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Barry Shnikov
6th-March-2006, 07:14 PM
Should we - as taxpayers - fund the medical intervention for Baby MB indefinitely simply because the baby is mentally alert? He cannot breathe, chew or swallow on his own. Must we strive / officiously to keep alive?

ducasi
6th-March-2006, 07:56 PM
I know absolutely nothing about this story, but what from you've said, I'd say yes.

Magic Hans
6th-March-2006, 08:05 PM
Call me a heartless philistine [or a Jehova's Witness] .... but I'd say no.

David Bailey
6th-March-2006, 08:07 PM
Should we - as taxpayers - fund the medical intervention for Baby MB indefinitely simply because the baby is mentally alert? He cannot breathe, chew or swallow on his own. Must we strive / officiously to keep alive?
Yes. Mental alertness is what makes us human.

And allowing someone to die because it's expensive to keep them alive is a pretty feeble argument - or would you kill someone who was similarly paralysed at, say, age 50?


Call me a heartless philistine [or a Jehova's Witness] .... but I'd say no.
OK, you're a heartless Philistine. And you mis-spelt Jehovah too, which is equally bad.

Magic Hans
6th-March-2006, 08:51 PM
... give someone a fighting chance ..... yes!

... keep someone alive at all costs, indefinitely .... no!

.... drawing the balance??? bl**dy difficult!

David Bailey
6th-March-2006, 09:01 PM
... give someone a fighting chance ..... yes!

... keep someone alive at all costs, indefinitely .... no!

.... drawing the balance??? bl**dy difficult!
If it were my kid, I'd want him to live. And the golden rule applies for this one IMO.

The parents think he has quality of life, so I'd go with their judgement.

It's one thing to apply for a DNR, as with baby Charlotte - although even then I think it's highly contentious - but it's another thing entirely to actually withdraw life support.

El Salsero Gringo
7th-March-2006, 12:31 AM
The parents think he has quality of life, so I'd go with their judgement.Actually, while I think their views are important, you could easily argue that the parents are too vastly swayed by their own emotional needs to make any kind of rational judgement over the child's quality of life.

Barry (rather cleverly, and perhaps deliberately) has posed the question in a provocative way by almost but not quite making the cost as the reasoning behind any decision. I don't think cost is relevant, and I don't believe the court will consider it. Even though the care is expensive, those who have ethical arguments that it should be withdrawn should not be attacked on the grounds that they're trying to "save money".

Barry Shnikov
7th-March-2006, 02:36 PM
If it were my kid, I'd want him to live.
That's begging the question, which is, should parents have the final say?

The parents think he has quality of life, so I'd go with their judgement.
That's begging the question again!

Compare the recent case of the adult woman in the US - her doctors and husband wanted to withdraw life support, but her parents argued that she still had quality of life. They posted footage on the internet which - they claimed - showed her following a balloon with her eyes and thus showed she was 'looking' at it.

When cooler heads prevailed (this is a reference to Bush getting the whole thing @rse-ways about) she died and the autopsy showed that half her brain, and almost the whole of the higher function centres, had turned to slush.

So just because parents say yay, doesn't really mean a lot. Few parents (understandably) can take such hard decisions.

Barry Shnikov
7th-March-2006, 02:37 PM
Barry (rather cleverly...:waycool:

Barry Shnikov
7th-March-2006, 02:41 PM
Barry has posed the question in a provocative way...

Not me, governor...but I did want to set out why we, as opposed to say, Americans, have an additional interest in the outcome of health decisions such as this. Keeping alive such a child indefinitely could cost, depending on how long it lives, £millions.

Whilst in an ideal world one would like to take decisions without considering the money issue, we can't. Allowing the parents application means, by definition, that money will not be available to meet other health needs. For example, hip replacements. I don't know offhand which are the 'low priority' treatments with this particular health trust/authority, but whatever they are they will suffer if the parents succeed.

David Bailey
7th-March-2006, 02:47 PM
That's begging the question, which is, should parents have the final say?
Yes.

Parents, by definition, have the final say over children (within the constraints of social, educational and legal systems of course). Of course they're biased, but in this case, I'd rather have a positive bias than a negative one.


Compare the recent case of the adult woman in the US
One of the many differences between these two cases is exactly that - she was an adult. Different rules apply - you have different relationships and responsibilities as an adult than as a 17-month baby.

Come on Barry, I appreciate your help in reaching my target, but I'm barely engaging my brain at the moment, you can do better than this I know...

