[♥]

My friend and I are in an argument over something in the news.

A hospital wants to turn off a baby's life support and let him die due to lack of oxygen.

Family: Death by asphyxiation would be painful

In Emilio's case, the family is united in wanting to keep the boy alive.

Last week, a federal judge refused to intervene and left it to the state court where a lawsuit was pending that seeks to declare the law unconstitutional. An Austin judge will hear arguments Tuesday on whether to block the hospital from cutting off Emilio's life support.

"We feel that the original decision is right, and it's time to proceed," said Regier, the hospital's lawyer.

If the hospital is allowed to go forward, the life support equipment would likely be turned off during the day Wednesday when the family can be present and have the aid of social workers and chaplains, he said.

Carden argues that Emilio's death by asphyxiation would be painful. He said the law prevents hospital workers from even giving the boy the drugs death row inmates receive to help them as they are executed by lethal injection.

"It's not like he'll just drift quietly off," he said

It has been followed in the Texas newspapers and now it has hit the mainstream.

I'm not going to say which side I'm on (whether the hospital should do this or not) but will read your responses here.

[Big Mac]

It's very sad for the family, but it appears the doctors are making the right choice.

[Dakar²]

law prevents hospital workers from even giving the boy the drugs death row inmates receive to help them as they are executed by lethal injection

I sincerely hope some nurse helps the family skirt this law.

[design219]

His "higher order brain functions are destroyed." Where is the mercy in letting this child suffer through the treatments he must endure every day to survive? There might be suffering in death, but it sure seams like he is suffering to live.

[macroy]

hm... tough.

All I can say is that if it was me, I'd want them to turn the machines off. If it was my son in there... I'd think it would be the right thing to do - but I don't know if I could actually go through with it.

To answer the question - murder? I don' t believe so. To me murder is accompanied by malice. Just my .02.

[OldManMac]

As a parent, that would be an enormously heart wrenching decision. In the end, however, keeping someone alive, to allow them to suffer needlessly, is not the appropriate decision. His mother already recognizes that he's dying, and that one day she'll have to let him go. Her reasons for waiting are perfectly understandable, but they are based on emotion, and the apparent facts of the case dictate that her child needs to be let go.

As to the question of whether it's murder or not, I don't consider this murder.

[jokell82]

What hasn't been posted in this thread (but expressed in the article) is that the family has decided to keep the child alive, while the hospital has decided to remove the child from life support. And according to the law, it is the hospital's decision. Not sure I agree with that one...

[Big Mac]

I think the hospital should be the one to decide unless the family can demonstrate that it's acting contrary to accepted medical standards of treatment.

[jokell82]

Originally Posted by Big Mac 

I think the hospital should be the one to decide unless the family can demonstrate that it's acting contrary to accepted medical standards of treatment.

Speaking in general terms, and not about this case in particular, I'm not sure I want a for-profit company (which is what a hospital is) deciding when someone no longer deserves to live.

[♥]

Okay, here is where I'll pipe up.

As a parent it would be terrible and heart-wrenching to have to let my child die. Every cell in my body would want to fight to keep that child alive by any means necessary. With the advances of modern medicine daily, it might be that in a year or two that there might be a medication or means that might result in significant improvement in the child's life.

Having said that, if I had a child that I knew would die without life support, I still could not choose to remove the child from life support, because my religious faith says that doing so is murder. What parent would willingly choose to terminate their child's life? Not many. Yes, maybe a few of you here would...but do you people who say that the machines should be turned off have children? Because it's easy to be more objective about children when you do not have the experience of having had children. Once you do, your values may change profoundly. Mine did.

Next, they want to simply stop the ventilators. The child will then suffocate.

Not even death row prisoners have to suffocate to death.

That is why I think it is inhumane.

Not to turn political, but I did note that George W. Bush is the one who originally signed this into law (that lets hospitals turn off life support regardless of medical testimony or parental wishes. And isn't GWBush the one that is supposedly pro-life? )

[Big Mac]

Originally Posted by jokell82 

Speaking in general terms, and not about this case in particular, I'm not sure I want a for-profit company (which is what a hospital is) deciding when someone no longer deserves to live.

For profit? Most hospitals are non-profit.

[♥]

What a great point: Yes, hospitals may or may not be for-profit.

But one thing is for sure: Their purses are tied to huge HMOS are definitely FOR-profit...and reducing all expenses, even if it means a life.

[olePigeon]

I'd pull the plug. It's what I'd want for me. Being a vegetable is some serious bullcrap, that's no way to live.

[Chuckit]

Originally Posted by ♥ 

What a great point: Yes, hospitals may or may not be for-profit.

But one thing is for sure: Their purses are tied to huge HMOS are definitely FOR-profit...and reducing all expenses, even if it means a life.

