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May 14, 2005

Today may be D-day for Maria Korp

Topics: News

Here's another story from purplekangaroo that's worthy of attention.

It's been three months since her injury due to attempted murder, and according to this news article she may have her diagnosis changed from Persistent Vegetative State to Permanent Vegetative State as early as May 13th, 2005--which would make her eligible to have life-sustaining treatment removed.

According to recent studies about PVS recovery which was discussed here and also here, Maria still has a significant chance of recovering consciousness at this point. Several doctors are arguing that it would be premature to consider her in a permanent vegetative state before 12 months have passed.

Please keep Maria and those making these decisions in your prayers today.

[Update: As of today, May 14th, the decision hasn't been made yet. According to , it is still being discussed.]

Posted by richard at May 14, 2005 10:14 PM


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Comments

When I was in Melbourne in the last week I did not hear a single word about the Maria Korp case.

When Maria was found in the boot of her car, her condition was very severe. It was probably worse than that of Terri. I am surprised that she has lasted this long.

When my father was in hospital as a result of his last stroke, the hospital staff attempted to put the weights on the family to sign a DNR. It seems that this is becoming a standard procedure in some of the large public hospitals.

The Alfred Hospital, that is the one where Maria is located is well well known for the treatment that it gives to these cases. My older sister (Linda is still living btw) Linda, was transported to the Alfred from Phillip Island after we had a major car accident. She was in a coma at that stage. This was in 1959. Linda spent two weeks in a coma. She had a broken leg, and she received some brain damage as a result of the coma.

I do not know exactly the state of Maria Korp. In other words I am not sure whether or not she has woken from the coma. If she has not woken from the coma then this might influence her outcome.

I am hoping that the doctors who say wait 12 months will have the final say. The doctor who is pushing for the alternative has an agenda. The Victorian legislation allows for Maria to be taken off any feeding.

Posted by: Maggie4life at May 15, 2005 2:03 AM

Maria is now on my prayer list, right at the top with little Charlotte. Maggie I'm so glad to see you again. I had begun to wonder if you were alright. We have begun a working forum to start getting something done about this, and I hope you will join. Juleni will have to tell you about it. But we are also desparately in need of more prayer warriors--do you know anyone that would commit to an hour every day of praying for these people and this endeavor? Let me know please.

Posted by: mary et. al. at May 15, 2005 9:12 AM

Maggie, I especially appreciate your news about the Victoria law. I had been wondering about this, as the earlier news stories said she had a 50/50 chance of breathing without a ventilator. So the ventilator may not even be strictly speaking necessary, but of course she will inevitably die without food and water. Heck, we couldn't leave her dying to _chance_, could we, by just taking her off the ventilator and continuing to feed her?

It also gets me the way the Catholicism argument has gone in court this time. The husband has argued that she would have religious objections to being dehydrated to death, because she was a devout Catholic. So the judge (without even bothering, as in Terri's case, to challenge the "devout" part) just fires right back something to the effect that, "Not everyone who is a Catholic agrees with the Church on everything." Well, so much for _that_. I mean, sure the husband has an ulterior motive in keeping her alive, but still it was a relevant argument. It seems that what really is good evidence of a person's wishes from _religion_ (to which the legal profession is hostile) is brushed off while the mere fact that lots of people do accept the secular, pro-death worldview of the legal profession is regarded as evidence that any randomly selected person would indeed want to die of dehydration. That actually violates a technical requirement in probability theory that says that you are supposed to look at _all_ the facts about a person and to find the "smallest reference class about which you have relevant information to which the person belongs." Now in this case, Maria isn't just some randomly selected Australian; she's a devout Catholic. You can't just throw that out as a consideration. I will keep praying for Maria.

Oh, well, excuse my logician's rant. :-)

Posted by: Lydia at May 15, 2005 1:32 PM

So much for any one's wishes (wills--living or otherwise) about anything whatsoever in this day and age. Are we dealing with rational people of good will here? I think not, and worse, everyone who thinks they are are going to get a last gasp surprise.

