life support

Comment Of The Day (2): “Observations On Britain’s Charlie Gard Ethics Fiasco”

/ Jack Marshall / 19 Comments

This is the second outstanding comment on the Charlie Gard post, and it boldly ventures into the ethics jungle of euthanasia. The discussion must go there, for if society has limited resources, and we have more limited resources than Paul Krugman and Bernie Sanders admit, then when people use up their allotted portion, they either have to die or someone else has to pick up the bill. The recent surge in popularity for single-payer health care is due in part to the old saw about how soldiers think when going into battle. It’s everyone else who’s at risk, not you. Or as my dad liked to put it, “Gee, I’m going to miss those other guys!”

Increasingly, as I get older and think about how different my family’s life would be if both Mom and Dad hadn’t contrived to pop off quickly after relatively short illnesses and minimal hospitalization, I see the same consideration in planning for my loved ones. I don’t want to waste my son’s inheritance to pay for the last and worst years of my life; indeed, I think it would be unconscionable to do so. However, that needs to be my choice, not the Death Panel’s.

Here is Mrs Q’s Comment Of The Day on the post,  “Observations On Britain’s Charlie Gard Ethics Fiasco”:

When medical care is socialized, nihilism & scientism combine to control those who can be useful to the state & those who need to be eliminated from it.

Dutch lawmakers are looking at a Completed Life Bill that would allow those 75+ in age to choose medical euthanasia. The lawmaker pushing the bill, Alexander Pechtold, said it would allow the Netherlands to…

“take the next step for our civilization.”

And what step is that exactly?

The Gard case highlights the dark workings of Marxism for what it is by defining life in terms of how much of a burden it supposedly is to others. That the “greater good” is better served when certain people s lives are considered “complete.”

Baby Gard, as Jack noted, cannot continue to be a financial burden in the context of socialized medicine because in such a paradigm, there are not enough resources to support all of those represented by it. Remember socialism ALWAYS promises more than it can ever deliver and always spends more than it has.

I love it when people tell me how great the health care in France is, while many there complain the immigrants are a drain on the system because they have not put their money into it for years. Or Canada, where our friends cannot afford private insurance and go without certain medications & treatments because they’re not covered by state. Or Europe, where rates of Downs Syndrome are jarringly low because doctors have advocated so severely for abortion of these unborn, that in some countries it has literally been years since such a child has been born. Continue reading →

Comment Of The Day (1): “Observations On Britain’s Charlie Gard Ethics Fiasco”

/ Jack Marshall / 5 Comments

I thought that the Charlie Gard story would stimulate some excellent thoughts on ethics and public policy from readers, and for once I was right. This is the first of two superb Comments of the Day it generated, and there were several others as well.

Here is Ryan Harkins’ Comment Of The Day on the post,  “Observations On Britain’s Charlie Gard Ethics Fiasco.”

The idea of the state telling me I could not seek medical aid for my child when I had both the money to pay for it and a provider willing to give me the services is terrifying. My sixteen-month-old daughter has been receiving the majority of her sustenance through a feeding tube for the past six months. Prior to that, we had been struggling to get her to eat enough calories so that she would gain just an ounce or two, only to find that weight gain vanish when she caught a cold or a stomach bug. Granted, the gastroparesis she suffers is not a severe condition, but without the feeding tube she would risk starving. The thought that the state might step in, tell me that they not only would not pay for my daughter’s tube and care any more, but also expressly forbid me from feeding my daughter through the tube, makes me shake uncontrollably. If I have to fight for my daughter without the state’s help, fine by me. But for the state to forbid me from fighting for my daughter? That is unconscionable.

However, at this time, I don’t have to face that issue. I live in a place and a time when I don’t have to contend with general threat, and my daughter’s condition is not terminal and readily treatable. I hope that my child-rearing and my fear for my daughter helps me to have empathy for the parents of Charlie Gard. I also hope that I can step back away from the emotional turmoil this issue raises and try to understand what is happening here.

The principle dilemma in the case of this poor baby boy lies in the fundamental tension between the fact that human dignity demands we do fight for life, while at the same time we know that we will all ultimately die. Because human life bears an intrinsic dignity, its wrong to deprive a human being of what it needs to survive. Because all humans ultimately die, it can become, through the use of extreme or unethical means, against human dignity to fight against death when death is inevitable.