That's a pretty serious accusation. I mean, I can see caring about funds — they can't treat anyone if they're out of business — but you seem to be suggesting that they're intentionally killing people just to get them out of the way.

According to the article, this kid is severely brain-damaged (not something any medicine is ever going to cure) and living a horrible life that's doomed to be cut very short as it is. Keeping him alive is a lazy decision based more on an inability to let go than an actual willingness to think of what's best.

[♥]

Not really.

Most HMOs are for-profit. The United Healthcare CEO got millions upon millions of dollars as a bonus for a year's work.

How about 124.8 MILLION?

Yet, those same HMOs routinely deny medical treatments, especially those that they deem questionable and not yet mainstream and might cost an HMO money and less profit.

Here is an interesting intro to an abstract where the author talks about limited resources on the behalf of managed health care organizations and who should make the call to allocate those resources.

The health care that people do get is declining in quality, according to a study co-authored by Dr. Hellander that was published in the July 13, 1999, Journal of the American Medical Association. Between 1985 and 1998 the proportion of HMO members enrolled in for-profit, or investor-owned -- managed care companies compared with non-profit ones, increased from 26% to 62%. Care at the for-profit institutions scored particularly low when it came to treating seriously ill patients. Another one of the study's co-authors, Harvard associate professor of medicine Dr. Steffie Woolhandler, went so far as to say that: "If all American women were enrolled in for-profit HMOs instead of non-profits, 5,925 more would die from breast cancer annually."

Dr. Hellander says that health care at for-profit HMOs is worse than non-profits because those companies spend less on providing services to their patients.

Great article

[Ghoser777]

The first article says that the baby is covered under Medicare... I don't see why money would be an issue in the hospital's decision.

[♥]

Actually, I don't know about Texas, but Medicare in our state is overseen by United Healthcare.

Also, Medicare does not pay very well at all. It is a minute fraction of what the real cost is. That is why it is so difficult for Medicare recipients to find doctors who will take it.

[Ghoser777]

It looks like the justice ruled in favor of the family.

ABC News: Judge Orders Baby Kept on Life-Support

[design219]

Poor kid.

[Jawbone54]

It sounds to me like the family might be short-sighted in this matter. It's not for me to say, but I don't think this should be considered an assisted suicide, if that's the family's argument.

I don't really know how I feel about this, not knowing all the details. I just feel really bad for the family and the boy.

[♥]

I feel sorry for the baby also.

I feel sorry for the family too.

I feel very fortunate not to be in their shoes, to be honest. It would be incredibly difficult.

This reminds me of the Schiavo case, actually.

[OreoCookie]

Originally Posted by ♥ 

As a parent it would be terrible and heart-wrenching to have to let my child die. Every cell in my body would want to fight to keep that child alive by any means necessary. With the advances of modern medicine daily, it might be that in a year or two that there might be a medication or means that might result in significant improvement in the child's life.

The article said that the child didn't have higher brain functions and that it can't live on its own. There isn't going to be some sort of miracle drug in this case.

Originally Posted by ♥ 

What parent would willingly choose to terminate their child's life? Not many.

Wait, I think you're mixing things here. The ultimate instinct of a parent is to prevent your child from suffering. Extending life support here means an extension of suffering without hope of the child ever being able to live without machines. That's not a life, it's `life' in prison without the possibility of parole.

I don't see how extending the suffering of your child lies in the interest of any parent/close family member.

[♥]

Well, the article also says that the child smiles and turns toward the mother's voice.

That's not brain dead in my estimation.

[OreoCookie]

Originally Posted by ♥ 

Well, the article also says that the child smiles and turns toward the mother's voice.

That's not brain dead in my estimation.

Nobody said brain dead. These reactions are instincts. The article particularly said the baby

- has no higher brain functions (the relevant parts of his brain are irrevocably destroyed,
- is unable to breathe on its own,
- is unable to eat and drink on its own,
- is unable to swallow,
- is unable make intentional movements.

A smiling baby makes it harder to get your head around the fact it's going to die soon (even with life support). It's a hard situation for the parents, because they have to accept that their child is unable to survive and terminally ill.

As a parent, you have to put the interests of your child before your own, and it's not in the interest of the baby to have it prolong its suffering in this situation. The parents' actions are egoistic (albeit understandable).

[design219]

I suspect if this baby was ABLE to cry, the parents might feel different.

[Mrjinglesusa]

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.

Seems to me the parents are being completely selfish in wanting to keep the baby "alive" via life support. In cases like this, I always question the family's motivations in keeping someone on life support when there is no hope for their recovery and no hope that they can ever live a normal, fulfilling life.

