VINCENT LAMBERT (en)

VINCENT LAMBERT

Italiano

Vincent becomes disabled following a car accident.

29 September 2008: Victim of a car accident, the 32 years old Vincent Lambert, a psychiatric nurse at the “Châlons-en-Champagne” Hospital Centre, falls into a state of a deep coma. He is hospitalised and put in the Intensive Care Unit (ICU) at the “Châlons-en-Champagne” Hospital Centre. After waking up from the comatose state, he progresses into a different state called “Pauci-relational-state” or in the state of “minimally conscious state”.

5 January 2009: Vincent is transferred to the neurosurgery department of the “Châlons-en-Champagne” Hospital Centre.

17 March 2009: For 3 months (from 17 March to 23 July 2009), Vincent is subject to motor physiotherapy and stimulating rehabilitation at the “Berck-sur-mer” awakening centre.

23 June 2009: 7 months after his accident, Vincent is transferred to the Residence of Friar Capuchin, led by Dr. Annie Reska who oversees the service unit of pauci-relational patients. Dr. Kariger, head of the “follow-up” care division, supervises Vincent for a long period of time.

From 2009 to 2011, Vincent is under the responsibility of Dr. Ana Oportus, Dr. Daniela Simon and Dr. Reska. Since 2011, after a reorganisation of the department, Dr. Kariger assumes the direct responsibility of the “pauci-relational” department in which Vincent is allocated.

5 – 12 July 2011: At the request of the family, Vincent is admitted at the “Coma Science Group” (University of Liege, Belgium). The unit is led by Prof. Steven Laureys which is asked to file a complete medical report. Prof. Steven Laureys is a specialist in neurology and palliative medicine; he is one of the world top leading experts in mechanisms and degrees of consciousness. His report concludes that Vincent is in a minimally conscious state. He recommends trying to establish a communication code with Vincent in order to prove that he is alive and in a well physical state.

16 November 2011: Vincent Lambert comes back to Reims into the palliative care Unit at “Sevastopol” Hospital (CHU). The Chief Medical Officer is the Dr. Eric Kariger, a geriatrician. In this palliative care unit, there are beds reserved to “pauci-relational” patients, and Vincent is one of them.

September 2012: Dr. Kariger gives permission to Vincent’s parents to bring him in their family house for a couple of days at “Drôme”. There are no restrictions from Dr. Kariger as Vincent does not show to be a patient with serious complications.

October 2012: Dr. Kariger decides to interrupt all physiotherapy treatments. Since then, Vincent has never restarted these treatments, even after few complaints from the family. These treatments are in fact necessary as stated in the directives for “pauci-relational patients” issued on 2 May 2002. The reason underneath the Dr. Kariger’s decision to interrupt the treatment is: “the physiotherapy treatments do not improve his neurological state”.

December 2012: Dr. Kariger accepts to organise a collegial consultation with other clinicians in order to establish whether Vincent is object of an “unreasonable obstinacy”. Vincent’s wife, Rachel, is the only one aware of this initiative. In the same moment Pierre Lambert, Vincent’s father, is surgically operated at the cardiology unit in Marseille.


2013: VINCENT IS A VICTIM OF TWO EUTHANASIA ATTEMPTS

5 April 2013: Viviane Lambert visits his son as she does for her husband many times a year, for 15 consecutive days. As always, she asks to talk with the consultant to receive information. On 5 April 2013, the consultant told her for the first time to think about the possibility “to let Vincent go”. Viviane suggests coming back with her husband after rehabilitation, and to have a second talk about it. The appointment is booked on 15 May 2013 at Reims with Dr. Kariger. Dr. Kariger never told her that the decision to cause Vincent’s death by withdrawing food and hydration was already taken.

10 April 2013: The medical team, without waiting for any further appointment and with Vincent’s wife consents, decides to start Vincent’s euthanasia plan by stopping nutrition and reducing hydration (200 ml/24 h). To justify the decision, his diet was called ‘treatment’. Only Rachel is informed of this. His parents and his brothers were not informed.

20 April 2013: Only by a hint of luck, during a visit, one of Vincent’s brother discovers that his brother was not properly fed and left in this condition for 16 consecutive days. He suddenly informs his parents. From now on, the confidence toward Vincent’s doctor is lost.

26 April 2013: Vincent’s parents send a bailiff who orders Dr. Kariger to restore Vincent’s nutrition and hydration. After this event, they filed a report to the prosecutor office for attempt of murder and ask for police assistance.

