Posted on 05/23/2007 9:27:08 AM PDT by NYer
Tuesday, May 22, 2007
Emilio Gonzales — Baby Emilio to the world — was born blind, deaf and with a fatal and incurable disease, but he posed a deeply troubling question in his 19 short months of life.
Baby Emilio was the intersection where medical ethics, parental rights, politics and the common good collided. He passed away last weekend as his mother, Catarina Gonzales, and her attorney fought to keep Children's Hospital of Austin from disconnecting the respirator that had been keeping him alive.
Doctors at Children's Hospital diagnosed Emilio with Leigh's disease, a fatal condition that causes the central nervous system to collapse. His physicians and the hospital's ethics committee felt the costly, aggressive care was causing him to suffer when he had no chance to survive.
Emilio's mother disagreed and, with the support of right-to-life advocates, sued to keep the hospital from terminating his care. At the heart of the argument is a 1999 state law, the Advance Directives Act, that gives physicians the authority to end extraordinary care in hopeless cases.
Because of the Gonzales' situation, that law has been attacked by advocates who believe it gives doctors power over a family's rights and desires. A bill before the Legislature would extend the time families have to move a patient before care is terminated and would give them more time to prepare a case for continued care.
Emilio's case was not just a test of the Texas law, it was also a test of the common good. A charitable hospital — Children's Hospital is part of the Catholic church's Seton Healthcare Network — should not be forced to provide expensive, extreme care in cases deemed hopeless.
A demand for extraordinary measures is not infinite. Public, private and charitable hospitals should not be made to provide special care when it is found to be unreasonable. The resources expended on Emilio were enormous.
It required a lot of doctors, nurses and expensive equipment to keep Emilio alive, all of it paid for by Medicare and Medicaid. Those resources devoted to an irreversibly terminal patient could have been allocated to others who stood to benefit from them.
These are difficult decisions. Catarina Gonzales, who says she can't have other children, suffered along with her only son. She wanted him to live as long as possible, and all who followed Baby Emilio's story felt her anguish.
But Children's Hospital did all it could and its decision to discontinue care was made after a careful and studied analysis of Emilio's condition. The Texas law worked as it is supposed to work, though revisions proposed by lawmakers this session to extend the period for argument and the time allotted to see if another facility will take the patient are good ones.
Baby Emilio's situation placed in stark relief the clash of rights in life-or-death decisions. Emilio's family's wishes could not be considered in a vacuum; Children's Hospital, the Catholic church and the community at large have rights and obligations, too.
Emilio is at rest, but the debate over conflicting rights continues as advocates challenge the Advance Directives Act as unconstitutional and discriminatory against people with disabilities. It's a debate likely to escalate as medical care and research continue to advance in extraordinary ways.
Emilio's case presented Austin and the world with a fundamental issue about life and death. Because no right is absolute, the discussion will be with us for years to come.
Where to begin?
Refusing to keep someone “alive” with extraordinary measures such as a respirator or other machinery is quite different from starving or dehydrating him to death.
I don’t know all the details of this case, although I have read other articles about it.
What you need is a reasonable definition of ordinary care and extraordinary care.
The Catholic Church is still debating some of these issues, but basically has said that ordinary care, such as food and water and proper medicines, must be given. Keeping someone on a respirator forever, however, is not ordinary care. If there is no chance of recovery, than a person can be removed from a respirator and allowed to die naturally.
There are several problems here, obviously. One is that with the judges who push “separation of Church and state” to extremes riding high, ordinary morality and religious advice is not allowed. The Texas legislature is certainly not going to base its decision on Catholic pronouncements, or even take them into consideration. So at best they will turn to professional “ethicists,” most of whom are infected by the Culture of Death, trained in leftist academic programs, and paid by hospitals and drug companies to give whatever advice suits their bottom line.
You would think that the difference between taking someone off a machine and starving them to death would be evident, but unfortunately it’s not, in today’s leftist-influenced, brain-dead culture.
NO hospital, not even a Catholic hospital, is required to use extraordinary means to keep a dying patient alive. Catholic hospitals will continue hydration, but keeping someone on a breathing machine is not required. It is sad for this woman, as this was her only child, but his death was imminent. I believe the hospital made the right decision.
