I was reading a few articles about various court cases and came across one dealing with "Baby K".

The Wiki on it can be found HERE

Anencephaly is basically when a baby is born without all or most of their brain. They can not do anything aside from very basic life functions.
Information on Anencephaly


Should a hospital be required to provide an anencephalic infant with care beyond preventing further suffering? Should choices like that be left for the parents to decide or should the hospital be allowed to refuse care?

I think a life is a life even if its incomplete. :/
I'm sure the baby's mother and father would
still love him/her regardless..or at least I would.
The hospitals should have a say in it since they
know what's best but in the end I think it mostly
relies on the parents and how they're going to
cope with the loss of their baby.

I think it should be up to the parents.
some people could handle the extra care needed for such a baby, but I know a lot of parents that couldn't.

It seriously makes me furious that a hospital would try to refuse care to any patient. The legal guardian IS the legal guardian because these choices are his or hers to make. I don't see how they could take a stance that it is ethically wrong to preserve life.

Don't get me wrong - I'm not Christian, but I do believe that life is a very precious thing, and should be taken care of.

Medically, as harsh as it sounds, the baby is incompatible with life. The quality of life medical technology can offer the infant is very poor. In these circumstances, I believe the hospital needs allow nature to take its course rather than prolonging the inevitable, wasting resources and prolonging suffering of the infant.
The Baby K case was incredible sad, but I would honestly say that Mother's wishes should have been overlooked for the sake of the infant. Rather than keeping the poor baby alive with invasive inventions (which often lead to infections and other complications), the baby should have been put on palliative care and allowed to pass away peacefully.

No. Don't get me wrong but I think the baby should just die naturally. Without most of the brain, from what I read not even having the part of the brain related to emotions and personality, if this baby was to be alive for years (provided it could), it would be an emotionless robot, something awful and not quite human in essence. We are more than lungs and heart, and this case and condition prove it.

As for your questions, whilst refusing care sounds bad of a hospital to do, I don't think the parents either should push the hospital into prolonguing the baby's life. It will be a sad one, not actually life but just a state of existence, and honestly, like I said, the baby should just die naturally. A shock for the parents, I'm sure, but no baby would grow up right like that.

Originally Posted by Anaxilea

It seriously makes me furious that a hospital would try to refuse care to any patient. The legal guardian IS the legal guardian because these choices are his or hers to make. I don't see how they could take a stance that it is ethically wrong to preserve life.

Don't get me wrong - I'm not Christian, but I do believe that life is a very precious thing, and should be taken care of.

The hospital wasn't refusing care. It was refusing to prolong the baby's life with life supporting interventions. The hospital wanted to put the baby on palliative care which is basically stop all life supporting interventions and providing nursing care and pain relief for a dignified pain free death. Doctors have more insight into patient prognosis and what the patient is actually going to have to suffer and endure from the result of their conditions/interventions. The legal guardian has limited concept and the impairment of an emotional attachment. That Baby K, probably suffered a lot because of the choices her mother made, even though they were made out of love. The baby needlessly suffered and it suffered for no good reason, it was never going to get better. I worked in hospital and have seen the complications that arise from ventilators, PEG etc and they are grim. Honestly I wouldn't want to see my child suffer like that if I knew it would not get better. What this baby needed more than anything was mercy and unfortunately that got blindsided by a mother's love and faith.

Don't get me wrong - I disagree with the mother's decision. But this seems like a very slippery slope to me. When hospitals get the power to overwrite a guardian's decision, they essentially get the power to decide if these patients live or die. If we give them this power, how much longer will it be before a hospital gets to decide to take comatose or non-responsive patients off life support, regardless of the guardian's decision?

My entire point is that it is not the hospital's decision to make, not that the mother chose correctly.

Originally Posted by Anaxilea

Don't get me wrong - I disagree with the mother's decision. But this seems like a very slippery slope to me. When hospitals get the power to overwrite a guardian's decision, they essentially get the power to decide if these patients live or die. If we give them this power, how much longer will it be before a hospital gets to decide to take comatose or non-responsive patients off life support, regardless of the guardian's decision?

My entire point is that it is not the hospital's decision to make, not that the mother chose correctly.

Medical teams have to make difficult decisions about life and death everyday, they decide when to stop chemo or when to give up on CPR or whether doing that life saving surgery on 100yr old woman would kill her. Doctors have to make a clinical judgment whether an intervention is beneficial or futile. They know their patients and the patient prognosis and they make choices based upon that. Unfortunately if someone is brain dead on a life support then that's it. Love and wishes from family members can't change that.
Also there is an element rationing you have to think about. Keeping someone on life support for years and years is a waste of time and resources that could be redirected onto someone who actually deserves it.

