"Do not resuscitate" prem baby

Discussion in '2004 Archive' started by Matt Black, Oct 8, 2004.

  1. Matt Black

    Matt Black
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    http://news.bbc.co.uk/1/hi/health/3724194.stm

    http://news.bbc.co.uk/1/hi/health/3701492.stm

    http://news.bbc.co.uk/1/hi/health/3706770.stm

    http://news.bbc.co.uk/1/hi/health/3693204.stm

    This is literally very close to home for me - about 10 miles away to be more precise. It was an appallingly difficult case and I for one as a fellow lawyer didn't envy Mark Hedley's job yesterday one iota; he made on balance a good judgment based on the following criteria:-

    1. Charlotte Wyatt will die soon in any event
    2. Do the benefits of resuscitating her again if she stops breathing outweigh the suffering caused to her by so doing? Based on the medical evidence presented to Judge Hedley, he said no

    NB what he quite rightly did not seek to judge, as far as I can tell, was Charlotte's 'quality of life'

    Thoughts? Sane decision or slippery slope etc?

    Yours in Christ

    Matt
     
  2. Matt Black

    Matt Black
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  3. BibleBob

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    I'm going to have to think about this. This really hits home with me. I was a preemie. I almost died, I stopped breathing a couple of times, but now I'm a perfectly nomral, healthy 18 year old college student. Granted I was born at 7 1/2 months, alittle later than Charolette, but still this just hits home with me. I'm not sure what I think yet. I'll get back to you on this.

    Bob
     
  4. Matt Black

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    Another aspect here is that the judge, Mark Hedley, is a committed evangelical Christian (he's president, I think, of the UK Lawyers' Christian Fellowship), as are the parents. All of them need our prayers right now...

    Yours in Christ

    Matt
     
  5. Pastor Larry

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    I struggle with the idea that a court can override the parent's decision in a matter such as this. I understand the "hopelessness" of the situation for the girl, but I find it hard to go from there to a court making the DNR decision.

    I wonder how an American court would rule on that. Over here, people like to talk about keeping the government out of the doctor's office (such as the abortion issue).
     
  6. Matt Black

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    This ruling was designed to keep the government out of the picture, and has succeeded in so doing. 99% of the time doctors and parents agree on these sort of very difficult decisions. Here, however, they were at loggerheads; the doctors concerned in particular and the medical profession generally wanted the court to make a ruling so that they wouldn't run the risk of being subsequently sued/ prosecuted for negligence or manslaughter. The result of this ruling is they won't be prosecuted, so the government consequently WON'T poke its nose in

    Yours in Christ

    Matt
     
  7. Matt Black

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    Another aspect here is that the government are already involved, through the National Health Service, of which the Portsmouth Primary Care Trust is a part. Don't forget, we don't have a massive private healthcare system in this country and therefore the vast majority of cases like this will arise within the publicly-funded healthcare system of the NHS. So these doctors were government employees; the government was already 'in the doctor's office'. But even if it was a private medical case, I suspect the doctor's concerned would have wanted a judicial ruling

    Yours in Christ

    Matt
     
  8. Artimaeus

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    I don't trust doctors to make the decision of what is best for the patient. I sure don't trust judges to make that decision. Parents are the only ones left and I am not so sure about them sometimes. I am a strong believer in the sanctity of life vs the quality of life, but it is the parents responsibility ultimately, to make that decision. I have strong empathy for those making this difficult decision.
     
  9. Johnv

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    I'm a mere 38 years old, and my DNR intentions have been made clear to my family. I think that every family of children needs to discuss whether / how they want DNR orders on minor family members, as well as the parents. As a Christian, I'm more interested in the life of my years than the years of my life. Smetimes, it might well be a sin to keep someone alive just for the purpose of keeping them alive. I don't in any way advocate killing, but I do advocate allowing someone to die naturally and with dignity.

    Now, getting to the case at hand, this is a toughie. I do indeed believe that these decisions of life and death should be made by the parents, but to what extreme? It happens frequently in cases of elderly parents where emotionally wrought children want every possible surgical procedure done to their parents (which may only increase their lifespan marginally while detracting from any quality of life), while the doctor might want to keep the patient comfortable and let nature takes its course. In this case, it's not an adult, but a child, which makes the whole situation more emotional. But the facts are similar: family who wants to "spare no expense", while doctors believe the best course of action is to keep the patient comfortable for whatever time there is. There are no winners in this situation, and no one is the bad guy. This is simply a difficult situation that has no right answer.
     
  10. Lori

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    My mother has what is called as a "living will" and I think that just has to do with her not being willing to be kept alive by artificial means. She had a massive heart attack in 1993 and the Lord is still not done with her yet so she keeps on truckin'. They gave her a 6mo life expectancy after her defibrillator was put in, and here she is now a little over 10 years later.

