Ruth Institute Blog

“because of their system of rationing health care ”

Health care is a business like no other. However, there is a cost for it, like every other business. And some choices are not easy. Let me use an example: would you spend $100,000.00 to renovate your home knowing it would burn to the ground in 6 months? Would you do it if someone else paid? How about, would you pay the money to extend this babies life 6 months if you knew that a mother in another part of Canada would die unless she got a heart transplant which would only be possible if the money was spent on her and not this baby? These are the health decisions we as a society need to make. And they are not easy.

I don’t want to learn the facts of any particular case, but in general, we have an obligation to give care and help to sick people and infirm people but not to go to extraordinary measures to prolong life. Every time, in every case, at any age, there is a point when we give up. We shouldn’t have to write a blank check to the hospital industry to keep every person alive as long there is a way to prolong their life another day, that’s ridiculous, whether they are 102 years old, or two months premature.

[There’s an 18-month-old baby boy in Canada who is about to be put to death by the Canadian government.]

This is simply not true. The Canadian government doesn’t even put criminals to death let alone sick people.

[However, the Canadian government has decided that they don’t want to spend any more money on Baby Joseph to keep him alive.]

Again, not true. There is no evidence anywhere that the Canadian government’s decision is motivated by monetary concerns.

[The baby, who is known as Baby Joseph, is suffering from a critical condition that requires him to have a breathing tube in order to stay alive.]

He has a breathing tube. The parents want the hospital to preform a tracheotomy because they believe it might keep the child alive for 6 more months. The child’s doctors are arguing that this is not in the medical best interests of the child. Every impartial legal and medical expert that has reviewed the case agrees that it is not in the medical interest of the child. Should doctor’s be forced to provide treatment that is not in their patients best interest because the parents want it?

[And, to everyone’s horror, the government won’t even let Baby Joseph go home with his parents.]

More untruths. The hospital has always been willing to allow the child to go home. It reiterated that as recently as yesterday.

[His parents need to obtain better health care for Baby Joseph by bringing him to the United States where a hospital — preferably a Catholic hospital where the baby will NOT be euthanized.]

Again not true. No hospital in the US Catholic or otherwise has agreed to take this child as a patient. And refusal of treatment is not euthanasia, the hospital is not suggesting that the child be given an overdose of morphine or have a pillow placed over his face. They are refusing to preform an invasive non palliative procedure on the child.

[In reality, the government “health care” system doesn’t want to spend money on anyone if they can’t make money on that patient.]

Explain to me how this child has generated any profit for the Canadian heath care system up to this point? Explain to me how this profit has been eliminated suddenly and so now it is not profitable to continue treating this child?

[The first thing I urge you to do is contact the officials in the Canadian government who are holding Baby Joseph’s life in their hands.]

I’m pretty sure that the Canadian government doesn’t really care what a bunch of American’s think. But have fun.

Also, people who live in glass houses shouldn’t throw stones. I know Texas has a futile care law & I am pretty sure that Arizona just passed one.

The Texas one according to Wikipedia:

The Texas Advance Directives Act (1999), also known as the Texas Futile Care Law, describes certain provisions that are now Chapter 166 of the Texas Health & Safety Code. Controversy over these provisions mainly centers on Section 166.046, Subsection (e),1 which allows a health care facility to discontinue life-sustaining treatment ten days after giving written notice if the continuation of life-sustaining treatment is considered medically inappropriate by the treating medical team.

One more idiotic, pandering-to-the-conservatives, article. Geez. It anything here factual? Is this what happens when your worldview is corrupted by ancient religious beliefs?

An apology is owed to the fine people of Canada for this insane take on a difficult medical situation.

. . . and were this case in the USA, the parents’ private insurance company would most likely take the same course of action: refuse to pay for it.

@Mont D. Law

Thanks, Mont D. Law, or adding these corrections.

@Betsy, I don’t know where you’re getting your facts from, but what you wrote is *not* what’s been happening. It’s a controversy, sure, but no one is “condemning” this child to death. His condition has already done that. The doctors certainly haven’t. The parents want to take him home to die, but they can’t do that without a tracheotomy, which the doctors have determined would lead to a very unnecessarily unpleasant and prolonged death.

