Tuesday, November 21, 2006

"Futile" Care And Premature Babies

Wesley J. Smith blogs about the recommended guidelines adopted by a Bioethics think tank in Great Britain in light of the British Medical Society's coming out in favor of euthanizing disabled newborns. The good thing is that the think tank disagrees with the concept of euthanizing newborns. The bad part is this:

The Council also suggested that infants born at 22 weeks gestation or earlier not be given intensive care unless as part of medical experiments. At age 23 weeks, it urges that no intensive care be given unless insisted upon by the parents and doctors agree. At 24 weeks and above, the provision of intensive care would be the norm.

Wesley concludes:

I am not comfortable with such guidelines in that each patient should be evaluated and treated as an individual, not as part of a group. Of course, knowing the odds of survival at any given stage would be part of that agonizing decision making process. I also worry that futile care theory could seep into this process and that infants would be denied treatment because they would be disabled.

I agree. But, as you will note in the comments such things are already happening in the United States. Take the case of Baby Nathan Valor Jackson. Baby Nathan's mother had some pre-delivery complications which necessitated that she be in the hospital with her legs up. Then the trouble started:

Early that morning, Brian and Kathy were visited by the hospital’s social worker, who wanted the uninsured family to agree to take Medicaid and SSI. Brian refused, explaining that he could not in good conscience accept state welfare assistance because of his conviction that this was not the jurisdiction of the state. Brian expressed his intention to pay the hospital all it was owed, explaining his understanding that the Bible placed this responsibility for payment first on him, with extended family, the local church, and ultimately the church universal coming alongside to help him, if necessary. The social worker pushed hard for the Jacksons to change their position, but they remained firm.

This would not be the only point of contention. A few minutes after the talk with the social worker, the doctor treating Kathy hinted to the Jacksons that the hospital’s neonatologist might not try to save their son if he were born prior to twenty-four weeks. When the Jacksons pressed her for an explanation, she responded evasively. The Jacksons were quickly becoming alarmed at the direction things seemed to be going and called on Vision Forum’s General Counsel, Don Hart, for assistance. Mr. Hart agreed to represent the Jacksons and began to advise the Jacksons on how to proceed.

A few hours later that same day, Brian and Kathy were visited by the chief of staff of the hospital’s neonatology unit. Upon entering their room, he stated his name and began his remarks with this statement: “Let me paint you some pictures of what may happen if you go into labor right now.” The doctor then grimly described the problems a premature baby might face. He told the Jacksons that if their son was determined at birth to have been in the womb for more than twenty-four weeks, then all action possible would be taken to save his life. He then stated bluntly that if it was determined upon the child’s birth that he had been in the womb for less than twenty-four weeks, the baby would be made comfortable until he died.

The hospital official said these things to both Brian and Kathy with no apparent regard for how his comments might affect Kathy’s condition as she lay on strict bed rest, with her feet elevated, on medication directed toward stopping her contractions. Kathy was on the verge of going into the labor, which if initiated, would be—according to this doctor’s casual statement—signing her baby’s death warrant.

Fortunately, the General Counsel for Vision Forum Ministries intervened on behalf of the parents and the hospital gave the treatment to Baby Nathan and soon he was ready to be discharged. Then this happened:

The day began to approach when Nathan Valor could actually go home, but the challenges for the Jackson family were not over. Despite the high-ranking hospital staffs’ expression of admiration for the Christian convictions of the Jacksons in their stand on paying his bills privately (instead of allowing the taxpayers to cover them through welfare programs), the hospital decided to make another effort to pressure the Jacksons into taking Medicaid. And why? If the Jacksons submitted to this pressure, the hospital would receive its payment more quickly. Thus, the hospital elected to pull out all the stops to accomplish this goal.

The Jacksons were informed that if they did not change their minds and accept welfare assistance, their son would not be released to them. They were told that Texas Child Protective Services would be called in and would take custody of their child, since no medical providers could be expected to work with the Jacksons unless they were on welfare assistance. The hospital which had earlier fought to kill Nathan Valor if he was born too early was now threatening to kidnap him unless paid a ransom obtained through the welfare coffers.

After dropping this bombshell on the young parents, the hospital asked for a meeting with all interested parties to discuss Nathan Valor’s discharge. The Jacksons attended, accompanied (much to the chagrin of the hospital) by their attorney, Vision Forum General Counsel Don Hart. Upon learning of Mr. Hart’s presence at the meeting, the neonatal chief of staff refused to attend. When confronted with their unconscionable behavior in threatening to take the Jacksons’ son in order to extort payment via welfare, and when called to task for the absurdity of their feigned surprise that the Jacksons would seek legal assistance in the face of such actions, the hospital officials had little to say. Not surprisingly, the bully tactics stopped, and no mention of CPS involvement was ever made again.

What a disgusting display of aggression on the part of the hospital. When the hospitals and doctors fighting for the Texas Futile Care Statute make the claim that they are compassionate when dealing with families during the "futility protocols", I will remember Baby Nathan.

Go read the whole article at Vision Forum Ministries.