How It Feels to Withdraw Feeding from Newborn Babies

Why should we care about euthanasia as present in Britain?  I care because we are following in their footsteps.  How soon before Obama-care mandates cost cutting methods effecting care of the elderly and the weakest among us. Abortion is only the beginning! How opposed to “First, do no harm, or, in Latin, primum non nocere,” a medical injunction of the “Hippocratic oath” is this:

 Sue Reid and Simon Caldwell report”

“THEY WISH FOR THEIR BABY TO GO QUICKLY. BUT I KNOW, AS THEY CAN’T, THE UNIQUE HORROR OF WATCHING A CHILD SHRINK AND DIE

Here is an abridged version of one doctor’s anonymous testimony, published in the BMJ under the heading: ‘How it feels to withdraw feeding from newborn babies’.”

The voice on the other end of the phone describes a newborn baby and a lengthy list of unexpected congenital anomalies. I have a growing sense of dread as I listen.

The parents want ‘nothing done’ because they feel that these anomalies are not consistent with a basic human experience. I know that once decisions are made, life support will be withdrawn.

Assuming this baby survives, we will be unable to give feed, and the parents will not want us to use artificial means to do so.

Regrettably, my predictions are correct. I realise as I go to meet the parents that this will be the tenth child for whom I have cared after a decision has been made to forgo medically provided feeding.

A doctor has written a testimony published under the heading: 'How it feels to withdraw feeding from newborn babies'A doctor has written a testimony published under the heading: ‘How it feels to withdraw feeding from newborn babies’

The mother fidgets in her chair, unable to make eye contact. She dabs at angry tears, stricken. In a soft voice the father begins to tell me about their life, their other children, and their dashed hopes for this child.

He speculates that the list of proposed surgeries and treatments are unfair and will leave his baby facing a future too full of uncertainty.

Like other parents in this predicament, they are now plagued with a terrible type of wishful thinking that they could never have imagined. They wish for their child to die quickly once the feeding and fluids are stopped.

They wish for pneumonia. They wish for no suffering. They wish for no visible changes to their precious baby.

Their wishes, however, are not consistent with my experience. Survival is often much longer than most physicians think; reflecting on my previous patients, the median time from withdrawal of hydration to death was ten days.

Parents and care teams are unprepared for the sometimes severe changes that they will witness in the child’s physical appearance as severe dehydration ensues.

I try to make these matters clear from the outset so that these parents do not make a decision that they will come to regret. I try to prepare them for the coming collective agony that we will undoubtedly share, regardless of their certainty about their decision.

I know, as they cannot, the unique horror of witnessing a child become smaller and shrunken, as the only route out of a life that has become excruciating to the patient or to the parents who love their baby.

I reflect on how sanitised this experience seems within the literature about making this decision.

As a doctor, I struggle with the emotional burden of accompanying the patient and his or her family through this experience, as much as with the philosophical details of it.

‘Survival is often much longer than most physicians think; reflecting on my previous patients, the median time from withdrawal of hydration to death was ten days’

Debate at the front lines of healthcare about the morality of taking this decision has remained heated, regardless of what ethical and legal guidelines have to offer.

The parents come to feel that the disaster of their situation is intolerable; they can no longer bear witness to the slow demise of their child.

This increases the burden on the care-givers, without parents at the bedside to direct their child’s care.

Despite involvement from the clinical ethics and spiritual care services, the vacuum of direction leads to divisions within the care team.

It is draining to be the most responsible physician. Everyone is looking to me to preside over and support this process.

I am honest with the nurse when I say it is getting more and more difficult to make my legs walk me on to this unit as the days elapse, that examining the baby is an indescribable mixture of compassion, revulsion, and pain.

Some say withdrawing medically provided hydration and nutrition is akin to withdrawing any other form of life support. Maybe, but that is not how it feels. The one thing that helps me a little is the realisation that this process is necessarily difficult. It needs to be.

To acknowledge that a child’s prospects are so dire, so limited, that we will not or cannot provide artificial nutrition is self selecting for the rarity of the situations in which parents and care teams would ever consider it.

 

War of Words – What’s In A Name?

NPR staff memo quoted by La Shawn Barber in NPR Drops ‘Pro-Life for'”Abortion Rights Opponents’:

NPR News is revising the terms we use to describe people and groups involved in the abortion debate.

This updated policy is aimed at ensuring the words we speak and write are as clear, consistent and neutral as possible. This is important given that written text is such an integral part of our work.

