Death Panel, Canadian Style
The parents of a Canadian boy ordered off life support by government health officials have been denied a request to transfer the 13-month-old to [a U.S. hospital].
Moe Maraachli and his wife, Sana Nader, of Windsor, Ontario, wanted the Michigan hospital to perform a tracheotomy on their son Joseph, who is currently kept alive by a respirator. Maraachli says turning off life support could cause his son to choke and suffocate. He told Fox News on Wednesday that the doctors at London Health Sciences Centre have said the “best treatment” is to “let him die… I don’t know what kind of treatment that [is].”
The family believes [the tracheotomy] will allow Joseph to breathe on his own, and thereby be able to go home and likely die there.
Full article on the Canadian life support battle.
This is an obviously heart-wrenching situation in which the patient’s family and the medical providers are at odds over what is most appropriate in caring for a terminally ill child. Clearly there is no one “right answer”. It is important to note however that this kind of impasse is not unique to government-run systems. I recall several similar cases in the US over the years involving young children. However, a foremost principle in medical ethics is the preservation of patient autonomy. Since the patient in this case cannot make decisions or exercize his autonomy, the surrogate is usually the parent(s) not the state. A tracheostomy is not a major procedure and does not command extensive resources (as opposed to, for example a bone marrow transplant)and therefore arguably does not deprive someone else of a lifesaving procedure. For these reasons one would hope that the parent’s would be allowed to decide on behalf of their son. I believe this is usually (but, unfortunately not always) what happens here in the U.S.
Amazing. This is in your future, folks.
Hard to believe a hospital has that kind of power.
If a U.S. health insurer refused to pay the hospital to care for this child, the insurer would face legal action and officials would likely intervene to require care. In this case the hospital wants care stopped because it’s funded using a global budget. Rather than intervening to require care, the provincial officials are providing the hospital cover to pull the plug. At issue isn’t whether the child can survive; rather my point is the huge difference in power between Canadian patients and American ones.
I agree with Denis. This is a problem in both systems. The difference is who makes the decisions and how much they can decide.
The whole issue of ending someone’s life (especially when it’s possible to prolong it artificially) is a very difficult one. But, by virtue of allowing a third party to pay, we are also giving that third party some leverage in the outcome of our decision. It’s a tough question.
So, just how much is a dying child worth? What treatment should be given? In terms of time and money, I would never want the government, or anyone, telling me that answer.
Thanks for your comment, Dennis. That was helpful.
What’s disgusting about this is that the parents are not allowed to determine what happens to their son — even when their prefernece would appear to be less costly to the government.
Update: Canadian hospital officals have agreed to transfer the infant so that he may die at home.
http://www.foxnews.com/world/2011/02/28/canadian-hospital-agrees-let-boy-vegetative-state-die-home/?test=latestnews