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Family wins 'right to life' case for severely disabled baby

http://news.bbc.co.uk/1/hi/health/4808442.stm

It's a very tragic and difficult case, but IMVHO the wrong decision has been reached.

Quite how the judge believes the baby obtains enough pleasure from life to outweight his horrific situation simply from listening to words and feeling touch is beyond me to be honest.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    This is an incredibly tough situation. From the viewpoint of his parents, they want him to have a tracheotomy (an operation to make long-term ventilator easier) and the judge seems to agree. Put it this way - this isn't a case I'd like to have to decide on, so I won't criticise the ruling either way.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I think that they were right to let him live, as he is capable of experiencing pleasure through sensory stimulation such as lights/pictures, and he can bond with his family, get used to their voices etc. I worked for a year at a school for kids with cerebral palsy, and a lot of them were in a similar situation, where they were only aware of the family/being talked to/sensory stimulation etc. The children were capable of being happy and the school was always full of laughter and giggles as the children were able to experience quite a high quality of life, despite their situation. so it hink that this child should have to right to experience that.

    Although i do appreciate that it is a tough thing to decide on, and that there are valid reasonings on both sides.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    hm, i'm no expert but i still feel it was more for the benefit of the parents than the baby who needs every bit of help to stay alive. From the other thread about this family when they told doctors to stop playing god by turning off his machine...then aren't they playing god by keeping him alive and not letting 'god' decide or whatever it is they believe in
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    It must cost quite a bit to care for a child with that disability... I hope they have the finances.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Quality of life over sanctity of life, please.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Quality of life over sanctity of life, please.

    So if you were this baby's parents, you'd rather have his life support machine turned off? Personally I would - it can't be nice for the baby's parents having to see their baby in this state and it wouldn't be easy to look after him...
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    my wife works with kids with all soughts of mental/physical conditions.
    when you first meet some of these kids and can be a bit disturbing.
    one kid i met ...my first reaction was ...what is the point?
    that kid is completely cabbaged but how wrong i was.
    as you get to know the kid ...and understand often very limited communication skils that the kid has ...you then learn they don't like the music their parents listen to ...they like something completely different.
    they don't like milk very much so please give me tea.
    turn the telly off ...put some music on ...i'm hungry ...leave me alone ...that was realy funny ...often with kids who are thought to be in a vegative state.
    the quality of life can be excellent but ...different from what we would accept ...because we have known differently.
    but saying that ...perfectly able bodied people with everything going for them can suddenly ...be put through accident or disease ...in a very different world.
    look at superman.
    did he want to die? no.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    what i don't get is why doctors are prepared to let a baby die thats stuck inside a body that doesn't work
    but when older people develop the same kind of problem when their bodies deteriorate and just end up trapped inside their body - they're not allowed to die with dignity
    how is it different?
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Ballerina wrote:
    ...doctors are prepared to let a baby die thats stuck inside a body that doesn't work... when older people develop the same kind of problem... they're not allowed to die with dignity...
    Spot on.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    my wife works with kids with all soughts of mental/physical conditions.
    when you first meet some of these kids and can be a bit disturbing.
    one kid i met ...my first reaction was ...what is the point?
    that kid is completely cabbaged but how wrong i was.
    as you get to know the kid ...and understand often very limited communication skils that the kid has ...you then learn they don't like the music their parents listen to ...they like something completely different.
    they don't like milk very much so please give me tea.
    turn the telly off ...put some music on ...i'm hungry ...leave me alone ...that was realy funny ...often with kids who are thought to be in a vegative state.
    the quality of life can be excellent but ...different from what we would accept ...because we have known differently.
    but saying that ...perfectly able bodied people with everything going for them can suddenly ...be put through accident or disease ...in a very different world.
    look at superman.
    did he want to die? no.

    Very true. Your experiences are based on how you perceive the world around you, so this child knows only what it has experienced so far. It doesn't 'know' about all these things it doesn't have.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I read a quality comment peice in the independent today. The guy who wrote it knows the judge and stuff, so it had an interesting perspective, I recommend that anyone who can get their hands on it have a look.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Fiend_85 wrote:
    I read a quality comment peice in the independent today. The guy who wrote it knows the judge and stuff, so it had an interesting perspective, I recommend that anyone who can get their hands on it have a look.