Barry Shnikov
7th-March-2006, 02:53 PM
Are you struggling with what 'begging the question' means?

Parents, by definition, have the final say over children (within the constraints of social, educational and legal systems of course).
Do those constraints on this occasion overbear the parents' understandable wishes?

One of the many differences between these two cases is exactly that - she was an adult. Different rules apply - you have different relationships and responsibilities as an adult than as a 17-month baby.
You seem to think this invalidates the comparison I draw - which is that in extremis parents are not good at distinguishing their own from their child's best interests - but it does not.

David Bailey
7th-March-2006, 03:25 PM
Are you struggling with what 'begging the question' means?
You posed, I answered :)


Do those constraints on this occasion overbear the parents' understandable wishes?
Which constraints specifically are you referring to? If you mean economic constraints (i.e. the baby costs too much to keep alive), then I'd say "Hell, no."
Other constraints - for example, demonstrable permanent, debilitating and crippling pain for the child, with no hope of recovery - might elicit a different answer.


You seem to think this invalidates the comparison I draw - which is that in extremis parents are not good at distinguishing their own from their child's best interests - but it does not.
In the case of the American woman, her husband was the next of kin, wasn't he? So the comparison isn't valid - if anything, it reinforces my point, that I'd trust the "next of kin" better than I would the government when this sort of decision is involved.

Little Monkey
7th-March-2006, 03:34 PM
Oh god, here we go again.....

This is yet another question with no "right" answers. Everyone's perception of what's ethically right or wrong is different, and people can argue to the end of the universe about this, and never reach a conclusion!

Personally I don't think cost (as in money) should have any influence on the decision. A human life cannot be measured in money!

On the other hand, I agree with people who say that parents are not always the best at making a rational and objective decision about their own child. They will "think with their heart rather than with their head" in cases like this, which is perfectly understandable. I have in the past personally refused my own mum to come with me to hospital when I've been rushed in to intensive care with anaphylaxis, as I know that her behavior will be irrational and hysterical due to her fear of me dying. I know this is a very different scenario, but I know in a situation like that, my mum will not be able to think clearly at all, like any other parent with a very sick 'child' (and at the age of 31, I'm still my mum's 'child'!).

So what am I saying? That the doctors should have the ultimate say over any person's life, regardless of age or circumstances? Well, not really. Doctors make mistakes, too. The real b*gger is that there really isn't a 'right' or 'good' solution to this question at all. And each case is different.

If it was my child, I would of course try everything to keep my baby or child alive. I would quite possibly be irrational, and unwilling to let my child go, even if I knew that my child would never grow up or be anything other than a 'vegetable', living on life support.

So what's my answer? Well, how should I know? After all, I'm just a Little Monkey. :rolleyes:

El Salsero Gringo
7th-March-2006, 04:13 PM
Not me, governor...but I did want to set out why we, as opposed to say, Americans, have an additional interest in the outcome of health decisions such as this. Keeping alive such a child indefinitely could cost, depending on how long it lives, £millions.

Whilst in an ideal world one would like to take decisions without considering the money issue, we can't. Allowing the parents application means, by definition, that money will not be available to meet other health needs. For example, hip replacements. I don't know offhand which are the 'low priority' treatments with this particular health trust/authority, but whatever they are they will suffer if the parents succeed.Yes, keeping a child alive could cost millions, but it might in fact cost rather less than that. If there were a treatment that could guarantee recovery but required space-programme style costs in the billions then clearly the public interest would not be served by providing it at public expense. But I don't think that the equivalent of one extra intensive care bed reaches those heights. So I don't think that cost should be an issue.

There was an interesting comment in the Times report on this today, which was that the Neurologist in charge of MB's care said he was convinced he was doing wrong by prolonging the treatment (including 20 minutes of painful physiotherapy on the child's chest every day, simply in order to clear the airways for the ventilators to be able to force enough air into the lungs) and that he was considering withdrawing his care unilaterally if the court decided in favour of the parents. Now that's an interesting decision.

LMC
7th-March-2006, 04:26 PM
You can't assess the value of human life in financial terms.

But I would suggest that the neurologist and other medical experts are better placed to judge whether a 17 month old baby is in pain and would ever recover from that pain than understandably distraught parents. As an outsider it's easy for me to have the opinion of: "If the expert view is that there is no potential for any quality of life then let the poor child die in peace".