I say you posted a pretty compelling argument in favor of stem cell research!
that wasn’t my intent, but you’re right.
This case became “famous” or “infamous” when certain MSM outlets decided to make an issue of it. The case involved a baby who was “in pain” and prolonging its life was causing it MORE pain. The hospital was Catholic, and the physicians asked Catholic bioethicists and moral theologians to weigh in concerning how to proceed.
The ethical and medical judgment was, after study, that the baby was being given extraordinary means to survive causing it more pain, and that withdrawing care was not against the moral law (see below).
The Catholic Medical Association was called into this case. In response, they backed the hospital and its practices. They also came up with a position paper to cover such contingencies since medicine evolves constantly.
http://www.cathmed.org/swf/cma_response_to_futility.swf
Here is their decision. I think it takes into account the Divine Law and the “gray area” being posed by developments in medical care.
Hopefully, this will not be posed as a “poor baby being shafted” case by the MSM in the future.
Requiescat in pace!
Frank
The moment you discover how to use fetal stem cells in any human without causing teratocarcinoma with the result of cartilage, bone and teeth growing in someone where it is not supposed to be, then you may be right.
To date, you are totally wrong for fetal stem cells—100%. Adult stem cells carry mitochondria too, however, and the PDH complex is present in those cells every bit as much as they are from fetal cells. That is the way to go. And, most scientists are.
“The moment you discover how to use fetal stem cells in any human...”
I referrred to a research application and not to cloning or other regenerative capacity.
Apples. Oranges.
Or did you mean something else?
I believe that yours is but one of several considerations that might have been possible in this case.
But to be coldly blunt.....this poor little guys existence was little more than a 17 month autopsy, since he entered the world with the already-advanced pathologies of the disease.
During her time working at the NICU, she witnessed many miracle babies leave the unit and go home, including some premature infants who were born at 24 weeks. Because CHOA and Brackenridge are the charity hospitals, she also witnessed many babies who came into the unit addicted crack and alcohol. Each infant that comes into the NICU receives the best care possible regardless of their circumstances.
The problem comes in when there is limited bed space, limited staff time and an infant which consumes a lot of both. How do you justify spending major resources and time on a terminal infant when there are other infants who can survive and go home that need those same valuable resources and time? I don’t have an answer to that.
I can tell you this: those doctors and nurses do agonize over these types of decisions! It is easy to criticize or praise the hospital if you are not the one having to make the decision.
I will leave you with this. If you ask any of these nurses in the NICU how they deal with working with infants they know will never make it and never go home, they will give you the same answer.
“God just meant for some babies to be angels”.
The connection I made - if erroneous? - is that Leigh’s is a NEUROdegenerative condition, as is Parkinson’s, and so I therefore assume it to be one of the diseases stem cell research aims to wipe out. There are other bad ones, too. Mind is not with it...neurofibromyalgia??? Amyotrophic lateral sclerosis??
Pure and simple, the Rich rule over the poor, and the borrower is slave to the lender.... nothing more can be said that this.
If she had been wealthy should could have paid for unending support, she wasn’t and the state was footing the bill... and as we all know, that comes with consequences.
What this woman has had to go through is heartwrenching, I pray that I am never in such a situation.
.
Actually WE were footing the bill. The "state" is merely a collection agency. And most of us are not rich, either.
I don't have full details on this case, but if it's true that there really was no hope for the baby, then palliative care would have been the most that could be justified.
Thanks for sharing that. I have a dear niece who had two preemies and went through incredible darkness during their long months before leaving the hospital. It struck her that her children were being given every benefit of medical care while two floors below, children who were further developed were being aborted!
I posted the guidelines above from the CMA which does its best to work out ethical treatments using God’s law first as the ultimate decision maker.
The mitochondria are the energy power plants in our bodies. Incredibly, every mitochondrion in that child’s cells came from its mom. There is no contribution from the father; he contributes the pronucleus. So, if this was explained, there may have been some remorse effect here. If a child has aberrant pyruvate dehydrogenase, it is not going to live long as that is a key energy pathway especially in neural development. This is a sad case, but those who treat these kiddies are heroes to me!
BTW, my niece wants to be a NICU nurse now. She has 5 kids but is still determined to do it.
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