9 May 2013: Vincent’s parents have no solution and after 15 days of negotiations with Dr. Kariger, who is inflexible and reluctant to feed Vincent decides, along with his siblings to apply to court addressing the judge for Vincent’s right of life. Vincent was left starving for 29 days. In the same day, Dr. Kariger tells Vincent’s parents and their solicitor that he will take the same decision, but now respecting all the appropriate procedure.

11 May 2013: The Administrative Court of “Châlons-en-Champagne” urges Reims Hospital to restore a normal diet and hydration for Vincent Lambert, after 31 days of withdrawn of vital supports. The Court challenges Dr. Kariger’s decision as he forgot to inform Vincent’s parents about the implementation of the procedure. 

July 2013: Rachel, Vincent’s wife, appeals to the court of appeals asking for a temporary measure to challenge the Administrative Court decision made on 11 May 2013. Her appeal is though rejected.  

9 December 2013: Again, in front of the Court due to Dr. Kariger’s will, it is concluded that the situation is, for the second time, unreasonable. Dr. Xavier Ducrocq, professor of neurology and ethic at “Nancy” Hospital and a consultant appointed by Vincent’s parents, is the only person, during the process, who claims in favour of Vincent’s life. He declared that “Vincent didn’t need palliative care, instead he needed a specialised institution/surgery for patients with strong disabilities.” He also declared that the court process was a “masquerade”, before to announce that “the decision of his death was already taken”. Doubting of CHU medical practices, Dr. Xavier Ducrocq addressed a report to the state medical board to get Vincent back into a Hospital.

18 December 2013: Vincent’s step-nephew asked to the Administrative Court of Châlons-en-Champagne to review its decision on Vincent’s nutrition treatments. This request was though rejected.

1 January 2014: Dr. Kariger informs the family about his decision to withdraw Vincent from nutrition and hydration. He gives them 2 days to appeal to this decision and after that he would have gone ahead with the withdrawn plan.

16 January 2014: Under the pressure from the family. The Administrative Court orders for the second time to restore all treatments suspended by the Hospital. The judge notes that the “unreasonable stubbornness” is not fully demonstrated and challenging Dr. Kariger’s report. The judge confirms that “continuing treatments is not futile and disproportionate as it didn’t only aim to sustain life in an artificial way”. The judge also declared that the Dr. Eric Kariger, chief of the medical team responsible for Vincent Lambert, “has evaluated Vincent’s will wrongly as they believed that Vincent’s will were to refuse any kind of treatments to keep him alive”.

17 January 2014: The Hospital of Reims decides to put into surveillance Vincent’s room. “The Hospital installs CCTV cameras at the entrance of his room, puts a clock system able to check who enters and who leave the room and puts a window on the door so that it is possible to see him without entering the room. Shifts of Hospital personnel are also planned. Visitors are obliged to be checked, to verify identities and the take notes of their identity cards during the visit” (Source: Dr. Eric Kariger, My truth about Vincent Lambert’s case, Bayard, 2015). In this moment Vincent’s life looks more like a prison.


APPEAL BEFORE COUNCIL OF STATES

End of January 2013: urged by Marisol Touraine, Minister of Health on 16 January 2014, his wife Rachel along with Francois, his step-nephew, and the Hospital, communicate their decision to appeal to the Administrative Court of “Chalons-en-Champagne” before the council of state. Dr Kariger withdraw his appeal.

Note that, as an incredible fact for a private matter that involves the life of a man, that the Minister of health gave a signed order to the General Director to appeal the decision, although he announced not to take this case before the Council of state.  Marisol Touraine personally called Rachel Lambert to express her sympathy and to ensure her full support.

6 February 2014: day of the hearing at the Council of State.  The judge who heard the application for interim measures refers the sentence to the Assembly of disputes (jury of 17 peers).

This is the first time that the highest French Administrative Court decides on the legitimacy of a medical decision that leads to a person’s death by discontinuing nutrition and hydration.

14 February 2014: First hearing of the Assembly of disputes of the Council of State.  The Assembly asks for a new medical report and orders a committee of three neuroscientists to decide on Vincent’s condition.

They are called upon to take a decision on:

  • Vincent Lambert’s irreversibility of lesions.
  • His ability to communicate in any way.
  • The meaning of his reactions to the will to/or not to continue treatments.  The Council of State gives them 2 months to decide from the date or their application.

The formulation of this report is reprehensible: a man’s life cannot be decided only on the ground of irreversibility of his lesions or on his capacity to communicate.

