Wednesday, January 26, 2005
- Today's Houston Chronicle has an article about a futility dispute between the attendings at Texas Children's Hospital and the mother of a 4-month-old who has been diagnosed with "thanatophoric dysplasia, a condition characterized by a narrow chest, small ribs, underdeveloped lungs and disproportionately short arms and legs . . . Thanatophoric dysplasia belongs to a family of genetic disorders that includes dwarfism, but this particular form is almost always lethal, said Ericka Peasley, a genetic counselor who serves on the medical advisory board of Little People of America, an advocacy group. . . . Infants with the condition usually are stillborn or die shortly after birth from respiratory failure." According to the story, "Texas Children's officials said the baby is not conscious and doesn't move" and is on ventilator support.
Neonatologists and bioethicists who have reviewed the case agreed with the physicians in the case that "it would be unethical to continue with care that is futile and prolongs [the patient's] suffering." Under state law, disputed life-sustaining treatment may with withdrawn over the objections of the surrogate decision maker, if the hospital's ethics committee agrees with the attending physician that the treatment is inappropriate. It is not clear from the article whether the ethics committee process was actually invoked. Instead, the hospital has elected not to rely on the "due process safe harbor" provided by the Texas Health & Safety Code, chapter 166, and has gone to court to obtain an order. The hospital is even paying for legal fees of the mother's attorney. A court hearing has been scheduled for February 9.
- The January 20 Washington Times reported that the Archbishop of Canterbury, Dr. Rowan Williams, wrote an op-ed in the Times of London reiterating the opposition of the more than 70-million-member Anglican Communion to euthanasia. Apparently the piece was prompted by the comments of "Robin Gill, a Canterbury University professor who advises Williams, [who] said publicly people should not be prosecuted for helping dying relatives in pain end their lives."
I always get nervous about blanket denunciations of "euthanasia" without a careful delineation of what is and is not being condemned, but Dr. Williams was careful to make clear that the target of his remarks was PAS and "active euthanasia":
Euthanasia is best defined as the initiating of a process whose explicit primary aim is to end life. It is not the same as continuing a medical process whose long-term effect may be to reduce the span of life, nor is it the same as embarking on a treatment that offers short-term relief at the cost of possibly accelerating overall decline. These are the commonplaces of palliative medicine. The right to be spared avoidable pain is beyond debate - as is the right to say yes or no to certain treatments in the knowledge of factors such as these. But once that has mutated into a right to expect assistance in dying, the responsibility of others is involved, as is the whole question of what society is saying about life and its possible meanings. Legislation ignores these issues to its cost.
The full text of his op-ed article can be found on the Archbishop's web site.
- The BBC reported last Sunday that an article in the Dutch Journal of Medicine reports that
Dutch doctors have reported 22 mercy killings of terminally ill babies since 1997. . . . None of the doctors involved were charged, although euthanasia for children is illegal in the Netherlands. . . .
The cases involved babies with extreme spina bifida, a disabling birth defect.
The study showed that prosecutors had decided not to file charges as long as four unofficial rules were met:
- the child's medical team and independent doctors must agree
- there is no prospect of improvement and the pain cannot be eased
- parents give their consent
- the life must be ended in the correct medical way
A survey has suggested Dutch doctors end the lives of about 15 to 20 disabled newborns a year but most go unreported.