Posted on 02/28/2011 3:57:32 PM PST by wagglebee
I do not understand this at all.
This is what happens when medical care is politicized, and this is what happens when your doctor answers to someone else besides the patient and the patient’s family.
But (if I'm understanding the details correctly) in this case I think the tracheotomy would be considered "ordinary care." It's a simple, routine way to help a patient breathe. "Invasive"? Yes, but only very slightly. Not expensive. And the little guy would go home, which means the care would be assumed by his parents, significantly cheaper and simpler than keeping him in the hospital.
Plus it would show a decent respect for his grieving parents' wish that they be allowed to spend a little time (more than minutes) with their dying son at ome.
And others are willing to pay ALL the expenses!! So what's the problem? Looks like a stone cold bureaucratic power trip to me. "We have ruled! Quod scripsit, scripsit!"
Actually, they could transfer the child with an endotracheal tube in place, as long as someone manually ambubags him during the transfer. So they’d only have to find a hospital to accept him. It sounds like they already have donors for the procedure, the home ventilator, and the supplies.
While I am sorry that this family is having to go through this horrible situation, I am wondering why they never were clued in when their 8-year-old died (apparently from this same neurological problem). A couple I know had two children, both of whom were severely neurologically “disformed” (one lay in her bed for some 18 months before she died...never as much as sat up). It came obvious to them that there was a problem in their genetic material, i.e., should have never had children together and they stopped. Why didn’t this couple?
It is not the tracheotomy costs but the cost of caring for the baby for several more months.
Yes, they pay for their health care. But I can guarantee that this family has already cost the system far more than they will every pay in, thus it is the other taxpayers who will pay.
Third, then I don’t understand what the problem is. Let them.
Actually, the term "brain death" was fabricated as a ruse to allow organ donation while the heart is still beating.
Many doctors and bioethicists want to reject the term altogether.
Also consider this, if Baby Joseph actually meets any of the criteria for "brain death" he will die within minutes of the ventilator being removed, with or without a tracheotomy.
Yes, they pay for their health care. But I can guarantee that this family has already cost the system far more than they will every pay in, thus it is the other taxpayers who will pay.
Do you support rationing health care?
And that leads to the question of are they being good stewards of the taxpayers’ money by denying the life extending tracheotomy or are they just stingy?
Even with private health insurance, you cannot demand endless benefits. There will be an end to them. At that point should the taxpayer be on the hook for an indefinite amount of money? In other words, does the sick person or their family have a right to a blank check from the government?
My wife and I had to make a similar decision a couple of years ago with her dying mother. She was very old and weak and on at least a dozen medications for her various ailments and we could have opted for a procedure that would have extended her life by a few weeks, but we knew the inevitable was near. When we saw that she was in no pain, we opted against the procedure and allowed her to slip away.
Could we have demanded more treatment. Yes, and she would have received it. But at some point money will ALWAYS be a factor. You shouldn’t expect money and services from others as if you have a right to it.
Yes, I think that the problem here is that the bureaucracy has declared itself the sole custodian of the child’s health care and even though it will cost them nothing, they are unwilling to give up that control. I cannot imagine why.
Nine Class IV studies have been published on the recognition of brain-death mimics, including fulminant Guillain-Barré syndrome, organophosphate intoxication, high cervical spinal cord injury, lidocaine toxicity, baclofen overdose, and delayed vecuronium clearance.6–14 The description of the examinations provided in these studies indicated that a complete brain death examination was not performed in any of these patients. We found no reports in peer-reviewed medical journals of recovery of brain function after a determination of brain death using the AAN practice parameter. (emphasis added)Translation - those who don't examine properly to determine brain death will make tragic mistakes. Take home point - do the right exam the right way.
Now, what do you suggest be done with those unfortunates who have had trauma, toxic exposure, cardiac arrest from which they were resuscitated, and whose brains were without oxygen for prolonged periods? Who show no evidence of brain function whatsoever? Should they all be kept on ventilators until the heart gives out?
Be practical. EVERYTHING is rationed. Even health care from private insurance companies. Someone WILL make that decision. Whether it is the individual or their family or an insurance bureaucrat or a government bureaucrat. They WILL make it. Hopefully the individual and their family will make good choices that balance the care they get with the expectations of that care.
Look at it this way: should a person expect the insurance company to pay for a procedure that will extend their life for 6 months if the cost is $2,000?
Okay, what if the cost is $20,000,000,000 and the person will be in a coma the whole time?
I’ll bet that you are tending to say that $20 billion is too much in that case. Does that make you a supporter of health care rationing?
What is an adequate observation period to ensure that cessation of neurologic function is permanent?
Recommendations for the length of observation periods have varied extensively throughout the world and the United States. There are no detailed studies on serial examinations in adult patients who have been declared brain dead.
Conclusion.
There is insufficient evidence to determine the minimally acceptable observation period to ensure that neurologic functions have ceased irreversibly.
Baby Joseph has 13,000 friends on Facebook! Yet the hospital continues
to put out disinformation about his condition and is insisting that
he won’t be allowed to have the tracheotomy needed to allow him
to survive the trip home.
I support not spending money on care that is futile.
The Catholics want everyone on a ventilator.
Euthanasia must be distinguished from the decision to forego so-called "aggressive medical treatment", in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family. In such situations, when death is clearly imminent and inevitable, one can in conscience "refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted".77 Certainly there is a moral obligation to care for oneself and to allow oneself to be cared for, but this duty must take account of concrete circumstances. It needs to be determined whether the means of treatment available are objectively proportionate to the prospects for improvement. To forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death.and from Congregation for the Doctrine of the Faith, Declaration on Euthanasia:
Therefore one cannot impose on anyone the obligation to have recourse to a technique which is already in use but which carries a risk or is burdensome. Such a refusal is not the equivalent of suicide; on the contrary, it should be considered as an acceptance of the human condition, or a wish to avoid the application of a medical procedure disproportionate to the results that can be expected, or a desire not to impose excessive expense on the family or the community.I see legitimate disagreements in the Baby Joseph case, but not with those who maintain one can never take someone off a vent, or that there is no such thing as brain death.
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