It was also stated that it would have been requested an opinion to the National Council of the Order of Doctors, the National Academy of Medicine and the Domestic Advisory Ethics Committee to obtain their “written observations” intended to “usefully inform on the right implementation of the principle of unreasonable obstinacy and artificial maintenance of life”. Also, the observation will also include the opinion of Jean Leonetti, rapporteur of the Law of 2005, to communicate the necessary clarification about the medical concepts and the spirit of the law.

7-11 April 2014: the three doctors appointed by the Council of State conduct extensive testing on Vincent Lambert at the “Pitie-Salpetriere” Hospital.

The consultant specialists are:

Marie-Germaine Bousser, suggested by the Academy of Medicine, is a university emeritus professor and chief of honorary service at the Lariboisiere Hospital in Paris, and neurologist specialised in headaches and migraines.  She is the head of the Academy of Medicine and member of the CCNE.

Lionel Naccache, suggested by CCNE, is a member of CCNE since September 2013. He is a professor of Medicine in Paris, neurologist and researcher at the Institute of Brain and Spinal Cord (ICM).

Jaques Luautè, suggested by the Physicians’ College, he is a university professor and director of the physical medicine and rehabilitation department at the University Hospital of Lion.

These three experts will prove in their preliminary report and in their final report their objection to Vincent Lambert’s death. According to them, Vincent Lambert’s condition cannot justify on its own, and in the absence of advanced directives, an irrational obstinacy. The CHU affirmed that they would have been removed from their positions, but the three experts wanted this to be in writing.

20 June 2014: Second hearing at the Council of State.


REFERAL TO ECHR

23 June 2014: the day before the decision of the Council of State, which was based on what stated by the preconceived mission of the Council and by the public rapporteur’s conclusions, Remi Keller, Vincent Lambert’s parents, against the opinion of Vincent being euthanised, urgently appeal to the European Court of Human Rights (ECHR). At ECHR, they make three requests:

The suspension of the execution of judgment of the Council of State and the restoring of life assistance treatments.

The transfer of their son in a specialised unit for heavily brain injured patients, the “Maison Bethel” in Oberhausbergen (Alsace).

The prohibition for Vincent to leave the French grounds as Rachel Lambert moved to Belgium in 2013 where euthanasia is legal and because Dr. Kariger told the parents that if Rachel would have asked the transfer of Vincent to Belgium, he would have agreed.


JUDGMENT OF THE COUNCIL of STATE AND THE DECISION OF THE ECHR

24 June 2014, two important events:

  • The Council of State approves the decision of the CHU to re-write the sentence of the Administrative Court of “Chalons-en-Champagne” made on 16 January 2014. Dr. Kariger’s decision is considered legal.
  • 4 hours later the ECHR, recognising the case as falling within its jurisdiction, orders the temporary suspension of this decision for the duration of the entire proceedings (judgment on merit). 

The Court also prohibits any movement of the patient in order to avoid the withdrawn of nutrition and hydration (for example to move the patient to Belgium, as proposed by Dr. Kariger to Rachel Lambert).

7 January 2015:

the European Court of Human Rights held a hearing of the Grand Chamber on the “Lambert and others against France” case. The date of the decision is not known 

5 June 2015: the ECHR confirms the withdrawn of nutrition and hydration to Vincent Lambert.


THE DECISION TO withdrawn FOOD AND HYDRATION IS NOT APPLIED

23 July 2015: Doctors decide not to apply the decision to suspend nutrition and hydration to Vincent Lambert asking the judges to appoint a legal guardian to represent Vincent and asking for him to be put under a protection plan.

9 October 2015: the administrative court of “Châlons-en-Champagne (Marne)” rejects the request of Vincent Lambert’s nephew who asks for the doctors of the Reims University Hospital to immediately apply the decision to stop treatments.


THE JUDGES ENTRUST THE PROTECTION OF VINCENT LAMBERT TO HIS WIFE

10 March 2016: The justice entrusts Vincent Lambert’s protection to his wife, Rachel Lambert.5 December 2016: Vincent Lambert attempted to vocalise four times in the presence of his parents. The 4th time he tried even in front of two auxiliaries (assistant nurses) who remained impressed.


TWO NEW JUDICIAL HEARINGS

26 May 2016: Vincent’s nephew requires a new hearing to cancel or confirm the decision of the Administrative Court of “Chalons-en-Champagne” which, in 2015, had rejected a new request to stop the hydration and nutrition of Vincent Lambert.9 Jun 2016: Mrs. Viviane Lambert’s solicitors challenge the grant of Vincent Lambert’s protection to his wife, Rachel Lambert, who is still a part of the conflict.


