Haleigh Poutre
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Haleigh Poutre (born February 24, 1994) is an American woman who became the subject of a legal controversy regarding the removal of
life support Life support comprises the treatments and techniques performed in an emergency in order to support life after the failure of one or more vital organs. Healthcare providers and emergency medical technicians are generally certified to perform basic ...
for patients in persistent vegetative states. In 2006, eleven-year-old Poutre awoke from a coma shortly before she was scheduled to be removed from life support. Poutre had a severe
brain injury An injury is any physiological damage to living tissue caused by immediate physical stress. An injury can occur intentionally or unintentionally and may be caused by blunt trauma, penetrating trauma, burning, toxic exposure, asphyxiation, or o ...
thought to be caused by abuse by her adoptive mother.Boston Heral
Court records: Haleigh Poutre ’making statements’ about abuse
February 27, 2008
The case brought about many changes in the
Massachusetts Massachusetts (Massachusett language, Massachusett: ''Muhsachuweesut assachusett writing systems, məhswatʃəwiːsət'' English: , ), officially the Commonwealth of Massachusetts, is the most populous U.S. state, state in the New England ...
Department of Social Services, both in the way they handle reports of
child abuse Child abuse (also called child endangerment or child maltreatment) is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to a ...
as well as their policies on end-of-life care for children in their custody.


Background

At the age of four, Haleigh Poutre went to live with her maternal aunt, Holli Strickland, and Strickland's husband Jason, following allegations of
sexual abuse Sexual abuse or sex abuse, also referred to as molestation, is abusive sexual behavior by one person upon another. It is often perpetrated using force or by taking advantage of another. Molestation often refers to an instance of sexual assa ...
at the hands of her mother's boyfriend. In 2001, Holli Strickland alone legally adopted Haleigh. When asked in court why he never legally adopted Haleigh, Jason Strickland replied "Honestly, I didn't feel like I needed a piece of paper to say I was her father."


Injury

On September 11, 2005, Haleigh was taken to the emergency room at Noble Hospital in
Westfield, Massachusetts Westfield is a city in Hampden County, Massachusetts, Hampden County, in the Pioneer Valley of western Massachusetts, United States. Westfield was first settled by Europeans in 1660. It is part of the Springfield, Massachusetts Springfield metrop ...
, by Holli and Jason Strickland. They reported to medical staff that she had become
unresponsive A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. Coma patients exhi ...
after suffering from "flu-like symptoms". Physicians determined that her
brain stem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is conti ...
was partly sheared, leaving her in a vegetative state. Physicians also noted a number of other injuries including broken teeth, numerous
contusions A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur close ...
and
lacerations A wound is a rapid onset of injury that involves lacerated or punctured skin (an ''open'' wound), or a contusion (a ''closed'' wound) from blunt force trauma or compression. In pathology, a ''wound'' is an acute injury that damages the epiderm ...
on Haleigh's body, and several
burns Burns may refer to: * Burn, an injury (plural) People: * Burns (surname), includes list of people and characters Business: * Burns London, a British guitar maker Places: ;In the United States * Burns, Colorado, unincorporated community in Eagle ...
in various stages of healing. On September 20, 2005, the Stricklands were arrested and charged with
assault An assault is the act of committing physical harm or unwanted physical contact upon a person or, in some specific legal definitions, a threat or attempt to commit such an action. It is both a crime and a tort and, therefore, may result in crim ...
and
battery Battery most often refers to: * Electric battery, a device that provides electrical power * Battery (crime), a crime involving unlawful physical contact Battery may also refer to: Energy source *Automotive battery, a device to provide power t ...
. Holli Strickland was shot to death two days later while out on
bond Bond or bonds may refer to: Common meanings * Bond (finance), a type of debt security * Bail bond, a commercial third-party guarantor of surety bonds in the United States * Chemical bond, the attraction of atoms, ions or molecules to form chemical ...
. Police believe her death on September 22, 2005, to be a murder-suicide at the hands of her grandmother, Constance Young.