Posted by: mary et. al. at May 15, 2005 7:24 PM

You might be interested in this article:

http://www.austlii.edu.au/au/cases/vic/VCAT/2005/779.html

Posted by: Maggie4life at May 16, 2005 4:03 AM

I am posting a portion of the decision that was made regarding the guardianship of Mrs Korp:

A submission was made on behalf of Mr Korp that I should not empower the guardian to make decisions concerning medical treatment. I was told, and for present purposes accept, that Mrs Korp is a devout Catholic. I was told that she maintains in her home a prayer room and that she regularly used that room. As I explained in the RCS decision, one matter that may be relevant to a decision as to whether or not to appoint a guardian with powers in respect of medical treatment will be the values of the disabled person. The difficulty is that even if I accept, as I do, that Mrs Korp is a devout Catholic, it does not necessarily follow that if she were competent and were asked to express a view as to whether particular medical treatment was unwarranted in the light of her present condition, that the answer would be that the continuation of medical treatment was warranted. In other words the hypothetical question posed by section 5B(2)(b) of the Medical Treatment Act is not one that is automatically answered in a particular way because a person holds a particular religious faith.
37 The relevant test, as I have explained, is whether there is a reasonable possibility that a decision, that the guardian is empowered to make, will be required to be made in the foreseeable future. A decision which is possible will be required in the foreseeable future. The fact that Mrs Korp is said to be a devout Catholic does not mean that a decision to refuse medical treatment will not be possible or unlawful.
38 Before the Public Advocate makes a decision concerning medical treatment that is likely to have profound implications for Mrs Korp, he is entitled to consult with the relevant stakeholders and would normally do so. In the course of this consultation, matters concerning the beliefs held by the represented person would no doubt be relevant. Given this, the tribunal can have confidence that the guardian, especially a guardian such as the Public Advocate, would give careful consideration to these issues before any profound decisions are made on behalf of Mrs Korp.


It is worth noting that the judge, in making his decision was not stating that being a Catholic was totally irrelevant, but that in the appointment of the guardian it was irrelevant. I think that the last paragraph sheds some light upon the decision-making of the judge in this case.

I have confidence in the ability of the judges of the Supreme Court of Victoria to make decisions that are in the best interests of the patient. I do not have confidence in the neurologist who has testified regarding Mrs. Korp's condition.

What I noted in the evidence as it was given, and it varies substantially from the evidence concerning Terri Schindler, is that there is no indication that Maria has been able to recognize anyone. If she has not responded by three months then the prognosis is not that good for her. All the same I disagree with the doctor where his comments regarding feeding are concerned.

For the time being we must wait and see what happens next.

Posted by: Maggie4life at May 16, 2005 4:18 AM

ack i just lost my post to Mary et al.

Mary I was away for a good proportion of last week because I had to fly to Melbourne to attend my sister's funeral.

Posted by: Maggie4life at May 16, 2005 4:45 AM

Maggie, I see your point that the judge said it was relevant. But I really don't think it bodes well that he keeps saying over and over again that this doesn't "automatically" decide what would be warranted, etc. Yes, that's true, but when people keep saying obvious things over and over again for no apparent reason, one starts understandably wondering if they mean more than they sound like they mean.

Also, I don't see why we should have faith in the judges to make a decision in her best interests. Why should we trust them? I think faith in judges was one of the problems in Terri's case. People who weren't that horrified and didn't want to make their own decision on the matter said again and again, "Well, it's all been hashed out in court, and I trust the judges." But judges have their own values, which aren't always right.

In this case I also don't think, ethically, that it should matter if her prognosis is poor, if she'll probably never recognize people, and the like. No one should be dehydrated to death, and even if one believes (as I don't) that it's okay if we have strong evidence that the person would want it, all the reports on this seem to indicate that this woman left no evidence at all about her wishes. A "best interests" decision can be very bad, because one person's notion of someone's "best interests" may be based on faulty ethical presumptions. As far as I'm concerned, even in a world where a person can be dehydrated by his own wish, this should be an open and shut case. If she left no written evidence and there is no credible testimony that she said she would want to be dehydrated to death, _plus_ she's a devout Catholic, there should be no _question_ of dehydrating her to death. The very fact that it's being raised as a live possibility shows that there is really not a presumption for life here at all in any sense.