It's a re-run of "Baby Charlotte" and a horrible horrible situation for everyone involved. It's not about the money - but fighting to keep the baby alive, however much pain s/he is in, when expert opinion is almost unanimous that there is little hope (I'm sure any number of medical professionals will have assessed the situation) just seems plain selfish on the part of the parents.

Barry Shnikov
7th-March-2006, 04:33 PM
Yes, keeping a child alive could cost millions, but it might in fact cost rather less than that.
Not very likely. See here (http://www.bnn-online.co.uk/news_datesearch.asp?page=2&SearchDate=27/Nov/2002&Year=2002) a 2002 report suggesting hospital beds cost up to £800 per day. That would, presumably, be intensive care beds; it seems ordinary beds in 2001 were about £1000 a week.
That sums up to quarter of a million pounds a year; as the baby is only 17 months old it would only have to reach the age of six to cost the NHS a million quid. That's not considering the cost of treatment.

There was an interesting comment in the Times report on this today, which was that the Neurologist in charge of MB's care said he was convinced he was doing wrong by prolonging the treatment (including 20 minutes of painful physiotherapy on the child's chest every day, simply in order to clear the airways for the ventilators to be able to force enough air into the lungs) and that he was considering withdrawing his care unilaterally if the court decided in favour of the parents. Now that's an interesting decision.
Why are we spending thousands on a High Court hearing then? I suppose the hospital would then be under a duty to find another neurologist to do the same work, presumably at higher cost - see my first paragraph.

Barry Shnikov
7th-March-2006, 04:45 PM
You posed, I answered :)
No, you didn't. I asked, should the parents wishes be paramount? And you kept telling me, what parents would wish!!

Which constraints specifically are you referring to? If you mean economic constraints (i.e. the baby costs too much to keep alive), then I'd say "Hell, no."
Other constraints - for example, demonstrable permanent, debilitating and crippling pain for the child, with no hope of recovery - might elicit a different answer.
Um...check your post. Earlier, you used the word constraints, which is why I used it in my reply. So those are the constraints I was referring to.

In the case of the American woman, her husband was the next of kin, wasn't he? So the comparison isn't valid - if anything, it reinforces my point, that I'd trust the "next of kin" better than I would the government when this sort of decision is involved.
Again, you are missing the point. (Is it deliberate?) I admit, I used the comparison; but I did it to show that parents aren't always the best judges. In that case, both the next of kin (husband) and the authorities were in agreement - she should not be forcibly kept alive. It was the parents who couldn't cope with that conclusion.
If MB's parents have their own resources, then they can make whatever decision they like. But while they are relying on money raised by taxes, then the taxpayer - in the form of elected representatives and the laws they formulate - gets to have a say. It isn't a question of what any individual pol or even the government thinks should happen, but what all of us think.
Your argument

I'd trust the "next of kin" better than I would the government
would have led to the expenditure of £millions in order to provide separate measles, mumps and rubella injections after the combined vaccine scare, in a situation where one half-wit non-scientist with an undeclared vested interest published a half-baked paper suggesting non-existent links with autism and later bowel disorders.

David Bailey
7th-March-2006, 04:46 PM
Not very likely. See here (http://www.bnn-online.co.uk/news_datesearch.asp?page=2&SearchDate=27/Nov/2002&Year=2002) a 2002 report suggesting hospital beds cost up to £800 per day. That would, presumably, be intensive care beds; it seems ordinary beds in 2001 were about £1000 a week.
That sums up to quarter of a million pounds a year; as the baby is only 17 months old it would only have to reach the age of six to cost the NHS a million quid. That's not considering the cost of treatment.

Why are we spending thousands on a High Court hearing then? I suppose the hospital would then be under a duty to find another neurologist to do the same work, presumably at higher cost - see my first paragraph.
Barry, I'm a little confused - is your argument one of cost or one of ethics?

Assuming it's cost, then how much is your tipping point? £100K per life? £1 million? 2?

El Salsero Gringo
7th-March-2006, 04:55 PM
If MB's parents have their own resources, then they can make whatever decision they like. But while they are relying on money raised by taxes, then the taxpayer - in the form of elected representatives and the laws they formulate - gets to have a say.I think you are 100% wrong as a matter of fact there.

It doesn't matter what money they have or don't have - they can't pay for treatment that's against the interests of MB, the patient. The medical team will make the same argument to the court - that ethics demand medical intervention to cease - regardless of who's paying them.