[JMan09]

I feel bad for the family, but would you want to visit your kid everyday knowing they wouldnt get better? And everyday see your kid with tubes and wires coming from everywhere to keep him alive? I say this without having kids, but I couldnt look at a loved one everyday hooked up to tubes and wires keeping them alive for the rest of their life and mine. Just my thoughts.

[ghporter]

Actually, executions by lethal injection (in Texas, anyway) do result in asphyxiation due to paralysis of the diaphragm and other muscles. The inmate gets sedatives because, unlike the baby in question, he has higher order brain functions, and thus can feel and notice those sensations.

This issue has two sides. First is the family wanting to keep alive a baby with absolutely no chance of ever doing anything but using up medical supplies and professionals' time, and the professionals not wanting to give up. The other is the exhausting quality of having a relative of any sort in an intensive care situation and how that can change one's perception of the entire world. If the hospital's ethics review board has decided that the child is hopeless, that means that they have worked VERY hard at their decision and there is no available professional advice that the child will ever be any better than he is right now. And that child is taking up space in an ICU that could be used to help a child who MIGHT be able to get better. He's also using up a number of resources, including the basic manpower needed to simply keep him breathing by machine, the nurses and doctors that have to assess him on a regular (at least twice a day for the nurses, and daily for the doctor) basis. The respiratory therapists who need to maintain his ventilator. The lab techs and phlebotomists who draw and perform regular tests to determine how to adjust the IV feeding. The rest of the ICU's staff who have to work around this poor child and his family. It's incredible how much effort goes into every single pediatric ICU patient every single day.

My wife is a NICU nurse; she sees NEWBORN babies with every problem from simple low birth weight through anencephaly. It is NECESSARY to let go sometimes. It is of course, incredibly hard. But they do have to let go.

Ethically, it is NOT the family that is the issue. It is the patient, and his potential for suffering for no good reason. Even if he does not notice it, he is suffering. It is not only unethical to continue unproductive treatment, but it is unethical to make the professionals that provide that treatment keep doing so on a child who cannot benefit from their work.

[Mac Write]

Why not kill disabled people who are in homes who can't move, who need to be fed etc? I think that would be a very good idea as well as killing any disabled who are a drain on society.

[Ghoser777]

Higher. Brain. Function.

[ghporter]

For those who have missed the critical importance of the three words Ghoser777 just posted, let's recap. This baby is not able to breathe, swallow, see, or feel anything. The upper centers of his brain are no more. There is nowhere for consciousness to be, and further, the brainstem, which handles the housekeeping issues like breathing and temperature regulation of a healthy body, is also not working, or he'd be breathing on his own. In other words, this poor little guy is merely a shell that consumes calories and produces heartache.

The child suffers from Leigh's Disease, a neurometabolic disorder that causes degeneration of the central nervous system. It is incurable with an extremely poor prognosis in even the best of cases. There IS NO CURE, there is no hope. The person inside that body has departed, leaving an empty husk. The probate judge who has ordered the hospital to maintain the child's life support had best tread lightly, or his 15 minutes of fame will be in the wrong direction for his continued political health (most judges in Texas are elected-this guy probably thinks that he's buying "pro life" votes, but I'll bet not.).

[TheWOAT]

I think the family should decide. Ultimately they will make the right choice, if not, I would understand.

[andi*pandi]

Given that diagnosis, I would let the child go. But it would be hard.

[design219]

Originally Posted by TheWOAT 

I think the family should decide. Ultimately they will make the right choice, if not, I would understand.

Todays technology allows us to do a lot of wonderful stuff. That's good and bad. Should decisions of how and when to use extreme technology measures be in the hands of people so close (too close) to this situation? I'm not saying governments or corporations have better judgement, but I don't think the family is thinking clearly about what is best for this child right now.

[Calimus]

Originally Posted by ghporter 

For those who have missed the critical importance of the three words Ghoser777 just posted, let's recap. This baby is not able to breathe, swallow, see, or feel anything. The upper centers of his brain are no more. There is nowhere for consciousness to be, and further, the brainstem, which handles the housekeeping issues like breathing and temperature regulation of a healthy body, is also not working, or he'd be breathing on his own. In other words, this poor little guy is merely a shell that consumes calories and produces heartache.

I have to agree. While it would be a terrible decision to have to make, there has to be a point where you draw the line. I know it's grotesque to bring up things like this, but what if someone where decapitated, but their body could be kept alive by machines? Would we still feel the same? How much of a body must be lost before we don't see it as a person?

And to the "murder" issue. I think in some cases it's almost more of a sin/crime to use machines to prolong life. There have been people in coma states that came to after years and said they were conscious the entire time and that it was a living hell, the worst torture imaginable, to be locked in their own mind with no outside contact. Of course that's not every case or even the majority, but it just makes you wonder about things like this.

