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State had own Schiavo case in 1990s

The Associated Press

Maryland had its own Terri Schiavo case in the 1990s, a court battle that led to the state's living will law.

Ronald Mack's wife unsuccessfully fought to remove him from a feeding tube and he remained in a vegetative state until he died two years ago, a battle that led to Maryland's current law, which has been a model for other states.

Even with the law, which is similar to Florida's, the same kind of battle could erupt again if a patient's wishes are not known and family members can't agree, those who helped craft Maryland's law said today.

"Talk with your family is the bottom line, absolutely," said Diane Hoffman, director of the Law and Health Program at the University of Maryland School of Law.

In the Mack case, the Baltimore County man never regained consciousness after suffering brain damage at age 21 in a 1983 car accident in California. His wife fought to have him removed from a feeding tube, and was opposed by Mack's father.

The court battle led the legislature in 1993 to draft the Health Care Decisions Act, based in part on a proposal drafted by Hoffman. The law allows competent adults to deal with future health care issues by leaving written instructions, giving oral instructions to a doctor, or appointing an agent to make health care decisions.

Attorney General J. Joseph Curran said at a roundtable discussion at the law school that the "tragedy of what's going on in Florida" has made people aware of the issue.

For example, about 27,000 people downloaded a living will form from his office's Web page last week, compared to about 15 last year, and another 1,000 asked that copies be mailed the them, Curran said.

The attorney general said it was important that "young people understand there's a need to at least think it through."

In Maryland, if the wishes of an adult who can't speak for himself are not known, state law spells out the order of relatives responsible for decision-making. If a guardian has not been appointed, a spouse would be first in line, followed by an adult child, parent, adult sibling and, finally, another relative or friend.

In both states, the surrogate's decision must be based on what the patient would have wanted, and if that can't be determined, what would be in the patient's best interest, Hoffman said.

In Maryland, prior statements and personal values can be considered, but not in Florida, Hoffman said.

Maryland's law is designed to avoid messy battles, said Karen Rothenberg, the dean of the law school.

"If you go to court, there's a winner and a loser," Rothenberg said. "But you've destroyed the family."

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