Why would it be wrong, in some circumstances, to keep fighting against death? The most clear-cut examples are when the means of preserving life are unethical. Bathing in the blood of virgins, selling one’s soul to the devil, killing an innocent to harvest his organs, transferring one’s consciousness into the unwilling body of another — all these (fantastical as some of them are) represent tactics to extend life that obviously violate ethical principles.

What about less obvious examples? Let’s consider a man in a coma. His state is persistent, perhaps even vegetative, but his body is capable of processing food and drink, although he is incapable of eating and drinking orally. A feeding tube could provide him with all the nourishment he needs, and he could be kept alive for years in such a fashion. To stop feeding him through the tube would be to deliberately deprive him of sustenance he needs to survive, and thus would be unethical. Death is not inevitable in this case, except in the most sweeping sense.

In times past, a feeding tube would not have been possible, or if possible, not recommended because of infection, and thus this would not have been a serious alternative. Absent any means of delivering food to the man in the coma, no one could be faulted for not providing food. And if trying to use a feeding tube would actually kill him quicker, or have negligible effect, then the extreme measure of using a feeding tube would not be ethical. However, since we are at time with the technology that makes the use of a feeding tube fairly easy and safe, we no longer have that excuse to deprive a person of nutrients.

What about a slightly different case, when the man in the coma can no longer process foods even through a feeding tube? Then providing food actually causes harm without any gain. Perhaps nutrients could be provided through an IV, but one would be justified, and perhaps is even obligated, to stop providing food through the feeding tube.

Now, the most challenging cases are when a person is terminally ill, but there are procedures that exist that can extend life. To what extent are we obligated to provide care? It depends on the nature of the treatment, the cost of the treatment, and the effects of the treatment. A person is fully justified in accepting that death cannot be stopped and let the terminal illness run its course. A person is not justified in taking steps to deliberately end that life, but is justified in procuring palliative care that eases the pain of the dying, even if it hastens death. But one is not obliged to pay for or undergo an extensive, dangerous, expensive procedure that will not provide a cure, but only a short extension of life.

It should be clear, though, that just because one is not obliged to pay for or undergo extreme care, it does not follow that one is obliged to never pay for or undergo such procedures. If a person has the money and desire to attempt such care, and that care is available, that person should not be denied.

Is there any instance, then, when that person could be denied that extraordinary care? Again, we are assuming that the person can pay for it and the care is available, so we aren’t discussing an instance in which the terminally ill patient is displacing someone else’s care.

I personally cannot think of an instance in which we could rightly deny that care. What I do know is that, in Catholic theology, death does not mark the end of the existence of a person. The soul survives death, and the soul will be reunited with the body at the Resurrection. There is danger in pursuing treatments at any cost, and that danger lies in the denial of the afterlife. That has consequences for one’s eternal soul. Continue reading →

Observations On Britain’s Charlie Gard Ethics Fiasco

/ Jack Marshall / 40 Comments

A recipient of Great Britain’s national health care, infant Charlie Gard was born with  a rare genetic condition resulting in what is probably irreversable brain damage.  He cannot move his arms or legs, eat or even breathe without a ventilator.

After 10 months of being kept alive, Charlie’s caretakers, the Great Ormond Street Hospital for Children in London, announced that it was time for Charlie to die. Chris Gard and Connie Yates, Charlie’s parents, wanted to take him to the United States to try an experimental treatment available here. The doctors at the hospital refused to allow them to take the child, and vetoed their decision, even though the parents had received sufficient funds from donations to pay for the effort.  In  the resulting lawsuit, British courts sided with the hospital. The parents then brought the case  to the European Court of Human Rights, which declined to hear the case last week. The previous court rulings that it was in Charlie’s best interest to withdraw life support and that the state, not the parents, got to make this life and death decision stood.

The  parents, Chris Gard and Connie Yates, appeared on a video this week,, sobbing and saying their son would be removed from life support at the hospital. “He’d fight to the very end, but we’re not allowed to fight for him anymore,” Gard said in the video statement. “We can’t even take our own son home to die.”

