Hospital withdrawing life support

[hadassahchana[$]]

I was going to post this in CE but it might turn into a debate, so here goes:

A Texas hospital is withdrawing life support from a toddler who has a degenerative disease. Under state law, the hospital can make that decision without the family's approval.

I am horrified by this. I don't want a medical ethics committee making that kind of decision for my family, or for anyone else's. To me, this is one small step away from the situation in the Netherlands which gives doctors the right to actively euthanize ill or disabled babies against the parents' wishes.

And in the insult to injury category, then-governor Bush signed in this legislation in Texas.

[rmthunter]

I'm on your side on this one. I think those decisions should be reserved to the family, along with all other end-of-life decisions. Doctors and hospitals should be required to satisfy all requirements for informed consent, and then their input ends.

[brian_igo]

hadassahchana said

And in the insult to injury category, then-governor Bush signed in this legislation in Texas.

This part I don't get. If he did not sign this would be out of character. At every opportunity where he has to act instead of just offering lip service, Bush has always, always, had a callousness toward life that would be called sociopathic if it was anyone other than a governor or president.

[pippadaisy[$]]

Except when it comes to Teri Schiavo.

[hadassahchana[$]]

Nope. He didn't act, he talked on that one, too. So did Jeb.

[phoenixx]

A Texas hospital is withdrawing life support from a toddler who has a degenerative disease. Under state law, the hospital can make that decision without the family's approval.

I am horrified by this. I don't want a medical ethics committee making that kind of decision for my family, or for anyone else's. To me, this is one small step away from the situation in the Netherlands which gives doctors the right to actively euthanize ill or disabled babies against the parents' wishes.

I'm ok with this, in theory. This decision is too emotional for a family to make, and too costly for the rest of us for it not to be made. I think we need to put aside our desire as a society to avoid death at any cost, and promote wellness. Not to mention the need for solid guidelines on such decisions by hospitals to ensure the decision is made after carefl consideration and is not just financial (because there is that risk with this, no matter how much of a good idea it seems).

[Prepoia[$]]

Many people have dormant degenerative diseases. Would you truly feel this way if your recent accident had triggered a dormant degenerative disease into full bloom and they decided that with that and possible disabilities from your accident to pull a plug?

[phoenixx]

That's a good point, and the reason for guidelines - what level of degenerative? What level of cost is acceptable, both to the hospital, the taxpayer and the family? What will the quality of life be with support? Without? These are all things I think the emotion of the situation make it hard for the family to consider - I know it would be hard for me to think clearly if it were to happen to me. I would hope that we could enact a system for such a contingency at any age.

As far as the accident triggering a degenerative disease, that's a new one on me. Let's hope not, shall we?

[erik_kosberg]

The CNN story has been updated:

A Texas judge Tuesday granted a family's request to keep their critically ill baby alive, ruling that the boy should not be removed from life-support equipment as the hospital had planned.

[phoenixx]

The boy is believed to have Leigh's Disease, a progressive illness difficult to diagnose. He cannot breathe on his own, must have nutrition and water pumped into him, and cannot swallow or make purposeful movements, Regier said. He said Emilio's higher order brain functions are destroyed.

So, here is where the guidelines would be handy. What kind of quality of life can this child have if he can never breathe on his own and has no higher brain functions? It seems so much more cruel to me to keep him alive to make the parents happy than to let him go. I'm no doctor, and I'm not clear where religion would stand on this as a general rule, and I have no idea idea what the cost of a lifetime of life support would be, but in the end it comes down to quality of life I think.

[erik_kosberg]

Cost is not directly an issue for the hospital (since Medicaid picks up the tab). OTOH, if scarce resources (nursing shortage debate, anyone?) are utilized for this case, they're not being utilized for other cases. What this family may gain in peace of mind has to come out of some other family's loss of care. Finite resources can be spread just so thin.

[MrsNormanMaine[$]]

Until our society comes to grips with the realities of death, we will spend increasing resources fighting the inevitable which will end up causing the health care system to become even more dysfunctional than it already is.

Dr. MNM

[drmomentum[$]]

We are so screwed.

[Prepoia[$]]

drmomentum said

We are so screwed.

Yep.

[lynnzop[$]]

MrsNormanMaine said

Until our society comes to grips with the realities of death, we will spend increasing resources fighting the inevitable which will end up causing the health care system to become even more dysfunctional than it already is.

Dr. MNM

Wow, I'm not sure which side of the fence that puts you on, MNM, but it's a very profound statement.

I would have to side that the family should be able to make the decision on the child's care. I know I would not want to be the one to have to make that awful decision, but I don't think it's the hospital's place to make it for them.

[theworm[$]]

I think that if this little boy has this horrible disease that he should be allowed to die, HOWEVER I can not support the hospiat making the decision without the parents approval or support. I agree with MNM that death is a normal part of life, and its heartbreaking when kids die, BUT a hospital should not override the parents.
The problem is again financial and insurance. How much should insurance pay in a case like this?

[mjfrombuffalo[$]]

I'm willing to bet that the hospital had tried to move the parents into the "acceptance" phase of dealing with grief (a hospital's staff would have to be pretty cold-blooded to just walk in and say "we're yanking the plug"), but apparently the parents weren't willing to go there. How long should a hospital devote resources to a family in denial?

[phoenixx]

How much should insurance pay in a case like this?

A finite amount that ends when the hospital determines care to be futile.

At that point if the family has emotional inability to let go, and the financial resources for the care, I can concede it would be up to the parents.

[mtomm[$]]

From my religious point of view dying isn't a thing to be feared and in the case of this baby certainly a blessing. I'm not sure how well I'd handle it if I were the actual parent but hopefully knowing this would make it easier. For those with other beliefs I think it would be terribly difficult if not impossible Sometimes we need others to help us make impossible decisions.

[emeleel]

The poor little fellow has died, removing the argument. :sad:

[frazzledspice]

I have read about this little boy's case, too.

The difference as I see it is that as soon as he was born he was put on a respirator. Had he not been put on a respirator he never would have breathed his first breath. He had no hopes of ever breathing independently. His condition was deteriorating.

In cases of terminal illness, it is ethically permissible not to take extraordinary measures to preserve life. This little boy's case met those guidelines.

I don't think that his mother was really thinking about what was best for him in this instance, and I understand that her reasoning was clouded by grief.

Although I think that the Texas law can deprive people of their rights, in this case the Texas hospital (which is a Catholic hospital) had the best interests of the patient and his family at heart.