Angela Carder

Angela Carder (née Stoner) was an American cancer patient who, in 1987, was forced to undergo a life-threatening Caesarean section in an unsuccessful attempt to save the life of her fetus. The case stands as a landmark in United States case law establishing the rights of pregnant women to determine their own health care.

Early history

At age thirteen, Angela Stoner was diagnosed with a rare and usually fatal form of cancer. She survived, and after years of chemotherapy and radiation therapy was declared to be in remission. Ten years after the initial diagnosis she developed another form of cancer, which she and her doctors fought with equal determination. The second cancer went into remission. Angela later married and became pregnant.

Pregnancy and cancer

In 1987, when Carder was twenty-five weeks pregnant, her cancer was discovered to have recurred and metastasized to her lung. Exactly what plan she made on learning this is unclear: one source claims that she was determined to prolong her life, and elected to start radiation and chemotherapy, regardless of known risks to the fetus; others state that she chose to institute only palliative care, in an effort to remain alive until the 28th week of gestation, when it was thought the fetus would have a better chance of survival.

Whatever her choice, the administrators of George Washington University Hospital – who were also the liability risk managers – were disturbed to hear that she had not elected to have an immediate C-section procedure. Fearing a lawsuit by pro-life activists, they convened a court hearing at the hospital and obtained separate counsels for Carder, her fetus, and the hospital. At the hearing, family members, including Carder’s husband, opposed the C-section on the grounds that she would be unlikely to survive it and that she would not want it (Carder herself, now gravely ill, did not testify). Her treating physicians also opposed the procedure. However, a neonatologist not personally familiar with her medical status testified that the fetus would have at least a 60% chance of survival – nearly that of a healthy woman’s fetus at the same gestational age. Carder’s own long-term oncologist was not contacted; he has since stated that he would have called the procedure "medically inadvisable both for Angela Carder and for the fetus".

Nonetheless, and despite medical testimony that such a procedure would probably end Carder’s life, an order was issued authorizing the hospital to perform an immediate C-section. Obstetricians at the hospital initially refused to carry out the procedure, but eventually one reluctantly agreed. A three-judge appellate panel upheld the decision in an emergency telephone appeal, despite Carder’s own repeated pleas of "I don’t want it done."

Exactly how long the fetus survived is a matter of some dispute. The most commonly cited figure is two hours. Susan Faludi quotes the obstetrician who performed the surgery as saying attempts to inflate the fetus’s lungs were "like trying to ventilate a rock".

Angela Carder survived her surgery by two days.

Aftermath

In the wake of the surgery, Carder’s family and the American Civil Liberties Union’s Reproductive Freedom Project asked the D.C. Court of Appeals to vacate the order and its legal precedent, on grounds that the order had violated Carder's right to informed consent and her constitutional rights of privacy and bodily integrity. One hundred twenty organizations filed amicus briefs on Carder’s behalf, including the American Medical Association and the American College of Obstetricians and Gynecologists. One attorney for the hospital argued that it was appropriate to sacrifice a dying woman for her fetus; an appeals court judge is reported to have replied, "Are you urging this court to find that you can handcuff a woman to a bed and force her to give birth?" On April 26, 1990, the court issued the ruling "In re A.C.", which vacated the previous decisions and ruled that Angela Carder had the right to make health-care decisions for herself and her fetus. [cite web |author=American Civil Liberties Union, September 30, 1997 |url=http://www.aclu.org/reproductiverights/gen/16529res19970930.html |title=Coercive and Punitive Governmental Responses to Women's Conduct During Pregnancy |accessdate=2007-03-08]

At the same time as the Court of Appeals case, the ACLU and Carder’s parents, Daniel and Nettie Stoner, instituted a civil action, "Stoners v. George Washington University Hospital, et al.", suing the hospital for deprivation of human rights, discrimination, wrongful death and malpractice, among other charges. In November 1990, days before the scheduled trial was to begin, the hospital settled out of court for an undisclosed amount of money and a promise of new hospital policies protecting the rights of pregnant women.

ee Also

Pemberton v. Tallahassee Memorial Regional Center

Notes

References

*cite book | author=Susan Faludi | title= Backlash: The Undeclared War Against American Women | publisher=Three Rivers Press | year=2006 | id=ISBN 978-0517576984
*cite book | author=Katha Pollitt | title= Reasonable Creatures: Essays on Women and Feminism | publisher=Vintage | year=1995 | id=ISBN 978-0679762782