Child Support

The father returned from that dark task, only to be pulled aside by Jacobs. "He didn't say anything to Karla," Miller recalls in a voice cracked by emotion. "He asked me to meet with some hospital people, said it would be a favor to him."

Miller was introduced to Anna Summerfield, then-chief administrator for The Woman's Hospital, and Dr. Ferdinand Plavidal, chief of the NICU. Summerfield told Miller there was a problem with the parents' decision. "She said, 'Our hospital has a policy that requires we resuscitate any child that weighs more than 500 grams.' "

As the tense conversation continued, Miller says, he asked for a copy of the written policy and was refused, and questioned them about federal and state practices. Medical personnel talked about premature babies who went on to become normal children. Summerfield asked him to sign a document, he says, and he refused. Miller left not knowing what would happen in the delivery room.

A half-hour after the meeting, Karla's temperature soared to over 100 degrees, and Jacobs switched her to the labor-inducing drug Pitocin. Karla gave birth. Dr. Eduardo Otero, a neonatologist sent to the room by the hospital, took the newborn from a nurse.

"He didn't weigh her, clean her up or anything," Mark Miller says. "He just put her down on the table, tilted her head back and started pushing a tube down her throat."

When her parents filed their lawsuit in September 1992, Sidney had just turned two and was in the early stage of a series of surgeries to repair or replace the shunt beneath her scalp, which drained cerebrospinal fluid along a plastic tube into her abdomen. Seizures would rack her body when something went wrong with the device, and if the Millers didn't act quickly enough, it could be fatal.

HCA spent more than five years trying to get the suit tossed out by arguing the Millers had filed a frivolous "wrongful life" claim. The trial judge rejected HCA's move to dismiss the case and barred any discussion of "wrongful life" in court as irrelevant.

That judge, Carolyn Marks Johnson, who has since left the bench, also barred HCA from using federal "Baby Doe" laws that prohibit withholding medical treatment from disabled children. Johnson pointed out that was irrelevant: Sidney Miller was not born disabled.

HCA hinged its defense during the trial on the meeting shortly before the birth. Summerfield and Jacobs testified that everyone, including Mark Miller, had come to a "consensus" that a neonatologist would be present at birth to evaluate the newborn and provide treatment as needed. But Summerfield admitted in testimony that Miller never changed his mind and approved resuscitation.

The Millers never brought Sidney to the courtroom; they wanted the case tried on the facts and not on emotion. Their sole legal burden was to demonstrate that they were caring, responsible people who were capable of objectively deciding what was best for their child. When Karla was asked at trial what she was thinking when she and Mark made their decision to withhold resuscitation, she replied:

"I wanted them to hand me my daughter and let someone that cared and loved her hold her. And I didn't want them to hurt or mistreat her, but I wanted her to feel loving hands. I just couldn't stand the thought of her suffering and being a part of whatever experiment they wanted to do on her."

About four months after the trial, Karla Miller received a call from a friend who had caught wind of a seminar being held that afternoon at One Fannin, a medical building owned by HCA. The topic, she was told, was "the Miller case," and one of the featured guests was John Serpe, HCA's trial lawyer.

Karla hoped to arrive unnoticed, but she was hailed from across the room by Mark Jacobs. The Millers had briefly considered suing the doctors involved, but in their view, the physicians were simply following the hospital's policy of resuscitating all newborns that weighed more than 500 grams, whether the parents consented or not. That was the real issue -- not medical malpractice.

However, HCA saw the case differently, despite the verdict. As Karla sat in horrified silence, Serpe explained in the seminar that the Millers had "opted for death" for Sidney because they did not want to care for a child with disabilities.

In the weeks leading up to the Texas Supreme Court session, HCA sought to perpetuate that image. The corporation's lawyers and spokesperson maintained that the Millers had filed a "wrongful life" claim. In March, Woman's Hospital spokesperson Linda Russell told the University of Texas Daily Texan newspaper that the Millers had consented to the treatment.

After the hearing, in a brief segment on the case on a legal-affairs program on MSNBC, Serpe repeated that claim. The show's host, Dan Abrams, didn't buy it.

"I don't think you're being totally honest here," he said.