Also, it has nothing to do with the Canadian government. Our medicare system is a provincial responsibility, but it has nothing to do with the provincial government, either. It’s strictly that hospital’s decision, and the decision of the doctors that are caring for him. His parents disagree with their decision and refuse to give permission to have the breathing tube removed. That forces the dr’s to take it to the next level.

What to do? Have the child continue being kept alive by machines in a sterile hospital, with no possible treatment remaining? Remove the breathing tube and allow him to die in a few days, still in hospital? Or allow him to go home and be surrounded by his family and their love, but suffer what is likely to be a slow, torturous death for perhaps as long as 6 months?

It’s a complex and painful issue that has no satisfactory solution.

Is baby Joseph dead by either cardiopulmonary criteria or by neurological criteria? NO.

If he is not dead, then removal of the breathing tube will kill him – deliberately (this is murder). Joseph is a human being and helping him to breath is not an extraordinary measure even if he will die in 6 months. So why would the hospital want to remove the breathing tube, thereby hastening death, if not for money?

@Deb
“So why would the hospital want to remove the breathing tube, thereby hastening death, if not for money?”

Because breathing tubes eventually erode into the bronchial tubes causing a great deal of pain and suffering. The other option – to cut open this babies neck and shove a trachea tube into it. And to what end? The child will die in 6 months. The are a LOT of reasons other than money to remove this tube.

However, if it is a money issue – are you willing to spend money on a child that will be dead in 6 months if that money could help even one other person live?

@Deb.

I’ll take a quick death over a slow, painful death any day. What good is life at that age when you’re strapped to a machine?

[Is baby Joseph dead by either cardiopulmonary criteria or by neurological criteria? NO.]

Under Canadian law the child is brain dead.

[If he is not dead, then removal of the breathing tube will kill him – deliberately (this is murder).]

Murder is a legal term that has a specific meaning under the law. Your definition doesn’t come close.

[Joseph is a human being and helping him to breath is not an extraordinary measure even if he will die in 6 months.]

At this time no one is helping him breath. He is on a ventilator which is breathing for him. They have tried to taking him off the ventilator and he can not breath on his own. His parents believe that if he is given a tracheotomy he will be able to breath on his own. Every expert that has reviewed the medical file says this is not the case. The hospital decided it was cruel to subject their patient to a pointless surgery in the vain hope that he will breath on his own. The courts who reviewed the case agreed with the hospital.

[ So why would the hospital want to remove the breathing tube, thereby hastening death, if not for money?]

The child is brain dead and being kept alive on the ventilator. The hospital feels it is the best interest of the child, who is their patient, to remove the breathing tube. At a certain point you are not prolonging life but stretching out death. There is no benefit to the hospital if the child lives or dies.

@Mark

“However, if it is a money issue – are you willing to spend money on a child that will be dead in 6 months if that money could help even one other person live?”

Who are you to decide that the baby’s life is not worth another 6 months? And how do you know he must die so another may live? And if this is the case for single payer health care… not good.

“I’ll take a quick death over a slow, painful death any day. What good is life at that age when you’re strapped to a machine?”

That is your opinion.

@Mont D. Law

“Under Canadian law the child is brain dead.”

What is the Canadian law for determining brain death? Is this the standard neurological criteria (all 4 of these are present: coma or unresponsiveness, absence of cerebral motor responses to pain in all extremities, absence of brain stem reflexes, and apnea)?

If he truly brain dead, then why not allow the tracheotomy so he may die in the arms of his parents? If he is truly brain dead, would he feel or know he has had “pointless surgery”?

“There is no benefit to the hospital if the child lives or dies.”

Really? So if he dies, the hospital doesn’t benefit from another open bed (of which there can be few in Canada)? It doesn’t benefit from not having to pay staff to care for Joseph?

Why do conservatives do this? Find some story, compose a fabricated version of it, and then wail indignantly? I don’t get it. Can anyone fill me in on the conservative propensity and fondness for this kind of approach to news stories?

[What is the Canadian law for determining brain death?]

I suggest you Google it.

[If he truly brain dead, then why not allow the tracheotomy so he may die in the arms of his parents? If he is truly brain dead, would he feel or know he has had “pointless surgery”? ]

His medical team who have provided his care for a extended period of time have made a medical decision based on their extensive experience in the field and with this particular child. Brain dead & insensate are not the same thing. He would certainly feel it and any medical complications from it.