Incorrect, at least in the US. I have no idea where you are, but here, the guardian has absolute last decision, not the hospital. See this for your first example:
When to Stop Chemotherapy | Stopping Chemotherapy | Caring.com

Medical teams my ass. They can advise. It is illegal for them to just "decide" to pull the plug.

My opinion on the whole thing is that yes, it should be the guardian's choice. I'm not saying that the mother was right in prolonging her daughter's life but I also believe that in cases where the child is going to suffer through life the fetus should be aborted. I'm against abortion in most cases but honestly, why make the child suffer in the first place when there is no way to get better and the quality of life is going to suck? I personally think it's kind of selfish on the mother's part to make her daughter suffer. I know it would be hard as a parent to know when to let go but sometimes people don't look at what's best and do what they can just to make someone live a life that's not worth prolonging.

The hospital should however, do what the guardian request even if it's against medical advice. My opinion is not just for the Baby K case but also other cases where mothers kept thier children alive. There's another story I was reading about where a mother kept her anencephalic infant alive and he has to be on more than 20 medications just to stay alive every day. It's sad to me that a child that young has to go through so much and suffer like that.

Originally Posted by Anaxilea

Incorrect, at least in the US. I have no idea where you are, but here, the guardian has absolute last decision, not the hospital. See this for your first example:
When to Stop Chemotherapy | Stopping Chemotherapy | Caring.com

Medical teams my ass. They can advise. It is illegal for them to just "decide" to pull the plug.

You're confusing consent with prescribed treatment. I can not go up to my doctor and demand that he give me appendectomy or a batch of morphine. Likewise I couldn't make those sort of demands when acting as a power of attorney for someone else. The doctor has to offer treatment first, then gain consent from either myself or power of attorney, I cannot prescribe treatment for myself and demand that he gives it to me. I think this is where you've got confused with your source and I mean this respectfully. Patients have the right to refuse chemo however they do not have the right to prescribe medical treatment for themselves and order a doctor to carry it out. A Doctor prescribes treatment and intervention- not the patients. Patient can only consent or refuse to the intervention/treatment.

With chemo the oncology department will be in charge of the treatment and if he patient does not respond to treatment then they will be a point where the cancer will turn terminal and chemo will be stopped because it is futile. Likewise in resus, the medical team will not wait for next of kin to consent for them to stop resuscitation. If the doctor decides that it is futile then he will stop treatment.

Secondly there are times when consent cannot be obtained, for instance in emergencies like arrests, trauma etc. Then the medical team have to make decisions on behalf of their patients, I've worked in hospital and we don't wait for the family to turn up and sign a form so we can start CPR.

There are cases when the medical team can override guardian refusal/consent. For example there have been controversial cases involving blood transfusions of minors who are Jehovah witnesses.

Consent is not straight forward and you'll find that legislation changes from state to state but generally family can give consent/refuse treatment on behalf of a patient but they cannot determine what treatment should be prescribed- that's the doctors job.

Finally it is a huge fallacy to believe the guardians will always act in the best interests of the patient. This is the main concern over propositions of implementing euthanasia in healthcare.

I don't think it should be up to hospital staff to decide on whether or not a life if worth saving. I feel like everything would be so much easier if the choice/burden to willingly let someone die or force them to live would be placed on the one who makes consent.
Just let people do what they want, I say. In cases where emergency health staff must act immediately and without consent they should only do so to prolong life.

Originally Posted by una

You're confusing consent with prescribed treatment. I can not go up to my doctor and demand that he give me appendectomy or a batch of morphine. Likewise I couldn't make those sort of demands when acting as a power of attorney for someone else. The doctor has to offer treatment first, then gain consent from either myself or power of attorney, I cannot prescribe treatment for myself and demand that he gives it to me. I think this is where you've got confused with your source and I mean this respectfully. Patients have the right to refuse chemo however they do not have the right to prescribe medical treatment for themselves and order a doctor to carry it out. A Doctor prescribes treatment and intervention- not the patients. Patient can only consent or refuse to the intervention/treatment... Finally it is a huge fallacy to believe the guardians will always act in the best interests of the patient. This is the main concern over propositions of implementing euthanasia in healthcare.

I'm sorry, I was having a bad day when you posted this and didn't want to pick through a huge explanation of something you've already said, only to realize we're arguing over semantics.

You're arguing whether it's right or wrong to trust the guardian to act in the best interest of the patient. I'm arguing that, regardless of whether or not it is, patients or, if incapacitated with no direction left, their guardians, trump a hospital's authority.