On the air, we should use “abortion rights supporter(s)/advocate(s)” and “abortion rights opponent(s)” or derivations thereof (for example: “advocates of abortion rights”). It is acceptable to use the phrase “anti-abortion”, but do not use the term “pro-abortion rights”.

What’s in a name?  Barber points us to: “How the Public is Manipulated” which gives us a heads up and out of the sand noting:

  • It Makes a Pro-Abortion Assumption that the Debate is About Abortion Rights, Not Abortion
  • It Plays Word Games with the Word “Rights”
  • It Ignores the Fact That Abortion Can Exist Without Abortion Rights
  • It Assumes the Negative
  • It Ignores the Concept of a Right to Life
  • It Affirms the Concept of a Right to an Abortion
  • Barber makes some points of her own for the mainstream media:

    • Refer to abortion supporters as “right to life opponents”
    • Refer to gun control supporters as “gun rights opponents”
    • Refer to “hate speech” backers as “speech rights opponents”
    • Refer to racial preferences advocates as “constitutional rights opponents”

    Write me if she missed any.

    Blurring the Line Between Life and Death

    Terri Schiavo died on March 31st, a week from today.  Next week will mark the 5 year anniversary of that murderous action/event, indicating a turning point . Next week also begins Holy Week leading to Easter.  It also marks the beginning of Passover, starting Tuesday, March 30th.  It is a good time to consider: Are we to value human life by its utility or because God has have placed His life in us?  Passover is about God delivering His people from Slavery and setting them/us free for Life. Easter celebrates the victory of Life over Death, Christ’s victory. Terri’s death brings both into focus.

    Writes Dr. Daniel Eisenberg, M.D. in The Death of Terri Schiavo: An Epilogue:

    Blurring the line between life and death, and between medical data and morality, her death signifies a disturbing turning point for American society.

    Terri Schiavo did not die of PVS; she died of starvation and dehydration

    Terri Schiavo died on March 31, 2005, after lasting 13 days without food or water. Her life and death had a profound impact on the American psyche and brought to the forefront the unresolved debate regarding how we treat severely disabled people and who should be their surrogate decision-makers. There is reason to be disturbed by the role that physicians play in molding public opinion regarding end of life issues, because their expertise is generally in medicine and not ethics.

    A letter from a neurologist in complete disagreement with Dr. Eisenberg prompted him to respond:

    He (the neurologist) states:

    …I find myself in sharp disagreement with Dr. Eisenberg. The article refers to PVS as a “cognitively impaired” condition. In fact, there is no cognition whatsoever in someone who is in a persistent vegetative state. Modern aggressive emergency care developed over the last several decades, has allowed us to resuscitate patients with what would have been terminal hypoxic brain injury (what happened to Terri Schiavo). Unfortunately, the entire brain cortex becomes nonfunctional in these people and we are left with a functioning brainstem that allows for reflex eye movements, facial movements etc. PVS patients can even track a moving object in their field of vision because collicular function of the intact brainstem reflexively guides these eye movements. It is all too easy to imagine sentience in the PVS patient because, as humans, so much of our communication is nonverbal and cued by facial and eye movements.

    Dr. Eisenberg responds:

    His assessment of the persistent vegetative state is succinct and it is accurate. To the best of our medical understanding, we presume that a person in a persistent vegetative state has no cognition whatsoever. I never gave much credence to those who argued about the rehabilitation potential of Terri Schiavo. Not because I did not believe it to be true (I have no way of knowing), but because it really does not make a difference to outsiders like myself. CT scan results, Glascow Coma Scales, and following balloons are really only of interest to neurologists and family members who need to arrange for the best possible care for the patient.

    As a society, what we must concern ourselves with are two questions: What is the significance of being so terribly impaired that there is no cognition and how should such people be treated? It is here that the doctor falls woefully short in his analysis. While I am sure that his credentials are impeccable and his understanding of neurology is excellent, he completely misunderstands the role that physicians should play in society’s evaluation of end of life issues (as we will discuss) and he clearly does not appreciate where medical knowledge ends and morality begins.

    Neurologist’s letter continued:

    Nevertheless, the activity of our cerebral cortex is what distinguishes our very “humanness”. If the cortex is dead, then the human individual is dead. . . If the cortex is destroyed, personhood ceases. PVS is an abomination of life –in essence a human shaped colony of cells with no sentience — a glorified cell culture. . .Thankfully, I have not seen this irrational preservation of “life” at all costs in this situation since my training in the early 1970’s. . . Patients with PVS and end-stage Alzheimer’s disease routinely have IV’s and feeding tubes removed in the United States every day.

