Passive euthanasia: English court rules on sick baby care

[Darth333]

An English court just rendered a judgement in which it granted to doctors , in the name of the child's best interest, the right to refuse medical treatment to a baby, against the will of the parents. The 9 month old baby, would be affected by Edwards’s syndrome, a rare chromosome abnormality. Apparently, the medical treatment could save the baby's life but with very minimal chances: the outlook for him would be “extremely poor”, with less than 10 per cent of chances to surviving his first birthday.

 

Where is the best interest of the child? Life at any price? or should it be possible to refuse treatment, even against parent's will, when there is a chance of survival but where the quality of life would be very low? What do you think?

 

Here are the BBC news excerpts: http://news.bbc.co.uk/2/hi/uk_news/wales/north_west/3764938.stm and http://news.bbc.co.uk/2/hi/health/3944503.stm

 

I haven't found the judgement of the court yet ( I rarely search in English law databases and don't know if there is an "express" way to get their cases) but found a similar judgement rendered a few weeks ago, also by an English Court, for those who are interested: http://www.bailii.org/ew/cases/EWHC/Fam/2004/2247.html

[Spider AL]

I have a problem with terming a lack of treatment "euthanasia". We could probably keep people's brains alive in jars if we were so inclined, but failing to do so doesn't qualify as "euthanasia". I guess my stance on the issue is pretty clear.

[Shok_Tinoktin]

It is important to note that there is a difference between active and passive euthanasia, so there is no reason to have a problem with the term. It is simply that people tend to replace "active euthanasia" with just euthansia, even though they are not synonomous. That being said, I do believe in both active and passive euthansia, but I believe it is the decision of the person involved, or whoever they give the right to make their medical decisions should they be unable. In the case of a baby, it is implicitly the parents right, and doctors should not be able to overrule them. Should the parents consent, that would be perfectly acceptable, however, such is not the case here.

[Spider AL]

It is important to note that there is a difference between active and passive euthanasia, so there is no reason to have a problem with the term.

Nonetheless, since euthanasia is a term that has acquired certain connotations related to the moral debate over mercy-killings over the years, I have a problem with the application of the term to cases in which bodies can not perform basic functions without medical assistance, and that assistance is withdrawn.

 

In the case of a baby, it is implicitly the parents right, and doctors should not be able to overrule them.

I'm afraid this argument does not apply to the earlier English case for one. To the child in question, life was pain. Artificially maintaining that life, which was what the parents wanted, amounts to intentional torture. Now we don't argue that parents should have the right to torture their kids, do we?

[Shok_Tinoktin]

Originally posted by Spider AL

I'm afraid this argument does not apply to the earlier English case for one. To the child in question, life was pain. Artificially maintaining that life, which was what the parents wanted, amounts to intentional torture. Now we don't argue that parents should have the right to torture their kids, do we?

 

 

I meant that it was implicitly the parents right from a moral standpoint, and not a legal one (anything else would be foolish, as I know nothing of English law). It is a moral decision whether life should be maintained no matter how unbearable, as some people have a special opinion of the importance inherently involved in life itself. I think it is important to let the parent decide what is more important, to live in pain, or die without it (or at least a minimal amount of it). It is not the responsibility of doctors to make moral decisions about the children of others.

[El Sitherino]

but doctors have sworn an oath to do what is in the BEST INTEREST of the patient. I think this was a good call, better to die without pain than to live with an over abundance of it. The parents wanting their child to live at the cost of it never living without pain is selfish and horrid.

[Spider AL]

I meant that it was implicitly the parents right from a moral standpoint, and not a legal one

Indeed, I too was referring to the morality of the situation. Do you think it's moral for parents to torture their child? I certainly don't. Thus, they should be stopped from doing so.

 

It is not the responsibility of doctors to make moral decisions about the children of others.

In these cases it is the responsibility of the COURTS to make such moral decisions, and they have come to the right one in this case, and the most moral. Many parents abuse their children in many ways... having given birth to a child doesn't give you the right to do whatever you want with it.

[Shok_Tinoktin]

I think it is immoral for me to tell others whether they should think that painlessness is more important than life. I completely respect if other people do not share that view, and I personally do think that painlessness is more important than life itself. However, I know that there is a significant percentage of the population does not share that view (shown by the fact that active euthanasia is so strongly opposed), and thus I have to say that it is up to the individual to make that moral decision, and that it should not be universalized.

[Spider AL]

thus I have to say that it is up to the individual to make that moral decision, and that it should not be universalized.

