Infant euthanasia....

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Postby BigJon » Wed Nov 08, 2006 4:21 pm

barfle wrote:
Shapley wrote:Without a process to determine, legally, that specific conditions are met before we terminate a human life, we have reduced people to being no better than animals, to be kept or disposed of based on our own selfish desires.
It's clear to me we're worse off than our animals in the case of agonizing terminal illness.

And you would be dead wrong. Since we humans have sophisticated communication and feedback mechanisms to gage levels of agony and medicate to appropriate levels to match the individuals wishes, we are significantly better off than the animals.
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Somewhat related personal experience

Postby Angie Parkes » Wed Nov 08, 2006 6:30 pm

I've never, thank heavens, had to make the decision about a child. But my mum had been sick for about 18 months, was very frail, and had congestive heart failure, so her death in the not-so-distant future was expected.

However, she and my sister bought a house together near mine for a number of reasons. Mum was spending the busy moving days with me while my sisters dealt with the move. The night before moving day, she and I stayed up late having a good time "chatting" (she could no longer vocalize, but mouthed words that I lip-read) and planning things for the new house. In the morning, after a normal and happy breakfast, she said her chest hurt a little. Her blood pressure was fine, so we agreed to wait. When she told me a couple of minutes later that the pain was a little worse, I called 911.

A few minutes after that (well under 10 minutes) a paramedic asked me, "Do you understand what's happening here?" "Yes," I said. "Should I intubate her?" he asked. "No," I said. "Let her go." And a minute or two after that it was all over.

About 15 minutes prior to her death, my mum had been cheerfully planning where the pictures would go in the new house. I knew both how she felt about further invasive medical treatment, and what her current condition was, and in the space of about a second I made the decision to end her life. And although the paramedics reassured me that at best she would have made it to an emergency room and died there, I have always suspected that this was said to comfort and reassure me, and that in truth, none of us knew what the other outcome might have been. I have second-guessed myself about this ever since July 29, 1998.

After she was dead, the paramedic asked me if my mum had any sort of paperwork. I had her "living will" that specified "no heroic measures" (intubation would not have been considered heroic) and a "do not resuscitate" order (my mother was still breathing when I made the decision to let her die). When I gave the paramedic the papers -- I always kept them at hand because they were frequently needed as my mum had one health crisis after another -- he said, "Good. This makes our job easier."

This is Canada, not the US, so the discussion doesn't really concern us north of the border, other than that we'll wrestle with the same things at some point. But in at least some cases, the decision to refuse the treatment that might keep a person alive will have to be made in seconds, not weeks.

Angie
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Postby OperaTenor » Wed Nov 08, 2006 7:16 pm

Angie, were your ears burning? ;)

Really good to "see" you! I hope you can stay and play - you're missed.
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Postby barfle » Thu Nov 09, 2006 12:00 pm

BigJon wrote:
barfle wrote:
Shapley wrote:Without a process to determine, legally, that specific conditions are met before we terminate a human life, we have reduced people to being no better than animals, to be kept or disposed of based on our own selfish desires.
It's clear to me we're worse off than our animals in the case of agonizing terminal illness.

And you would be dead wrong. Since we humans have sophisticated communication and feedback mechanisms to gage levels of agony and medicate to appropriate levels to match the individuals wishes, we are significantly better off than the animals.

That depends on the condition. I'm certain I could have drugged my cats to the point where they were in a stupor until their deaths, but what would be the point?

Again, I've watched people die, and even though my mother-in-law was in a coma, she was clearly in severe distress. You don't writhe like that unless you can't help it. She deserved better, but it was not legal to do anything but starve her to death.
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Postby Shapley » Thu Nov 09, 2006 12:23 pm

She deserved better, but it was not legal to do anything but starve her to death.


And therein lies the dilemma. You can shoot the cat that's suffering and the government's okay with it, but if you starve it to death you'll go to jail for cruelty.

You can starve a person to death that's suffering, but if you shoot them you'll go to jail for murder.

Both of these conflicting rules exist in the name of compassion.