    Dr. Eisenberg responds:

    The opinions expressed above are very widespread in the medical community today. Variations of these views are espoused by many of the physicians with whom I have discussed this topic. For this reason, they cannot be lightly brushed aside. Please understand that the issue is not autonomy (which is an independent and important issue), but the definition of life. Is the cerebral cortex what makes us human and is it true that “if the cortex is dead, then the human individual is dead”?

    Of course not. My physician critic clearly has stepped beyond the bounds of medicine into the realm of philosophy, and that is the problem. As any physician knows, there is neither a state in America nor any sane physician in the world who would declare that someone who is in a persistent vegetative state is dead. If PVS really equals death then why bother pulling the feeding tube? Just bury the patient with the feeding tube still in place! The doctor’s comments are clearly hyperbole, and represent a very insidious type of bias that leads people to equate PVS with death.

    People want to feel “good” about the killing they allow whether by deeming a fetus ‘not a real living person’ or a person in a persistent vegetative state ‘as good as dead.’  In matters of morality, the doctor steps beyond the data and expertise of his training to play God.  Dr. Eisenberg asks “why the medical knowledge of the physician seem to translate into skill in evaluating the value of life?”

    Dr. Eisenberg reminds us:

    “The belief that medicine can determine which lives are worth preserving was an intrinsic part of the pre-Nazi German medical establishment (see “Why Medical Ethics“). In the late 1920’s and early 1930’s:

    “a number of prominent German academics and medical professionals were espousing the theory of “unworthy life,” a theory which advanced the notion that some lives were simply not worthy of living. . . If Mengele himself (an infamous physician who performed murderous experiments on live concentration camp inmates) became a cold-blooded monster at the height of his Nazi career, he certainly learned at the feet of some of Germany’s most diabolical minds. As a student Mengele attended the lectures of Dr. Ernst Rudin, who posited not only that there were some lives not worth living, but that doctors had a responsibility to destroy such life and remove it from the general population. His prominent views gained the attention of Hitler himself, and Rudin was drafted to assist in composing the Law for the Protection of Heredity Health, which passed in 1933, the same year that the Nazis took complete control of the German government. This unapologetic Social Darwinist contributed to the Nazi decree that called for the sterilization of those demonstrating the following flaws, lest they reproduce and further contaminate the German gene pool: feeblemindedness; schizophrenia; manic depression; epilepsy; hereditary blindness; deafness; physical deformities; Huntington’s disease; and alcoholism.

    I ask again: Are we to value human life by its utility or because God has have placed His life in us?

    Read more here.

    Bart Stupak Caved! Bye Bye Baby!

    “The Baby” SBA List Healthcare TV ad

    Praise Bart Stupak Now!

    Democrats Against Abortion » First Thoughts | A First Things Blog.

    Joseph Bottum directs us to Marjorie Dannenfelser, president of the Susan B. Anthony List,who” has an op-ed in the Washington Post called “If Republicans Keep Ignoring Abortion, They’ll Lose in the Midterm Elections.”

    Dannenfelser writes:

    Republicans oppose President Obama’s health-care reform effort for many reasons: It will cost too much, it’s “socialist,” it’s big government at its worst. But they are letting Stupak and his fellow antiabortion Democrats lead on that issue. And the more the GOP ignores abortion and focuses on economic populism—taking up the “tea party” cause—the more the party risks leaving crucial votes behind in November.

    Bottum responds:

    That’s right—and yet, it isn’t. There are genuine reasons for pro-lifers to resist any move toward a nationalized health-care system. The iniquitous distribution of American healthcare is a scandal, but even the incomplete moves of the current plan create a system that no future bureaucracy or Congress will be able to resist using for purposes of social engineering. And, given the condition of social-elite opinion today, that will always mean increased government-sponsored abortion and euthanasia.

    Bottum further says:

    All of American politics has been corrupted by this murderous procedure, and, at present, the party platforms are clear enough. But pro-life forces should not want an America in which the great pro-life message is shoved off into one party. We shouldn’t want an America that squanders its religious exceptionalism by having a political party of believers and a political party of non-believers—a European-style division between the Christian Democrats and the Socialists. This is everyone’s issue, we must believe, and when Democrats such as Bart Stupak arrive, they ought to be celebrated.

    Choice – You Get To Choose

    The Real Meaning of Choice

    It is interesting to note that people advocating “choice’ in issues of pregnancy and life use ‘choice’ as a euphemism.  It sounds good and reasonable until you ask them to finish the sentence.  Choose what?  Spelled out in blood and guts, it’s neither good nor reasonable.