Initially, the hospital would not delay the fatal  disconnection of the child from life support so family members could gather and say goodbye. It has since relented.

Observations: Continue reading →

The Strange Case Of The Brain Dead Mother-To-Be

/ Jack Marshall / 92 Comments
In happier times; Mr. and Mrs. Munoz with their first child. And she really wanted her second child to die with her?

In happier times; Mr. and Mrs. Munoz with their first child. Did  she really want her second child to die with her? Is that a respectable request, if she did?

Dead people are causing a lot of anguish in the ethics world lately. First, a family wants to force a hospital to keep their brain-dead, which is to say, dead, daughter on life support just in case a miracle occurs, while the rest of society pays for it. Now, in Texas, we have a true brain death dilemma that once again highlights the problem with U.S. abortion law and ethics.

Texan mother Marlise Munoz was 14 weeks pregnant with her second child when she collapsed and later died from a blood clot in her lungs. Her parents and husband told the intensive care unit at  Fort Worth’s John Peter Smith Hospital to honor her stated wish not to be left on life support, but the hospital has so far refused to comply with their instructions.  Texas is one of 31  states that prohibit medical officials from cutting off life support to a pregnant patient. Now, more than a month after her brain stopped functioning, the late Marlise Munoz is still connected to life-support machines, and her unborn child is now in its 20th week of development. Continue reading →

Race-Baiting At “The Root”

/ Jack Marshall / 44 Comments

The African-American news and commentary site The Root has plowed some new ground in the field of disgusting race-baiting.  An article by Charles D. Ellison argued that the same conservatives who fought to block Terri Shiavo’s husband from authorizing the withholding of her food so his vegetative wife could die should be supporting Jahi McMath’s parents’ efforts to keep their brain dead 13-year-old daughter on life support. That they are not, he suggests, is because Terri was white, and Jahi is black.

I wrote about Schiavo’s plight here, over at the Ethics Scoreboard, in 2005. I wrote recently about Jahi McMath, here. There is no inconsistency in my positions, but there is also none in the reactions of some conservatives to the two cases, because they are not comparable. Here’s  Billy Crystal explaining the divergence exquisitely in “The Princess Bride”:

In Billy’s words, Jahi is all dead. She is brain dead, which is to say, dead. Keeping her on life support is a waste of resources, and a tragic exercise in denial. Terri was mostly dead, and was never getting better. Most of her brain was gone, but her vital functions were still operating. Conservatives regarded the withholding of food from her as murder, just as they oppose the destruction of frozen embryos that will never be born.

They were wrong to try to interfere in Terri’s case, but that is irrelevant here. There is no racism involved at all. If Jahi were white, she would still be all dead, and even the most doctrinaire conservatives don’t believe that dead people should be kept on respirators.

The Root’s piece is dishonest, ill-informed, hateful and unfair.

_____________________________

Pointer: Althouse

Jahi’s Plight: Why Death Panels Are Inevitable And Necessary If We Are Going To Pay For Each Other’s Health Care

/ Jack Marshall / 30 Comments

death panels

Even while the Affordable Care Act debacle is mired in other problems, the “death panel” controversy lingers on, as conservatives exploit the public’s visceral reaction against an inevitable result of modern health care cost-sharing, and progressives dishonestly deny and ridicule the reality of that result, because it makes health care reform less attractive.

The case of Jahi McMath is instructive, if anyone bothers to consider its practical and ethical implications. Jahi, 13, underwent a tonsillectomy Dec. 9, and emerged from her post-op recovery legally dead, due to massive swelling in her brain. She was placed on a ventilator, and according to its policy, Children’s Hospital Oakland was preparing to take her off life support when the family strenuously objected. It petitioned a court to keep her technically alive so she could spend Christmas with them. An Alameda County judge Monday ordered hospital officials to keep Jahi on a ventilator until Dec. 30 while an independent neurologist reviews her case. Meanwhile, her mother told CNN and other local media that although she appreciates  the second opinion and court order, she will fight to keep her daughter on life-support as long as possible, saying,

“I’m her mother. I’m going to support her. It’s my job to do it. Any mother would do it. I just want her to have more time. There are so many stories of people waking up in her situation.” Continue reading →