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Postby barfle » Thu Nov 09, 2006 12:26 pm

At least we agree that there's a dilemma. What's cruel to an animal is apparently not cruel to a human being. Which is another reason to not have politicians making these decisions for you.
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Postby Shapley » Thu Nov 09, 2006 12:32 pm

Hi, Angie!

Thank you for dropping in. Sorry to hear that you had to be burdened by such a decision, and thanks for reliving that decision for the sake of our discussion here on the board.

I think the key issue is that your decision was whether or not to allow your grandmother to die from the affliction that was killing her, not whether or not to induce artificial means to end her life. It may seem a hazy line, but I think it is a very real distinction, both physically and morally.

V/R
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Postby jamiebk » Thu Nov 09, 2006 2:59 pm

Shap, In Angie's case (which is a sad and hard decision) you do not question allowing someone to pass. The prognosis of long term care and suffering is avoided and I think everyone agrees that it is the most compassionate thing to do.

Yet, when faced with the question of this infant euth. your response is different, citing that it is the taking of a life. Keep in mind that such an act is ONLY considered in the most serious and terminal situations or where the prospect of any sort of quality of life is nil. Great pain and suffering is likely and would be both physical and psychological (on a number of people involved). Sure...we could allow the infant to pass and likely this would take a great deal of time, pain, and suffering. When the end conclusion is certain death or life as a total vegetable, I do not see a point to subjecting all those involved to the pain of enduring the process of death over a protracted period of time. To me, that shows a lack of compassion all in the name of standing on principle with whether one allowed death or assisted it. However, I totally believe that this is as deep and personal decision as there can be and so I come back to the right of those involved to choose how to deal with the situation based upon the specific circumstances. It is that right that must be preserved.
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Postby Shapley » Thu Nov 09, 2006 3:28 pm

Jamie,

My stepson was born severely handicapped. He stopped breathing during birth and was resuscitated, but brain damage resulted from the period of oxygen deprivation during birth. Of course, doctors had no way of knowing at the time if that would be the result, nor would they know now in time to make the decision whether or not to rescucitate a child.

Doctors at the time told his mother (now my wife) that he would be a vegetable and would not live six months. That was twenty-seven years ago, and he is still with us. He is unable to walk or talk, but he is aware and expresses his feelings to us. He is a long way from being a vegetable. He laughs, he cries, he enjoys rides in the country and classical music. I do not know, nor does anyone else, whether he would prefer that he were never rescusitated, but I know that his mother does not regret having raised him, difficult though the task has sometimes been.

I do not believe that they now know any better how a child will develop based on an analysis of the child at birth. Nor would I want the doctors that proclaimed that he would be a vegetable to be the ones who will make the determition for others. If the determination has to be made, some sort of criteria has to exist that specifically determines what conditions have to be met, and some sort of review has to exist to ensure that those conditions have been met, before a life should be taken.

V/R
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Postby jamiebk » Thu Nov 09, 2006 3:58 pm

Shap...I have never stood in your shoes and I respect your feelings given your situation and experience. I think we all hold out hope in even the darkest of situations and sometimes that hope is rewarded. I am glad that it was in your case.

I am a somewhat pragmatic person and at this point in my life hold to the opinions I expressed above. I cannot say if those opinions would change were I in your shoes or faced with some similar circumstance. Perhaps they would. However, I can certainly understand why you feel that way you do and appreciate you sharing that.
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Postby Shapley » Thu Nov 09, 2006 5:31 pm

No problem. I wouldn't wish my stepsons' problems on anyone, but I also wouldn't want someone like him to be deprived of the chance at whatever level of life they can enjoy just because a doctor declared them to be undeserving of it. As I've said, there has to be some rule, some guideline that says 'if 'x' exists then the person lives' or 'if 'y' exists then the person can be terminated' before we can think about legally allowing it.

Had my stepson not been resuscitated, there would have been nothing morally wrong. Once the decision was made to resuscitate, then everyone has to live with the consequences. You can't put the genie back in the bottle.

