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View Full Version : Fight over baby's life support divides ethicists



lily
04-25-2007, 09:32 PM
It seems like most of the threads here are discussing Religion, but Ethics was also in the title, so I thought I would post this here.

I admit that the mother's statement of she wanted her child to die naturally the way God wanted it, while a ventilator was breathing for him kind of threw me for a loop as did all the experts saying the child was in pain.......but putting all that aside, I think it is the mother's wishes that should be upheld, not the courts, not the hospital and certainly not Medicade. This law needs to be overturned.

Also, if it was reversed and the mother said enough, and the state said no, I would also be on the mother's side. This is a choice that needs to be made by family and no one else.




http://www.cnn.com/2007/HEALTH/04/25/baby.emilio/index.html?eref=rss_topstories



Fight over baby's life support divides ethicists



By Elizabeth Cohen



AUSTIN, Texas (CNN) -- When Emilio Gonzales lies in his mother's arms,
sometimes he'll make a facial expression that his mother says is a smile.

But the nurse who's standing right next to her thinks he's grimacing in
pain.

Which one it is -- an expression of happiness or of suffering -- is a
crucial point in an ethical debate that has pitted the mother of a dying
child against a children's hospital, and medical ethicists against each
other.

Emilio is 17 months old and has a rare genetic disorder that's ravaging his
central nervous system. He cannot see, speak, or eat. A ventilator breathes
for him in the Pediatric Intensive Care Unit at Austin Children's Hospital,
where he's been since December. Without the ventilator, Emilio would die
within hours.

The hospital contends that keeping Emilio alive on a ventilator is painful
for the toddler and useless against his illness -- Leigh's disease, a rare
degenerative disorder that has no cure.

Under Texas law, Children's has the right to withdraw life support if
medical experts deem it medically inappropriate.

Emilio's mother, Catarina Gonzales, on the other hand, is fighting to keep
her son on the ventilator, allowing him to die "naturally, the way God
intended."

The two sides have been in and out of courts, with the next hearing
scheduled for May 8.

The case, and the Texas law, have divided medical ethicists. Art Caplan, an
ethicist at the University of Pennsylvania, supports the Texas law giving
the hospital the right to make life or death decisions even if the family
disagrees. "There are occasions when family members just don't get it
right," he said. "No parent should have the right to cause suffering to a
kid in a futile situation."

But Dr. Lainie Ross, a pediatrician and medical ethicist at the University
of Chicago, says she thinks Emilio's mother, not the doctors, should be able
to decide whether Emilio's life is worth living. "Who am I to judge what's a
good quality of life?" she said. "If this were my kid, I'd have pulled the
ventilator months ago, but this isn't my kid."

The law, signed in 1999 by then-Gov. George W. Bush, gives Texas hospitals
the authority to stop treatment if doctors say the treatment is
"inappropriate" -- even if the family wants the medical care to continue.
The statute was inspired by a growing debate in medical and legal
communities over when to declare medical treatment futile.

Dr. Ross says that under the law, some dozen times hospitals have pulled the
plug against the family's wishes. She says more often than not, the law is
used against poor families. "The law is going to be used more commonly
against poor, vulnerable populations. If this family could pay for a nurse
to take care of the boy at home, we wouldn't be having this conversation,"
she said.

Emilio is on Medicaid, which usually doesn't pay for all hospital charges.
The hospital's spokesman said that he doesn't know how much it's costing the
hospital to keep Emilio alive, but that cost was not a consideration in the
hospital's decision.

"[Our medical treatments] are inflicting suffering," said Michael Regier,
senior vice president for legal affairs and general counsel for the Seton
Family of Hospitals, of which Austin Children's is a member. "We are
inflicting harm on this child. And it's harm that is without a corresponding
medical benefit."

"It's one thing to harm a child and know this is something I can cure," he
added. "But that's not the case here." Regier says Emilio is unaware of his
surroundings, and grimaces in pain. He said the ventilator tube down his
throat is painful, as is a therapy in which hospital staff beat on his chest
to loosen thick secretions.

But Gonzales says her son is on heavy doses of morphine and not in pain. She
said her son does react to her. "I put my finger in his hand, and I'm
talking to him, and he'll squeeze it," she says. "Then he'll open his eyes
and look at me."