I don't think anyone involved in the case has actually brought cost into this at all Barry. And on this Forum it's basically only you.

David Bailey
7th-March-2006, 05:02 PM
No, you didn't. I asked, should the parents wishes be paramount? And you kept telling me, what parents would wish!!
My answer to your question was "Yes". :)

But, OK, I should have said "next-of-kin" instead of "parents".


Um...check your post. Earlier, you used the word constraints, which is why I used it in my reply. So those are the constraints I was referring to.
Specifics?


Again, you are missing the point. (Is it deliberate?) I admit, I used the comparison; but I did it to show that parents aren't always the best judges. In that case, both the next of kin (husband) and the authorities were in agreement - she should not be forcibly kept alive. It was the parents who couldn't cope with that conclusion.
OK, but, in the case where the next-of-kin and the authorities disagree, as here, then I think the wishes of the next-of-kin should be paramount, except for the circumstances ("cruel and unusual punishment" type existence, basically) I described.

In the Schiavo case, the next-of-kin weren't the parents. And in addition to being in a permanent vegetative state, she'd previously said that she would not wish to be kept alive on a machine. So that's the wishes of the person herself, her next-of-kin, the authorities, and incidentally, every single court in the USA that tried the case. (The fact that Bush was against it, and made a complete idiot of himself in trying to overrule these wishes was, to me, another indication that the next-of-kin was right).


Your argument

would have led to the expenditure of £millions in order to provide separate measles, mumps and rubella injections after the combined vaccine scare, in a situation where one half-wit non-scientist with an undeclared vested interest published a half-baked paper suggesting non-existent links with autism and later bowel disorders.
Nope - different situation entirely.

I'm not saying "never trust the government about health matters regarding your child" - I had the MMR for mine done at the height of the scare, but I'd done a lot of research about it beforehand.

I'm saying "If it's a matter of immediate life and death, the next-of-kin are better placed to judge whether their child has quality of life than the authorities." Which, I believe, is usually the case anyway - it's unusual for a court to rule against the next-of-kin.

Dreadful Scathe
7th-March-2006, 05:08 PM
Yes. Mental alertness is what makes us human.

Is it? Surely theres more to being human than that, or are you suggesting the mentally handicapped are not human? How 'alert' do we have to be for you? ;) I often 'zone out' a bit during Ceroc classes - should I be shot ? :)


And allowing someone to die because it's expensive to keep them alive is a pretty feeble argument - or would you kill someone who was similarly paralysed at, say, age 50?

Your OR is not valid - I think we can credit you with intelligence enough to know the difference between 'allowing someone to die' and killing them.

'Honest officer, I allowed him to die naturally with this bullet wot I fired from this ere gun' 'Thats alright Sir, carry on'

Despite protestations to the contrary - money is a huge issue. We are capable of prolonging life to such a degree that money can go into unnaturally prolonging life in a few high-profile cases where it could be better spent in better healthcare overall, which would save many more lives.

It was simpler a few hundred years ago, no artificial extensions to life were possible when anything major went wrong with the human body. No arguments over this sort of thing then. No lawsuits brought against doctors and nurses who are only trying to do their jobs as we have now.

The problem is that some people want themselves or their relatives to live for as long as possible no matter what that involves - even at the expense of the lives of others. Thats human nature for you. Humans - a nasty selfish species if you ask me ;)

David Bailey
7th-March-2006, 05:36 PM
I often 'zone out' a bit during Ceroc classes - should I be shot ? :)
Well, that's always an option...


Despite protestations to the contrary - money is a huge issue. We are capable of prolonging life to such a degree that money can go into unnaturally prolonging life in a few high-profile cases where it could be better spent in better healthcare overall, which would save many more lives.
Amazingly enough, I agree. Money is a factor, and it always is. The NHS does operate a rationing system. Devolution of power to local authorities does lead to a postcode lottery.

And yes, it's a bit facile to say "Human life has no price". Clearly it does, few people would be comfortable spending, say £500 billion to save almost any human being. Everyone has a price.

But, in this case, my feeling is that the cost is relatively low enough to not be a major factor. Honestly, I regard the value of a human life to be higher than £1 million, and possibly higher than £10 million - but definitely lower than £100 million. What are other people's values?

Dreadful Scathe
7th-March-2006, 06:15 PM
Honestly, I regard the value of a human life to be higher than £1 million, and possibly higher than £10 million - but definitely lower than £100 million. What are other people's values?

