Tuesday, March 8, 2011

Baby Joseph

Baby Joseph is a 13-month old infant in London, Ontario, Canada, who suffers from an incurable neurological disease that will result in his eventual death. London's Victoria hospital, where Joseph has been a patient since October, originally planned to remove life support from the baby over the objections of his parents. The hospital asked the Office of the Public Guardian to assume decision-making power. This situation is what has made national headlines.
There is no doubt that the outcome of this case will have worldwide consequences in the areas of euthanasia, parental rights and national health care.

Baby Joseph's parents understand that he has no chance of recovery, but have requested that the baby have a tracheostomy (a permanent tracheotomy) so that they can bring him home to die. Their daughter died from a similar disorder eight years ago; but in her case, the physicians performed a tracheostomy, and the family was able to take her home to die.

The case made news in the United States when Father Frank Pavone, the Euthanasia Prevention Coalition and the Terri Schiavo Life and Hope Network came to the support of the parents. There is a debate over the cognitive function of the baby. The hospital has said he is not responsive. The parents claim that he responds to voice, touch and pain. In a recently released video, the baby is shown clearly responding to all three.

The debate centers around 2 issues.
  • The first: no hospital should be able to unilaterally impose an end of life-sustaining treatment based on financial concerns or a subjective quality of life.
  • The second issue is that of the tracheostomy. The family wants the procedure done in order to take the baby home to die. The hospital says this would impose a burden on the parents, and in their best medical judgment, they are refusing. The question here is, what is the burden? If it's the baby, then the treatment is being withheld because the baby is perceived as the burden.
Keep in mind that Gabriella Gifford, the Arizona Congresswoman who was shot in the head, received a tracheotomy almost immediately. Tracheotomies are performed for many reasons, but for long-term ventilatory support they are done for comfort. The question I would ask as a medical professional is, since the baby has been hospitalized since October, why wasn't the tracheostomy performed months earlier? This is standard procedure in hospitals.

There is a lot more to this case that is unfolding. As of today, the hospital is refusing to release the medical records.

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