Nobody's trying to universalize anything, as far as I'm aware. Not even the doctors associated with these cases are trying to impose mandatory withdrawal of care from all patients.

 

shown by the fact that active euthanasia is so strongly opposed

There's a lot of religion involved in the factions that oppose active euthanasia, and of course the concern that it could be abused by relatives, doctors etcetera. But since religion is unacceptable as a support to an argument, and care can also be abused by relatives and doctors, the case for allowing active euthanasia in law is overwhelmingly strong.

[Shok_Tinoktin]

If you allow doctors to passively euthanize children without the parents consent you are saying that it is univerally immoral for a person to care more about their childs life than their pain. It is as simple as that. Giving in to the moral beliefs of a significant percentage of the population, even if they are based in religion, is not a union of church and state. Therefore, it is still important to consider those people's beliefs, before deciding what rules should be made. And the fact is, the government has no right to ignore such a high percentage of what people think.

[Spider AL]

If you allow doctors to passively euthanize children without the parents consent you are saying that it is univerally immoral for a person to care more about their childs life than their pain. It is as simple as that.

Nonsense! Each judgement is, has been and must always be based on the unique aspects of the situation, including but not limited to: The presence of higher cognitive functions, the AMOUNT of pain, the possibility of recovery, etcetera. None of these doctors want to set a universal precedent to apply to all cases, and they haven't done.

 

And the fact is, the government has no right to ignore such a high percentage of what people think.

If people are ill-informed, religiously or dogmatically motivated and/or closely and emotionally involved in an issue (parents), their opinions must be at least treated as being suspect before being acted upon. Or would you like our countries to become religious states, like certain Middle-Eastern nations?

 

Logic and morality must rule our actions, or we are no better than brainless zombies.

[Shok_Tinoktin]

Originally posted by Spider AL

Logic and morality must rule our actions, or we are no better than brainless zombies.

 

The problem with that is, that there is no universal morality, and that it is, IMO, quite subjective. I understand that not all people share that perspective, and I would expect nothing short of desperately trying to protect those beliefs. What I meant by "universalizing", was making it a universal rule that parents not be the ones to choose what medical decisions their doctors make about their children. Also, I would like to say there is a difference between having a religous state, and having a state that respects the religions of its collective members.

[Spider AL]

What I meant by "universalizing", was making it a universal rule that parents not be the ones to choose what medical decisions their doctors make about their children.

I know that's what you meant, and it's still wrong. Parents will always choose what happens to their child... unless the COURTS say otherwise. This is right and good, and it's hardly a universal statement on such cases. QED.

 

The problem with that is, that there is no universal morality

Morality based on reason, logic etc... tends to be as universal as one can get, because logic is a universal basis of reasoning. From a few basic universal moral tenets one can extrapolate a whole moral tapestry, and no matter who's doing the weaving, as long as they use their brains, it'll come out in the same pattern.

 

I understand that not all people share that perspective, and I would expect nothing short of desperately trying to protect those beliefs.

Pssht. Don't start implying that people you're debating with are "desperately" trying to do anything. That's just going off the rails...

 

Also, I would like to say there is a difference between having a religous state, and having a state that respects the religions of its collective members.

Respecting people's right to practice whatever religion they like, within the law, is great for a state. Doing what religious dogma dictates is NOT great. Government must be secular to function efficiently and morally.

[ET Warrior]

Originally posted by Shok_Tinoktin

If you allow doctors to passively euthanize children without the parents consent you are saying that it is univerally immoral for a person to care more about their childs life than their pain.

 

This has nothing to do with the parents caring more for their CHILD than it does them caring more about their OWN feelings. They didn't want to be sad because their baby died before it was 1 year old, so they wanted to be selfish and hold on as long as possible. even though the baby would NEVER have any quality of life. I agree with the courts AND the doctors.

[Shok_Tinoktin]

ET, I might agree with you (and am sure you are right about this in many cases), except for the fact that many people believe that such a practice is wrong, even when they are not in a situation where it is personalized, and they thus dont have the emotion that would lead them to such a decision. Perhaps the solution is to have expecting parents sign something saying their wishes far ahead of time?

 

Spider, I think I am a little unclear about what your first comment meant. Are you suggesting that the courts decide on a case by case basis?

