State compels parents to pull plug on terminally ill baby

[lone wolf]

What are the odds of lightning striking twice in the same spot? I can't fault the parents for trying - or even trying again if they can stand the heartache. I can't fault the doctors, nurses or any other medical staff. It's beyond me why there should be anything standing in the way of the child dying at home as per the parents' wish. Risk of infection is a moot point if the baby was doomed anyhow. Having been in the same situation 28 years ago when our first daughter was born preemie and developed a blood infection (at the same time Nurse Nellie and digoxin were running around Sick Kids) it's hard to forget the call - or the decision we had to make. We were lucky. Many folks aren't.

 

[karrie]

There is also the issue of 'use of facilities'. Not to sound cold-hearted, but deploying medical resources may have an impact on other patients and their families.




I'll ask you the same question as I did Colpy: Do you really want to open Pandora's Box on the issue?

Part of the 'use of facilities' that we pay for is counseling and care when it is the end time for one of our family. Unless counseling has failed and the state has to declare the parents mentally unstable, then medical care should be able to follow a schedule that fits with their needs as well as the need of the child.

Do I want to open Pandora's Box on the issue? I don't think that's an issue considering that the parents are willing to say farewell to their son on their terms, and doctors are simply unwilling to wait to discuss it adequately.

 

[captain morgan]

Part of the 'use of facilities' that we pay for is counseling and care when it is the end time for one of our family. Unless counseling has failed and the state has to declare the parents mentally unstable, then medical care should be able to follow a schedule that fits with their needs as well as the need of the child.

I am not questioning the parents. I am questioning the logic of labeling the state or the attending physician as "killers" because they don't pander to individual needs on a case like this. These people (state included) already carry a huge burden home with them each and every night in having to balance these issues. In this case, this newborn is not going to survive, does it make any sense to risk the lives of those people that might stand a fighting chance if they receive timely medical treatment?

As far as paying for this service. Our relative contribution(s) towards healthcare in any province don't come anywhere close to the actual cost.

Do I want to open Pandora's Box on the issue? I don't think that's an issue considering that the parents are willing to say farewell to their son on their terms, and doctors are simply unwilling to wait to discuss it adequately.

Great... So, when the child is having this surgery (as I assume that it won't be done at bedside), what do the nurses/Doctors tell the family of a car accident victim that is in emergency awaiting a surgical suite to stop the internal bleeding and mass trauma? WHat will be the cost to that family if the worst-case-scenario unfolds?

 

[karrie]

I am not questioning the parents. I am questioning the logic of labeling the state or the attending physician as "killers" because they don't pander the individual needs in this case. These people (state) included already carry a huge burden home with them each and every night in having to balance these issues. In this case, this newborn is not going to survive, does it make any sense to risk the lives of those people that might stand a fighting chance if they receive timely medical treatment?

As far as paying for this service. Our relative contribution(s) towards healthcare in any province don't come anywhere close to the actual cost.




Great... So, when the child is having this surgery (as I assume that it won't be done at bedside), what do the nurses/Doctors tell the family of a car accident victim that is in emergency awaiting a surgical suite to stop the internal bleeding and mass trauma? WHat will be the cost to that family if the worst-case-scenario unfolds?

Palliative care is given out, at cost both money wise, resource wise, and manpower wise, across this country all the time. You seriously want to try to justify withdrawing palliative care based on treating traumas? No. Palliative care, end care, is just as important a part of a healthy medical system as emergent care is, even if it less rewarding. Sending two tax payers home with as little trauma as possible after an already devistating loss, pays for itself (if we want to be cold and calculating about it). Dragging their child out of their arms, does not. It merely perpetuates a very grave image.

 

[Corduroy]

Your giving Joseph 2 options: Die via suffocation or die via the illness. Are you not?

No, I'm not. I had no part in it.

 

[captain morgan]

Sending two tax payers home with as little trauma as possible after an already devistating loss, pays for itself (if we want to be cold and calculating about it). Dragging their child out of their arms, does not. It merely perpetuates a very grave image.

Tell that to those people in the waiting area of the emergency department.

 

[karrie]

Tell that to those people in the waiting area of the emergency department.

I don't have to. We don't pull the staff out of hospitals to work the emergency room... we staff both. To try to pretend that the only way to treat this child appropriately, with dignity and empathy, is to let someone else die, is a hollow argument.

 

[lone wolf]

If I'm in ER, the last people I want hanging around would be from palliative care...

 

[captain morgan]

To try to pretend that the only way to treat this child appropriately, with dignity and empathy, is to let someone else die, is a hollow argument.

