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Lest We Forget….
Part Two of Three By Dave Andrusko Of all the many thousands of articles I've written about attacks on innocent human life, none have drained me more than what were (then) the famous "Baby Doe" cases. There were many differences, but one soul-wrenching commonality in these cases from the 1980s: a baby was born with serious medical issues and his or her parents had decided to "forgo treatment." That can mean "discontinuing" or never beginning medical treatment and/or food and fluids. The "problem" in these cases was not that the baby would die. The "problem" was, if provided with medical treatment (or even just food and fluids) the baby would live! Only occasionally does this barbarism show its ugly face. Over at National Right to
Life News Today, I've reprinted a blog entry from bioethicist
Wesley Smith about a study discussed at Medscape.com. The
article he comments on is titled "Prolonged Survival Frequent
After Withdrawal of Neonatal Nutrition and Hydration" and is
written by Kate Johnson. It is based, we are told, on "a case
series presented here at the 18th International Congress on
Palliative Care." In addition to Wesley's typically astute comments, I'd like to add a couple of thoughts. The first four sentences of the article are among the most chilling I have read in a long, long time. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ October, 7, 2010 (Montreal, Canada) -- Neonatal survival after withdrawal of artificial hydration and nutrition can last up to 26 days, according to a case series presented here at the 18th International Congress on Palliative Care. Although physical distress is not apparent in the infants, the psychological distress of parents and clinicians builds with the length of survival, said Hal Siden, MD, from Canuck Place Children's Hospice in Vancouver, British Columbia. "These babies live much, much longer than anybody expects. I think that neonatologists and nurses and palliative care clinicians need to be alerted to this," he said. "The time between withdrawal of feeding and end of life is something that is not predictable, and you need to be cautioned very strongly about that if you are going to do this work." ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
They were apparently
pretty successful at "dampen[ing]" the babies' crying. But what
they couldn't hide was how emaciated the babies became. Are they
worried about the babies' suffering? They have morphine and the
like, which they persuade themselves handles that little
difficulty. "A critical factor for counseling is to anticipate the kind of suffering that comes with witnessing the emaciation," she writes. "It isn't something people can prepare themselves for" (emphasis added). The autopsies appear problematic, even though recommended. What's the hang-up? "Parents should be warned that the report will document the technical cause of death as 'starvation' -- a loaded word for all concerned," Johnson writes. "It is important that parents separate this word from any notion of suffering, he said." Oh. Speaking of suffering, "All of the children we've cared for have been in a very quiet, low metabolic state -- not an agitated state -- with no overt signs of hunger behavior," Dr. Hal Siden, MD, from Canuck Place Children's Hospice in Vancouver, British Columbia, tells Johnson. Sounds reassuring. Then he adds, "Whether they are neurologically capable of hunger behavior is another question, and I don't know the answer." However, "Not everybody is comfortable or aware that it's morally and ethically permissible to make decisions to discontinue these types of interventions," said Joanne Wolfe, MD, director of pediatric palliative care at Children's Hospital Boston, in Massachusetts. "This study highlighted those key things more systematically -- that it's acceptable and it doesn't invoke suffering -- while acknowledging that there is a physical change that we need to be prepared for, and that we need to help the family prepare for and proceed through." The scariest comment? "An informal poll of the room by Dr. Siden revealed that most of the attendees had direct experience with this type of case." Please send your comments on Today's News & Views and National Right to Life News Today to daveandrusko@gmail.com. If you like, join those who are following me on Twitter at http://twitter.com/daveha. |
The
details are given clinically. Johnson writes that once food and
fluids are "discontinued the mean duration of survival was 13.2
days (range, 3 to 26 days), she said." (The "she" is Kerry
Keats, MSW.) "Infants' ages at death ranged from 18 to 67 days."