Gonzales said she'll continue to fight for treatment for her son. "I love my
kid so much, I have to fight for him," she said. "That's your job -- you
fight for your son or your daughter. You don't let nobody push you around or
make decisions for you."

shattered
04-25-2007, 09:38 PM
You don't let nobody push you around or
make decisions for you."

Perhaps that decision should be made on her dime, then - not someone elses.

gabosaurus
04-26-2007, 03:26 PM
I have to agree with Samantha. There are a lot of people who oppose welfare and social programs. Yet you want hospitals to spend hundreds of thousands of dollars to artificially prolong life.
God gives life and God takes away life. If your child is dying, obviously you want to keep it alive. But by what means. A child is NOT a stuffed animal. It is not a plaything that someone else is paying for.
This is why we have trained physicians. If you can't live except through artificial means, then you should allow God to decide. Unhook the machines. If you are meant to live, you will continue to live. If you are meant to die, then it will happen.
This is already written in a document that covers everyone in my family. None of us wish to be kept alive by machines.

shattered
04-26-2007, 05:05 PM
Who is Samantha?

lily
04-26-2007, 05:24 PM
I have to agree with Samantha. There are a lot of people who oppose welfare and social programs. Yet you want hospitals to spend hundreds of thousands of dollars to artificially prolong life.

So then, only the rich and well insured should be allowed the choice?


God gives life and God takes away life. If your child is dying, obviously you want to keep it alive. But by what means. A child is NOT a stuffed animal. It is not a plaything that someone else is paying for.

Interesting, not to turn this into another abortion thread, but what would your opinion be if this child was found inutero to have this disease, would you allow her to break the law and get a partial birth abortion?


This is why we have trained physicians. If you can't live except through artificial means, then you should allow God to decide. Unhook the machines. If you are meant to live, you will continue to live. If you are meant to die, then it will happen.
This is already written in a document that covers everyone in my family. None of us wish to be kept alive by machines.

Yes, you have made this choice yourself. This woman has also made her choice. It just happens to differ from the choice you would make.

shattered
04-26-2007, 05:27 PM
So then, only the rich and well insured should be allowed the choice?



Interesting, not to turn this into another abortion thread, but what would your opinion be if this child was found inutero to have this disease, would you allow her to break the law and get a partial birth abortion?



Yes, you have made this choice yourself. This woman has also made her choice. It just happens to differ from the choice you would make.

If this womans "choice" was on her own dime, coming out of her own pocket, then she should be able to make the choice on whether or not to spend HER money on medical care that's seemingly making no difference whatsoever..

However, since she's spending my money, your money, and everyone ELSES money "fighting" for what she wants, *I* prefer MY portion of that money go to someone else that may get more out of it, since I'm forced to give it in the first place.

gabosaurus
04-26-2007, 05:33 PM
Who is Samantha?

I plead blondeness. :lame2:

shattered
04-26-2007, 05:34 PM
I plead blondeness. :lame2:

Understood.

Mr. P
04-26-2007, 05:36 PM
Mom says....
She wants him to die "naturally, the way God
intended."
Then disconnect the machines.

gabosaurus
04-26-2007, 05:36 PM
Money means everything. Those with money are afforded better health care, better legal representation and a higher standard of living.

For those who favor prolonging life through artificial means -- who pays for it? How can you be for "giving a free ride" to some needing health care and against others?

Powerman
04-27-2007, 03:16 AM
Mom says....
She wants him to die "naturally, the way God
intended."
Then disconnect the machines.

No shit

What a heartless, selfish bitch she is

Powerman
04-27-2007, 03:21 AM
Money means everything. Those with money are afforded better health care, better legal representation and a higher standard of living.

For those who favor prolonging life through artificial means -- who pays for it? How can you be for "giving a free ride" to some needing health care and against others?

I find myself in an awkward position here. I'm all for painless death via euthanasia, but I'm not so much into the class envy tone in your post. Why shouldn't those with more money have access to better health care? Honest question. I know it sounds cruel, but if you can't pay, then why do you deserve the same treatment?