... But to brand the hospital and staff as killers is A-OK

 

[karrie]

... But to brand the hospital and staff as killers is A-OK

It's an empathetic response. I guarantee if it were your child they were taking to terminate before you were okay with it, you'd feel the same. We train people for this everyday, subsidize the education for it too, so that families shouldn't have to go through such trauma. There should be appropriate counselling and communication in place so that families feel in control at times like these, not powerless, not like their child is being killed.

 

[Goober]

First of all, Bull****. The choice of trying again was theirs entirely, and they deserve no condemnation for that.

Secondly, it is irrelevant to the discussion. It is done, the child is here......does the fact of the parents (alleged by you) irresponsibility give the state the right to kill?

I think not.

If the parents were aware that having another child would in all certainty / high probability have the same degenerative disease they are morally culpable.
But the news articles do not state that.

 

[Corduroy]

I'll ask you the same question as I did Colpy: Do you really want to open Pandora's Box on the issue?

What exactly do you imagine will come out of this Pandora's Box when opened?

 

[TenPenny]

It's an interesting question, I personally believe that if the parents want to take the child home to die, a compassionate doctor would facilitate that, but then again, I don't know the details.

Suggesting that the state is committing homicide, or playing God, by disconnecting the life support is funny - who installed the life support? Isn't that playing God as well?

 

[captain morgan]

What exactly do you imagine will come out of this Pandora's Box when opened?

Where do we draw the line? How do we balance the current needs (ie non-terminal) with the entirely subjective needs of a family? Ultimately, we can keep people alive for months or years beyond the time when the body is incapable. So, who gets sacrificed? Who do we label as the "killer"?.. Who's gonna pay for these astronomical increases in costs of a system that is already consuming 40+% of provincial GDP?

That is the Pandora's Box

 

[Corduroy]

Where do we draw the line? How do we balance the current needs (ie non-terminal) with the entirely subjective needs of a family? Ultimately, we can keep people alive for months or years beyond the time when the body is incapable. So, who gets sacrificed? Who do we label as the "killer"?.. Who's gonna pay for these astronomical increases in costs of a system that is already consuming 40+% of provincial GDP?

Your slippery slope argument could be used in the other direction. If we allow the state to overrule a family's wishes and order a patient die earlier than he would without medical care, what other calculations could we make? If we are worried about the cost of medical care, why bother treating the elderly who have few years left in them anyway? Or cancer patients with types of cancers that have low survival rates? Why bother wasting money on easing the pain on the terminally ill when they're just going to die? Why not legalize euthanasia and then enforce it to save money?

If people drive through intersections on green lights and we allow people to speed up on a yellow light, we'll soon be letting people drive straight through red lights.

See, slippery slope arguments are ridiculous and hysterical.

 

[mentalfloss]

Bioethicists usually argue something along the lines that not only is it highly unlikely the child would survive, but the resources used to maintain its life could be used to actually help others who really need it.


...

Utilitarian bioethics is based on the premise that the distribution of resources is a zero-sum game, and that it therefore medical decisions should logically be made on the basis of each person's total future productive value and happiness, their chance of survival from the present, and the resources required for treatment.

For those whose cost of medical treatment or maintenance outweighs their total future economic value (because they are terminally ill, are no longer productive, and have no reasonable chance of becoming productive or happy in the foreseeable future), it is economically efficient to free up medical resources by not treating them.

As an example of this logic, every nurse who cares for a terminally ill Alzheimer's or cancer patient, a comatose individual, or an individual in a vegetative state, is one less nurse to take care of a sick baby or a 12-year-old gunshot victim. See opportunity cost.

Therefore, the benefits utilitarian bioethics include increased medical expenditure on other patients with a higher chance of survival and return to a productive and/or happy status. This would ideally lead to an overall net increase in wealth and happiness.

The perceived downsides of utilitarian bioethics include : potential justifications for physicians to kill patients, a gravitation towards acceptance of mortality and death, lack of medical progress (as the treatment of severe injuries would not be explored), the uncertainty in measuring 'happiness', and the possibility of classification of many disabled or old people as "nonpersons".


http://en.wikipedia.org/wiki/Utilitarian_bioethics

 

[Goober]

Your slippery slope argument could used in the other direction. If we allow the state to overrule a family's wishes and order a patient die earlier than he would without medical care, what other calculations could we make? If we are worried about the cost of medical care, why bother treating the elderly who have few years left in them anyway? Or cancer patients with types of cancers that have low survival rates? Why bother wasting money on easing the pain on the terminally ill when they're just going to die? Why not legalize euthanasia and then enforce it to save money?

If people drive through intersections on green lights and we allow people to speed up on a yellow light, we'll soon be letting people drive straight through red lights.

See, slippery slope arguments are ridiculous and hysterical.

