Due to an end-of-life issue a Canadian child was moved from a Canadian to a U.S. hospital, as reported on March 14, 2011 by Jim Slater of the Associated Press.
Tragically a couple in Canada lost one infant eight years ago to a probable genetic degenerating neurologic disease. The couple is now trying to cope with a similar outcome in a second child thirteen months old. This second child is in a permanent vegetative deteriorating state, with the Canadian hospital wanting to “take him off assisted breathing.” The parents objected, thinking that removing assisted breathing would cause the child to suffocate, undergo undue suffering and die. Instead they wanted the child to have a tracheotomy, reasoning this would extend his life by about six months and then die at home.
The parents took their case to a Canadian Court and lost. They then sought help from hospitals in the U.S. via the internet. Cardinal Glennon Hospital in St. Louis agreed to take the child, with transport supplied by a New York City group, Priests for Life.
Rebecca Dresser, a Professor of Law and Medical Ethics at Washington University, is reported to have commented that in the U.S. courts generally decide with the family in such cases, even in seemingly hopeless medical situations. Furthermore, she believes that similar end-of-life cases will likely become more common in the U.S. because of cost issues.
I believe this case is representative of many misconceptions present in today’s thinking about end-of-life issues.
1) Did the parents receive genetic counseling before attempting another pregnancy that could result in a similar outcome as their first child? There was no mention of this in the news report.
2) Were the parents advised of the possibility of a repeat problem when pregnant with the second child, and if so was there pre-delivery testing?
3) Could this child have been sent home with the breathing tube, dying at home as per the parents’ wishes, but without the tracheotomy?
4) Can a human in a permanent vegetative state suffer? If the child’s cerebral cortex is no longer functioning, blood flow scans, etc., the child can no longer experience suffering.
5) Can a child who does not have a functioning cerebral cortex be called alive? In effect the parents and the St. Louis hospital are keeping a heart beating in what appears to them to be a child, but in reality is only the container of that child; that individual is gone.
6) Was the professor who commented that cost issues will bring to the fore many more of these types of cases referring only to financial cost? I would respond that there are many complexities in the term “cost”. The most obvious is the amount of treasure spent without changing the outcome. There is also the cost of prolonged suffering of the parents in a vain attempt to put off the inevitable. Additionally there is the cost of time, energy and frustration spent by the medical staff knowing it will have no benefit.
The issue is the inability of the parents, Priests for Life, and the St. Louis hospital to understand what constitutes “life.” Without a functioning cerebral cortex there is no “life”; what they are seeing is only the shell that contained that life. The question becomes, at what point are the parents using this shell of a child as a means to their own ends? Unfortunately in this world sometimes very sad things happen to very fine people. Nothing is gained by not dealing with reality.