Legal, moral, and ethical controversies happen often in health care. Recently the world media reported the legal case where the parents of 18-month-old boy with a terminal muscle-wasting disease expected to die within a year appealed to the court in order to stop the doctors from turning off the ventilator necessary to sustain his life. The baby “cannot breathe for himself, has to be fed through a tube, and can only move his eyebrows, feet, and fingers very slightly.” (CNN, 2005, para.2)
The doctors’ argued that his life was intolerable, while the parent opposed this claim by stating that the critter was still capable of enjoying communication with his parents.
The judge James Holman of the High Court in London said the following when explaining his decision in favour of the parents’ plea to leave the baby alive:
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“He continues to see and hear and feel touch and to have awareness of his surroundings and in particular of the people who are close to him — his family — and to have the normal thought process of a small child of 18 months.” (CNN, 2005, para.6)
The judge agreed that the life of the boy is helpless and sad; however, he firmly opposed the idea of switching off the ventilator:
“I … consider that currently it is positively in his best interests to continue with continuous pressure ventilation and with the nursing and medical care that properly go with it.” (CNN, 2005, para.7)
However, the judge didn’t side with the parents concerning the issue of future treatment:
“Although siding with the boy’s parents on the main issue in the case, the judge also said he could not endorse other medical treatment which could inflict additional pain on the baby.” (CNN, 2005, para.9)
The Justice said the following:
“If that point is reached, it would be in his best interests then to withhold those procedures even though he would probably die.” (CNN, 2005, para.10)
In fact, this case is of particular importance for the medical community and wider public because it set a precedent:
“The case was believed to be the first in which doctors had asked to allow a patient who is not in a persistent negative state to die.” (CNN, 2005, para.2)
So now let me analyze the implications and consequences of the piece of information presented above. Was the doctors’ proposal ethical? Was it humane or cruel? Was it generous or unacceptable? These are the fundamental questions that have been troubling the world community for many decades already. The case presented above obviously sends the clear and consistent message that every life is equally valuable regardless of the state of a patient.
Generally, the presented media report will have implications for both healthcare workers and health organizations. Let me start with the influence on the healthcare workers.
On the practical level, the case has implications for nursing and medical care. Regardless of the state of the patient, nursing and health care services of adequate quality should be provided to them. It sometimes happens that ignorant and negligent doctors and nurses give up on “hopeless” patients and stop delivering quality services to them. This shouldn’t happen under any circumstances. The report clearly shows that healthcare workers should do their job regardless of the state of the patient. Any discrimination based of the conditions of the illness is very much frowned upon.
The case also sends the message to doctors that they shouldn’t try to interfere within the matters of life and death and push any stakeholder involved in the problem (patients, relatives, or authorities) to side with them on any decision.
As for implications for healthcare organizations, the report may have certain financial consequences for them. On the financial level, some proponents of euthanasia argue that health care provision to “hopeless” patients is too expensive. However, this report shows that hospitals are obliged to allocate sufficient financial resources on treatment of terminally ill patients on the same grounds as in cases with other patients.
Many hospitals perceive the technologies, medications, and labour used to sustain life of terminally ill patients as being used “in vain”; there were also some horrible cases when doctors/hospital staff performed euthanasia illegally.
The report definitely shows that the hospitals should allocate reasonable amount of money on the treatment of terminally ill patients. The article shows how patients in very bad condition can still enjoy the surrounding world and experience emotions; therefore, it’s the duty of healthcare organizations to provide decent conditions of life even to terminally ill patients. This can possibly include certain social activities, access to media and entertainment devices, proper diet etc.
So, the major implication for both healthcare workers and organizations is that no patient can be neglected because of his/her condition.
References:
CNN.com. (March 15, 2006). “Court to doctors: Keep baby alive.” Retrieved March, 21, 2005, from
http://edition.cnn.com/2006/WORLD/europe/03/15/uk.baby.legal.reut/index.html
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