I understand what you're saying about demanding to start procedures - I do. Patients can't demand unprescribed marijuana any more than hospitals can demand a patient starts chemo. But obviously this baby was originally placed on life support, which was later strongly advised to be stopped. The mother didn't demand to start her child on life support; she demanded that the support her infant was already on be continued. Hospitals can't force a guardian to take their loved one off life support (though, as shown in the case above, they can make it very hard for the patient to remain in their facility).

The examples you're providing all demonstrate instances where a guardian could not be easily reached to give consent - of course, in life-or-death situations, or when no guardian can be found after a substantial amount of time, a doctor is going to make the decision she feels is best. But when the guardian is right there, saying either "It was his/her request to continue life support in a critical situation" or "As his/her guardian, I'm choosing to hope/have faith/not let go quite yet," the hospital has to respect those wishes.

It's right here in the patient rights:

Patients and when appropriate, their families have the right to be told about the outcomes of care, including those outcomes that are very different from the anticipated outcomes.

{Patients, parents and legal guardians have the right to refuse or request treatment to the extent allowed by law. Patients have a right to join in their plan of care and to be informed about advanced directives.}

Patients, parents and legal guardians have a right to reasonable continuity of care. That means a patient should know, in advance, what appointment times and doctors are available for follow-up care.

Or, from another source:

Discussing your treatment plan
When you enter the hospital, you sign a general consent
to treatment. In some cases, such as surgery or
experimental treatment, you may be asked to
confirm in writing that you understand what is
planned and agree to it. This process protects
your right to consent to or refuse a treatment.
Your doctor will explain the medical consequences
of refusing recommended treatment.
It also protects your right to decide if you want
to participate in a research study.

Understanding your health care goals and values
You may have health care goals and values or
spiritual beliefs that are important to your
well-being. They will be taken into account as
much as possible throughout your hospital
stay. Make sure your doctor, your family and
your care team know your wishes.

Understanding who should make decisions when you cannot
If you have signed a health care
power of attorney stating who should speak for
you if you become unable to make health care
decisions for yourself, or a “living will” or
“advance directive” that states your wishes about
end-of-life care; give copies to your doctor, your
family and your care team. If you or your family
need help making difficult decisions, counselors,
chaplains and others are available to help.

More reading to back this up:
What if I don't want the treatment that is offered?
Patient Rights resources
Guide to Understanding Informed Consent

This is both a tricky and sad situation. Although the mother has legal rights to the child her emotions are getting in the way, not allowing her to see what is best in this situation FOR THE CHILD. For her, the best is to save the childs life for as long as possible, it makes her feel like she's accomplishing something, and also she clings to her fear of losing the child, creating perhaps really bad situations. The hospital see's these kinds of things everyday, and although they are not unsympathetic to the current situations they still have the power to make unbais decisions on the behalf of the child. They aren't going to make the child suffer because they don't know how to let go. I think the hospital should be allowed to make such decisions. After all they where going to make the child comfortable......just not keep it on life support.

I think the guardian's wishes should be considered first, but in the case of something that is extremely terminal, they should not be in the care of a hospital but instead of a hospice, and I think a hospital should have the right to say, "I'm sorry but there is nothing we can do except for keep them alive just a little longer, but these resources are needed elsewhere for people with more promising outcomes. The condition is terminal and perhaps a hospice or staying at home with the family for their final days may be better."
Keep in mind that not all hospitals will choose to refuse to treat, even if they have a right to.

Originally Posted by monstahh`

I think the guardian's wishes should be considered first, but in the case of something that is extremely terminal, they should not be in the care of a hospital but instead of a hospice, and I think a hospital should have the right to say, "I'm sorry but there is nothing we can do except for keep them alive just a little longer, but these resources are needed elsewhere for people with more promising outcomes. The condition is terminal and perhaps a hospice or staying at home with the family for their final days may be better."
Keep in mind that not all hospitals will choose to refuse to treat, even if they have a right to.

My personal opinion to a tee, monstahh. :yes:

i don't know much about this topic.
but i do feel that only God should recover a soul.
my heart goes out to those who have to make this decision.
what prompted you to this topic?

Originally Posted by Anaxilea

I'm sorry, I was having a bad day when you posted this and didn't want to pick through a huge explanation of something you've already said, only to realize we're arguing over semantics.

You're arguing whether it's right or wrong to trust the guardian to act in the best interest of the patient. I'm arguing that, regardless of whether or not it is, patients or, if incapacitated with no direction left, their guardians, trump a hospital's authority.

