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Morristown - An anorexic and bulimic New Jersey woman who petitioned a court to refuse force-feeding has died three months after a judge granted her request.
Her court-appointed lawyer, Edward D'Alessandro jnr, told the Daily Record of Parsippany the 30-year-old, identified as Ashley G, died on Monday at Morristown Medical Centre's palliative care unit.
"I feel glad that she is no longer suffering, but I feel a profound sense of sadness that modern science and all the efforts by a strong, loving family couldn't overcome this problem," D'Alessandro said.
She weighed 31kg and had been a patient at Greystone Park Psychiatric Hospital in Parsippany since 2014. She told the court in 2016 that she did not want food or water and would prefer instead to enter palliative care.
Terminal anorexia-nervosa
The state attorney general's office argued she was not mentally competent because of chronic depression. It said anorexia was not a terminal condition and asked the court to approve force-feedings, requested by state Department of Human Services. The attorney general's office said the woman's depression could be treated using an experimental drug.
Doctors testified that the woman had been diagnosed with terminal anorexia-nervosa. She told the court she would resist force-feedings, which are administered through a tube inserted through the nose and pushed down the throat.
D'Alessandro said his client's bone density was comparable to a 92-year-old's and she would be at risk for injury if restrained.
Judge Paul Armstrong on November 21 determined the woman's testimony was "forthright, responsive, knowing, intelligent, voluntary, steadfast and credible". He said the woman's parents, doctors, psychiatrists, court-appointed medical guardian and the ethics committee at Morristown Medical Centre all supported her decision to refuse force-feedings.
"This decision was made by AG with a clear understanding that death was or could be the possible outcome," the judge said.
Armstrong cited previous "landmark" cases where patients, their families, physicians, and their institutions were found to be "proper co-operators" in making difficult medical decisions.
As an attorney in the 1970s, Armstrong represented the parents of Karen Ann Quinlan as they fought successfully to have their 21-year-old daughter - who was in a persistent vegetative state after mixing alcohol with Valium at a party - removed from a ventilator so she could die with dignity. She lived nine more years, but never came out of her coma.