[Jawbone54]

The family should make the extremely difficult (and right) choice to allow the child to pass on, but it won't happen quickly. I'm not sure what their reasoning is to keep him around with absolutely no chance for normality.

[ghporter]

Originally Posted by TheWOAT 

I think the family should decide. Ultimately they will make the right choice, if not, I would understand.

Letting the family decide means that they are both running up astronomical bills that will NEVER be paid, and that the resources keeping their hopeless child going cannot be used for someone who MIGHT ACTUALLY GET BETTER. There are limited amounts of hardware, personnel and materials in any hospital; why should a family that does not want to take the expert opinion of a large number of doctors, including many not at all connected to their case, be allowed to commit all those resources to the possible detriment of some other family's baby?

That issue by itself is a huge ethical problem.

[climber]

ghporter is right on. This decision means that a few hundred thousand dollars will be hopelessly spent prolonging this misery for another couple weeks. And only because it made the front page on CNN. Regardless of whether this hospital, or the State Medicaid program picks up the cost, those financial resources will effectively be stolen from other families in need. Medicaid in every state is stretched thin and access to beneficial health care for the poor suffers. For good or bad, Medicaid only has so much money to spend each year.

[ghporter]

Originally Posted by climber 

ghporter is right on. This decision means that a few hundred thousand dollars will be hopelessly spent prolonging this misery for another couple weeks. And only because it made the front page on CNN. Regardless of whether this hospital, or the State Medicaid program picks up the cost, those financial resources will effectively be stolen from other families in need. Medicaid in every state is stretched thin and access to beneficial health care for the poor suffers. For good or bad, Medicaid only has so much money to spend each year.

More likely it's the citizens of Travis county that are footing the bill. Children's Hospital of Austin is part of Brackenridge Hospital, which I'm pretty sure is "the county hospital" (= indigent care, suck up the costs, pass it on to the taxpayers). And please note that this is no backwater, ten-bed, backward and behind the science hospital! Brack is GREAT in a whole lot of ways, and their Children's Hospital is both purpose built and well run.

[♥]

So, all of you ready to pull the plug...who is going to stay to watch that baby struggle to breathe and die in front of you? It's easy to say "pull the plug," but a lot harder when you're the one watching a child or loved one die in front of you.

Something to think about...

[Ghoser777]

It just depends on what you consider death - most of use here are saying that the lack of Higher Order Brain Function indicate that the child is not alive already. There is no self-sustaining force inside it - only a machine can keep it running, and it has no concept of self, nor will it ever obtain that.

It's like you died and went to heaven, and while you're in heaven, everyone you loved down on earth is spending their time with an empty shell hooked to a machine. There's a point where you really have to let go.

[OreoCookie]

Originally Posted by ♥ 

So, all of you ready to pull the plug...who is going to stay to watch that baby struggle to breathe and die in front of you? It's easy to say "pull the plug," but a lot harder when you're the one watching a child or loved one die in front of you.

Something to think about...

If I were one of the parents, I'd stay. My baby shouldn't die alone.
You are only hesitating, because it's hard on you (on all of us, if we happened to be a parent of such a child) … 

[ghporter]

Originally Posted by ♥ 

So, all of you ready to pull the plug...who is going to stay to watch that baby struggle to breathe and die in front of you? It's easy to say "pull the plug," but a lot harder when you're the one watching a child or loved one die in front of you.

Something to think about...

I'd do that. I'd stay there and hold mom's hand too. Because the baby deserves to not suffer anymore, and mom deserves the respect that is due someone whose child is dying. It would indeed be sad and very hard to do, but it would be the RIGHT thing to do.

You titled this thread "Murder or Not?" No, not murder. Mercy, both for the child and his family. It's not always easy, but it's something that sometimes must be done.

[Chuckit]

Originally Posted by ♥ 

So, all of you ready to pull the plug...who is going to stay to watch that baby struggle to breathe and die in front of you? It's easy to say "pull the plug," but a lot harder when you're the one watching a child or loved one die in front of you.

Something to think about...

So what? I'd have an emotionally difficult time sacrificing myself to save my family too, but that doesn't make it immoral. Refusing to do the right thing because it's painful doesn't make the wrong choice right — it just makes you a coward.

(This is a generic "you" here — no personal attack intended.)

[Timo]

some great posts in here

thanks especially to ghporter

[JMan09]

Originally Posted by Ghoser777 

It just depends on what you consider death - most of use here are saying that the lack of Higher Order Brain Function indicate that the child is not alive already. There is no self-sustaining force inside it - only a machine can keep it running, and it has no concept of self, nor will it ever obtain that.

It's like you died and went to heaven, and while you're in heaven, everyone you loved down on earth is spending their time with an empty shell hooked to a machine. There's a point where you really have to let go.

Same thing I was thinking.