Runboard.com
You're welcome.
Keshi Heads The Neutral Zone Rogue's Holonet Bit O' Moander
Susa's Sunroom If... Temple of Illusia Final Fantasy Dreams


runboard.com       Sign up (learn about it) | Sign in (lost password?)

Page:  1  2 

 
Li0nh3eart Profile
Live feed
Blog
Friends
Miscellaneous info


Global user

Registered: 01-2008
Posts: 7732
Karma: 117 (+120/-3)
Reply | Quote
Parents' prerogative


It's been a month or so, but a story involving the tragic case of a terminally ill child made the headlines over here and it initiated discussion over who should have the final say over who makes the final decision determining the fate of ill children. The case I'm referring to is that of Alfie Evans.

Alfie was a 1 and 3/4 year old child from Liverpool who suffered from an as of now undiagnosed neurological condition that resembled mitochondrial DNA depletion syndrome. After being on life support for many months the hospital argued that he would not survive and it would be the most humane solution to turn off life support.

The obviously devastated parents then campaigned to pursue a course of action in which they desired to transfer Alfie to Italy who would offer palliative care to Alfie. After a court case it was argued that this would be inhumane to Alfie, because travel would likely induce further damage to Alfie's brain given that assessments revealed he was suffering from epileptic seizures. Court cases in the UK and the EU both agreed with the hospital that turning off life support was the most humane way forward for Alfie, even if tragic.

Unfortunately this case then stirred up the hornet's nest. The Pope promised the parents that he'd bring Alfie over and such false hope left Alfie being granted Italian citizenship in his last week during a last ditch attempt to transport him to Rome. Pro-life protesters descended on the hospital airing their views about how the Alder Hey staff were murdering Alfie and chanted as such, confronted staff as they were arriving to and leaving work and attempted to storm the hospital.

The case wore down as life support was removed on the 24th of April and he died 4 days later.

Subsequently there have been campaigns led by the likes of UKIP politician Stephen Woolfe to have a new law called Alfie's Law. Such a law would mean that hospitals, courts and other authorities would no longer have the final say on what happens to child patients, but the parents. So in this case Alfie's parents could have demanded the Alder Hey doctors to keep life support on even if they thought this would harm him further. They argue that as the parents they are the legal guardians, not the 'state,' so they should decide what happens to Alfie.

Do you agree with those arguing for Alfie's Law?

Personally, I think this is a very dangerous route to go down and do not support such a law. I fully support the hospital's actions. I think allowing parents to have the final say over such instances could lead to damaging scenarios of parents mistreating and abusing children because authority is overruled. If we argue that parents should determine the actions bestowed upon children then the parent can decide potentially dangerous fates for children. If this law was to pass (it won't) then it could lead to a situation where FGM was permissible and beating a child could be seen as ok if passed as discipline. Social services could become powerless if parents' prerogative is made paramount over the child. I don't know why people assume parents always know what's best for the child when cases of neglect and parents pursuing the wrong course of action, even if for understandable reasons (such as this case; I do not think Alfie Evans' parents neglected him), have been evident throughout recent history. Libertarians decry the 'nanny state,' but I do not see how we can truly judge what's best for the child without intervention from authorities who are well experienced in assessing the situation, be it social services in the home, doctors in the hospital or lawyers if it goes to court. We like to think of parents of doing best for the child, but sometimes this may not be the case (and not always for negative reasons), so leaving the decision in their hands won't necessarily mean what's best for the child, but what's best to soothe the parents' egos. Besides, all the talk of state in this ignores the fact that those making decisions are trained professionals operating from professional opinion, not as operatives for the state, so I find this argument used by the conservatives and libertarians to be rather moot here.

On a personal level this case has led to one of my friends being abused. I have a friend who worked at Alder Hey during this time as a junior doctor. He didn't work with Alfie, but heard the heckling from the protesters, which did disturb the other patients and staff. He had 'murderer' shouted at him when leaving. I find it all very distasteful and the actions of the protesters leaves a very sour taste in the mouth, especially when you consider that they are trying to frame themselves as the good guys.
May/20/2018, 20:12 Link to this post Send PM to Li0nh3eart
 
Kaunisto Profile
Live feed
Blog
Friends
Miscellaneous info

The Big Boss
Global user

Registered: 01-2008
Location: Finland
Posts: 8873
Karma: 67 (+69/-2)
Reply | Quote
Re: Parents' prerogative


To certain degree I think that law and medical experts should have last say on treatments, limiting parent's rights to choose actions that are against the best interests of child.

However, here we are talking about decision to effectively end the child's life. And this is (understandably) justified by harm, suffering and damage, that would be the alternative.
But is any harm greater than death? I personally think so, but I also consider that a difficult moral question that can be easily answered oppositely.

I oppose, under any circumstances, that legal system is allowed to end a human life. And because that is a moral decision, doctors are even less qualified to make it than judges.

When it comes to medical actions where one alternative is known to certainly end patient's life sooner than others, my opinion is that only the person themselves or their guardian have right to choose that action.

You are worried what parents would be allowed to do to their children?
I am equally worried of doctors being given power to decide for any person incapable of arguing that they are better off dead.