I recall in CPR classes that one of the things that they stress is (or at least used to be) 'once CPR is started it must be continued until competent medical personnel relieve you, order you to stop, or you are physically unable to continue. The decision to prolong life carries a great responsibility. The decision to terminate it carries an even greater one.

V/R
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Postby Haggis@wk » Wed Nov 15, 2006 9:33 am

Church backs calls for severely disabled babies to be killed at birth

This is what I meant when I said the argument has switched from “should we let them die?” to ”should we let them live?”

” Bishop of Southwark, Tom Butler, who is the vice chair of the Church of England's Mission and Public Affairs Council, has also argued that the high financial cost of keeping desperately ill babies alive should be a factor in life or death decisions.”


And this concern only happens in socialized medicine countries, when you have vague feelings that the cost of taking care of someone else might affect your health care.
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Postby Shapley » Wed Nov 15, 2006 9:39 am

That's interesting. Earlier in this thread it was said that the cost factor shouldn't be a consideration, only 'quality of life' of issues. Of course the cost will affect the quality of somebody's life.

As Bob Dole said: "A nation that takes control of the economy for the good of the people will end up taking control of the people for the good of the economy."

How long before the criteria slips from "severely disabled" to "disabled"?
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Postby audiogirl » Wed Nov 15, 2006 10:28 am

Has anyone read The Giver?
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Postby Haggis@wk » Wed Nov 15, 2006 10:52 am

Sweden, that great beacon of Socialism, officially practiced eugenics based on research by the Nazi and forcibly sterilized women considered “socially unfit” from 1936 until 1976.

” Some women were forced to undergo the operation in order to get out of prison, to qualify for certain welfare benefits or to avoid losing custody of their children.

Several of the people sterilised were children”

…” Since the Swedish case came to light, it has been revealed that many other countries carried out sterilisation programmes, based on eugenics ideas linked to the Nazis. They include Austria, France, Finland, Norway and Switzerland.”


As I’ve mentioned before, socialist states get up to all kinds of mischief that could not happen in the U.S.

So my question remains, Europe and the EU are relevant to our way of life..because??
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Postby Haggis@wk » Wed Nov 15, 2006 11:29 am

Hey Northern Neighbors!!!

Last year Bill C-407, which legalized euthanasia and assisted suicide died when the government lost the election. Has it been revived? What the general concensus on it in Canada??
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Postby GreatCarouser » Wed Nov 15, 2006 12:22 pm

Haggis@wk wrote:As I’ve mentioned before, socialist states get up to all kinds of mischief that could not happen in the U.S....

So my question remains, Europe and the EU are relevant to our way of life..because??


So Haggis, refresh our memories, please. Was it the socialist paradise of Alabama or Mississippi that forcibly sterilized blacks 60 or 70 years ago?...but that "kind of mischief could not happen in the US"....
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Postby piqaboo » Wed Nov 15, 2006 12:33 pm

Somewhere upthread Shapley appears to have drawn an unwarranted and indefensible conclusion that the choice would only affect unwed mothers, and that the OB would somehow cooperate because this is an unwed mother, regardless of the infant's health. Boo hiss.

Also he indicated that its ok to not-intervene when death is imminent, but its not ok to remove lifesupport once intervention has begun (perhaps I misinterpreted but thats what it appears to say). This effectively removes the choice, if thirdparty oversite is required. Also, its not ok to administer any treatment that might hasten death, such as painkillers. So a child that is not intervened with to save its life, may suffer its way to death, and that's ok within the bounds of his morality. barfle has a problem with that. Me too. If the decision is not to intervene to save the life, then pain mediation must be allowed.

I agree that doctors would require special training in the conditions deemed 'appropriate' for euthanasia. Govt oversite in taht case would be to define the conditions (via public discussion and vote), and then the OB's or pediatricians are certified, and the decision can be made on the spot.

There is huge room for debate on what conditions would be acceptable for pain & suffering abatement and lack of life support. I am not at all clear where I would draw the guidelines.

My friend was given <6 yrs to live at birth, then "she'll die before she's 12", then 15, 18, 21..... She died eventually of her cystic fibrosis, because she declined lung transplants. She was 31. Her sister had a double transplant and is still alive in her 40's. Sometimes technology can start to keep up with the progression of a disease. This complicates the decision.