 

Assuming you are not (which I think is correct, but would rather confirm without making too much a fool of myself), I think I may need to explain the difference between a universal moral rule, and an absolute moral rule. An absolute moral rule, is saying that something is wrong or right regardless of the circumstances (for example, one could say that killing is wrong no matter what, even if it is a matter of self defense). A universal moral rule is one that is applied to all people (like if a society thinks that stealing is acceptable, they are morally wrong). So if you say that it is wrong under specific circumstances to allow parents to make the decision instead of doctors no matter what society or that person's own beliefs are, then it is a universal moral rule.

 

Originally posted by Spider AL

Morality based on reason, logic etc... tends to be as universal as one can get, because logic is a universal basis of reasoning. From a few basic universal moral tenets one can extrapolate a whole moral tapestry, and no matter who's doing the weaving, as long as they use their brains, it'll come out in the same pattern.

I am going to have to disagree with you on that one. I'll give an example (its a little vague, but I think it can still deliver my point). Lets say that a person has done nothing that would be considered wrong, but killing that person would save the lives of a hundred other people. Logically, it would be reasonable to save the hundred and kill the one. However, there are many who would consider that amoral.

 

In hindsight, perhaps "desperately" was poor word choice. I think passionately may be better to describe what I mean (I expect I will find out soon enough).

 

I dont think that a negative freedom can be considered partial to any religion. The only one who may have their beliefs be attacked by this is the baby. That sounds absurd, but someone unrelated to the passive euthanization (or lack thereof) is not having their beliefs directly attacked. The closest we can get to the moral decision of the baby is the parent, not the doctor. The parent has to decide what is morally right for their child.

[swphreak]

Originally posted by Shok_Tinoktin

I meant that it was implicitly the parents right from a moral standpoint, and not a legal one (anything else would be foolish, as I know nothing of English law). It is a moral decision whether life should be maintained no matter how unbearable, as some people have a special opinion of the importance inherently involved in life itself. I think it is important to let the parent decide what is more important, to live in pain, or die without it (or at least a minimal amount of it). It is not the responsibility of doctors to make moral decisions about the children of others.

 

But the doctor has a right to refuse the procedure (at least in the states) based on moral grounds.

 

I agree with the courts and doctor as well. I'd rather die than be tortured for life.

[El Sitherino]

Shok read this please.

Originally posted by InsaneSith

doctors have sworn an oath to do what is in the BEST INTEREST of the patient.

 

Originally posted by Shok_Tinoktin

Lets say that a person has done nothing that would be considered wrong, but killing that person would save the lives of a hundred other people. Logically, it would be reasonable to save the hundred and kill the one. However, there are many

or you could just oh I don't know... cripple them? or perhaps just confine the person.

 

Originally posted by Shok_Tinoktin

The parent has to decide what is morally right for their child.

so we give the parent, who is selfish enough to keep their child alive in excrutiating pain, the decision of should the child live or die? pardon me but that is foolish and very wrong.

 

Why don't we just legalize wife-battering and child abuse while we're at it.

[Shok_Tinoktin]

Phreak, I agree that the doctor has that right, but I believe if the parents want it, I think they have the right to go to someone else.

 

What I meant by that killing someone example, is not that they would do something, but that somehow that persons being alive would somehow cause a hundred to die. I didn't get any more specific, to avoid an overly dramatic example.

 

The sad fact, is that there is not moral consensus about which is more important: having minimal pain or having life. For that matter, what is in the best interest of the patient is not clear. IMHO, it is more important to die with minimal pain, then live in pain. However, I have no desire to impose that belief on others. Although, I will admitt that the selfishness of the parents does worry me. That is why I think expecting parents should sign something ahead of time, to minimalize the emotion involvement, so they can truly decide what they believe is in the best interest of the child.

[El Sitherino]

but then the doctor would have broken his hippocratic oath.

 

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

 

taken from this oath.

 

Pain = harm. Pain = bad. Bad = not wanted. life of pain = injustice and torturous.

 

as far as I know torturing a child is wrong, immoral, and damn near illegal...

 

 

learn about the hippocratic oath.

[Shok_Tinoktin]

I agree that pain=harm. Some people believe that death=harm. And also believe that (harm of pain)<(harm of death). You and I disagree with that statement. The difference is, I think it is morally acceptable to have that opinion. You don't. I dont think that is going to change for either of us.

[El Sitherino]

Originally posted by Shok_Tinoktin

The difference is, I think it is morally acceptable to have that opinion. You don't.

not true, I think people are allowed to have that opinion. but they can't force it upon someone when someone it's someone elses life.

after all, I'm not some opinion monster that eats other peoples opinions then sh*ts them out.