    It is a very difficult desicion whether to terminate treatment or not when the patient isn't in one of those cut and dry types of situations. Think the lady in FL that is on life support. That must be a very hard situation and I am thankful to my mother that she has set up her will so that we will avoid having to make the decision of what more treatment to do for her. Her wishes are known and will be at the time of her death. More and more people should do this so that there is no question of what they want.

    azwyld
    &lt;*}}}&gt;&lt;
     
  11. Johnv

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    Amen, Lori, preach it!
     
  12. Stacie

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    First, correct me if I'm wrong, it is my understanding that the lady in FL is only on a feeding tube. That she is brething on her own and is alert. (Which to me means she has some quality of life and God's not through with her yet.) I could be wrong, but I didn't think that a feeding tube was life support.

    I don't want to be kept alive by machines. If I'm in the sitution that she is in, I'm not sure if I would want to live. But I would also realize that God still has some use for me if I'm alive. I would have to learn to learn to live in whealchair and not be able to move. I have a second cousin who is like that. And she has done wonders in recovering. She can now talk a little bit. (She was hit by a car a long time before I was born. I am now 32) As far as I can remeber my cousin has been able to talk a little bit. She has this board that she can point to letters on so that she can comunitcate. Her diagnoses was the same as the lady in FL. But no one not even her dr.s gave up on her and look at what she can do know. She has to be fed by someone like a baby, but she can eat some solids. She gets so much enjoyment out of seeing her grandchildren. I love it when I get to see her at the Christimas Family Reunion. The rest of the year she is in a Nursing home. Her children and hubby do come by and get her and take her places every now and again. She is at all of her imidate family's clelbrations. So who is say that the lady in Fl can't live? Only God can say that.

    While I do not want to be kept alive by machines, I don't consider a feeding tube to be in that catagory. When I say that I donot want to be kept alive by machines I mean I don't want a machine to make my brain work, heart beat, or breathe for me for a long period of time. Let me stay on it for a short time and if my condition doesn't improve, pull the plug, but please don't let me starve to death!!! That's creul!

    Second, I personaly know this little girl with Spina Biffida. I met her when she was just a little over a year old back in Sept. 1994. I didn't know about her condition until I asked the person training me (I was working in a daycare) about why she was crawling with her feet turned out. She then walked over and corrected the feet and told me about Spina Biffida. She also told me that the dr.s never expected her to crawl and since she was crawling when I saw her feet were not in the correct possiion, just to help her to correct it. It was dr. oders for us to do that. The dr. told the parents when she was born she would never learn to roll over, well she rolled over. They then said she would never learn to sit up, well, she learned to sit up. Then she would never learn to crawl. She was crawling when i met her. Sure she "late" in doing thees things but she learned to do them. At that time the drs were saying that she would never learn to stand. Well she showed them, she learned to pull up about a month after I got there. We then had this standing thing that we had to put her in because she didn't have control over her legs (or so they thought) and when she stood in it, it helped to strenghten her legs and keep in the correct posistion rather than her feet pointing out like a ballerenia. They then said that this little girl who was proving them wrong at every milestone, would never walk. (By this time I think they were saying it to make her prove them wrong. ;) ) Well about year later, the little girl learned to walk and we had to make her use a walker so that she would walk correctly and not have her legs tunred out while she was walking. Then she got braces and again we had make her wear them She hated them. She left our daycare center when she was 4 to go to a preschool that catered to developmently delayed kids.

    I have learned that when it comes to humans, babies espically, never believe a dr. when they say that the baby will never be able to do something. But at the same time, don't be disappointed if their predictions are right. They are basing their knowedge on studies and past expeiancees and what they believe. However, God doesn't enter into the equation. When God come in, you have the little girl I just described. Who is to say that God won't do that for Terri (the lady in FL ) or baby Charalette? I think it is wrong for the courts to over rule he parents.
     
  13. TC

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    Terri Shiavo, the woman in Florida, is not on life support. A feeding tube is just like the plastic straw you get when you buy a milkshake from McDonalds - nothing high tech about it. It is simply how she eats and drinks. It is her ex-husband that wants to kill her and her mom and dad want to keep her alive. I think he is wrong and if her parents want to take care of her, the he should get out of the way and let them.

    As far as the case in the OP, I don't think there is really a right answer. Personally, I lean toward letting the parents make the final decision.
     
  14. Gina B

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    I'm shocked that the parents decision is questioned and that we've given the courts authority to even be able to over rule a parents decision in a situation like this.
    The child is in the parents custody, so the parents should have every right to make the medical decisions for that child.
    I'd probably make the opposite decision, but that doesn't mean I should have any legal authority to go against the parents wishes and beliefs, and neither should the government!

    When did we give them that power to?
    My goodness, about the only thing we're going to be able to do on our own in a few years is pick out the color of our verichip!

