Quadriplegic Man's Coronavirus Death Stirs Fear Of Medical Bias Against Disabled The hospital said it made a humane decision to end treatment. Michael Hickson's widow says doctors ended his care because they underestimated the life of a man with significant disabilities.
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One Man's COVID-19 Death Raises The Worst Fears Of Many People With Disabilities

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One Man's COVID-19 Death Raises The Worst Fears Of Many People With Disabilities

One Man's COVID-19 Death Raises The Worst Fears Of Many People With Disabilities

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RACHEL MARTIN, HOST:

At the beginning of the pandemic, a federal civil rights office warned states, doctors and hospitals, don't place elderly or disabled people at the back of the line for care. Now several disability groups have asked that federal office to investigate the death of a man with COVID-19 in Texas. They say he was denied treatment because of his significant disabilities. NPR's Joseph Shapiro has this story.

JOSEPH SHAPIRO, BYLINE: What Melissa Hickson says happened to her husband and what the hospital says are in conflict. Michael Hickson was a quadriplegic. He'd been diagnosed with COVID-19. Now he had pneumonia. On June 5, Melissa Hickson went to see her husband on the ICU at St. David's South Austin Medical Center in Austin, Texas. A BiPap machine, a kind of ventilator that people often use in their own homes, was pushing air into his lungs to help him breathe. Through the mask, he answered her questions with short answers.

MELISSA HICKSON: I said, I want you to say it with me, and I want you to keep it in your mind. I said, you will live and not die. You will live.

SHAPIRO: Under the mask of the breathing machine, she could see his lips move as he said it. She called the kids on the phone, their five teenage children, for a FaceTime conversation. They told their dad what they were up to. The 16-year-old was excited she was going to get her driver's license.

HICKSON: They chattered - very chattery (laughter). And so I could see him kind of saying to himself, like, yeah, yeah, yeah.

SHAPIRO: One morning three years ago, Michael Hickson was driving his wife to work when he went into sudden cardiac arrest. Blood stopped flowing to his brain and his organs. The result was a brain injury, blindness and quadriplegia. In the three years since, he'd move from hospital to nursing home to back home and then back to more hospitals and nursing homes.

On that day at the hospital, Hickson found her husband's doctor in the hallway. He told her, we're going to stop treating your husband and move him from the ICU to hospice care. This is from a recording of their conversation.

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UNIDENTIFIED DOCTOR: The decision is...

HICKSON: OK.

UNIDENTIFIED DOCTOR: ...Do we want to be extremely aggressive with his care...

SHAPIRO: The doctor was explaining, do we want to be extremely aggressive with his care, or would it be futile?

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED DOCTOR: As of right now, his quality of life - he doesn't have much of one.

SHAPIRO: The doctor says her husband doesn't have quality of life. And if we have to intubate him - put him on a more powerful ventilator - in his weakened condition, he's not going to survive. That didn't make sense to Melissa Hickson. Her husband had pneumonia before. Other hospitals had successfully treated it.

DEVRY ANDERSON: This decision was not made based on a disability in any way.

SHAPIRO: Dr. DeVry Anderson is the chief medical officer at St. David's, the Texas hospital. He said it wasn't a decision to ration health care. He says Michael Hickson was much sicker than his wife may have realized - that he had sepsis, pneumonia in both lungs, that his organs were shutting down and that it wasn't one doctor who made the decision to end treatment. It was a medical team of doctors, palliative care specialists and the chaplain. They got signoff from Michael Hickson's guardian.

A Texas probate court had appointed an elder care agency to make medical decisions for Michael Hickson. That happened after Melissa Hickson disagreed with a previous hospital that wanted to discharge her husband to a nursing home. She insisted he needed specialized care at a brain injury center. Dr. Anderson says the doctor who used the term no quality of life - he wasn't talking about Michael Hickson's disabilities.

ANDERSON: But rather he was trying to help Mrs. Hickson understand compassion based on understanding what quality of life is, how someone might suffer more based on doing things that we consider to be treatments or interventions that are actually not helping them be better or feel better.

SHAPIRO: On that tape, Melissa Hickson challenged the doctor. Are you saying because he's paralyzed with a brain injury he doesn't have quality of life?

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED DOCTOR: Correct.

SHAPIRO: Correct, the doctor says. Devan Stahl is an associate professor of ethics at Baylor University in Waco, Texas. Hospitals call her in on cases just like this. She wasn't consulted on this case, but she's listened to the tape.

DEVAN STAHL: It was very troubling, kind of a gut punch...

SHAPIRO: Kind of a gut punch...

STAHL: ...Because a treatment working or not working has nothing to do with a patient's quality of life, however it's deemed by this physician - and by all accounts by his wife, that he had a quality of life.

SHAPIRO: Stahl says there's research that we - all of us, including doctors - see someone like Michael Hickson with a significant disability and say, I wouldn't want to live like that. And we have a bias to underestimate what that disabled person would say about their quality of life. Melissa Hickson says no one asked her husband if he wanted treatment.

HICKSON: He would say, I want to live. I love my children and my family. They are the most important things to me. He would probably say that that's the reason, for the past three years, I have fought to survive.

SHAPIRO: On June 11, Michael Hickson died, less than a week after the hospital stopped his treatment. Several disability organizations have filed complaints against St. David's Hospital. They've asked the Office for Civil Rights at the U.S. Department of Health and Human Services to investigate.

Joseph Shapiro, NPR News.

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