I understand what you're saying about demanding to start procedures - I do. Patients can't demand unprescribed marijuana any more than hospitals can demand a patient starts chemo. But obviously this baby was originally placed on life support, which was later strongly advised to be stopped. The mother didn't demand to start her child on life support; she demanded that the support her infant was already on be continued. Hospitals can't force a guardian to take their loved one off life support (though, as shown in the case above, they can make it very hard for the patient to remain in their facility).

The examples you're providing all demonstrate instances where a guardian could not be easily reached to give consent - of course, in life-or-death situations, or when no guardian can be found after a substantial amount of time, a doctor is going to make the decision she feels is best. But when the guardian is right there, saying either "It was his/her request to continue life support in a critical situation" or "As his/her guardian, I'm choosing to hope/have faith/not let go quite yet," the hospital has to respect those wishes.

It's right here in the patient rights:


Or, from another source:


More reading to back this up:
What if I don't want the treatment that is offered?
Patient Rights resources
Guide to Understanding Informed Consent

This is a grey area and I don't think you are going to find answers in patient charters. If the laws were so black and white, then these cases would not end up in courts. Recently a minor was made to have life saving chemo by a judge. There are other examples like religious beliefs regarding organ transplants and blood transfusions etc. The hospitals have some leeway in these matters of somewhat ethical dilemma. Look at the wording of your provided examples, i.e allowed by the extent of law, express wishes etc. There is subtle reluctance to hand the reigns completely over to the patient. The medical staff have to have some control. Unfortunately the physical state of the patient is completely unrelated to the mentality of the patient/family. If the patient is dying and cannot be saved then death is imminent, regardless of how the family feel. The baby in this case was undoubtedly loved, but that didn't change the fact it virtually had no brain.
Its tragic, but the circumstances were what they were. That child had most its brain missing and it could not survive. There was no point or benefit to prolonging its life.

---sorry for long wait between replies <3

Originally Posted by una

Medically, as harsh as it sounds, the baby is incompatible with life. The quality of life medical technology can offer the infant is very poor. In these circumstances, I believe the hospital needs allow nature to take its course rather than prolonging the inevitable, wasting resources and prolonging suffering of the infant.
The Baby K case was incredible sad, but I would honestly say that Mother's wishes should have been overlooked for the sake of the infant. Rather than keeping the poor baby alive with invasive inventions (which often lead to infections and other complications), the baby should have been put on palliative care and allowed to pass away peacefully.

This.

While the mother is the legal guardian, that's an extremely biased outlook on the situation. While a few would be able to recognize their baby probably wouldn't have a good life and let nature take its toll, of course most would do anything to keep their baby alive because they don't want to let go, ever. Mother doesn't always know best.

The hospital didn't have bad intentions in turning treatment away, I'm close to sure of it. I've seen a lot of sick babies and a few sick adults that probably would've preferred death over their birth defects. Honestly, even with the best treatment, I don't think that baby would've ever been happy. But what parent could admit that without a fight, one that they couldn't win?

Originally Posted by monstahh`

I think the guardian's wishes should be considered first, but in the case of something that is extremely terminal, they should not be in the care of a hospital but instead of a hospice, and I think a hospital should have the right to say, "I'm sorry but there is nothing we can do except for keep them alive just a little longer, but these resources are needed elsewhere for people with more promising outcomes. The condition is terminal and perhaps a hospice or staying at home with the family for their final days may be better."
Keep in mind that not all hospitals will choose to refuse to treat, even if they have a right to.

This, exactly this. A thousand times over. There are plenty of other people in the hospital that need more attention, care, and resources then a newborn baby who, in the best situation, would only live a short while later after birth. If the baby isn't going to survive for more then a few hours after birth, then the best course of action would to be to let nature take over at this point and only let the baby be comfortable up to the point of death.

Don't get me wrong, it's a horrible and sad situation to be in. I would not have wanted to be a mother that's told her unborn baby will die almost right after it's born, that would be awful. But there is no reason to prolong that life when there's no chance for the baby to actually enjoy it while they can. It's like being in a horrible accident and being a vegetable state for the remainder of one's life: that's no way to live.

Absolutely not.

We are looking at a child who will never speak, be active or be able to live a normal life. They are only going to die in the end. I think it is better to not prolong the inevitable.
The woman may have been going on her religious beliefs, but she was being terribly selfish. The fact that she preferred to let her kid suffer other than let her go is the reason I'm an atheist. =-=;; Not only that, but she deprived other patients who really need constant care. A braindead baby is SOMEHOW more important that a living patient who has a chance of recovery?
I don't think so.
THIS IS WHY WE CAN'T HAVE NICE THINGS.