THE NANCY ADMINISTRATIVE COURT OF APPEAL REQUIRES THAT THE COLLEGIAL PROCEDURE TO BE RESTARTED

16 June 2016: The Administrative Court of Appeal of “Nancy” asked the CHU of Reims to provide the doctor ground to continue the consultation process of experts which could lead to the withdrawn of nutrition and hydration of Vincent Lambert.

February 2017: Dr. Simon resigns from the CHU of Reims. She’s replaced by Dr. Sanchez.


THE STATE COUNCIL RE-EXAMINES THE CASE AGAIN

10 July 2017: The State Council re-examines Vincent’s situation who was kidnapped by his nephew and his parents after the Administrative Court ruling of “Nancy” on 16 June 2016.
The public speaker said that a doctor must take a medical decision for himself following a new collegial procedure and must not be obliged to follow the decisions made by the doctors in the previous college.

19 July 2017: The State Council rejects the requests of François Lambert, Vincent’s nephew and an ardent supporter of his uncle’s euthanasia, who firmly wanted the sentence of January 2014 to be implemented. The Court declares that the decision to stop feeding and hydration can only be taken after a new collegiate procedure is heard.

Vincent’s parents solicitors filed a criminal complaint during April-May 2013 for malpractice, attempted murder, violation of medical confidentiality, kidnapping and violation of personal freedom towards the university hospital and Vincent’s doctors. Also, they filed a criminal complaint against Rachel, accused of attempted fraud and perjury during the judicial process.

At this point, a judge instructor has been named. The prosecutor claimed that Vincent parent’s requests would be inadmissible because in its opinion they would have not suffered any personal harm from the situation (although they are present in his room every day). The investigating judge refused to inform about it and found that they were inadmissible as civil parties. An appeal was filed against these decisions before the Appeals Chamber of the Court of Appeal of “Reims”.


A FOURTH COLLEGIAL PROCEDURE HEARING

22 September 2017: Dr. Vincent Sanchez, a new doctor in charge of Vincent at the University Hospital of “Reims”, informed the family that a new collegial procedure would be started under the request of Vincent’s nephew, François Lambert.

14 November 2017: Vincent Lambert’s relatives will be welcomed at the end of November by Dr. Sanchez who will announce the decision taken by the college.


4th EUTANASIA ATTEMPT

9 April 2018: Dr. Sanchez announces his decision to withdraw Vincent’s nutrition and hydration which means condemning him to death meanwhile many care institutes are ready to take care of him.

16 April 2018: Vincent’s mother writes a letter to President Macron.2 May 2018: the administrative court of “Châlon-en-Champagne” asks for “a preliminary medical report which considers the specificities of patients like Vincent Lambert” and appoints three new doctors. The CHU Hospital in Reims cannot yet withdraw the hydration and nutrition of Vincent.

24 May 2018: Vincent’s parents, brother and sister solicitors, filed a recuse against the three experts appointed by the President of the Court of “Châlon-en-Champagne” because the three consultants are not specialised in the treatment of patients with paucity-relational state like is Vincent. Moreover, they refuse a confrontation with other medical experts and in particular with those who have long been supporting the Lambert family and the family members. They dispute “their determination to carry out an examination in just one day and to deliver their medical report in haste ”

5 June 2018: The Court rejects the request of recuse of the three medical experts.

7 June 2018: Vincent’s mother writes a second letter to Macron

– On waiting for the new decision made by the Administrative Court, more than 70 medical experts for patients in the pauci-relational state have filed an appeal against Vincent’s scheduled death, stating that “it is clear that Vincent Lambert is not at the end of his life”

15 June 2018: The three doctors appointed by the Tribunal resign because they do not consider themselves having the necessary skills to evaluate Vincent. They also specify the need to carry out repeated assessments within a specialised environment and in a different place with respect to the palliative care service offered by Dr. Sanchez. (who is a geriatrician).

Therefore, the doctors recognise that the medical report, which was scheduled to happen in one day and with 2 hours of examinations, was appropriate to the state of health of Vincent. Furthermore, the experts named a list of personalities “outstanding skills” that could take well care of the case, including medical ethics specialists (stressing that the problem is not just medical) and hope the patient to be moved to an appropriate care institution. 
20 June 2018: The hearing at the administrative court of “Chalons” ended.

The decision will be issued in a matter of hours or in a few days.

 

by: Filomena Neri, Steadfast LifeAid

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