When loved ones can't let go

Arthur Caplan

June 05, 1991|By Arthur Caplan

THE LEGAL battle over the fate of Helga Wanglie, the 87-year-old woman who has lain in a permanent coma in a bed in the Hennepin County Medical Center in Minneapolis for 17 months, finally has begun.

Despite media reports that the court proceedings will determine whether Helga Wanglie lives or dies, the hearing that ended last week in Hennepin County District Judge Patricia Belois' courtroom will do nothing of the sort.

The only question Belois must decide in the next two or three months is whether Wanglie's husband, Oliver, should be appointed her legal guardian, or whether that job should go to an independent professional conservator, Terrance J. Larpenteur.

No plugs will be pulled, no tubes withdrawn before the issue of guardianship is resolved.

While the stakes in the Wanglie case are not yet life or death, Belois still faces a tough decision. I think she should decide in favor of allowing Larpenteur to serve as a temporary guardian.

The reasons for appointing a stranger to act as a guardian for Helga Wanglie rather than her own husband are contained in the testimony of her doctor, Craig Peine; the hospital ethics committee's consultant, physician-ethicist Steven Miles; and the testimony given by other physicians and nurses during the three-day proceeding.

Peine testified that Oliver Wanglie is not competent to make decisions about his wife's medical treatment. He does not seem able to understand that her condition is irreversible and hopeless. Other health professionals said he has trouble understanding her prognosis, is more prone to ranting than to listening and has been next to impossible to involve in planning her care.

But Oliver Wanglie, himself, is the best case against my contention that Belois should appoint a temporary independent guardian.

In his courtroom testimony, Wanglie did not come across as a nut, a kook or anything close to incompetent. He is a man of deep personal and religious convictions who is hoping against hope for a miracle. He believes he should be appointed his wife's guardian because he loves her and can accurately reflect her wishes.

So, why turn to a third party to control decisions about Helga Wanglie's care? Because sometimes love can distort a person's understanding of what is the right thing to do.

By appointing Larpenteur as a temporary guardian, Belois will allow someone not a party to the dispute to answer tough questions:

* Is it really true, as doctors contend, that no other institution will accept Helga Wanglie?

* Physicians say her coma is irreversible, her prognosis hopeless. And no one -- no doctor, nurse or therapist -- has publicly disagreed. Does Oliver Wanglie understand how hopeless his wife's situation is?

* Does he understand the position of his own church as to the morality of stopping artificial medical technology in hopeless cases?

It's likely that Oliver Wanglie simply cannot bring himself to allow his wife to die. Many husbands and families cannot. But there comes a time when medicine reaches the limits of what it can do.

For more than a year the doctors and nurses at Hennepin County Medical Center have been trying to tell Oliver Wanglie that the limit has been reached. Maybe an independent guardian can make him hear what his heart refuses to acknowledge: It is time to let his beloved Helga go.

Arthur Caplan, director of the Center for Biomedical Ethics at the University of Minnesota, is a columnist for the St. Paul Pioneer Press.

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