About 11 million children under the age of 5 (http://www.globalissues.org/health/) die from malnutrition and mostly preventable diseases, each year. So if its £10million per preventable death we need to raise £110,000,000,000,000. Clearly that is silly - money will be better spent on stopping this sort of thing happening on a global scale and less worrying about unnaturally prolonging the life of individuals in countries where malnutrition is rare. We rarely take that sort of global socilaist view though. Why are so many children being brought into the world when they cannot be supported? Thats a whole different issue.

Could it be the fact that breeding is a natural way to make sure the species, and locally our own family, survives - but in Western countries especially, we expect to survive and think something is seriously wrong if we dont and therefore someone else is to blame!

LMC
7th-March-2006, 06:28 PM
Despite protestations to the contrary - money is a huge issue. We are capable of prolonging life to such a degree that money can go into unnaturally prolonging life in a few high-profile cases where it could be better spent in better healthcare overall, which would save many more lives.

It was simpler a few hundred years ago, no artificial extensions to life were possible when anything major went wrong with the human body. No arguments over this sort of thing then. No lawsuits brought against doctors and nurses who are only trying to do their jobs as we have now.

The problem is that some people want themselves or their relatives to live for as long as possible no matter what that involves - even at the expense of the lives of others. Thats human nature for you. Humans - a nasty selfish species if you ask me ;)
:yeah:

Although for me, quality of life would have to be the key indicator - we're talking here about keeping a child alive on the slim chance that medical advances in the future might provide another solution where none exists now. Interventions such as kidney transplants and open heart surgery have only been recently available, but that doesn't mean they shouldn't be carried out - as they now have reasonable success rates, are still expensive, but if successful are usually guaranteed to improve quality of life. In Baby MB's case, there doesn't appear to be the possibility even of 'experimental' treatment, where the patient would have nothing to lose by trying groundbreaking surgery/a new drug - s/he is merely having life maintained in pain.

El Salsero Gringo
7th-March-2006, 06:32 PM
we're talking here about keeping a child alive on the slim chance that medical advances in the future might provide another solution where none exists now.Er, no, we're explicitly *not* talking about that. The court gets to decide on current quality of life, not some hypthetical future.

LMC
7th-March-2006, 06:36 PM
The court decides on current quality of life, yes.

But I wouldn't mind betting that the parents' thinking is more along the lines of "hopefully something will come along", which is why they are kicking up such a fuss. As usual, the media are generally trying to raise public emotion because it's a ickle defenceless baby - sure, similar stories about adults do make the papers. But with less emotion and more logic.

El Salsero Gringo
7th-March-2006, 07:09 PM
The court decides on current quality of life, yes.

But I wouldn't mind betting that the parents' thinking is more along the lines of "hopefully something will come along", which is why they are kicking up such a fuss. As usual, the media are generally trying to raise public emotion because it's a ickle defenceless baby - sure, similar stories about adults do make the papers. But with less emotion and more logic.There's nothing at all in any report I've read that suggests that's what the parents are thinking. Their argument seems to be based on believing that the child's quality of life, as it stands, is worth living. Nor have I read any 'ickle baby' stories either. Every report I've seen appears very responsible, and not playing either side as right or wrong.

David Bailey
7th-March-2006, 08:41 PM
About 11 million children under the age of 5 (http://www.globalissues.org/health/) die from malnutrition and mostly preventable diseases, each year. So if its £10million per preventable death we need to raise £110,000,000,000,000. Clearly that is silly
Is it? So how much would be enough to spend then? What's your price, in other words?

Dreadful Scathe
7th-March-2006, 11:42 PM
Is it? So how much would be enough to spend then? What's your price, in other words?

I dont have a price :) I was trying to say that putting a price on a life is silly - those 11 million deaths are preventable but the figure of 10 million pounds you gave per life is silly when all thats needed to stop malnutrition in the world is the food that supermarkets bin every day. Surely its where the money is thats the problem.

And to get back to this specific life, if theres never going to be a point where the child can life a normal pain free life without artificial aid - should the parents not just let go? Would the millions of pounds of care not be better spent on others ? Theres nothing heartless about discussing the economics of the situation - the basic human needs of food, water, shelter aren't enough for this child and the parents do not have the skills needed to keep the child alive, so don't others have to do this when their efforts, and resources, could be better used elsewhere!

