A federal judge in Baltimore has issued a preliminary injunction to bar removal of a brain-damaged Army veteran from the Veterans Administration Medical Center at Fort Howard pending a possible state court decision on who should be the man's legal guardian.
Judge Marvin J. Garbis said yesterday, at the end of an hour-long hearing in U.S. District Court, that he has "serious questions" about the validity of legal guardianships in Maryland and Florida claimed by Deanna V. Mack, the man's wife.
So the judge gave Ronald Mack's father and sister, Ronald E. Mack and Karen Mack Carson, of Essex, who petitioned for the injunction, time to challenge the guardianships in state courts.
Garbis did not rule on the merits of the right-to-die issue. He said he wants to tread carefully, and will decide later what jurisdiction he has over the merits of the case.
"For the time being, I think I should preserve the status quo," the judge said.
"Nobody enjoys making these decisions. The ultimate decision on this man's life is a personal one. It has to be made in the appropriate way that would . . . try to do what Mr. Mack would wish to be done. I want to be sure that whatever court sorts that out, it is the proper court and that they have a chance to do it while Mr. Mack is alive."
The subject of the hearing, Ronald W. Mack, 28, suffered serious brain and liver damage in a 1983 auto accident in California. He has been a patient in the Veterans' Administration Medical Center at Fort Howard for nearly eight years. He is said to fluctuate between a total coma and semiconsciousness, and is being kept alive by food and water fed to him through gastric feeding tubes.
His wife, also 28, lives in Dunnellon, Fla. with their two children.
She said she wants to take him to Florida to be examined by doctors there and present evidence about his medical condition in court. She has petitioned a state court in Ocala for permission to remove his feeding tubes under Florida's right-to-die law. If a judge determines her husband unlikely to recover, she could have the tubes removed and he would be expected to die in three to 14 days.
She said yesterday, however, that she would put her husband in a nursing home, and seek better medical care for him than he is getting, if the Florida court denies her petition.
Her lawyer, C. Christopher Brown, said she obtained legal guardianship over her husband in Baltimore County Circuit Court in 1984, 11 months after the accident left him critically injured and incompetent to handle to his own affairs.
She also obtained guardianship of her husband in 1985 from a state court in Florida, Brown said.
Brown argued that she has the legal right to remove her husband from the VA hospital here and take him to Florida, and that the hospital cannot block such a move on legal, moral or religious grounds.
Attorney Gary I. Strausberg, who represents Ronald W. Mack's father and sister, said he was startled by the Maryland guardianship claim, which he learned about during the court hearing.
But Strausberg said he will challenge the validity of it later this week because Deanna Mack no longer lives in Maryland. He said he will seek to have Ronald W. Mack's father declared his legal guardian.
Strausberg also questioned the validity of the wife's Florida guardianship because it was obtained without her husband ever being in that state.
The emotion-rooted legal fray began Saturday, when Carson and her father filed a petition in federal court asking Garbis to block Deanna Mack's alleged plan to move her husband to Florida over the weekend by air ambulance. The judge issued a temporary restraining order then, and scheduled yesterday's hearing.
To Deanna V. Mack, the issue is her husband's right to die with dignity.
"I want him to have his right to die, if he's going to be a complete vegetable for the rest of his life," she said yesterday.
She contended that her husband told her several times, before his accident, that he wouldn't want to live if he couldn't take care of himself.
To her husband's family, the issue is his right to live and, possibly, to recover from his injuries.
"He does have a lot of brain damage," said Ronald E. Mack. "But I'm not gonna give up. It would take an act of God to take my son's life.
"He does respond. Always."
VA lawyers told Garbis they oppose Ronald W. Mack's removal from the hospital by anyone who intends to end his life. They have refused to let Deanna Mack remove her husband and refused to grant her request for termination of his nourishment.
Dr. Edward Rusche, the hospital's medical chief, testified that the patient is not technically comatose and that he would die if his feeding tubes were removed.
"He is awake, he moves his eyes, moves his face in response to stimuli," Rusche said.
The doctor acknowledged that he personally opposes removal of the patient's nourishment on moral ground. "Miracles happen," he said.
Outside the courtroom, Carson and her aunt, Mary Bell, charged that Deanna Mack has never come to see her husband since she moved to Florida years ago.
They also claimed that she would benefit financially by his death, from $2,600 a month in VA and Social Security benefits for her and her two children.
Deanna Mack hotly denied both of those claims. She said that her husband told her several times before the accident "that he never wanted to live like this, like a vegetable.
"If I've never come to see him, how did our children's pictures get in his room?" she said.
She said her husband "has been unresponsive to all stimuli" for eight years, and said she should be allowed to terminate his life-support procedures.
She also said her children have come with her at times to see their father, and that her son, Ronald Timothy Mack, age 10, agrees that her husband should be allowed to die.
"He told me, 'Daddy will be better off. God will take care of him,' " she said.