---

May/21/2018, 0:33 Link to this post Send PM to Kaunisto
 
Li0nh3eart Profile
Live feed
Blog
Friends
Miscellaneous info


Global user

Registered: 01-2008
Posts: 7732
Karma: 117 (+120/-3)
Reply | Quote
Re: Parents' prerogative


I think the question of doctors ending life in this case is moot, because Alfie was going to die anyway. The Italian hospital could only offer palliative care. It was an undiagnosed condition, possibly related to another illness which is hard to treat, so the chances of doctors finding a way to keep Alfie alive with some kind of meaningful life was effectively nil. In this case I think it was the parents whose decisions would have led to a worse end for Alfie, not the doctors.

Doctors have a say here, not because they have a greater understanding of morality necessarily, but because they have a greater understanding of what medical procedures Alfie would need to have life sustained and what quality of life he would have. The doctors adjudged that prolonging Alfie's life would have led to a poor quality of life and the most humane way was to end his life now than have a longer more drawn out death. The courts agreed.

It's all based on human judgment, so there is potential for error, but I don't think there is any other way which wouldn't be. I think giving the parents a greater say would have the potential for greater error because they would be understandably swayed by emotions, so in cases like this I agree that professionals may need to make a more informed decision. This is not to say that parents' views should be ignored and when making a decision the professionals should have this at the forefront of their minds, but I don't have reason to think that professionals like doctors have not considered parents in cases like this, I think they will have pursued actions which gave Alfie and others the best chance of recovery. They did keep him on life support for months, which indicates that they were hoping for something positive to happen.

Putting greater control in the parents hands would not always lead to ill children surviving. In this we could see children suffering drawn out deaths and there may be situations where a child is refused treatment because of the parents' religious beliefs. Doctors could be refused to give a one year old child a blood transfusion because the Jehovah's Witness parents disagree with it and because of parents' prerogative they'd have the final say. I wonder if the self-righteous pro-lifers would be so eager to demand parents prerogative then. Law has to be consistent, it cannot argue that parents should have greater say for one instance and say that professionals should in another, so a problem like this would be likely. As it is I am happy with the current system and have not seen abuses of power from the authorities in which they've made morally questionable decisions.
May/21/2018, 9:33 Link to this post Send PM to Li0nh3eart
 
Kaunisto Profile
Live feed
Blog
Friends
Miscellaneous info

The Big Boss
Global user

Registered: 01-2008
Location: Finland
Posts: 8873
Karma: 67 (+69/-2)
Reply | Quote
Re: Parents' prerogative


quote:

Law has to be consistent, it cannot argue that parents should have greater say for one instance and say that professionals should in another

But isn't that reality? There's infinite list of operations and procedures (that could be potentially fatal, at least in [sign in to see URL]% range) that are parent's to decide whether to risk life or other harm for some permanent benefit.

I don't think it possible to make absolute rules one way or other, sometimes it has to be decided by courts case-by-case on who makes the choice.

But making general rules, I would make it that actions that end person's life should only happen when both guardians and experts agree to this. I would give both sides a veto against pulling the plug.

---

May/21/2018, 16:36 Link to this post Send PM to Kaunisto
 
Li0nh3eart Profile
Live feed
Blog
Friends
Miscellaneous info


Global user

Registered: 01-2008
Posts: 7732
Karma: 117 (+120/-3)
Reply | Quote
Re: Parents' prerogative


If the parents had evidence which could persuade the court that the professionals, the doctors in this case, had overlooked a scenario in which there'd be hope for the child patient it would be different. This has never not been the case. Your argument about no veto for either side may stop parents from leading to unnecessary suffering, but it doesn't prevent children suffering because of well intentioned but questionable decisions to keep them alive.

It's not as if parental responsibility doesn't have superiority anyway, Alder Hey had to apply to the courts so that they could overturn parental responsibility, there are plenty of cases of older children refusing treatment because their religious upbringing. Once the decision had been made the parents made appeals against this so that their view could be aired and this could have led to an overturning of the original decision. It didn't. These steps all ensure that individual liberty is paramount, and the process of hospitals having to apply for parental responsibility to be overturned is of course agreeable and enforces legal representatives to consider the case with the child in mind and at the forefront. Of course the parents may never accept the decision and want the case to be pursued differently, some may never want life support to be turned off. We should sympathise with them, but I do not think this should be given greater precedence in a similar way to how we shouldn't allow murder victims' families having a greater say on the outcome of the murderer. There's a crucial difference between parental liberty and the child's liberty. The current system in which doctors give their informed opinion that the most humane course of action is turning off life support and having to do this through the courts forces child's liberty to be paramount, by engaging parents with similar powers I fear that decisions could be swayed by how parents feel best, parents who do not have the same expertise in the fate which awaits the child. I fear that those calling for Alfie's Law are neglecting to think this thoroughly and are not considering that what they're calling for is just to soothe the desires of parents, who for no damnable motive, are pursing a wayward course of action.

Naysayers can all point to cases where the doctors and judges got it wrong, but one or two cases where they've been proven wrong should not be used when there will always be error due to fallible human judgement. I think pushing forward parental prerogative in cases like this would lead to more errors in human judgement to the detriment of the patients.