CM point is that the present system is unsustainable - It is rising faster then inflation and govt revenues. Change will eventually have to take place.
next - Karrie made an excellent point on staffing and palliative care - The Hosp in my opinion did not or was not willing to work with the family - perhaps they thought the baby would suffer less. i do not know. but it was not handled properly.

Next - Emergency rooms - Last place to go if you are sick - recent study has shown that going to emergency first off increases your hospital stay by 10 days on average.

Yes i know there are times you have to go to Emerg - Why - not enough medi centers available. So the costs for medi care rise because of this.

Just some points to consider.

 

[captain morgan]

Your slippery slope argument could used in the other direction. If we allow the state to overrule a family's wishes and order a patient die earlier than he would without medical care, what other calculations could we make? If we are worried about the cost of medical care, why bother treating the elderly who have few years left in them anyway? Or cancer patients with types of cancers that have low survival rates? Why bother wasting money on easing the pain on the terminally ill when they're just going to die? Why not legalize euthanasia and then enforce it to save money?

If people drive through intersections on green lights and we allow people to speed up on a yellow light, we'll soon be letting people drive straight through red lights.

There is no free lunch. You or I can make whatever arguments we wish that suits our individual needs. All of these arguments fall flat when the facilities/services are restricted in terms of access, # of beds, etc.. We can boil this down to the needs of the many vs the needs of the few.

See, slippery slope arguments are ridiculous and hysterical.

Up until the point that you are forced to pay directly for your care... Then it is no longer a slope as much as it is a sheer cliff.

Let me ask you this. Would a solution to this specific issue (the terminally ill child) be solved if the parents bought/rented a respirator and took the child home? Ultimately, they would achieve their goal and possibly offer their newborn even more time.

I'm very interested in reading your response.

CM point is that the present system is unsustainable - It is rising faster then inflation and govt revenues. Change will eventually have to take place.
next - Karrie made an excellent point on staffing and palliative care - The Hosp in my opinion did not or was not willing to work with the family - perhaps they thought the baby would suffer less. i do not know. but it was not handled properly.

Next - Emergency rooms - Last place to go if you are sick - recent study has shown that going to emergency first off increases your hospital stay by 10 days on average.

Yes i know there are times you have to go to Emerg - Why - not enough medi centers available. So the costs for medi care rise because of this.

Just some points to consider.

Goober,

Much of what I am driving at relates to the inflexibility of the Canadian healthcare system. One of the merits that it offers is the universality (or thereabouts) of the system. Regrettably, a broad and all encompassing system is not very capable of being responsive to individual variations like we see here. The discord between the capabilities of the existing system and the individual demands/entitlements of the consumer are simply not compatible.

 

[Corduroy]

There is no free lunch. You or I can make whatever arguments we wish that suits our individual needs. All of these arguments fall flat when the facilities/services are restricted in terms of access, # of beds, etc.. We can boil this down to the needs of the many vs the needs of the few.

I don't like to repeat arguments people have already made. Karrie covered this change of subject well enough already. Returning to what I was actually addressing, are we in agreement that your slipper slope argument doesn't work?

Up until the point that you are forced to pay directly for your care.

Let me ask you this. Would a solution to this specific issue (the terminally ill child) be solved if the parents bought/rented a respirator and took the child home? Ultimately, they would achieve their goal and possibly offer their newborn even more time.

I'm very interested in reading your response.

I don't know what are the exact conditions of this child's survival. Presumably, if his parents bought all the medical equipment keeping him alive and set up their personal ward in their home, the child could be sent home and eventually die there as his parents wish.

Now, I don't see how that response was interesting. You asked a question with an obvious answer

 

[captain morgan]

I don't like to repeat arguments people have already made. Karrie covered this change of subject well enough already. Returning to what I was actually addressing, are we in agreement that your slipper slope argument doesn't work?

I don't know what are the exact conditions of this child's survival. Presumably, if his parents bought all the medical equipment keeping him alive and set up their personal ward in their home, the child could be sent home and eventually die there as his parents wish.

Now, I don't see how that response was interesting. You asked a question with an obvious answer

The argument was never directly addressed. Stating that it is a service that you are entitled to is not an answer in light of the entitlements of everyone that relies on the HC system... And no, this isn't a change of subject, it is the crux of the issue.

Who are you (or I or anyone) to unilaterally determine that the physicians are wrong and go further in accusing them of murder. Are you a doctor? Are you keenly aware of the stressors, the limitations and the patient loads? Is it reasonable to expect that someone be bumped from their long-awaited and scheduled surgery to accommodate this family's needs?

Those are extremely hard questions, however, the reality is that there would be (potentially) significant ramifications for other patients and their families... So, who trumps who in this scenario?

As far as your answer to my hypothetical question; congratulations, you support private medicine. Looks like you are well on your way down the slippery slope that you believe to be ridiculous and hysterical.