Posted on 03/04/2011 5:41:50 AM PST by wagglebee
Joseph Maraachli with his father, Moe
March 3, 2011 (LifeSiteNews.com) - The case of baby Joseph started out fairly clear, but as time has passed many people have interpreted it as something it is not.
Joseph Maraachli was born without any problems. Then in May 2010, the Maraachli family brought Joseph to the Children’s Hospital in Detroit because he was unable to breath. After several weeks of treatment, Joseph went home with his family in good health.
In October 2010, Joseph experienced a similar problem with breathing. His parents were driving home from Toronto and stopped at the hospital in Ingersoll, Ontario. From there he was transferred to the Children’s Hospital in London, where he remains.
Who has the right to decide?
The baby Joseph case concerns the question of who has the right to decide what is in the best interests of baby Joseph.
The hospital decided to withdraw the ventilator from Joseph, which would result in death, likely occurring within a short period of time. Joseph would die while gasping for air.
The family decided that they wanted to bring Joseph home to die while in their care, in the same way that they cared for their first child who died of a similar condition more than 8 years ago. The family asked that a tracheotomy be done to allow Joseph to breath on his own, so they could bring him home.
The issue is, who has the right to decide? Does the hospital and doctor, or does the family have the right to decide on how to care for their terminally ill child?
Not about futile care
This case is different from most of the similar cases because it is not about a family requesting treatment that is futile, burdensome or extra-ordinary.
The family is not asking for a portable ventilator to be set up in their home, even though this would be a reasonable option. They are not asking for in-home nursing care to be provided. They did not ask for experimental treatment plans.
The family only asked to bring Joseph home; but to do so would require Joseph to be capable of breathing on his own. This is why they requested that a tracheotomy be done. A tracheotomy is not a difficult procedure; it is not futile, burdensome or extra-ordinary.
Not about euthanasia
Some people have suggested that to withdraw the ventilator from baby Joseph would constitute an act of euthanasia. This is not true.
Euthanasia is an action or omission that directly and intentionally causes the death of another person with the intention of relieving suffering. Euthanasia is a form of homicide.
If the ventilator is withdrawn from baby Joseph, he is likely to die, but he may survive. If he dies, his death would be caused by his medical condition and not because of a direct and intentional action or omission. Even if the intention is to cause his death, the reality is that his death is not direct because it is caused by his medical condition and therefore is not euthanasia.
The precedent set by the baby Joseph case affects everyone
If I have a massive stroke, I am not competent, I am unable to swallow effectively and I have not indicated in any way what I would want in such a circumstance and my wife would like an intervention done to allow me to be effectively fed, but the doctor says no, what will happen?
The precedents that have been set by the baby Joseph case and similar cases would force my wife to hire a high-priced lawyer to defend her right to provide reasonable care for me. She would face a well-paid lawyer who is financed by the hospital.
If the Consent and Capacity Board sided with the hospital she would be forced to appeal the decision to the Superior Court, which would cost an excessive amount of money, simply to defend her right to have basic care provided for me.
In the courts, legal precedents, like the baby Joseph case, would be used to convince the judge that the decision of the doctor and the hospital is correct.
We are all at risk, unless decisions like those made in the baby Joseph case are reversed, or unless the legislation in the Province of Ontario is not amended.
I continue to support the plight of baby Joseph and the Maraachli family and I continue to hope that the family and the hospital can achieve a mutual agreement. Maybe Joseph should be sent home and cared for on a portable ventilator?
See Baby Joseph Facebook page.
It was made extraordinary by a judge without any medical background and also inhuman by such a judge. If you can refuse nutrition to a coma or semi-comatose patient, you open the door to refuse food to anyone. I have also had patients that would go in and out of coma. Be alert and talk with you and suddenly lose consciousness and not even respond to painful stimulus...Some doctors use no stimulus to pain as a condition for the depth of coma.
You are looking more like a troll by the minute.
Look up the terms "logical fallacy" or "disproving a negative" and you will see the problem.
From my time in medicine, traches were not consider ordinary in all circumstances.
Name one under which they weren't. You want to make a case, you need to prove it.
This case raised many questions for me, and I can see both sides.
A real conservative is only going to be interesting on one side of this case.
A simple assertion on your part that it isnt extraordinary isnt very educational.
Actually, it is.
Let me be perfectly clear, I am only interested in this baby's life -- I don't give a damn about "educating" you.
Do you have a citation or reading suggestion? If not, Ive obviously learned all I can from this discussion.
Your intention was never to learn, it was to push pro-death talking points.
Agreed.
His type of brain cancer, he was going to die, no doubt bout it but he deserved to be treated with love and talked to and rocked by his mother until he took his last breath. He also deserved nutrition and fluids to keep him comfortable. His death was peaceful and its the way we should treat all those dying unless as adults they sign forms that say otherwise.
For me, I have signed such a document, and talked with my kids about their Power of Attorney for health care. All adults should do this and not have the family make the decision..and do it in writting. No one likes to think about it, but it will happen to everyone living today. If someone wants extraordinary means its their decision. If they don't again its their choice..Its no doctors job to determine what quality of life is except for his own life..
Thanks for the link. You are right that is is not an easy subject. I will read more about it.
Euthanasia and Extraordinary Care
Ordinary and Extraordinary Means of the Preservation of Life: The Teaching of Moral Tradition
NCBC's A Catholic Guide to End-of-Life Decisions (scroll down to Obligatory and Optional Medical Means)
Bioethical Magisterium on Normal Treatment and Ordinary Care: Medically Assisted Feeding and Hydration
Ordinary vs. Extraordinary Care: A Moral Dilemma
You seem to be a reasonable person, so I will answer your questions.
A trach does not help a person breath. A trach is just a way air can get into your lungs. It is a conduit only.Inhaling and exhaling is a brain stem function, which this baby does not have.A trach does not perform the function of inhaling and exhaling.
This baby is nasally intubated. You can tell by the pictures. Intubation serves the same function as a trach. There is no difference.You have to extubate and place a trach for long term use because of issues with tissue erosion.
The Canadian hospital has tried to wean this baby off a ventilator, but cannot because the baby stops breathing when they do.
You can keep a person on a ventilator after death ( which this baby is) for a long time. Eventually, the body stiffens, pulmonary resistence occurs ( decreased chest wall compliance), and you keep pumping oxygen in, to no avail.
Eventually the chest does not rise . This “suffocation” they are all talking about is going to happen no matter what.
This is care beyond the extraordinary.Way,way beyond.The family is from Lebanon, so there are cultural differences between them and the western health care system. They want to bring this baby to the US- so then your tax dollars are on the line for the care. If not your tax dollars, then your health insurance premium, because hospitals will pass the buck to the insurance companies .They will negogiate for higher rates when they lose money on patients like this..
This poor baby has no reflexes, is blind, no brainstem function,pupils fixed, cannot eat, cannot breathe without a ventilator,cannot maintain metabolic balance. He will eventually get bedsores, and could die of sepsis as a result.
His sister had a trach, but no ventilator. This baby is much more severley disabled.
There is no way a hospital in the US will accept this patient. They are not going to give up a precious ICU bed, have questionable compensation, and have difficulty sending this baby home.
Not only that, when you operate on a patient, the complications are yours. Therefore,the hospital performing the procedure would be on the line for postop infections, respiratory issues. They have searched for a week, so far, no American hospital will accept this patient.
Time to let this baby go with some dignity to be with God.
The parents are in denial. Send the baby home with the ventilator, extubate at home with clergy there, and let this baby have some peace.
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