FUNERAL DENIED

FUNERAL DENIED
ST. CATHARINES, Ont.

When their stillborn baby disappeared from the  hospital morgue the night before his burial, a Southern Ontario couple began  pushing for an apology. When they discovered the same thing had happened to  another family at the same hospital, they began calling for a system-wide  change to the way the medical establishment regards its youngest, tiniest  patients.

"It's awful enough having to deal with the fact that my son's heart  stopped beating, but to have to deal with the fact that I don't know where  his body is now is just too much to bear," says Debra Lynn Poirier, whose  baby was stillborn on Dec. 2, 17 weeks into the pregnancy, then inexplicably  lost even though his body had been tagged for burial.

The loss has devastated the parents and shaken public confidence in  St. Catharines General Hospital. Further, it highlights conflicting  attitudes about what should happen when parents lose a fetus early in a  pregnancy.

It has been standard practice for a fetus delivered before 20 weeks to  be regarded as tissue matter and typically disposed of along with the  hospital's biomedical waste, but there has been a growing movement to allow  parents more opportunities to deal with their loss.

Dr. Margaret Somerville, a leading Canadian ethicist, said the  evidence shows the traditional attitude of denial toward this kind of  reproductive loss often makes it more difficult for parents who have  experienced stillbirth, miscarriage or infertility trials.

"It's about the lens that you put on and it's intensely personal,"  said Dr. Somerville, founder of the McGill Centre for Medicine, Ethics and  Law. "If it's tissue that just didn't go right, you dispose of it in a way  that doesn't offend anyone's sense of decency. But if you look at it as the  loss of human life, then it requires something completely different."

In Ms. Poirier's case, the hospital did endeavor to show  consideration. She was offered compassionate care by doctors and nurses when  she had to deliver a baby she knew was dead; she was allowed to spend time  holding the fetus, which she and her husband named Ethan; and she received  helpful counselling from the hospital's chaplain, who performed a special  blessing ceremony shortly after Ethan's delivery and advised Ms. Poirier she  could hold a full funeral service later.

She said by the time she and her husband left the hospital, every  nurse on the floor knew they wanted a funeral, so much so that when staff  discovered the couple had not filled out the requisite paperwork, they  called them at home late at night to come sign the forms.

Ethan was born on a Tuesday. His father, Leo Rochon, signed the papers  to release Ethan's body at about 11 p.m. on Wednesday, but by the time the  mortician showed up to prepare the body for burial on Thursday morning, it  was gone from the morgue.

The St. Catharines General Hospital has assumed responsibility for the  missing fetus and apologized to the family, but officials are saying little  else because the matter is the subject of negotiations between lawyers for  the hospital and the couple.

Dr. William Shragge, chief of staff for the Niagara Health System, the  regional hospital authority, refused to say whether the hospital had  determined what happened to the fetus or whether officials had completed the  hospital's internal investigation into the matter. He said he could not  comment because "the process was under legal constraints."

The couple's lawyer, Brian Banfield, said it is too early to know  whether this case relates only to this couple's ordeal, or whether it  indicates a broader failure "to deal with the needs of those mothers and  fathers who feel that a burial is what they require."

He has heard from another St. Catharines woman who said the hospital  did not heed her request that the body of her stillborn fetus be prepared  for burial. The woman, who is now a 28-year-old social worker, said she was  about 16 weeks pregnant when she lost her baby seven years ago and found  hospital staff "completely disregarded" her wishes to see the fetus and have  a funeral service.

"At the time, they almost seemed appalled that I wanted to have a  burial," said the woman, who does not want her name used. She said there was  some dispute about how far along her pregnancy was, but she made it quite  clear to all medical staff that because she had miscarried before and  because this pregnancy was the furthest along she had ever been, "I really  needed closure on this one."

She said officials simply pushed aside her requests and attempted to  shift her focus, and then, when she eventually asked about the remains, she  was told there simply was not any fetal tissue.

When she read about Ms. Poirier's case in the local newspaper  recently, she said she felt as if she were going to pass out.

"I just want the system changed so that people's wishes are given  consideration," she said. "It has to change. More and more women are losing  children [because of infertility and the rise in miscarriages], but the  health system is still not changing."

In a recent book called Grieving Reproductive Loss, Kathleen Gray and  Anne Lassance, health care workers and bereavement counsellors in Montreal,  say there is growing evidence of the need for grieving time for people who  experience these kinds of pregnancy losses.

"The grief associated with such reproductive losses is often  minimized, denied and considered to be outside the normal grieving rules of  society," they say in the book.

"Yet individuals who have suffered these losses can experience  profound grief and emotional pain. Their grief needs to be acknowledged by  themselves and by others."

Mr. Rochon said he and Ms. Poirier would never have pursued legal  action if someone at the hospital had just explained to them what happened.

"We understand that mistakes are made. We just want someone to come  before us and apologize ... to look in our eyes and say, 'I screwed up, it  was me, I'm sorry.' "

aowens@nationalpost.com

© National Post 2004