A 71-year-old cancer patient died yesterday at Walter Reed Army Medical Center, about six hours after a federal judge ordered Army doctors to honor the woman's wishes by removing her from life-support equipment.
A hospital spokesman said the patient, Martha A. Tune of Falls Church, the widow of an Army lieutenant colonel, died "peacefully" at 3:55 p.m. with her son and daughter and other family members at her bedside.
A respirator tube providing oxygen to Tune was removed by doctors at 11:10 a.m., about one hour after U.S. District Judge Thomas Penfield Jackson signed an order granting her request that she be allowed "to die a dignified and natural death."
Tune, who suffered from cancer of the pericardium, the sac surrounding the heart, had been on the equipment since Sunday.
Jackson's decision came after an emergency hearing yesterday morning at which a court-appointed guardian for Tune told the judge the woman "understood she more than likely would die immediately" if life-support equipment was withdrawn.
The lawyer, James P. Schaller, said in court he had interviewed Tune at Walter Reed on Wednesday evening in an emotional session attended by family members.
"We were passing the Kleenex around and I was the biggest user," Schaller said.
According to Schaller, Tune wrote him a brief note during the interview. "I would like to get off the life-support system under which I am now having to live," the note said.
Army policy permits military doctors to withhold the use of life-prolonging equipment at a patient's request but prohibits removal of the equipment once it is in use, according to the hospital spokesman, Peter Esker.
The U.S. attorney's office, representing the Army, said in court that the government was taking no official position with regard to Tune's request.
Assistant U.S. Attorney Royce C. Lamberth, chief of the office's civil division, said that government lawyers were influenced by the fact that Tune was clearly mentally competent and expressed no doubts about her desire to die.
Tune's son and daughter and their spouses agreed that Tune's wishes should be honored, Lamberth said.
The government intervened to halt the removal of life-support equipment in a 1981 case in California involving a Veterans Administration hospital.
But that patient was wavering about his desire to die, Lamberth said, and some family members were opposed to the move.
There was also a medical question about whether that patient was in terminal condition, according to Lamberth.
Tune's two-page request to the court that she be allowed to die was prepared by her son, Cecil C. Tune, a faculty member at Bob Jones University in South Carolina.
Martha Tune, whose husband died about 30 years ago, was admitted to Walter Reed on Feb. 21. Doctors first believed she was suffering from pneumonia. A test in which doctors extracted fluid from her pericardium showed she had cancer.
Tune had breast cancer 10 years ago but had had no recurrence of cancer until a week ago, according to Lamberth.
Schaller, the court-appointed guardian, said that Tune appeared "highly competent" during the 90-minute interview Wednesday night.
Schaller said Tune had written about 50 notes detailing which funeral director she wanted, which clothes she wished to be buried in, the fact that she preferred a closed casket, how she wanted her property disposed of and where to find it in her home.