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On Heroes and Villains in the Linares Drama

Published online by Cambridge University Press:  29 April 2021

Christine Mitchell
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Extract

The Linares case is one of the memorable moral dramas played out in a pediatric intensive care unit and in the press in a decade of momentous moral cases concerning the care of children. It was a vivid tragedy that posed intense conflict. Its characters were sharply drawn, and it culminated in a final, dramatic scene.

High drama tends toward heroes who are admired for their courage and distinguished performance, and villains who are embodiments of evil reviled for their wickedness. To make it simple for the audience, the good often wear white and the bad wear black. Not so in this story. Two nurses who took care of Samuel Linares, Karen Stratton and Laura Stark, wrote, ‘‘The media sensationalized Rudy Linares as a hero while Rush PICU staff members were portrayed as the villains. Who is right?”’

Nurses played a central role in the Linares case. Accounts of the drama in newspapers, television stories, and articles across the country contained opening paragraphs giving the basic facts: Rudy Linares, a 23-year-old laborer, held nurses at gunpoint just after midnight on April 26, 1989, while he disconnected his 16-month-old unconscious son, Samuel, from a respirator at Rush Presbyterian St. Luke's Hospital in Chicago and held him in his arms until he died.

Type
Article
Information
Law, Medicine and Healthcare , Volume 17 , Issue 4 , Winter 1989 , pp. 339 - 346
Copyright
Copyright © American Society of Law, Medicine and Ethics 1989

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References

Stratton, Karen RN, BSN, and Stark, Laura RN, BSN. “Linares: The Untold Story”. The Nursing Spectrum, Illinois Edition. Vol 2, No 14, July 10, 1989, p 15.Google Scholar
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I do not mean, by indicating that Mr. Linares could have gone to court, that he should necessarily have been the one with the burden of doing so. I agree with the comments of Kathleen Nolan that it would have been “morally desirable” for the hospital to obtain a court order. According to Nolan, “The burden should be placed on the physician and the hospital if they wish to treat a child over the parents' objection.” (“The Linares Case,” Hospital Ethics. July/August 1989. p. 13) However, since the hospital did not take the responsibility of bringing the case to court itself, Mr. Linares was left to decide what he would do. In choosing between the alternatives for ending his son's life by seeking a court order or using a gun to keep others away while he unplugged life-supporting equipment himself, I am suggesting that Mr. Linares should have chosen to go to court first.Google Scholar
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Ibid. Presumably it took some time for the security guards to arrive in the PICU and intervene. One would like to know how the nurses, who were probably the only ones present for the entire incident, handled this crisis which was the forerunner of the later incident with the gun. (In private telephone conversations the author was told that, coincidentally, the same nurse was taking care of Samuel both times.)Google Scholar
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The actual content of what nurses should advocate for Samuel and his parents bears mention, if not discussion, in this short paper. I have assumed in subsequent paragraphs that Samuel's nurses would advocate the position of his parents, in keeping with the recommendations of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (Deciding to Forego Life-Sustaining Treatment [Washington, DC: U.S. Government Printing Office, 1983] p. 218). When the medical assessment is that treatment is of ambiguous, uncertain or no value to the child, and the parents prefer to forego treatment, the President's Commission recommends that treatment be foregone. There is not space here to address the responsibilities of advocacy when a nurse has a different view of the value of medical treatment for a child or a serious concern about the capacity of a parent to make a decision for their child. If either of these complications occurred concerning Samuel Linares, I did not learn of it.Google Scholar