[So if he dies, the hospital doesn’t benefit from another open bed (of which there can be few in Canada)? It doesn’t benefit from not having to pay staff to care for Joseph?]

You know nothing about the Canadian health care system, how it works or how it is funded. The above statement is meaningless.

[… so he may die in the arms of his parents?]

He may die in the arms of his parents anytime they wish – at home or in the hospital. That is not at issue. At issue is the hospitals unwillingness to preform an unnecessary medical procedure before he dies in his parents arms.

@Deb
“Who are you to decide that the baby’s life is not worth another 6 months? And how do you know he must die so another may live? And if this is the case for single payer health care… not good.”

Did you read the rest of my post? The doctors caring for him say he will die in 6 months. What is it worth TO YOU to keep him alive? Are you willing to FOOT THE BILL for the care he will need and receive? Are you willing to FORCE a doctor to rip his throat open and shove in a trachea tube? Do you even, REMOTELY understand the medical situation here? Obviously you don’t. Try taking even a beginning medical ethics class.

There are several aspects to this issue; ethics and financial. Unfortunately, you are too emotional to look at either of them rationally.

@Mont D. Law

I am a stupid, conservative Christian, so I need you to explain Canadian Law on brain death, exactly. Also, I want you to explain how the Canadian health care system works such that the hospital and health care system, in general, does not benefit financially from his death.

“Brain dead & insensate are not the same thing. He would certainly feel it and any medical complications from it.”

Fine, then he would also then be able to feel himself suffocate when the ventilator is removed. But if he were truly brain dead, then he wouldn’t know that he was suffering, or would he? If he can realize his suffering, then he would be alive, no?

@Mark

“What is it worth TO YOU to keep him alive?”

Why are you in such a hurry to see him dead? Assisting Joseph to a natural death (including neurological death) is the way a civilized culture treats the weakest among us- even those who will die in 6 months.

@Deb
“Assisting Joseph to a natural death (including neurological death) is the way a civilized culture treats the weakest among us- even those who will die in 6 months.”

And removing that endo tube will do just that. Why are you trying to prolong the inevitable?

[I am a stupid, conservative Christian, so I need you to explain Canadian Law on brain death, exactly. Also, I want you to explain how the Canadian health care system works such that the hospital and health care system, in general, does not benefit financially from his death.]

I am sorry you feel the need to comment extensively about something you know nothing about, however it is not my job to educate you on the Canadian system, medical or legal.

[Fine, then he would also then be able to feel himself suffocate when the ventilator is removed. But if he were truly brain dead, then he wouldn’t know that he was suffering, or would he? If he can realize his suffering, then he would be alive, no?]

Google can provide a definition of insensate for you as well as legal brain death in Canada.

@Mont D. Law

If he is brain dead, then he can’t realize he is in pain and suffering, even if the nerve endings still sense it. If that is the case, then let him go home with a tracheotomy with his parents to die in their home. Why must courts brute force the parents in such an insensitive way? Why are all so set that the breathing tube be removed now, to hasten the inevitable? If he can’t KNOW that the tracheotomy hurts, even if the nerves sense it, why is the hospital opposed?

[If he is brain dead, then he can’t realize he is in pain and suffering, even if the nerve endings still sense it. If that is the case, then let him go home with a tracheotomy with his parents to die in their home. Why must courts brute force the parents in such an insensitive way? Why are all so set that the breathing tube be removed now, to hasten the inevitable? If he can’t KNOW that the tracheotomy hurts, even if the nerves sense it, why is the hospital opposed?]

The hospital is opposed because it is not in the best interests of their patient. It is unethical to subject people to pointless surgery, whether they are brain dead or not. In many ways it would be easier to simply concede to the parents wishes so this whole things goes away. But medical professionals have ethics and are for the most part bound by them. Are you arguing that Doctors should not act in the best interest of the patient if the parent or guardian disagrees?

And again, the hospital is willing to send the child home to die among family, it is just not willing to perform the tracheotomy because it is not in the best interests of the patient.

@Mont D. Law
Well said.