Barry Shnikov
8th-March-2006, 12:43 AM
You can't place a value on human life; it's truly priceless. Most people would agree with that.

But that's a sterile argument when money isn't actually involved.

Here's the crunch questionthen. (A) Keep baby MB alive for four years, or (B) carry out 160 hip replacement operations. For the purpose of the thread, answer the question 'A' or 'B', before going on to discuss all the reasons why the question isn't fair. Because, even by not getting involved in the dispute, we are all giving an answer to that question one way or another. Yes it may be that we prefer not to face the hard choice and give our own answer; but one way or another that's how our money will be used.

For me; I'd have to go with B.

Barry Shnikov
8th-March-2006, 12:55 AM
Specifics?
I say again, you first mentioned constraints, and then you gave a sample list of such constraints. I was quite happy to go with those, which is why I adopted your label.

OK, but, in the case where the next-of-kin and the authorities disagree, as here, then I think the wishes of the next-of-kin should be paramount
What, against the whole world? Every person in the country disagrees but the parents' wishes must prevail? That can't be right, surely?

In the Schiavo case, the next-of-kin weren't the parents. And in addition to being in a permanent vegetative state, she'd previously said that she would not wish to be kept alive on a machine. So that's the wishes of the person herself, her next-of-kin, the authorities, and incidentally, every single court in the USA that tried the case. (The fact that Bush was against it, and made a complete idiot of himself in trying to overrule these wishes was, to me, another indication that the next-of-kin was right).
You make broad assertions and then seek to narrow the terms when those broad assertions are contradicted. If 'parents' doesn't suit you transfer your allegiance to 'next of kin' - I say potarto, you say potayto. The question is, how do we cope with the difficulties inherent in these situations, given that resources are not infinite. If you truly believe that the 'next of kin' have the final say come hell or high water (even if that is restricted to judging what quality of life the patient has) then I think you're in serious difficulties.

Nope - different situation entirely.
No it's not. If parents get to be the sole judges of quality of life, why can't they be the sole judges of the risk of iatrogenic disease?

I'm not saying "never trust the government about health matters regarding your child" - I had the MMR for mine done at the height of the scare, but I'd done a lot of research about it beforehand.
Lots of other people did lots of research and came up with a different conclusion. Hardly surprising.

I'm saying "If it's a matter of immediate life and death, the next-of-kin are better placed to judge whether their child has quality of life than the authorities." Which, I believe, is usually the case anyway - it's unusual for a court to rule against the next-of-kin.
I don't think it's at all correct that next of kin are better placed than someone who's spent their entire career in that particular field. As an instance of how parents sometimes fail to have their child's best interst at heart, see Munchausen's syndrome by proxy. And courts routinely rule against next of kin. They usually follow the advice of the professionals.

El Salsero Gringo
8th-March-2006, 01:05 AM
You can't place a value on human life; it's truly priceless. Most people would agree with that.

But that's a sterile argument when money isn't actually involved.

Here's the crunch questionthen. (A) Keep baby MB alive for four years, or (B) carry out 160 hip replacement operations. For the purpose of the thread, answer the question 'A' or 'B', before going on to discuss all the reasons why the question isn't fair. Because, even by not getting involved in the dispute, we are all giving an answer to that question one way or another. Yes it may be that we prefer not to face the hard choice and give our own answer; but one way or another that's how our money will be used.

For me; I'd have to go with B.Or increase the money raised through taxation so that you could do both?

It's undoubtedly in the public interest to have some money to fund hip replacements. It's also in the public interest to have money available to fund intensive care for patients who are severely disabled. Otherwise we'll be wheeling anyone who needs any kind of long term expensive care into the euthanasia clinic faster than you can say 'protecting the gene pool for the benefit of the master race'.

David Bailey
8th-March-2006, 08:59 AM
What, against the whole world? Every person in the country disagrees but the parents' wishes must prevail? That can't be right, surely?
That's a silly example, there's too much extension and reducto ad absurdum going on here.

For example:

No it's not. If parents get to be the sole judges of quality of life, why can't they be the sole judges of the risk of iatrogenic disease?
Your extension implies that parents should therefore be the sole judges of everything regarding their child - which is clearly ridiculous, and not what I meant at all.

I don't think we're getting anywhere here, so I'll bow out from this point...

Barry Shnikov
15th-March-2006, 11:46 PM
Or increase the money raised through taxation so that you could do both?

