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Before Schiavo, 1991 Case Led to Landmark Md. Law

By Eric Rich
Washington Post Staff Writer
Wednesday, March 30, 2005; Page B01

The case carries a distant echo of Terri Schiavo: Ronald Mack was said to be in a vegetative state. His spouse wanted a feeding tube removed. His father did not.

That was more than a decade ago, in a courtroom in Baltimore County. Attorney C. Christopher Brown argued that Mack, his client's husband, would not want to live unconscious and confined. Judge John F. Fader II, ruling against Brown and his client, named Mack's father the guardian, ensuring that the tube would remain in place.

The Schiavo case has "made people aware," Maryland Attorney General J. Joseph Curran Jr. says. (File Photo)

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Yesterday, in a conference room at the University of Maryland School of Law, Fader and Brown -- who are now affiliated with the university -- discussed the contentious case that would become a landmark in the state. Brown, the judge said, "still thinks I'm wrong."

The 1991 legal battle over Mack's fate motivated legislators two years later to pass Maryland's living will law, which has served as a model in several other states, said Karen H. Rothenberg, dean of the university's law school.

Even Florida, where Schiavo continued to weaken yesterday, "borrowed heavily from the Maryland law," said Diane Hoffman, an associate dean at the university and one of the architects of the Maryland law.

Interest in living wills and related issues has surged in Maryland and elsewhere as publicity has surrounded the Schiavo case.

Attorney General J. Joseph Curran Jr. (D) said that 27,000 people have downloaded living wills and related forms from his office's Web site in the past week. That figure compares with just more than 600 during a one-week period in January, said Curran's spokesman, Kevin Enright.

An additional 1,000 callers to Curran's office have requested printed forms.

"The tragedy that has gone on in Florida . . . has at least made people aware," Curran said at the university, where he and others recalled the Mack case and emphasized the importance of living wills.

Mack, of Baltimore County, suffered severe brain damage from a 1983 car accident in California. The 21-year-old father of two never regained consciousness.

His wife, Deanna, fought to have his feeding tube removed. She was opposed by Mack's father.

"The psychological pressure is what I remember most," Brown said yesterday. "The wife, my client, her life was sort of out of kilter because there was this matter that hadn't been resolved." After Fader's ruling, the tube remained intact, and Mack lived until 2003.

Prompted by the court battle, the legislature in 1993 passed the Health Care Decisions Act, based in part on a proposal drafted by Hoffman and others at the law school.

The law allows adults to anticipate health care issues by leaving written instructions, giving oral instructions to a doctor or appointing an agent to assist in decision-making.

The law also establishes surrogate decision-makers in cases in which a person's wishes are not known.

That default hierarchy begins with a legal guardian, if there is one, followed by a spouse, adult children, parents, adult siblings and friends or other relatives.

Even with such a law -- even with a living will -- it might not always be possible to avoid extensive litigation, contributors to the measure said yesterday.

But, Fader said, "All day, every day, this law is working, and it's working as it should in the overwhelming majority of cases."

Fader, recalling the days before the law passed, said he was relieved that the Mack case did not play out under the publicity that has surrounded the Schiavo saga.

"I would not have relished that," he said. "I'm not sure that all that notoriety belongs with a personal decision of death or life."

Staff researcher Bobbye Pratt contributed to this report.

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