A Question of Life

Doctors told Mark and Karla Miller their unborn daughter would face a life of pain and illness. Then, against the Millers' wishes, Woman's Hospital did everything it could to keep the newborn alive. Last month, after an extraordinary trial in a Houston co

The little girl began to smile as the red rubber ball was dribbled on the wooden bench. With some effort, she turned her head toward the sound. The rhythm -- slap-thunk, slap-thunk, slap-thunk -- was slow at first, then began to pick up speed, faster and faster until Sidney Ainsley Miller let loose a shriek of laughter.

It was a tiny pleasure, to be sure, and a rare one. Since her birth on August 17, 1990, at barely 23 weeks gestation, Sidney Miller has known few conscious moments in which she has not suffered. She is severely retarded, and there is no chance she will ever walk, talk, read, write or provide for her own needs. Sidney's eyes are a lovely shade of brown, but only one is capable of sight, and that vision is limited to about two feet. Her birth, some 17 weeks premature, resulted in a form of cerebral palsy that contracts the muscles in Sidney's legs and pulls them toward her chest.

Less than a month after she was born, Sidney's brain began to leak cerebrospinal fluid, a condition known as hydrocephalus. She was no bigger than a pocket paperback when a shunt was implanted in her skull. The pumplike device is connected to a tube that runs beneath Sidney's translucent skin for the length of her torso, where the fluid drains into her abdomen. A lifelong affliction, the hydrocephalus causes seizures that rattle Sidney's frail body without warning. Because she has virtually no muscular development, Sidney's head often rolls involuntarily from side to side. When she's especially tired, it tilts back at a desperate angle, like a broken toy.

Anyone can see that Mark and Karla Miller love their daughter. They try to provide the simple delights -- a favorite meal or a horseback ride -- that, in their minds at least, give some semblance of normalcy to Sidney's childhood. They know better, of course. They have from the beginning.

When Karla's pregnancy took a turn that threatened her own life in August 1990, doctors at Woman's Hospital of Texas told the Millers that a 23-week-old fetus was not ready to live outside the mother's womb. If, by chance, the infant survived the birth, it would likely die within minutes if it did not receive artificial life support. Beyond that, there was a high risk the child would suffer from severe abnormalities.

The Millers then made a decision that, in a perfect world, no parent would ever have to make: They asked that their newborn baby be placed in Karla's arms and allowed to pass away peacefully.

Woman's Hospital had other plans, however -- plans that failed to consider the tragic outcome that Sidney Miller and her parents now struggle with every day. A hospital administrator informed the Millers that if their baby were born alive and weighed more than 500 grams (one pound, two ounces), it would immediately be handed to a specialist in the delivery room, who would do whatever was necessary to save the infant's life.

Indeed, Sidney was born alive -- barely. Her first experience was not a mother's love, but a tube inserted down her throat, followed by the searing sensation of 100-percent pure oxygen being pumped into her undeveloped lungs. With that, Sidney Miller became the victim of a complex yet dispassionate set of values. The same medical brilliance that could forecast a life of pain and disease for an unborn child could not -- would not -- muster the humanity to preclude it.

For two weeks last month, during an unprecedented lawsuit tried in the Harris County courtroom of state District Judge Carolyn Marks Johnson, a jury of eight women and seven men listened to testimony about the events surrounding Sidney's birth. On January 16, after fewer than six hours of deliberation, they found Woman's Hospital of Texas and its owner, Columbia/HCA Heathcare Corporation, grossly negligent for ignoring Mark and Karla Miller's request that their 23-week-old newborn not be subjected to life-support measures.

The jurors awarded the Millers $29.4 million to assist with the extensive care Sidney will need for the rest of her life. They also punished the hospital and Columbia/HCA with another $13.5 million in damages for violating Mark and Karla's right to decide what was in the best interest of their child and to make medical decisions accordingly.

The speed with which the jury reached its verdict surprised both sides, particularly Columbia/HCA. In its only response to date --a written statement -- the corporation said it was "astounded" by the verdict and planned to appeal. Columbia/HCA argued that Woman's Hospital had a "legal and moral obligation" to provide the best treatment it could for Sidney Miller.

Not if her parents did not consent to that treatment, says Michael Sydow, the family's attorney. The jury's decision, says Sydow, goes directly against "an ingrained social attitude that [physicians] are smarter than the rest of us."

"For most of the 20th century, the courts and everybody else in this country have sort of placed doctors ... not even on a pedestal ... they've prayed to them when they go to bed at night," Sydow said in a recent interview. "But intelligent people are able to make decisions about their own health and the health of their loved ones."

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