There is a futile care case in court in Canada involving an infant named Isiah, whose parents want to continue life support, versus the hosptial that seeks to unilaterally remove treatment. From the story:
When Isaiah was born in Oct. 2009, he suffered severe oxygen deprivation. Doctors say they’ve done everything they can. But the parents believe their son is showing signs of improvement. The boy was born in the Rocky Mountain House Hospital after a difficult 40-hour delivery. On Oct. 24th, 2009 the boy was airlifted to hospital and admitted for treatment. The boy was then placed on a ventilator in the hospital’s neonatal intensive care unit. A letter sent to the parents by Alberta Health Services on Jan. 13th stated that the boy’s doctors believed all medical procedures had been exhausted. They informed the parents that the boy will never recover from a severe lack of oxygen at birth. “The diagnosis is unchanged; your son suffered severe anoxic brain injury at birth and has irreversible brain damage. There is no hope of recovery for Isaiah,” the letter stated.
What does “no hope of recovery” mean? Does it mean the baby will die, even with life support? But he has been alive for 90 days and hasn’t succumbed yet. Or instead, does it mean he will be permanently disabled? If so, that should not be reason to cut off wanted care. Indeed, doing so is discrimination.
According to the family, the medical team has been wrong about how Isaiah would fare:
Isaiah’s mother Rebecka May stated in court documents that her son has continued to grow since his birth. May said medical staff informed the family that “Isaiah would not grow.” But the woman noted that Isaiah has “continued to grow since his birth and now weighs ten pounds eleven ounces.” May also mentioned in documents that her son’s pupils dilate, his eyes open daily, and he moves his hands, arms and feet with “increasing frequency.”
Doctors are not perfect, and prognoses are sometimes wrong, particularly when it comes to children. Remember Haleigh Poutre, who doctors said would never recover–but who was saved when she showed signs of awareness before the “plug could be pulled” and is now receiving special schooling, much improved.
This case is in court, where it belongs rather than being decided behind closed doors by an ethics committee. The parents want to give it another 90 days, but the hospital has “offered” 30–haggling as if this were a lawsuit over the value of a damaged car. At least the judge is clearly taking this matter very seriously and has decided to get another medical opinion. But it seems to me, that when parents want their baby to be able to continue to fight for life, when he seems to be showing apparently unexpected signs of improvement, a tremendous burden of proof should be required for hospital administrators to veto the parents’ decision.
Alex Schadenberg, of the Euthanasia Prevention Coalition, has been following the case closely. For more details, check out his blog.
January 19th, 2010 | 6:16 pm
I guess it doesn’t matter that a patient who has absolutely no hope of recovery is taking up a space and resources that could be utilized by a patient who DOES have a chance of recovery. BTW, Wesley, are YOU going to pay the bill for keeping him attached to his tubes indefinitely? You, who claims that “Obamacare” is going to bankrupt the country. Answer: yes, you’ll pay for it in increased premiums. Fine, if that’s what you want; but don’t speak for me, and don’t insist on financing your philosophy with my wallet.
January 19th, 2010 | 6:22 pm
BTW, whatever became of the famous Rom Houben who was writing his memoirs with his big toe? Remember Rom? All the “life” sites whose darling he was just a couple of months ago are awfully quiet about him these days. Did they finally realize they were being suckered?
Wesley J. Smith Reply:
January 19th, 2010 at 6:35 pm
No. He is conscious and there remains controversy over “facilitated communication.”
January 19th, 2010 | 9:02 pm
This is the dirty little secret that no one would talk about during the health care “debates”. All anyone wanted to talk about was pulling the plug on Granny. Not nearly as scary as pulling the plug on Baby Darlin’.
I worked as a nurse for oh, say a zillion years and the nurses in the NICUs are really wondering if their field will be scaled back dramatically. The costs of NICU makes ICU and CCU look like chump change.
January 19th, 2010 | 10:06 pm
So, HW, could you please give us the name of the patient that this child is taking resources from? Real children trump hypothetical children whom you have birthed in your mind to support your mysanthropic argument against this patient’s right to continue receiving care based on his family’s decision.
January 19th, 2010 | 11:28 pm
HW:
I love how you think you have everything figured out from one or maybe even a few news stories. At least Smith is asking questions; you are just making assumptions.
January 19th, 2010 | 11:32 pm
Don’t forget, HW is the last line of defense against us mean-spirited conservatives who care nothing for human lives!
January 20th, 2010 | 9:09 am
Safepres: you mean “hypothetical children” like those presidents of the US and discoverers of cancer cures who’ve been aborted — the ones the anti-choice crowd are always moaning about? Do you have a problem thinking in the abstract? Do you lack imagination to such a degree that you can’t picture the possibility that over the next forty years someone might need that ICU bed? Perhaps you’ve just provided a clue about why people support policies that are against their best interests.