 

The doctor did what he believed was best for his/her patient, the baby, not what was best for the parents. Even though this did save the the grief of losing their child after trying so hard to save it.

[Shok_Tinoktin]

I think you misunderstand me Sith. I didn't mean to suggest that you don't care about others opinion. I was just saying that you don't find it morally acceptable to allow someone to make that decision for their child, but I do. I think that is the only difference between us on this.

[Spider AL]

I think I may need to explain the difference between a universal moral rule, and an absolute moral rule.

No, you don't. What you said was this:

 

If you allow doctors to passively euthanize children without the parents consent you are saying that it is univerally immoral for a person to care more about their childs life than their pain. It is as simple as that.

And this is incorrect, because whether the doctor recommends the withdrawal of treatment is dependant on the amount of pain, the possibility of recovery, the presence of cognitive functions, the possible lifespan, etcetera.

 

It is NOT a universal statement that death is preferable to pain, it is a statement that death is preferable to IMMENSE pain with NO possibility of recovery, and inevitable death before long anyway. This is the fundamental distinction that you're missing, and this is where you have been incorrect all along.

 

Spider, I think I am a little unclear about what your first comment meant. Are you suggesting that the courts decide on a case by case basis?

Ah, I forget you're in another place...

 

In England, when there is disagreement between the parents and the doctors on whether to withhold treatment, this decision is taken to the court for judgement. The two recent cases of "passive euthanasia" (for want of a better term) that have hit the news, have both been brought to a conclusion through high court rulings. The court judged the cases on their specific, separate merits at separate times. A rather nice aspect to our otherwise flawed legal system, no?

 

I am going to have to disagree with you on that one. I'll give an example (its a little vague, but I think it can still deliver my point). Lets say that a person has done nothing that would be considered wrong, but killing that person would save the lives of a hundred other people. Logically, it would be reasonable to save the hundred and kill the one. However, there are many who would consider that amoral.

There are many who consider evolution to be blasphemous, that does not make them right. The reasoning in your example is fairly simple... Each innocent person has an unquantifiable right to life, right? But each innocent person has an EQUAL right to life, right?

 

So we can represent this right to life with... x.

 

x vs x100? Obvious. As a group, these one-hundred other innocent people have a greater right to life than the also innocent single man. Thus, if faced with the choice, I would be morally obligated to inhume this man in the quickest, most painless way at my disposal.

 

As you say, some might consider that amoral... but that's because they have not used logic or reason to determine their moral stance on the subject, they have used their emotions. Garbage in, garbage out.

[Shok_Tinoktin]

Originally posted by Spider AL

x vs x100? Obvious. As a group, these one-hundred other innocent people have a greater right to life than the also innocent single man. Thus, if faced with the choice, I would be morally obligated to inhume this man in the quickest, most painless way at my disposal.

 

As you say, some might consider that amoral... but that's because they have not used logic or reason to determine their moral stance on the subject, they have used their emotions. Garbage in, garbage out.

 

Now you have hit the nail on the head. There are a variety of different ethical theories, and I believe that people have a right to that. Utilitarianism (which is what I assume is what you are more or less claiming should be accepted), is not held by all people. Some believe that other moral rules supercede pure logic, and to me it seems quite unfair to deny them that.

 

I think I have misstated what I mean about universalizing, but I don't feel the need to elaborate, due to your answer to my question.

 

Originally posted by Spider AL

A rather nice aspect to our otherwise flawed legal system, no?

 

Agreed. I think that is quite a fair way of determining what is in the best interest of the child. That being said, I think I am content to accept the current system.

[Spider AL]

Some believe that other moral rules supercede pure logic, and to me it seems quite unfair to deny them that.

I've stated this in another thread recently... if someone's "morality" is arbitrary judgementalism, it becomes (obviously) intrinsically immoral. Morality cannot be arbitrary. It can't be one standard for one thing and another standard for another.

 

Logic and reason are the only methods of determining what is moral and what is not, in a way that is not... whimsical. That is not arbitrary.

 

Anyone who doesn't believe that... isn't being logical.

 

As for unfair... well, I dunno. I think that letting someone continue to believe nonsense is unfair. To deny someone the right to lie to themselves might be considered to be doing them a favour.

 

As for utilitarianism, it's a little limited. I'd view some of its principles as genuine parts of a good moral structure, but morality is a larger construct entirely. It is, after all, just a school of thought. Morality must be universal to exist at all.