End of life debate

Following criminal charges, the department of social services took custody of eleven-year-old Poutre. Eight days after she was admitted to the hospital, Harry Spence, the commissioner of the Massachusetts Department of Social Services, sought to remove her from life support. Physicians involved in the case asserted that Poutre was in a vegetative state, and "virtually
brain dead Brain death is the permanent, irreversible, and complete loss of brain function which may include cessation of involuntary activity necessary to sustain life. It differs from persistent vegetative state, in which the person is alive and some aut ...
." On October 5, 2005, a judge approved the request. Jason Strickland, Poutre's stepfather, appealed the decision. Although Jason Strickland had never legally adopted Poutre, he asserted his right to make the decision as the ''
de facto ''De facto'' ( ; , "in fact") describes practices that exist in reality, whether or not they are officially recognized by laws or other formal norms. It is commonly used to refer to what happens in practice, in contrast with ''de jure'' ("by la ...
'' parent. Complicating the issue was the criminal case against Jason Strickland. If Poutre died, the state could bring murder charges against Strickland. But if she lived, even in a vegetative state, the charges brought against Strickland were significantly less severe. Many perceived the actions of Strickland to be an attempt at evading homicide charges. On January 17, 2006, the
Massachusetts Supreme Judicial Court The Massachusetts Supreme Judicial Court (SJC) is the court of last resort, highest court in the Commonwealth (U.S. state), Commonwealth of Massachusetts. Although the claim is disputed by the Supreme Court of Pennsylvania, the SJC claims the di ...
ruled in favor of the Department of Social Services that life support could be removed. On January 18, 2006, Poutre's biological mother indicated Haleigh was responding to her. As physicians were preparing to remove life support, Poutre regained consciousness. In the presence of Harry Spence,
social workers Social work is an academic discipline and practice-based profession concerned with meeting the basic needs of individuals, families, groups, communities, and society as a whole to enhance their individual and collective well-being. Social work ...
asked Poutre to identify a series of items in front of her and she successfully completed the task. The order to remove life support was cancelled. A number of
Right to Life The right to life is the belief that a being has the right to live and, in particular, should not be killed by another entity. The concept of a right to life arises in debates on issues including capital punishment, with some people seeing it as ...
groups involved themselves with Poutre's case. They noted parallels between this case and the high profile
Terri Schiavo The Terri Schiavo case was a series of court and legislative actions in the United States from 1998 to 2005, regarding the care of Theresa Marie Schiavo (née Schindler) (; December 3, 1963 – March 31, 2005), a woman in an irreversible ...
case which had ended in her death earlier that year. Schiavo's family, who runs the Terri Schindler Schiavo Foundation Center for Health Care Ethics Inc., contacted
Mitt Romney Willard Mitt Romney (born March 12, 1947) is an American politician, businessman, and lawyer serving as the junior United States senator from Utah since January 2019, succeeding Orrin Hatch. He served as the 70th governor of Massachusetts f ...
regarding the Poutre case. Schiavo's father, Bob Schindler Sr., commented that there have been many similar cases and his foundation's goal is "essentially to guard against this rush to judgment."


