainty, see Tversky, A, Kahneman, D. Judgment under uncertainty: heuristics and biases. Science 1974;185:1124.CrossRefGoogle Scholar

19. Schneiderman, LJ, Jecker, NS, Jonsen, AR. Medical futility: its meaning and ethical implications. Annals of Internal Medicine 1990;112:950.CrossRefGoogle ScholarPubMed

20. See note 19. Schneiderman, et al. 1990;112:950.Google Scholar

21. See note 19. Schneiderman, et al. 1990;112:950.Google Scholar

22. See note 19. Schneiderman, et al. 1990;112:950.Google Scholar

23. See note 6. Tomlinson, Brody. 1990;264:1277.Google Scholar

24. See note 6. Tomlinson, Brody. 1990;264:1277.Google Scholar

25. Truog, RD, Brett, AS, Frader, J. The problem with futility. New England Journal of Medicine 1992;326:1560–4.CrossRefGoogle ScholarPubMed See note 7. Veatch, Spicer. 1992; 18:15Google Scholar. Brody, B. Special ethical issues in the management of PVS patients. Law, Medicine and Health Care 1992;20:104.Google ScholarPubMed

26. Physicians chose this route out of their ethical conflict in the Baby L case. See Paris, JJ, Krone, RK, Reardon, F. Physicians’ refusal of requested treatment. New England Journal of Medicine 1990;322:1012.CrossRefGoogle ScholarPubMed

27. See note 25. Truog, et al. 1992;326:1563.Google Scholar

28. See note 7. Veatch, Spicer. 1992;18:23.Google Scholar

29. See note 7. Veatch, Spicer. 1992;18:29.Google Scholar

30. Wickline v. State of California, 228 Cal. Rptr. 661 (Cal. App. 2 Dist. 1986).

31. See note 25. Brody, . 1992;20:113.Google Scholar

32. See note 25. Brody, . 1992;20:104.Google Scholar

33. See note 25. Brody, . 1992;20:113.Google Scholar

34. Autonomy, Schwartz R., futility, and the limits of medicine. Cambridge Quarterly of Healthcare Ethics 1992;1:159–64.Google Scholar

35. Callahan, D. Medical futility, medical necessity. Hastings Center Report 1991;21(4):30, 34.CrossRefGoogle ScholarPubMed

36. See note 34. Schwartz, . 1992;1:163.Google Scholar

37. Miles, SH. Legal procedures in Wanglie: a two-step, not a sidestep. Journal of Clinical Ethics 1991;2:285–6.Google Scholar