January 20th, 2010 | 9:12 am
Smith is “asking questions” so that he can answer them with his own philosophy. His philosophy is based on assumptions (such as “human exceptionalism”) for which there are no proofs. So what’s the difference? None at all.
January 20th, 2010 | 2:44 pm
Safepres: you mean “hypothetical children” like those presidents of the US and discoverers of cancer cures who’ve been aborted — the ones the anti-choice crowd are always moaning about?”
Great way of changing the subject to avoid responding to someone else’s response to your misconceived argument! Give yourself a pat on the back, HW.
Do you have a problem thinking in the abstract? Do you lack imagination to such a degree that you can’t picture the possibility that over the next forty years someone might need that ICU bed?
The next Forty Years? Are you seriously suggesting that what might happen in the ICU in the next FORTY YEARS has something to do with what Baby Isaiah is going through NOW? That’s completely illogical!
Perhaps you’ve just provided a clue about why people support policies that are against their best interests.
Ah, I see. Well, if I am ever gravely ill, I or my family will decide when I’ve had enough medical care, NOT you, NOT the doctors, and NOT the hospital ethics committee, thank you very much.
January 21st, 2010 | 11:09 am
“Well, if I am ever gravely ill, I or my family will decide when I’ve had enough medical care, NOT you, NOT the doctors, and NOT the hospital ethics committee, thank you very much.”
But that’s exactly the kind of choice you would deny those who desire assisted suicide. Hypocrite!
January 21st, 2010 | 3:19 pm
This is another reason why I support health care given at home.
In nearly all cases there are versions of monitors that can be portable and taken home, as in the breathing alarms that preemie babies wear.
That way there is no fight about “taking up space” in the hospital. Home care, even with 24-hour nursing care, is somehow usually cheaper than the hospital, too.
January 21st, 2010 | 5:55 pm
Ah, but NO-I said that I and my family will decide when I’ve had enough medical treatment. I did NOT say that I and my family will decide when I’m so desperate that I should be abandoned to a lethal injection. Thus, my position, unlike yours, is not hypocritical.
January 21st, 2010 | 7:22 pm
Does this remind any of you about another international fight for life case? Do you remember Terri Schiavo?
This woman was oxygen deprived and was diagnosed PVS (Persistabt Vegatative State). She was not in PVS. Her heart was beating, her lungs were functioning and she even interacted with her family. There was a time when her Fater, Robert Schindler, visited Terri and talked with her about her lazy eye as a child. When this took place, Terri and her father both laughed about it.
So, was this woman PVS? NO she was not, she was a disabled woman who was murdered at the hands of her husband and the courts!!!!
January 22nd, 2010 | 9:59 am
Safepres: you’ve already said what you’d do. The question is simply about how you’d like to do it. Whether it’s by abandoning your meds and waiting to die, or deciding to speed up the process, the end result is the same, so please stop the charade. You do, in fact, want to deny others the choice of how they will deal with a similar problem.
January 22nd, 2010 | 10:09 am
Dawn: if you read Terri Schiavo’s autopsy report you’ll see that she was unable to talk at all, let alone joke about he childhood eyesight problems.
PVS has nothing to do with whether your lungs are functioning or your heart is beating. It has to do with what’s going on in your brain. Terri Schiavo was not brain-dead; enough of her brain stem was functioning to support her heart and lungs. However, the parts of her brain responsible for sentience were almost entirely deteriorated and had been replaced by cerebrospinal fluid. What you consider “murder” is considered “deliverance” by millions of others.
January 22nd, 2010 | 12:11 pm
HW…
You may be right about Schiavo’s mental state. The problem was that there were a whole lot of attendant issues that were never addressed – to include the fact that the judge who issued decisions on the matter was a Scientologist (in a heavily Scientologist populated area) and Scientology teaches that defective people should be eliminated. (eliminated might be too strong a word – not given medical support; not given special care. It isn’t deliberate murder exactly, but like euthanasia, it’s darn close) Also the fact that in Florida, up until something like 1994, maintenance of feeding tubes and water were considered “ordinary” care. About ’94, their legislature passed a law changing the maintenance of feeding tubes and hydration for the physically disabled to “extraordinary” care, which is the statute under which it became legal to remove those from Terry Schiavo. Why was that law changed? Who initiated the change?
I don’t pretend to know the moral right and wrong of that particular case – these things are hard decisions – but I think there were many facets that have never been explored. Why, for example, since her husband was living with a different woman and had children with her, was he still considered her legal husband? He’d been living with the other woman long enough to be considered a legal common law marriage – if he hadn’t still been married to Schiavo. Why did he still have the legal authority to require cessation of the extraordinary care? Why didn’t the court simply designate her parents – who were willing to accept that responsibility? And I never heard the insurance/who’s going to pay question addressed. Assuming the parents were given responsibility…could they pay for her care? I don’t know – too many questions I had at the time were left unanswered and unaddressed.