Policy changes in response to the case

The Department of Social Services faced harsh criticism for their role in the case. On June 14, 2006, a legislative oversight committee determined that Department of Social Services was at fault for failing to protect Poutre. Department of Social Services officials have acknowledged that they missed signs of abuse before she was brought to the hospital in September. The Department of Social Services received at least twelve reports of abuse or
neglect In the context of caregiving, neglect is a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. It can be a result of carelessness, indifference, or unwillingness and ...
of Poutre between 2001 and 2005. The department had been working with the Strickland family since 1998. The panel recommended a number of changes, including the creation of an audit bureau to review cases, an increase of educational requirements for social workers, and a revamping of abuse reporting systems. In March 2006, Governor Mitt Romney appointed a panel of specialists to evaluate the case. "Haleigh's case highlights a frightening confluence of a health care system ignorant of abuse and a child protective system ignorant of medicine," they said. The panel also said current Department of Social Services procedures are "substantially insufficient" in their ability to make decisions regarding the withdrawal of life support from children in their custody. Recommendations included a number of changes, including increased access to medical, psychiatric, and child abuse expertise, and the creation of a new system for making end-of-life decisions. On July 8, 2008, Governor Deval L. Patrick signed a new law to overhaul the child welfare system in Massachusetts. Changes include a requirement that the case undergo a special review by a state board if the Department of Social Services receives three or more reports of suspected child abuse. The results of that review will then be evaluated by prosecutors and police in the area. A new child-advocate position was also created. This advocate reports directly to the governor regarding severe child abuse or
neglect In the context of caregiving, neglect is a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. It can be a result of carelessness, indifference, or unwillingness and ...
in the state. The new law also involves increased penalties for failing to report child abuse. A new registry for keeping track of
foster parents Foster care is a system in which a minor has been placed into a ward, group home (residential child care community, treatment center, etc.), or private home of a state-certified caregiver, referred to as a "foster parent" or with a family memb ...
was also implemented. These changes were made largely in response to the Poutre case.


Criminal case

In 2008, Jason Strickland was tried for the assault. Strickland admitted noticing Poutre's injuries, but claimed he believed Holli's story that the injuries were self inflicted. The story was also believed by the Department of Social Services and was the reason she was not removed from the home despite numerous reports to the agency. During deliberations, jurors questioned whether Jason Strickland had to be present at the time of the assault in order for them to return a guilty verdict. Judge Carhart instructed them that he did not have to be present, but they would have to believe that an "ordinary person" would have realized that leaving Poutre in the care of Holli Strickland presented a serious risk of bodily harm. Strickland was convicted under this premise. Earlier in the trial, a friend of Holli Strickland's testified that she witnessed Holli push Poutre down the stairs three times in a row as a punishment, each time screaming at her to walk back up before pushing her down them again. Jurors did not believe that Jason Strickland was present for the specific assault that led to Poutre's near fatal injuries, but that he knew the abuse was ongoing. He was also convicted of other charges of assault and battery for striking Poutre himself on previous occasions; he was convicted on the assumption that although Holli was the primary abuser, he failed to stop that abuse. Strickland was sentenced to twelve to fifteen years in prison.


Poutre's recovery

In 2008, Poutre was released from Brighton rehabilitation hospital to live as a foster child with Keith and Becky Arnett in
Southwick, Massachusetts Southwick is a town in Hampden County, Massachusetts, United States. The population was 9,232 at the 2020 census, down from 9,502 at the 2010 census. It is part of the Springfield, Massachusetts Metropolitan Statistical Area. History Southw ...
. She was adopted by the Arnetts in 2010 at the age of sixteen and attended a special education program in the Southwick public school system. She remains substantially disabled and relies on a wheelchair, but is able to feed herself and use a letterboard to communicate. Regarding the attack, Poutre's adoptive father reports that she knows she was hurt, but she is unable to remember any specifics about the event.


See also

*
Persistent vegetative state A persistent vegetative state (PVS) or post-coma unresponsiveness (PCU) is a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. After four weeks in a vegetative stat ...
*
Right to life The right to life is the belief that a being has the right to live and, in particular, should not be killed by another entity. The concept of a right to life arises in debates on issues including capital punishment, with some people seeing it as ...
*
Right to die The right to die is a concept based on the opinion that human beings are entitled to end their life or undergo voluntary euthanasia. Possession of this right is often understood that a person with a terminal illness, incurable pain, or without t ...
*
Traumatic brain injury A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury TBI/concussionto severe traumatic b ...


References


External links


MassLive.com Haleigh Poutre index pageDSS sought early end to life supportVirtually Brain Dead
{{DEFAULTSORT:Poutre, Haleigh 1994 births Living people People with severe brain damage People from Westfield, Massachusetts Child abuse incidents and cases Child abuse law Child abuse legislation Euthanasia in the United States Child welfare Child welfare activism Medical controversies in the United States People with traumatic brain injuries People from Southwick, Massachusetts