    I can't, mind summarising it?
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I'll copy it out tomorrow.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    FilthyChav wrote:
    It must cost quite a bit to care for a child with that disability... I hope they have the finances.
    "They" being the taxpayer? Sadly, they don't.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    human emotion replaces sensible thought imo...we are all educated enough to realise that this child will have no "REAL" quality of life. it's selfish on the part of the parants to keep this child alive!....they are only thinking of themselves,and not the child!....this is not a situation that can't be helped!.........if this kid were a dog, you would'nt think twice.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    does it ease peoples consciences then? that this child will never know any better?(in their opinion)...bollocks!!....the kid will still see other people doing things that he or she cant do,as they grow!.......its not fuckin fair!!!
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    As Promised

    From the Independent, Friday 17th March, Editorial&Opinion section

    A paralysed infant has helped save the lives of some of our most vulnerable children By Dominc Lawson

    As governments post and present have discovered to their fury, British judges are not impressed by the authority of the state, no matter how unpopular that may make them. Sometimes that refusal to be overawed can be magnificent: seldom more so than in the decision of Mr Justice Holman on Wednesday to refuse to grant and unnamed NHS trust his consent to the removal of a ventilator tube from the nostrils of "Child MB".
    Child MB, a 19-month-old boy, suffers from the most acute formof Spinal Muscular Atrophy. This degenerative disease - which affects the body by leaves the brain completely undamaged - has now rendered him inert, and he cannot breathe withou the aid of a ventilator. His parents refused to give their consent to the trusts's wish to remove his breathing ait - which would cause his immediate death - and so the trust attempted to use the law to overrule the parents' wishes.
    Its submissions to the court were impressive, in that not only were the 12 doctors involved in the case united, but also the two doctors who gave evidence on behalf of the parents told the judge that in their view it was time for Child MB to "be allowed to die". Even the guardian to the child appointed by hte court sided with the NHS Trust - and therefore the state. Yet Mr Justice James Holman listened politely and then told them that they were all wrong, and that the parents were right: Child MB's life was worth preserving.
    As it happens, I know James Holman - his holiday cottage in the Scilly Isles is less than 100 yards from the one which we rent each August. James is one of those rare Englishmen who absolutly adores children. He is unstoppably affectionate not just to his own childre, bu to all those he meets. And unlike some adults, the children don't seem to mind the fact that his greetings boom so loudly that they can be heard on the next island. My point is that James Holman is the last man to be insensitive to any suffering experienced by Child MB.
    As begits and obsessive sailor, James HOlman did something very practical at the outset of the hearing: he asked all those involved to write down on a piece of paper a list of the benefitsand disadvantages of the course of action they proposed.
    In his judgement, Holman notes that "Even at the end of the hearing the list from the NHS Trust contains only one item [in favour of the child's continued existence]: 'Preservation of life.' It does not recognise any specific benefit that MB may be getting from his life although the disbenefits are listen in considerable specific detail."
    I am not surprised that James Holman was puzzled by this. As he points out, after detailling the medical evidence: "MB is concious. He is awake during most of the day and sleeps at night. He continues to hear, see, feel and touch, to have an awaremness of his surroundings and of the people who are most close to him, his family, and to have the normal thought processes of a small child of his age... No court has before been asked to approve that, against the wishes of a child's parents, life support may be discontinues, leading the the inevitable death of a child with sensory awareness and assumed normal cognition, and no reliable evidence of brain damage."
    As to the suffering of Child MB, the doctors told the court: "It is very difficult to assess how much distress he experiences. it is inveitable that some interventions, particularly blood sampling, endotracheal suctions and physiotherapy are uncomfortable to him. An asessment of his quality of life is very difficult."
    In essence, therefore, the consultants are saying that they have no idea how much MB is suffering, or how happy or sad he is. Only the medical staff who have spend most time with MB, the junior nurses, made it clear that they were aginst the trust's court action. The mother, who has been with him in hosptal for at least eight hours a day throughout his entire life, told the court that not only does the corner of his mouth turn up when he sees his two brothers, but also when he watches barney the dinosaur on television.
    She also told the court that he wiggles his toes when she tells him "to do a big one". James Holman saw a video of this, to verify that the mother was telling the truth, and comments: "The doctors who have seen the video say they have not witnessed any such movements, but they agree they are visible in the video and cannot explain them."
    In conclusion, James holman told the court - and I can imagine the booming tones in which this was uttered - "I can not and will not make a declaration in the terms sought. I actually go further and consider that it is actively in MB's best interests to continues with ventilation and with the nursing and medical care that properly goes with it." Case dismissed.
    In his column last week, Johann Hari argued that hte NHS Trust was right to seek sto disregard MB's parents' wishes, on the grounds that he is "in ceaseless agony" and that we should abandon "the sanctity of life rhetoric, a leftover from the rotting carcass of Judaeo-Christian philosophy... Of course it is much easier to accuse anybody who tries to craft the least cruel form of ethics of being a mini-Mengele".
    Well, I shan't accuise Johann of being a mini-Mengele, although I do think he ought to read Michael Burleigh's Death and Deliverance. It is an account of the systematic murder of almost 200,000 mentally or physically handicapped people by doctors under the Nazi regime.
    The Nazis produced films to persuade the german public of the virtues of the policy. The voice-over of one, accompanying footage of severely handicapped children, declares, in scandalised tones: "They have to vegetate in an existance which no longer has anything in common with the purpose of human life. They must, because a religion whcih is alienated from reality has give rise to medical ethics, still current today, which make it the task and duty of the doctors to preserve the life of every person under all circumstances."
    Johann favours lethal injections for those he thinks should be let go, but hte Nazi film instead proposes the "human and painless" operation of a gas chamber: this was the trial run of the method later used to exterminate the Jews.
    I wish Johann the best of luck as he tries to craft his very own form of ethics, but I'm grateful to James Holman for ensuring that English law remains, at least as regards to compulsory euthanasia, tied to Judaeo-Christian philosophy.
    And as for Child MB: his short life is now anything but meaningless. With the aid of his morther's stubbornness and love he will go down in legal history as the person who, unwittingly, help to preserve the lives of the most vulnerable children of all.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    The right decision has been reached.