A coworker had a child who might have been considered in a persistent vegetative state. He was born that way, and stayed that way til he was 9, when he died. His parents took him to parties etc, he was fed by IV his entire life. He'd be carried in, laid flat in some safe space, and his IV would be hooked up. I think these folks would have chosen as they did, regardless of the law. However other folks might not have the mental or emotional or financial resources to keep such a child healthy. There was no way to judge 'quality of life' for this child. He didnt appear to be suffering. But its hard to imagine the child would have been better off in a dark corner, with bedsores, because his folks couldnt deal & couldnt opt out. Are there 'state' institutions for such children, these days?

Then there are the conditions at birth that come with very short expected lifespans (days, weeks, months) and associated pain/suffering. I'd need a lot more research into the possibilities before I could even begin to define a guideline. This is why we need public debate.
The end result of debate could be guidelines for legal euthanasia, or it could be the creation of support systems instead.
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Postby Shapley » Wed Nov 15, 2006 2:25 pm

Somewhere upthread Shapley appears to have drawn an unwarranted and indefensible conclusion that the choice would only affect unwed mothers, and that the OB would somehow cooperate because this is an unwed mother, regardless of the infant's health. Boo hiss.


Piq,

I don't know where you drew this conclusion from anything I've posted. My wife was not an unwed mother at the time of my stepson's birth. Nor did I suggest that the OB would always cooperate because of her marital status (I don't think I've brought marital status into the issue, but I could be mistaken). All I've said is that, without a codified set of rules as to when it is acceptable, there is no safeguard to prohibit the OB with going along with the mothers wishes. I don't know how you can infer from that anything resembling the above quote.

The law right now is that it is okay to not intervene if death is imminent, but that once intervention begins, it must be carried through. That is, in my opinion, as logical as it can be. One involves stepping in to stop the natural process of death, while the other involves not terminating a life that has been preserved, whether artificially or not. As I've said, the decision to prolong life is a weighty one, the decision to terminate it is even more so. I've nowhere suggested that easing a patient's sufferning through the use of painkillers should be prohibited. Killing a patient should be.

So a child that is not intervened with to save its life, may suffer its way to death, and that's ok within the bounds of his morality
You've no measure of the bounds of my morality. I'm talking legal issues here. I've always heard that you can't legislate morality.

I agree that doctors would require special training in the conditions deemed 'appropriate' for euthanasia. Govt oversite in taht case would be to define the conditions (via public discussion and vote), and then the OB's or pediatricians are certified, and the decision can be made on the spot.


And I have no problem with that, if that is the States determination of 'due process'. But, as I've argued from the start of this - the State has to make that determination via, as you say, public discussion and vote.


Are there 'state' institutions for such children, these days?


I don't know about California, but there are in Illinois. I'm sure California has them as well. Sometimes they just remain at the hospital. There are wards where such children live. Cardinal Glennon Children's Hospital in St. Louis has several children who were more or less being raised by the hospital. One child I recall was a real handful. He was known to all the regular patients and their families that spent time on that ward, because he visited with everyone. But his condition was not so severe as others.

My own observation is that children such as you describe do not survive as long in most such facilities, although Cardinal Glennon is clearly an exception. They usually do not receive the love and care that a mother can provide. My wife has argued and disputed physicians and nurses many times over their diagnoses of my stepson, and she rarely leaves his side when he is hospitalized (which, BTW, has become increasingly rare). There are times I'm sure that, had she not been there, he would have died under the care of the staff. Not because of negligence or lack of compassion, but because my wife has had to instruct them on how to respond, based on her experiences with him. One doctor at Cardinal Glennon told me that he has outlived their own experience with such children.

V/R
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Postby Shapley » Wed Nov 15, 2006 2:54 pm

I did see where I mentioned 'unwed mother'. But I did not imply that the situation only applies to them. I chose an unwed mother for that example because it is the only situation I could think of where 'those involved' would have the smallest number - the mother, the child, and the physician.
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