Haleigh Poutre (born February 24, 1994) is an American woman who became the subject of a legal controversy regarding the removal of life support 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 thought to be caused by abuse by her adoptive mother. The case brought about many changes in the Massachusetts Department of Social Services, both in the way they handle reports of child abuse 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 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, by Holli and Jason Strickland. They reported to medical staff that she had become unresponsive after suffering from "flu-like symptoms". Physicians determined that her brain stem was partly sheared, leaving her in a vegetative state. Physicians also noted a number of other injuries including broken teeth, numerous contusions and lacerations on Haleigh's body, and several burns in various stages of healing. On September 20, 2005, the Stricklands were arrested and charged with assault and battery. Holli Strickland was shot to death two days later while out on bond. 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." 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 parent. Complicating the issue was