Posted by: Lydia at May 16, 2005 9:33 AM

Lydia,

the issue before the judge was not the decision on whether or not she would have her life support removed. The question before the judge was the appointment of a permanent guardian.

If you check carefully what the judge said, he has indicated that the guardian is to take this factor into consideration.

This is a very well balanced document as far as Maria's well being is concerned. What is not clear is the actual condition of Maria Korp.

The only neurologist report that I have seen is one that states that she is non-responsive. It said that she was in sleep wake cycles but she is not even responding to her name.

If you compare the excuses that had to be made by the team for Michael Schiavo, they had to cover up the fact that she was cognizant. However, with Maria the report is stating the exact opposite.

I am needing to find further information on this case. It is not easy to find sufficient information about her exact condition.

Let me see what else I can discover, and see if I can find any other court information on the subject.

In some ways Maria is protected because she has a state appointed guardian. Her husband does not have any say. He obviously wants her to remain alive because he is facing attempted murder charges. I do think that it was his mistress alone who injured Maria, but we have to wait for the court case in August to find out all the facts. If the husband wants her alive he might even be hoping that she will recover and so exonerate him from what has happened.

This whole story is not very pretty. I have seen some of the details on the case and the court case might prove to be very interesting.

Keep in mind that it is certain doctors who are wanting to end her life, and not her husband. The guardian has to weigh up all the information. I assume that means that he has the power to seek further medical advice from other neurologists before making any final decision. Also, and I am not completely up on the Victorian laws, the doctors are not supposed to do anything outside of the 12 month period. The judge indicated that the guardian is to take Maria's religion into account.

I think that the judge gave a very pragmatic decision when agreeing to a state guardian.

Posted by: Maggie4life at May 17, 2005 4:09 AM

http://theage.com.au/articles/2005/05/12/1115843312088.html

A permanent vegetative state means the patient is alive but does not mentally interact with the world in any way.

A doctor told the court that once her condition had been upgraded, a decision would have to be made whether to continue with life support.

Joseph Korp has vowed to fight any move to have his wife's life support system turned off, which recently resulted in the Victorian Public Advocate, Julian Gardner, being appointed Mrs Korp's guardian.

While Mr Gardner must consult Mrs Korp's family before any decision is made, he has the final say.

In a statement, the acting Public Advocate said the office was continuing "the process of finding out what Mrs Korp's values, beliefs and wishes might have been had she been able to express them herself".

Posted by: Maggie4life at May 17, 2005 4:23 AM

http://theage.com.au/articles/2005/05/13/1115843370311.html

A court hearing last month was told that Mrs Korp's condition would be upgraded from a "persistent vegetative state" to a "permanent vegetative state" after three months, which elapsed yesterday.

A doctor told the court that once her condition had been upgraded, a decision would have to be made to continue with life support.

But a spokesman for Mr Gardner said yesterday that any decision might take several months.

"The guardian has been meeting with hospital, family and friends for the last two weeks since his appointment as guardian and he will be continuing to do so to gather information for any decisions that will be made," his spokesman said.

"But certainly the guardian is not going to be rushed by this new indicator, which has happened today."

Mr Gardner was appointed to be a limited guardian last month after Mr Korp said he would fight any move to have his wife's life support turned off.

He can make decisions concerning accommodation, access by people to Mrs Korp and her medical treatment.

I think that there is reason to believe that the public guardian is not going to make a hasty decision and it is good news that he is consulting the family about Maria's beliefs. Any decision that he makes will have regard to those beliefs. There is definitely no suggestion at this stage that the public guardian will allow this woman to be starved to death. It seems to me that he will give her every chance to start recovering.