January 22nd, 2010 | 6:38 pm
suek: I agree that there were other issues, but none of them had a direct bearing on the case. The matter to be decided was whether Terri Schiavo, absent a written directive, had made known her desire to have feeding and hydration discontinued if she ever entered a PVS. A judge heard testimony and rendered a decision that was upheld on appeal.
That the judge’s Scientologist religious beliefs made a difference in the outcome implies that his religion interfered with his administering the law in the manner in which he was sworn to do. Not only is there no proof of this; it implies that the Schindlers would have received preferential treatment had the judge been a fundamentalist Protestant, a Roman Catholic or an Orthodox Jew. I think it’s better to assume that members of the judiciary act with integrity unless proven otherwise.
Terri Schiavo’s treatment was funded by the malpractice settlement Michael obtained against her physician. It included money for her treatment and rehabilitation, and compensation to Michael for what is called “loss of consortium.” There is no indication that Michael squandered the money. There is no indication that he refused to pay for efforts at Terri’s rehabilitation until it became clear that further efforts would be fruitless.
Michael took up with another woman after a number of years of Terri’s being insensate. In that regard he did what any normal man would have dome under the circumstances. He wasn’t an ascetic, after all. I can’t say why he didn’t divorce her, except to speculate that he might not have wanted to lose the ability to direct her care. Or, he might have wanted to keep control of the funds so that the Schindlers couldn’t. Be that as it may, he was not divorced from Terri but was living in an adulterous relationship; therefore, declaring a “common law” marriage would have made him a bigamist. To the best of my knowledge adultery is not a crime in Florida, but bigamy IS a crime just about everywhere. While Michael remained married to Terri he maintained the legal authority to make judgments as her next of kin.
Admittedly the case presents a number of points on which moral judgments can be made, but what’s moral and what’s legal are often two very different things. All I can say is that I think it’s unfortunate that supporters on both sides used the case to “earn points” for their particular agendas.
January 24th, 2010 | 12:54 am
HW…human exceptionalism unproven…has that stopped you from gorging yourself on unproven liberal doctrines? God does not exist, man made climate change, evolution, utilitarianism…
Please share with us your ability to discern how much neurologic function a person can recover after injury. Teach HW to know which of the dreaded human species is worth saving. Imbue us with the possibility that someday we can look beyond the value a less than perfect individual like yourself may have. Help us to stop being the speciests we don’t want to be HW!
Sadly, I have to admit you may make your own point. Assuming it can be proven that you are human, you could be exhibit A in the case against human exceptionalism. We all may be doomed after all.
If I were you I would be exquisitely careful about whom you cede control of your life and death decisions to. I gotta believe some of your family members might relish the opportunity to make such decisions.
January 24th, 2010 | 12:59 am
Edit to my prior comment. Submit instead if possible Wesley.
HW…human exceptionalism unproven…has that stopped you from gorging yourself on unproven liberal doctrines? God does not exist, man made climate change, evolution, utilitarianism…
Will you please share with us your ability to discern how much neurologic function a person can recover after injury?! Teach us HW to know which of the dreaded human species is worth saving. Give us hope that someday we will overcome the fault which forces some of us to appreciate the value a “less than perfect individual” may have! Help us to stop being the speciests we don’t want to be HW!
Sadly, I have to admit you may make your own point. Assuming it can be proven that you are human, you could be exhibit A in the case against human exceptionalism. We all may be doomed after all.
If I were you I would be exquisitely careful about whom you cede control of your life and death decisions to. I gotta believe some of your family members might relish the opportunity to make such decisions.
January 27th, 2010 | 12:07 am
What I’m surprised that no one has mentioned is the fact that it this woman endured a 40-hour labor and her son was choked by his own umbilical cord–two conditions that should have never happened were the hospital competent in the first place. Why was there not a C-section? Was this baby not monitored? And these are the professionals that these parents are now supposed to trust?
Wesley J. Smith Reply:
January 27th, 2010 at 10:36 am
Karen, I wondered about that too. But, I didn’t have the information to know.
February 19th, 2010 | 11:47 am
[...] I have written before of the futile care case in Canada involving “Baby Isaiah,” an infant who experienced a severe brain injury during a very long labor process. When the physicians sent a letter stating they would unilaterally cease life support, Isaiah’s parents sued. [...]
March 12th, 2010 | 12:37 pm
[...] received word last night that Baby Isaiah, the subject of a bitter futile care case in Canada, died in his parent’s arms after they [...]
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