Monday, March 23, 2009

empathy and distress: bad medicine for Baby OT

We've just had the sad death of Baby OT, whose parents fought a court battle to force doctors to resuscitate their child should breathing stop because of the effects of respiratory failure and metabolic disorder; brain damage was also present. His parents said:

We are and always will be convinced that despite his desperate problems his life is worthwhile and is worth preserving as long as it is possible to do so without causing him undue pain.
The case was not without inconsistencies: OT's parents showed the court footage of the little boy smiling when his feet were tickled, and stated that some of the nurses believed that OT experienced happiness; whereas the Telegraph's Caroline Gemmell reported that one of the medical staff, Dr C, told the court that "the boy would 'certainly' be dead by the age of five...[and]conceded that OT was suffering from a very rare disorder about which not much was known, but said it was "very, very, very unlikely" that his condition would improve." [My italics.]
British Medical Association (BMA) logo
Something that struck me about the affair was a remark by an unnamed British Medical Association (BMA) spokesperson that "Cases like this are very distressing and we have every empathy with the parents": this is the language of counselling, and bears no relation to medicine.
The remark appeared in an article entitled "Courts are right to make decisions on Baby OT treatment withdrawal cases, said British Medical Association".

However, in another context referring to the end of life, last year the Director of Public Prosecutions let it be known that it is not for the courts to make law in cases of euthanasia (unlike Debbie Purdy's, the doctors in baby OT's case were seeking permission to visit non-voluntary euthanasia upon the child, and succeeded).

Flitting over to the other side of the pond for an earlier case, I found out today fromTirhas Habtegiris, thanks to for the pic - click to read Janet St James' reportage on the healthcare insurance crisis Wesley J Smith's blog, Secondhand Smoke, that Tirhas Habtegiris, a "dying, uninsured cancer patient", died in hospital in Baylor, Texas, in 2005. Her ventilator had been shut off because her family could not afford to keep her alive long enough for her mother to come over from Eritrea and hold her daughter while she died. Her family say she was conscious over most of the 15-16 minutes it took for her to suffocate.

What had exercised Wesley was an article by Ronald Bailey, a "libertarian transhumanist" (avaricious Terminator fan) who contrasted Habtegiris' penurious death with that of Terry Schiavo, who was on a ventilator for seven years before her allegedly abusive husband won a court case to have life support - in this case a feeding tube - removed. Bailey asked, what "obligation do physicians, hospitals and the rest of us have to pay for the health care of others?"

Bailey links to "hardcore libertarian" (rapacious Wall Street wannabe) Steven Landsburg who, in an article called Do the Poor Deserve Life Support? analyses the situation with the semi-psychotic utilitarianism of Mill Sr that Mill Jr tried so hard to destroy:
If you ask people—and especially poor people—what their most dire needs are, you'll find that "guaranteed ventilator support" ranks pretty low on the list. OK, I haven't actually done a survey, but I'm going out on a limb here and predicting that something like, say, milk, is going to rank a lot higher up the priority list than ventilator insurance.

In fact, I'll go further. The back of my envelope says that a lifetime's worth of ventilator insurance costs somewhere around $75. I'm going to hazard a guess that if, on her 21st birthday, you'd asked Tirhas Habtegiris to select her own $75 present, she wouldn't have asked for ventilator insurance. She might have picked $75 worth of groceries...Tirhas Habtegris would probably have taken the cash. Then she'd have gotten sick and regretted her decision. And then we as a society would have been in exactly the same position we were in last week—deciding whether to foot the bill to keep Ms. Habtegris alive a little longer.
Although I realise British and American health systems are different, what I'd like to note that Habtegris' family were not requesting an eternal deferment of death, merely enough time for her mother to be brought over from an all-but failed state and hold her daughter while she expired. Just as Baby OT's parents wanted up to five years of life with a little boy who liked having his feet tickled.

As much as I think Steven Landsburgh's ideas are foul, he is at least honest, which is slightly easier to stomach than the BMA's dissembling when it speaks of the "quality of life" of a baby which they have no way of assessing. Likewise, Baroness Warnock has said that dementia sufferers have a "duty to die; just so, hospital managers have defended plans to refuse operations for groups including the elderly "because of the higher risk of complications on the operating table for unfit patients", while one the other hand one in three in a survey of hospital and family doctors said "elderly patients should not be given free treatment if it were unlikely to do them good for long".

Sometimes we pro-lifers are accused of concentrating on abortion, but the euthanasia movement has a powerful head of steam right now because of the truths and rights that were crumpled and torn in the fight to de-recognise the humanity of unborn babies - a process which has also tied women more securely into the structures of oppression from which the original feminists sought to free them. Cast adrift from moral certitudes, courts in, for example, the UK, the US, France and Singapore have prosecuted doctors for failing to kill a child during an abortion, effectively recognising what LifeSiteNews calls "wrongful life" - a concept powering some doctors' determination that Baby OT and Tirhas Habtegiris had to die.

It's certainlPatricia Hewitt - click to see the Pro-Life Alliance's comments on her suicide tourism campaigny a matter of money, but it's also more: a pathological need to control other peoples' lives, and the very same inflated sense of self-importance which compels some of those who seek euthanasia to involve not only health-care professionals, but also judicial systems and even governments in the attention-seeking path to their self-destruction. (Some, similarly narcissistic, reciprocate for their time in the sun: former health secretary Patricia Hewitt is calling for the legalisation of what's already being called "suicide tourism").

In 2006, echoing the confusion that reigns over people's rights at the end of life, an Italian court declared that an unborn child did not have a "right not to be born". It sounds like a fillip for the pro-life movement, but in reality it's as vacuous as saying Jade Goody did not have a right not to die from her endstage cancer, and echoes statements that Baby OT had a right to life, but not a right to be kept alive.

In the US, giving care to somebody who is bound to die is called futile care, a title that is at least more honest than the language of empathy and distress. Given that all lives will be interrupted by death, all care is ultimately futile. But we give it anyway, because we recognise that in the midst of life's compromises, to give without hope of return is good, makes us more human, makes us something more than the earthly account-book detailing the money we will generate minus what is required to keep us going long enough to die in a loved one's arms.

Related post: Baby RB and the misery of medics

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