    I thank fiend for posting that up, it pretty much covers what I think.

    If a person is alive with full cognitive action, it is not right to kill it unless it wants to be killed.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Fiend_85 wrote:
    From the Independent, Friday 17th March, Editorial&Opinion section...etc etc
    Thanks mate, I thought you would just summarise it, not copy the whole thing! Top effort :thumb:

    I agree, I think the right decision was made by the judge. It really does make you wonder about the decisions these medical staff are making on behalf of so many people. Should people listen to their doctors' advice? Of course they should, but this example shows how the doctors don't necessarily see everything in the picture in every case (IMO).
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    For the record, 1200 words, ish, took me a while, but I felt a summary wouldn't really do it justice.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    YOU live that life then!!
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    THE BEST OF A BAD DEAL IS NO DEAL AT ALL!!....................IMO! this thread hurts me!
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kermit wrote:
    If a person is alive with full cognitive action, it is not right to kill it unless it wants to be killed.
    It is entirely misleading to suggest that removing artificial ventilation is an act of murder. The active medical intervention in this case is delaying death, not saving a life. I agree in principle that cognitive function is an important consideration in such cases, but that cannot be the only factor upon which a decision is made. It is a great tragedy that a young child has developed this incurable and progressive neurological condition and I have every sympathy for the parents too but, like the furore surrounding Herceptin, our emotions are abused and the reality that (unfortunately) a line must be drawn somewhere is forgotten.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    DEANO MAC wrote:
    YOU live that life then!!
    Fortunatly I am not required to. I can remember it wasn't that long ago that I was staring a wheelchair in the face, I can remember thinking nothing was scarier, because of who I am. My physio had to threaten me with surgery to get me to rest from an injury and the three months I had to hold of training was torture. But if I really had to stop, I'd rather live, than die just because I can't play sport anymore. You don't know what is in that child's mind, but I would suggest, based on the article that he can smile at the small pleasures and interact on a small level with his own mother, that he would rather live, for the short time that he can. What's he really missing anyway?

    Incidentally I wonder if anyone has ever asked stephen hawking if he'd rather be left to die. I can't help but think that the only reason this child can't communicate, is because he's not yet 2 years old. A fantastic mind could be trapped in that body.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kentish wrote:
    It is entirely misleading to suggest that removing artificial ventilation is an act of murder.

    It is an act of killing.
    The active medical intervention in this case is delaying death, not saving a life.

    But that is the same thing.
    a line must be drawn somewhere

    I quite agree.

    But if the child is fully conscious, then the line has not been reached. Fiend mentions Stephen Hawking, but there have been other cases where doctors have decided that someone has passed the line, only for them to wake up again.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    my uncle had his life support switched off after he tried to kill himself when he was 20 ish against the wishes of his family. somehow, miraculously, his organs took over themselves. this was a long time ago, he's about 60 now - but he's lived his life since then, had 4 kids, and has all manner of stories to tell. if his organs hadn't of kicked in then he'd have been robbed of all that.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kermit wrote:
    It is an act of killing.
    The result is death, but it is a passive process - letting nature take its course, if you will.
    But that is the same thing.
    I disagree. The child has a progressive disease, which is incurable and the only treatment being offered is support for his vital organs. Regardless of the cost, it's a pretty futile effort.
    I quite agree.

    But if the child is fully conscious, then the line has not been reached. Fiend mentions Stephen Hawking, but there have been other cases where doctors have decided that someone has passed the line, only for them to wake up again.
    Shock horror! medicine is not an exact science. Anyone would think that the doctors were prepared to let all their patients die just for the sake of reducing their workload. It is up to the medical team to properly counsel parents on the situation and come to a genuine consensus. If no consensus is reached, doctors would be negligent NOT to involve the courts, and they were entirely right to bring this case to court.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I do think doctors do sometimes rush into turning machines off, especially with comatose patients. I think they are too quick to say a person has "no quality of life".

    They were right to go to court, and the court has rightly told them to not kill this child.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    It is extremely difficult to have to tell a parent that their child is dying and that they have the option to turn off the ventilator and the child will die on its own in a few minutes. Of course the parent/relative will not want that responsibility because they will be left with the inevitable What If? questions.

    Thankfully, cases such as this are uncommon and cases where there is disagreement even rarer.

    "Quality of life" is entirely subjective and you can discuss a quality on both sides and make valid arguments either way.

    Cost of a paediatric intensive care bed: £1702 (per day)
    A child's life: Priceless?
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Only thing I can say is, that I don't agree with the parents, but understand them fully.
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