Thursday, December 3, 2009

The Courts, The Family, and Artificial Life Support.

Catholic News Agency reports that a British court has approved removal of a child from life support. Removal of the child from respiratory and feeding support became a case in the courts when the mother and father disagreed over his care:

A British couple elected on November 10 to discontinue medical care for their son of 13 months of age. "RB" suffered from congenital myasthenic syndrome and, his doctors said, would only live a short life on artificial respiration and feeding tubes. Irene Gemeno, of the Scottish Edinburgh Napier News, reported that "RB", as he was referred to in order to protect his identity and that of his parents, could barely, if at all, move his limbs or breathe due to limitations resulting from the neuromuscular condition, but his brain appeared to be healthy.

Doctors, however, advised that he wasn't expected to live beyond three years of age and would never shed the artificial support for basic body functions.

According to the boy's father, the child was able recognize relatives and made an effort to play, but his doctors said it was impossible to know if these responses were involuntary or a result of the child's will.

After all known treatments for the congenital disorder had been attempted and the professional medical personnel had made their best efforts to treat the condition, doctors advised that they were out of options.

The mother of the child consented to disconnecting all life support, but the father, "Mr. AB," took the case to the tribunal in defense of RB's life, hoping to put the boy on a portable life support system through a tracheotomy, reported the Italian daily, La Stampa. The case was then taken to Britain's Family Division of the High Court to determine from experts' testimonies if any improvement in the baby's health could be expected.

Justice McFarlane, the court magistrate, reported in his remarks on the evidence provided by doctors, that RB “has not shown any effective response and the prospect of effective treatment for him, which would involve both identifying the defective gene and relying upon the development of a new pharmaceutical, which must be many years down the line."

After a week of the hearings, Mr. AB withdrew from the legal battle.

RB was taken off life support shortly thereafter.

Opinions supporting both sides surged on internet forums and in local British media. Some call it a case of child euthanasia, while others say that there is no obligation for doctors to provide treatment if there is no possibility that it will benefit the patient.

No one has criticized parents, of whom Justice McFarlane recorded RB's key nurse describing them as "brilliant; they are great parents; they love him dearly, are always at his bedside and always want what they feel is best for him." But, many have called for an evaluation of the case and its relevance to the euthanasia debate.

As with the case of Terri Schiavo, often family disagreement regarding the nature of care for an individual who is not able to speak for themselves become matters for the courts. It's a sad trauma for a family already under the grief and stress of a fatal disease, a loss of privacy and often a loss of family relationships. Only discussions regarding end of life care - even when the life is a new - can help smooth the way for decision-making.

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