    Gina
     
  15. SaggyWoman

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    I haven't read the articles, but I struggle with a "do not resuscitate" clause.

    I think they need to do whatever is possible and feasible. To not do anything is beyond me.
     
  16. untangled

    untangled
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    This seems to be somewhat familiar to me because I work in healthcare. I have seen many DNR's and they are honored most of the time. However, if we are at a patients home and see a DNR but the family says try to get them back (If they are in full arrest), then we sort of have to.

    Even if the patient wanted the DNR and the children wanted it. I've seen it many times. 99% of the time the family just ends up spending unnecessary money in order to be given false hope.

    About a month ago my partner and I were called out to a possible death. A ninety year old female was found by her relative dead. We confirmed she had been dead for a while. The relative (sister) said to call the funeral home. However, she started calling family too. The oldest daughter said for us not to move the body until we got there. She wanted an autopsy done to see how she died. Well, she had been sick... Anyway, what I'm trying to say is that alot of unnecessary steps were taken because one of the children wanted something different then all the other people. People are sue crazy these days.
     
  17. Johnv

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    You're correct that she's breathing on her own, but as far as her being alert, her original physicians diagnosed her as being in a vegetitative state, while her parents were insisting that she was responding to stimuli (it's unclear whether the responses they're asserting are of a voluntary nature or not). So it depends on whom you ask. The biggest issue in the Florida case was, however, what her wishes were. The husband says one thing, while the parents said another. The courts ultimately erred on the side of caution, and sides with the parents. If, however, it could have been shown that her wishes were to not be given a feeding tube, then the courts would have sided with her husband. Unfortunately, that case has become politically infused, ans thus has polarized people into one camp or another. However, the Florida case aside, in the case of feeding tubes in general, I think that it, too, falls into the "what are the person's wishes" category. If, for example, I were in a comatose state for a length of time, and were being supported by a feeding tube, I would want the tube removed. Those are my wishes. My own mother has expressed similar wishes, and I would hoor that, difficult though it would be. Other people might have different wishes. Regardless, this is another one of those things that we need to make know with our surviving family.
     
  18. Lori

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    I think when I mentioned the woman I fl I didn't realize she had a feeding tube, I was thinking of another lady that i guess is kinda in the same state - comatose - to where her eyes are open and she's moving from time to time, but it's like you can tell that they're definately not the same person, just that person's body practicaly.

    I don't know if it's possible or not, but maybe if you can somehow I dunno make up a paper that will say what you want done in the event that you go into one of those types of comas, you tell people how long you're willing to proceed with the treatment. I know that we will never know if something like that is going to happen to us or not, but it just seems like that would help us have our wishes known even in situations that were not quite so black and white. Aka whaddaya want done if you have to be put on machines to keep alive? Blah Blah Blah your answer here. whaddaya want to do if you are in a coma that shows you in a vegitative state, but you have some bodily responses, etc etc.

    Basically I feel like even when we don't know when we're going to be called home, or which of our loved ones will go before/behind us we really should put together a detailed packet just for our family. Possessions, Last Wishes, Personal Goodbye Letters to immediate family members etc. Just some way to talk to them as if we were so that they would have less burden on them.

    I dunno if any of these make sense or not, and no you probably shouldn't dwell on dying and the like, but this is just some ideers running around in my head. Does any of this make sense to anyone else?

    azwyld
    &lt;*}}}&gt;&lt;
     
  19. Gina B

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    The lady in Florida is Terry Schindler Schiavo.
    She wasn't on life support, she was on a feeding tube. Without it she would starve to death, which would be long and drawn out, so in a sense it is life support.
    In her case, there were MANY more factors to consider also. Not only would the death be slow, but the fact that her husband wanted it and that the family wanted the cause of her injury investigated as possibly involving not so natural causes, there was a mess of a legal situation. If need be I'll dig up and repost the original article I wrote about it, but most people who respond to threads like this probably have read it in the past anyhow. If you haven't and you want the full story reposted say the word.
    Gina
     
  20. Karen

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    Dear Johnv,
    I don't think I could carry out such a wish for a member of my family. My mother and I had power of attorney for my grandmother's health care. My grandmother had drawn up a standard health care directive while in the nursing home. She did not want heroic measures, but neither did she want any potential feeding tube prevented or removed.
    All three of us were agreed on this one.

    I just do not see a feeding tube as heroic or excessively invasive. It is different from extreme measures. It carries on normal functions. Essentially a person asking to not have a feeding tube or have one removed could be asking for slow, painful suicide.

    If, theoretically, we had not agreed on this, I would not have participated in carrying out wishes I could not agree with.

    My grandmother died at 95 of congestive heart failure, and we did have all reasonable care provided. But there were no heroics or heart transplants. There was no disagreement among any family members or medical professionals, blessedly.

    Karen
     

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