I'm a compassionate person. If health care was the ONLY thing subsidized by government, I'd support it in principle. But where do you draw the line?

diuretic
04-27-2007, 04:44 AM
I have to agree with Samantha. There are a lot of people who oppose welfare and social programs. Yet you want hospitals to spend hundreds of thousands of dollars to artificially prolong life.
God gives life and God takes away life. If your child is dying, obviously you want to keep it alive. But by what means. A child is NOT a stuffed animal. It is not a plaything that someone else is paying for.
This is why we have trained physicians. If you can't live except through artificial means, then you should allow God to decide. Unhook the machines. If you are meant to live, you will continue to live. If you are meant to die, then it will happen.
This is already written in a document that covers everyone in my family. None of us wish to be kept alive by machines.

Aside from the obvious fact that this is a terribly difficult situation for the parent(s) and the hospital I'm a bit concerned about your insertion of the concept of God into the argument. I just need to clarify something. Should the god concept have anything to do with public policy? I have no problem with someone being able to express their own wishes about their condition and how it should be treated or not treated (obviously assuming sound mind) and if they want to include the god concept in their instructions then that's fine. But I'd be very disturbed if that crept into public life. I'd be very disturbed if, in the broader debate, someone tossed the god concept into the mix. There are perfectly useful analytical tools that can be used for the broader discussion and religion shouldn't feature in that debate, except to allow for the individual's wishes.

CockySOB
04-27-2007, 06:40 AM
Hmmmmm.....

Leigh's disease (http://www.madisonsfoundation.org/content/3/1/display.asp?did=454) is a cellular disfunction wherein the powerplant for the cell (the mitochondria) is deficient in some of the materials (enzymes) necessary to convert food and oxygen into energy. The problem is that even though we know what causes the problem, we don't yet have any means correct the genetic defect. Prognosis for patients with Leigh's disease is extremely poor, with only a very few children living past the age of 6 or 7.

That being said, this is not a hopeless situation. Emilio may only have a slim chance to survive, but IMO the state should allow him that chance as long as his legal guardian is willing. The state law in this case would be euthanizing someone with the possibility of some 5 more years of life, and a slim possibility of even a decade or more of life. Granted it's a slim chance, but where there's life, there's hope.

First glance over the Texas law involved and I am under the impression that it doesn't sufficiently protect the interests of the patient. But I'll know more once I dig into the law more.

Roomy
04-27-2007, 07:01 AM
I would bet a pound to a penny that if the baby recovered enough to be allowed home under the 24hour care of his mother she would soon sicken.

lily
04-27-2007, 10:47 AM
Hmmmmm.....

Leigh's disease (http://www.madisonsfoundation.org/content/3/1/display.asp?did=454) is a cellular disfunction wherein the powerplant for the cell (the mitochondria) is deficient in some of the materials (enzymes) necessary to convert food and oxygen into energy. The problem is that even though we know what causes the problem, we don't yet have any means correct the genetic defect. Prognosis for patients with Leigh's disease is extremely poor, with only a very few children living past the age of 6 or 7.

That being said, this is not a hopeless situation. Emilio may only have a slim chance to survive, but IMO the state should allow him that chance as long as his legal guardian is willing. The state law in this case would be euthanizing someone with the possibility of some 5 more years of life, and a slim possibility of even a decade or more of life. Granted it's a slim chance, but where there's life, there's hope.

First glance over the Texas law involved and I am under the impression that it doesn't sufficiently protect the interests of the patient. But I'll know more once I dig into the law more.


Thank you for the very sane repsonse to something that is obviously emotional. I think you are the only one I know that is pro-life and can see boths sides of this situation, which is what I was trying to see when I posted this article.

CockySOB
04-27-2007, 01:48 PM
Thank you for the very sane repsonse to something that is obviously emotional. I think you are the only one I know that is pro-life and can see boths sides of this situation, which is what I was trying to see when I posted this article.

Yeah, well *you* probably remember my arguments during the Schiavo incident in Florida. Same basic opinion here as there, the difference being that Emilio's mother cannot afford private care while Terri Schiavo's parents were more than willing to pay for private care. I know the two cases carry only a passing semblence, but I thought enough of it to mention it.

BTW, the reason I mentioned Terri Schiavo is that many who supported her husband to turn off life-support were using this same Texas law to support their argument.