Brain-dead Canadian woman lives on awaiting birth

Ottawa, Ontario: Nearly six weeks after a pregnant Canadian woman was declared brain dead, she remains on life support in Victoria, British Columbia, because of her family's hope that her fetus will mature enough to be delivered.

The decision by Robyn Benson's family to try to deliver her child has drawn growing attention in Canada, largely because of a series of moving blog posts by her husband, Dylan Benson.

While Robyn Benson's situation is unusual, it is not unique. Its circumstances, however, differ significantly from the recent case of Marlise Munoz, a Texas woman whose family successfully sought a court order to end life support intended to bring a child to delivery. Dylan Benson supports the efforts to sustain his wife's body, and unlike the Texas case, it appears that the fetus in Canada remains healthy and growing.

Dylan Benson, who according to Canadian news reports works in information technology, began blogging about his wife's death as part of an effort to raise money to care for the baby and to extend his work leave beyond the 35 weeks of partial pay that Canada provides to fathers.

"My wife is dying," Benson, who did not respond to an interview request, wrote in a post dated Dec. 29. "Yesterday morning she was complaining of a headache and asked me to go to the store to get some Tylenol for her, and when I came back she was unconscious on the bathroom floor."

At Victoria General Hospital, doctors found that Robyn Benson had suffered a fatal brain hemorrhage, according to the blog posts. Sarah Plank, a spokeswoman for the Vancouver Island Health Authority, confirmed that there was an intensive care patient with Robyn Benson's name at that hospital. Citing medical privacy laws, she declined to offer any additional information.

It is unclear what other relatives Robyn Benson may have or to what extent they have been involved in the decisions about her care. About his decision to keep his wife's body functioning long enough to give birth, Dylan Benson wrote, "Her family and my friends are all very supportive and all think that my wife would want me to try."

The plan, he wrote, is to keep her on life support until she reaches her 34th week of pregnancy, which would be 12 weeks after she was declared brain dead. Assuming all goes well, the baby will then be delivered by cesarean section and soon after his wife removed from life support.

"On one hand I can't wait to meet my son and try and give him the best life possible and try my hardest to be a great dad for him," Benson wrote last week, "on the other hand I know that the day or the day after he is born will be the day that I have to say goodbye to Robyn. It is so tough to see her every day."

He has taken a leave from his job, in part because any rapid deterioration in the state of his wife's body or the fetus could require an immediate attempt at delivery.

He set a fundraising target of $36,000, to match a year of his wife's salary. But after his posts were amplified by news reports, the campaign surpassed that limit and stood at $132,157 on Thursday.

Dr. Jeffrey P. Spike, a professor at the McGovern Center for Humanities and Ethics at the University of Texas Health Science Center at Houston, said that there were about 30 known cases of babies being born to women whose bodies were sustained after they became neurologically dead, what he called "posthumous motherhood." During the 1990s, Spike was among a group of physicians who kept a neurologically dead woman on life support for 100 days before a healthy baby boy was born.

"I had some misgivings," he said of that case. "I don't want to be portrayed as a spokesperson for this being a good idea under any circumstances."

He said that keeping a brain-dead pregnant woman on life support was "very risky and there could be a very bad outcome."

Ideally, Spike said, the mother's body should be sustained until at least the 34th week of pregnancy before delivery, although 38 weeks is preferable, to minimize delivery dangers and developmental problems for the child.

Sustaining a brain-dead woman to allow birth, Spike said, was often an emotional strain on medical staff.

While having a relatively young mother with a short time to be kept functioning increased the chances of a successful birth, he said, the decision to go ahead with life support must also address one difficult question: Would it have been the mother's wish? Not all women, he said, would want to see their child brought into the world without a mother.

"From the news accounts, the current case in B.C. is better justified than most," Spike said. "But I don't know if the husband has thought about whether this is what his wife would want, or is just telling us what he would want."

Caring for a brain-dead patient on a ventilator is not easy, and requires a complex mix of drugs and hormones to maintain blood pressure and keep the heart beating, said Dr. Panayiotis N. Varelas, director of the neuroscience intensive care unit at Henry Ford Hospital in Detroit.

"Brain dead equals dead," said Varelas. who questioned the value of tying up often scarce intensive care unit resources to sustain the bodies of brain-dead patients. "I understand the family wants to have a little bit more time, but I don't think it's a wise thing to do."

In the case that involved Spike, the brain-dead woman's body gradually became emaciated while her abdomen began to swell. That woman's ventilator was stopped 20 minutes after the baby's delivery, and her heart stopped minutes later.

In Victoria, Dylan Benson, who has chosen the name Iver for the boy who may be born, has found the level of public interest and sympathy greater than he had expected.

"We are overwhelmed with the response from not only the community, but now the nation and beyond," he wrote this week.