Fight over baby's life support divides ethicist

CNN ^ | April 25, 2007 | Elizabeth Cohen

[amchugh]

When Emilio Gonzales lies in his mother's arms, sometimes he'll make a facial expression that his mother says is a smile.

But the nurse who's standing right next to her thinks he's grimacing in pain.

Which one it is -- an expression of happiness or of suffering -- is a crucial point in an ethical debate that has pitted the mother of a dying child against a children's hospital, and medical ethicists against each other.

[amchugh]

So sad.

[amchugh]

Title should read: divides ethicists

[garandgal]

Emilio's mother, Catarina Gonzales, on the other hand, is fighting to keep her son on the ventilator, allowing him to die "naturally, the way God intended."

What?

[Polonius]

Also from the CNN story: “Emilio is on Medicaid, which usually doesn’t pay for all hospital charges. The hospital’s spokesman said that he doesn’t know how much it’s costing the hospital to keep Emilio alive, but that cost was not a consideration in the hospital’s decision.”

Crass as it sounds, in cases like this cost really should be a consideration. According to this article, the baby suffers from a genetic disorder with no cure, and would die in a matter of hours without the use of a ventilator. It seems, then, that the hospital’s resources — expensive medical equipment and staff — are being spent on a patient with no hope of recovery. Who will compensate the hospital for this futile care, and what about other pediatric patients with a real chance of recovery who can’t be admitted to the hospital because of the finite resources being consumed for a child whose mother can’t let him go?

If the hospital believes nothing more can be done for the child, and the family or other parties want to continue care, then they should take on 100% of the cost for any further care. Otherwise, we’re asking the hospital to expend its limited resources (with little hope of recovering more than a fraction of its expenses) on a lost cause just to postpone one mother’s pain. That’s not fair to the hospital, the medical personnel or the other patients who could be served by those resources.

[amchugh]

I agree with you that triage is essential to medicine, but the fact that there is a cost to human life is difficult for people to acknowledge. I suspect this drives a lot of bad decision making in medical policy circles.

[Coleus]

.

[8mmMauser]

At the heart of the Emilio matter is the Texas Futile Care Law. Mercifully the law is now under seige.

In essence, the law was supposed to mean denial of medical care which may be futile. It has been reinterpreted to mean denial of care to lives deemed futile.

It first came to our attention in Terri Dailies quite awhile back when Andrea Clark was about to be killed under the law, and then Mrs. Vo and numerous others, in a rather arbitrary way. The law gives a very short window for those lives deemed unworthy, and if the patient is not moved to another facility within that short window, they kill the patient. In the case of Emilio, they have made a prognosis not much unlike which doctors made on our own son, decades ago. Our son lived twenty six happy years after, despite the grim diagnosis. He would have lasted only days under the Texas Futile Care Law and we would have been powerless to stop the killing.

Currently many concerned people have questioned the law which is now under review. Terri's family are engaged in this issue as well.

Nurses sometimes saw our son's smile as a grimace of pain. People who knew him and knew better realized it was a smile of happiness.

Emilio may now die on his own, or he may not. Had good people not intervened on the side of Emilio he would have been killed already, no more chance to reconsider.

Pinged from Terri Dailies

8mm