Asoutrage spreadsover the revelation that a29-year-old woman who’d been in a vegetative state for more than a decade unexpectedly gave birthlast month at an Arizona nursing facility, it’s been twinned with a parallel — and unanswered — question.
How could no one there have known or reported that she was pregnant?
“It’s a little hard to believe that at times when she’s bathed or toileted that somebody didn’t see something,” Arthur L. Caplan, the director of medical ethics at NYU School of Medicine, tells PEOPLE.
Police, who confirmed their sexual assault investigation in the case, said they found the woman “helpless” after officers responded to a call ofa newborn in “distress” with trouble breathing, Phoenix Police Sgt. Tommy Thompson said at a news conference Wednesday.
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The woman and infant are recovering at an area hospital, according to police, as the investigation broadens into what a member of the Hacienda board of directors described in a statement as “this absolutely horrifying situation.”
The company’s CEOhas resigned.
Several factors might have led to the woman’s condition being overlooked, says Dr. Mark Ashley, the CEO and founder of the California-basedCentre for Neuro Skillswho sits on the board of theBrain Injury Association of America.
Neither Caplan nor Ashley are involved in the current case or affiliated with Hacienda HealthCare.
The lower ranks of certified nursing assistants receive less-sophisticated training, smaller paychecks, and see typically higher turnover, he says. “If a staff member sees her in the first trimester, and a second staff member sees her in the second trimester … you can imagine they’re seeing her for a short time and not recognizing changes” in a patient’s body, he says.
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“The staff would have known if she was menstruating,” he adds. But in the case of brain injury patients, “the complication is that the menstrual cycle may not have been regular. A patient may have just a few periods within a year, or may menstruate regularly, or anything in between.” Thus, an interrupted cycle may not have stood out.
“You have all of these factors that, in the worst of all situations, could combine to a legitimate miss, if you will,” he says.
Police and Hacienda HealthCare have confirmed thecollection of DNA from male staffersin an effort to find a link to the apparent assault.
But “they’re also going to want to test visitors, which raises other thorny issues if someone who was a family member or a friend was involved,” says Caplan.
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Caplan concedes that staff members might have suspected the patient’s emerging pregnancy, but neglected to report it. “We’ll have to see what the testimony is from her caregivers,” he says.
Incidents of sexual assault of disabled persons leading to births are “not unprecedented,” says Caplan, although he could not cite statistics. “The institution has a responsibility to make sure the environment is safe for the residents,” he says.
Says Ashley: “This was preventable, there’s no doubt about it, and it’s obvious this patient was taken advantage of and it’s a disappointment without a doubt that better measures were not in place to make this much less likely, if not impossible.”
source: people.com