It's undoubtedly in the public interest to have some money to fund hip replacements. It's also in the public interest to have money available to fund intensive care for patients who are severely disabled. Otherwise we'll be wheeling anyone who needs any kind of long term expensive care into the euthanasia clinic faster than you can say 'protecting the gene pool for the benefit of the master race'.

I don't think I set up a false dilemma. We aren't in an 'either keep children alive or have hip replacements' discussion. It's 'where do we draw the line against "officiously" keeping alive? The complexity is that Baby MB cannot express his wishes, so the doctors are obliged to try and think what is best for him.

The irony is that they were off to the High Court to get permission to withdraw life support. But where people have health problems which all parties agree will lead (e.g.) to them living in permanent pain but who have insufficient capability to be able to take their own life, they are prevented from turning to other persons to help them.

The High Court judge has said that he isn't persuaded that it's in Baby MB's interest to have life support withdrawn; more, he thinks it is in Baby MB's interest for life support to be continued. He has also said that the parents (or the mother, at least) are sadly deluded about their baby's chances of improvement. He's said that no additional intervention (or possibly no additional intervention of certain kinds, the report was a little vague) is justified and doctors should not be required to give it.

Debster
15th-March-2006, 11:56 PM
... you could easily argue that the parents are too vastly swayed by their own emotional needs to make any kind of rational judgement over the child's quality of life...
:yeah:

El Salsero Gringo
16th-March-2006, 12:13 AM
I don't think I set up a false dilemma. We aren't in an 'either keep children alive or have hip replacements' discussion. It's 'where do we draw the line against "officiously" keeping alive? The complexity is that Baby MB cannot express his wishes, so the doctors are obliged to try and think what is best for him. The false dilemma is raised principally when you demand that the cost of the treament is a criterion. If we can accept that money is *not* the issue in this case then we agree.

Barry Shnikov
20th-March-2006, 10:11 PM
The false dilemma is raised principally when you demand that the cost of the treament is a criterion. If we can accept that money is *not* the issue in this case then we agree.

How can money not be an issue? We don't have enough to buy all the treatment everybody needs.

I agree with you that it's in the public interest to strike a balance; that's why I said I didn't think I'd set up the false dilemma - 'either one or the other'.

ducasi
20th-March-2006, 10:42 PM
Wow, we're back to this again? :respect:

El Salsero Gringo
20th-March-2006, 10:54 PM
How can money not be an issue? We don't have enough to buy all the treatment everybody needs.Simple: money's not the issue because the NHS *can* afford to treat this particular baby - which is the only one on behalf of whom the court was asked to make a decision.

I can't agree that it would be for the court to decide on NHS priorities as to which cases were more deserving of funding from a limited budget. That would be for the NHS itself, and ultimately, the legislature.

Barry Shnikov
28th-March-2006, 01:30 PM
Simple: money's not the issue because the NHS *can* afford to treat this particular baby - which is the only one on behalf of whom the court was asked to make a decision.

I can't agree that it would be for the court to decide on NHS priorities as to which cases were more deserving of funding from a limited budget. That would be for the NHS itself, and ultimately, the legislature.

I may be missing something, but in my original post I had hoped I made it obvious that I was inviting people to discuss, amongst other things, NHS spending priorities. Yes, the NHS has funds to treat this baby; but (in a sense) spending the money on this baby by definition means that it isn't available to spend on something else.

The judgment was quite illuminating. It's clear that the parents - certainly the mother - are deluding themselves in hoping for some sort of recovery or alternatively to keep the baby alive until a 'cure' is discovered. The judge found that even were treatment available it could only, at best, arrest the progress of the illness; there was no chance that it can be reversed. (So much for the parents being the best judges.)

He also found that some of the procedures the baby endures are positively unjustified and must not be carried out in future. The medical evidence shows that monthly blood tests are required to monitor the baby's situation; the judge forbade any further tests.

Having had a tracheostomy some years ago, I was somewhat nauseated to see that the baby requires frequent suction applied to its lungs to empty them of fluid. I had this 'suction treatment' and while on the whole it was not painful, I can tell you it was the most unpleasant, uncomfortable, grisly and sickening sensation I've ever experienced (like having the 'jewels jostled', chaps, if you know what I mean!). The judge accepted medical evidence that for this baby, the suction on occasion had to be applied so vigorously that it would in fact be painful. I can well see why the doctors (and the more experienced nurses) felt that further intervention to prolong the baby's life was insupportable.

What a horrible shame.