BOSTON -- At the outset, the court coolly offered a rasher of sympathy. ''Condolences,'' it began, ''are extended to those who lost the mother and child.''
I don't know how I would take those words if I were the parents or husband of the 27-year-old Washington woman who lost her rights before she lost her life. How would I respond to the condolences of a court that justified the decision to treat a sick woman as if she were already dead?
The woman I know only as A. C. was a fighter. She had to be. A. C. had bone cancer at 13 and spent much of her life in and out of hospitals, in and out of surgeries that left her with one leg.
At 27, married and believing she was free of cancer, she became pregnant. Then, on June 11 of this year, the doctors told her that the back pain and shortness of breath she was experiencing were due to a large tumor in her lung. She went from being an expectant mother to being a terminally ill patient with perhaps only days to live.
If A. C. had not been pregnant, she might have died as she chose. After all, we have become more sensitive to the wishes of the dying. We don't override their desire to control or refuse intervention. Indeed, we require the informed consent of any conscious adult.
But A. C. was carrying a 26-week fetus. So, unknown to her, the administration of The George Washington University Hospital called the hospital attorney to ask if the hospital was required to perform a forced Cesarean section.
The lawyer in turn requested an emergency ruling from the District of Columbia Court of Appeals. In less than six hours, through a series of bizarre and rushed hearings, the D.C. court gave its final ruling while A. C. was being prepped for surgery: the hospital had to try to ''save the child.''
Despite the objections of a woman who was well enough to communicate clearly ''I don't want it done,'' despite the objections of her family, despite the objections of her physicians, a Cesarean section was performed.
The baby, by no means ''viable,'' died immediately. A. C. died two days later. On her death certificate, the surgery is listed as a contributing factor.
Now, months later, the court that issued its ''condolences'' also upholds the view that A. C. properly forfeited her rights because she was about to die. As the attorney for the fetus had said, ''All we are arguing is the state's obligation to rescue a potential life from a dying mother.''
Is this to be a new standard then? Is this how we are to think about other dying people? Would we allow the state to harvest organs or bone marrow or blood from a dying member of society, against his will, to give it to a ''viable,'' existing adult? Do you lose rights as you lose your health? Or is it only if you are a pregnant woman?
Increasingly, pregnancy is the exception to the rule. In several states that have a ''living will'' statute, everyone has the right to refuse extraordinary treatment except for pregnant women. We have seen several cases in which a brain-dead woman has been kept on respirators so that a fetus might survive.
More controversial, we now see pregnant women who are not brain dead, not even terminally ill, being threatened or forced into medical treatment. Last year, Pamela Rae Stewart was arrested in California on the charge of fetal neglect for having disobeyed her obstetrician's orders. The case was thrown out of court, but the pattern persists.
Some 24 women in this country have been ordered to have Cesareans. In the case most commonly cited by courts, a Georgia woman in her 39th week of pregnancy was ordered to have surgery because, the doctors said, there was a 99 percent chance the fetus could not survive delivery. The courts fail to add that before the surgery could be performed, the baby arrived on its own -- healthy.
Lynn Paltrow of the American Civil Liberties Union, which is petitioning for a rehearing, believes ''we are treating fetuses with rights above and beyond any existing person.'' In this case, she adds grimly, ''The question is no longer whether the fetus is viable, but whether the mother is.''
The court argues that A. C. lost only a few hours, or at most days, of life. But those hours and days are not the state's to decide.
The court treated A. C. as if she was dead. They shortened and brutalized her life in a wholly misguided fantasy of playing savior. All they offer is pious condolences. Justice would be a more appropriate memorial.