I must admit I would like to see another doctor examine and give a diagnosis on her condition. I fear that the bioethicist who is so keen to turn off the life support might have too much pulling power, but I am hopeful that nothing will happen that will go against our Catholic faith, at least in the short term.

Posted by: Maggie4life at May 17, 2005 4:30 AM

Actually, if she has been in a PVS and shown no sign of recognition of anyone, etc. her chances of recovery at this point are still qite substantial.

The chances of recovering from a PVS if a patient is still alive after the three-month point are at least 39% for a traumatic injury and 13% for non-traumatic injury. Just for perspective, margin of error is supposed to be 0.1 percent or below for a level of certainty in medical standards.

I've been discussing this in quite a bit of detail on my blog recently. My two most recent posts on PVS recovery statistics are here: http://purplekangaroopuzzle.blogspot.com/2005/05/calculating-pvs-recovery-statistics.html and here: http://purplekangaroopuzzle.blogspot.com/2005/05/rate-of-error-in-diagnosing-pvs-as.html

Posted by: purple_kangaroo at May 18, 2005 4:43 PM

Okay, I just understood something in your posts, Maggie. They appointed the guardian rather than the husband *because* the husband said he would "fight any attempt to turn off her life support." Now, I think this confirms my bad feeling about this case. When we consider that "life support" here means, among other things, a feeding tube, it looks like they are saying the guardian _must_ be someone who would consider dehydrating her to death and that this is part of why they are replacing the husband. That puts all the stuff about Catholicism in your quotations from the judge in rather a different light. He really _is_ saying, "Now, we wouldn't want this Catholic consideration to be taken too strongly. We _must_ have a guardian who would consider over-riding that consideration and taking her off her feeding tube."

Now, I fully understand that the husband probably beat her up. But the fact remains that it sounds like they are replacing him as guardian in part because of his determination that she not die. I don't like the sound of that at all.

Posted by: Lydia at May 19, 2005 12:19 PM

Lydia,

correction. Joe Korp did not bash up Maria. He is accused of conspiracy in the attempt to strangle her, but that accusation is based upon the evidence of a jilted mistress, Tania Hermann.

Also Joe Korp was never Maria's guardian, so he is not being replaced as guardian at all. He cannot be appointed as her guardian because of the serious nature of the offence he is accused as committing.

I saw Joe Korp on TV and he had genuine tears and he is genuinely upset over the fate of his wife. It is not right to claim that he bashed his wife. He did not do it. Tania Hermann alone attempted to strangle Maria.

No, the appointment of the public guardian was necessary because there needed to be an independent party. Personally, I think the daughter could have been appointed as guardian, so yes, the decision seems to be that it is the family's opposition to what the doctors want that has prompted the court case and the appointment of Julian Gardner as Maria Korp's guardian.

I maintain that Julian Gardner did what the law required of him. He consulted with the family, Maria's parish priest, and others. He also sought a second opinion about Maria's condition. That does not mean however, that everything that he did was correct. For example, the Catholic bioethicist, Bill Uren is not the typical Catholic spokesperson who is used by the media and ohers to give the Church's view on this matter. It is probably that he is a Catholic in name only and that he also promotes the culture of death in his understanding of the teachings of the Catholic Church. This is not clear to me at all.

Then there is the matter of the second opinion. It was sought and given and apparently the second opinion confirmed what Maria's doctors had been saying. Does that make the decision right? NO. It does not make it right. The decision that has been made is really quite shonky. I think that is why I feel so uneasy.

What I do know about the state of Victoria is that it is the home of Peter Singer. Most of the Victorian bioethicists have been trained by Peter Singer when he was in charge of bioethics at Monash University. It means that the doctors and the bioethicists are well versed in the language of the culture of death, and that they are capable of using subterfuge when they do not get their way immediately. I think that this is what struck me about this case when I first began to realise that Maria's life was also hanging in the balance.

Posted by: Maggie4Life at July 28, 2005 10:08 PM