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Woman in coma renews debate

FRESNO, Calif. — Three years after the fight over Terri Schiavo pulled the nation into the end-of-life debate, the case of a comatose Fresno County woman is reopening old wounds — and could prove even more inflammatory.

The family of Janet Rivera, 46, wants to keep her alive in a Fresno hospital. The county, acting as her legal guardian, wants the issue decided in court.

Among the questions her situation has raised: Should a government agency be able to overrule family members and withhold life support when the patient's wishes are unknown?

The Schiavo family has taken an interest in this case. The Terri Schindler Schiavo Foundation helped find a lawyer to represent the Rivera family, said Schiavo's brother, Bobby Schindler.

Rivera's situation is more alarming than his sister's, he said. "We had a family dispute," he said. "This is a family in agreement."

Schiavo, 41, of Florida, was the subject of a well-publicized debate over the removal of her feeding tube. Doctors said she was in a persistent vegetative state, and her husband, Michael Schiavo, decided to have the feeding tube removed. The Schindlers wanted her kept alive and went to court. After a lengthy court fight, the feeding tube was removed in 2005. She died 13 days after food and water were withdrawn.

In Rivera's case, the county became involved after the hospital where she was staying contacted the Public Guardian's Office. According to court records, one of the concerns was that Rivera's conservator at the time — her husband — was not making decisions related to his wife's health.

Dr. David Hadden, the county's coroner, public administrator and guardian, has said the county did not seek to become conservator. He said he decided to seek a judge's opinion because five doctors have said Rivera's condition is untreatable and irreversible.

The county removed life support on July 11 but had it reinstated Tuesday. Hadden said he restored life support because Rivera was surviving longer than expected and he wanted to hear a judge's opinion. A Fresno County judge on Wednesday granted a temporary order for life support to continue until the case is heard this week.

A hearing Tuesday in Fresno County Probate Court could decide if the Sanger, Calif., woman remains on life support.

Rivera has been comatose for two years since a heart attack. It's unclear what Rivera's preferences about life-support would be.

It's unusual for a conservator to argue for removing life support without evidence that's what the patient would want, said David Magnus, director of the Stanford Center for Biomedical Ethics and co-chair of the hospital's ethics committee.

The cost of Rivera's care also has become part of the discussion.

While Hadden says financial considerations have played no role in whether to keep her on life support, her family contends Rivera might not be in this situation if she had more money or better health-care coverage. Rivera's medical bills are being paid by Medi-Cal, the state-federal insurance program for low-income families.

Woman in coma renews debate 07/27/08 [Last modified: Sunday, July 27, 2008 11:08pm]
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