Last edited by Li0nh3eart, May/21/2018, 18:22
May/21/2018, 18:21 Link to this post Send PM to Li0nh3eart
 
Kaunisto Profile
Live feed
Blog
Friends
Miscellaneous info

The Big Boss
Global user

Registered: 01-2008
Location: Finland
Posts: 8873
Karma: 67 (+69/-2)
Reply | Quote
Re: Parents' prerogative


I do not consider hope of survival or recovery a relevant or at least not decisive matter in this issue. (Except that in all cases where is such there definitely mustn't doctors have right to end life.)
To me this is about who has right to choose death of another person (even if it's just slightly sooner than later, but then again it always is, at some scale).

What if the same logic was applied to capable adults? There are after all legal limits of what kind of harm a person can't do to oneself, where authorities are allowed to intervene.
So when a person, terminal and terribly suffering, chooses to demand form of treatment that prolongs his life, would then not authorities have right to override his wishes to stop him from harming himself (by forcing him to die)?

Of course this brings question, whether parents and others acting behalf a person have same authority as a person speaking for oneself?

---

May/21/2018, 22:20 Link to this post Send PM to Kaunisto
 
Li0nh3eart Profile
Live feed
Blog
Friends
Miscellaneous info


Global user

Registered: 01-2008
Posts: 7732
Karma: 117 (+120/-3)
Reply | Quote
Re: Parents' prerogative


The difference with an adult is that they have the function to communicate their own wishes. This is not the case for a one year old child. Some adults may be in a condition in which they can't communicate at that time, but presumably they will have communicated their wishes to relatives.

We treat children of that age differently because they are unable to communicate their internal desires in the same way, they can't talk and they don't have developed mental faculties. Therefore, we can't easily say what course of action the child would rather pursue. I think the best course of action in dealing with such patients who cannot express their own desires is to pursue the most humane treatment available. In the majority of cases this would mean operating on them and trying to cure them, but there may be some where treatment is incredibly unlikely to work. In such cases the most humane course of action may be to turn off life support and prevent further suffering. I think the decision should be made on a rational assessment of what would be the best course of action for the child, but for understandable reasons many parents may not always choose this, but I do not think that they should hold powers to stop us from pursuing the most humane option because it would harm other individuals.

Last edited by Li0nh3eart, May/22/2018, 8:18
May/22/2018, 8:17 Link to this post Send PM to Li0nh3eart
 
Morwen Oronor Profile
Live feed
Blog
Friends
Miscellaneous info

Chief of Staff
Global user

Registered: 01-2008
Location: South Africa
Posts: 30621
Karma: 109 (+133/-24)
Reply | Quote
Re:


As you well know, I'm in favour of assisted dying. If I had a child who was suffering, and there was no hope for recovery, I wouldn't allow treatment to keep them alive to go on to the point of being merely keeping them breathing, but dead otherwise. I'd do the same for the child, or myself, or any relative, that I would do for a pet.

In this case, I agree with the hospital. Human life isn't sacred. We murder non-humans every day by the worst means imaginable, but we accept that we can do this because humans are "created in God's image". I don't contribute to the killing of healthy non-humans, and I don't support the death penalty for horrific crimes. I do support the humane ending of a life that has no hope of recovery, no matter what animal the life is, human or non-human.

So here I agree with the hospital. parents are way too emotionally involved to make clear-headed choices, and the public should mind their own business. In this I blame the media. Too much publication of too much information getting the world's ignorant involved in personal choices.
May/22/2018, 10:16 Link to this post Send PM to Morwen Oronor
 
Kaunisto Profile
Live feed
Blog
Friends
Miscellaneous info

The Big Boss
Global user

Registered: 01-2008
Location: Finland
Posts: 8873
Karma: 67 (+69/-2)
Reply | Quote
Re: Parents' prerogative


How does one rationally compare value and humanity of existing versus not existing? I find this too philosophical dilemma to have an absolute answer.

Personally, I agree that it is better decision to end life and would do so if I had to choose for someone. But I also think there is so strong moral argument for the other opinion that there is no rationale or logic to dictate a standard.

---

May/22/2018, 13:46 Link to this post Send PM to Kaunisto
 
Li0nh3eart Profile
Live feed
Blog
Friends
Miscellaneous info


Global user

Registered: 01-2008
Posts: 7732
Karma: 117 (+120/-3)
Reply | Quote
Re: Parents' prerogative


A lot of it is down to subjective assessment. No-one can truly know what a suffering child is feeling like, but we can have a good idea based on whether they're conscious, can breathe freely etc. I think doctors have a fairly good idea of what quality of life is likely to be for a child patient, more so than most others.

Indeed MO, the self-righteous response from some talking heads and the pro-lifers who descended on the hospital leaves a lot to be desired and unnecessarily treats this as a black and white issue with them as the goodies and the doctors as the baddies.
May/22/2018, 16:46 Link to this post Send PM to Li0nh3eart
 


Reply

Page:  1  2 





You are not logged in (login)

Back to top