Bioethics, end of life, medical ethics, politics, professionalism, public health, public policy

Explaining

This is a re-write of a post I made as part of the conversation about Emilio Gonzales’s treatment at Wesley Smith’s Second Hand Smoke.

I’m a family doctor because I have always seen the patient as part of the family and (ideally and sometimes not so ideally) the family as integral to the patient’s condition and health care. We do treat family members, even if we never see them.

However, when the family’s needs conflict with the patient’s, the patient’s interest has to come first. We naturally identify with a mother’s wish to keep her child alive. However, when the doctors sense that we are treating the mom at the expense of the child’s care and comfort as he is dying, the duty is to the child, our patient.

The determination as to what the best interests are in each case depends on whether it is true that (as the blogger-published report of the Ethics Committee says) the baby is having increasing injuries requiring aggressive treatments due to the ventilator, more uncontrollable seizures, progressive spastic muscle effects, loss of brain tissue due to the disease and what I suspect is multiple organ failure (liver and kidneys) due to both his underlying cell malfunction and the lactic acidosis.

I just don’t believe in conspiracies that would allow a deception to play out over a month. Jerri Ward wrote on Wesley Smith’s blog about the earlier hearing on February 19th, and said that the mother originally did not want the child to have a tracheostomy and a permanent feeding tube. Evidently, the mom and doctor were in such conflict that a new attending was named.

The nurses I know would be tearing themselves up over the condition of the baby as it is. To have the doctors write orders that make them cause the baby pain, over and over, without seeing the good of healing or at least a little relief of pain, is abuse of them, as well.

Patients have taught me lessons in caring for them as they die. Even in my first week as a phlebotomist nearly 25 years ago I had to draw blood from a brain dead child. The only way I could get through it was to care for this child and be grateful to his parents for being generous enough to donate his organs. I still treated him – and was encouraged to treat him by my bosses and the nurses caring for him – as though he were a living, feeling person. I count it a blessing that I was able to do what I could to respect them and do what I had to do without causing more pain and injury.

Instead of caring and concern for this mother and Emilio, the fuss and attention is focused on personalities and organizations.

It’s shocking to me to see the use of the word “futile” brought up over and over – even though it’s not in the law at all. It’s used as some sort of weapon and focus to call in the troops. There are bad doctors, bad nurses, bad judges, husbands, wives, children and bad examples of surrogates. This law does not make it any easier for them to end a patient’s life. The doctors and hospitals still have to answer to the public, courts and community. No doctor wants his failure to heal made part of a public press event and no hospital wants to be known as a place where patients are killed if they don’t go home well. The formal process laid out in the law gives structure to very hard times in the lives of patient’s families. (and I’ve offered several times to come to the aide of anyone in Texas who suspects that the law is used to cause the death of someone who is not dying)

What’s worse is the attack mode and personalized accusations in the press and the blogs. Who would have ever thought that anyone would publish the names and phone numbers of a Bishop, accusing him of complicity with murder?

We can be sure we’re being mocked by our traditional non-pro-life counterparts. At the American Society of Bioethics and Humanities meeting last year in Denver, it seemed as though most of the sessions knocked the concept of conscience and individual rights that trump the community’s.

We’re fighting the skeptics and unbelievers – not to mention those who claim to be believers yet feel the need to justify their complicity with abortion and push for embryonic stem cell therapy for their diabetic daughters, etc. The claims that nurses and doctors just want to empty a bed in the hospital make it harder to assert that our beliefs are not just personal opinions, that they are matters of right and wrong. Not to mention that we don’t come off as good Christians when we make statements that assume the worst of nurses and doctors or when we ally with someone whose reaction is to attack a Bishop.

About bnuckols

Conservative Christian Family Doctor, promoting conservative news and views. (Hot Air under the right wing!)

Discussion

One thought on “Explaining

  1. >Beverly,I would like to see some support for your claim that the Bishop has been attacked. If you are accusing me of that, then you are committing defamation. I have seen no attacks on the Bishop. What is your source?Furthermore, in your last post, you quoted an article which you represented as a statement by me that this particular hospital had a bed to free up. First, I didn't say that to the reporter and I don't know where she got that. Second, even if I had, the context of the statement was about apparent conflicts of interest.There is an apparent conflict of interest when a committee that is dominated by people with ties to the hospital make these kinds of decisions–because of the economics.I am also concerned about the representations that you have been making about the medical condition of Emilio–much of which is contrary to the chart. You are getting close to defamation by representing his condition as worse than it is. This could impact our efforts to tranfer him to a place that will trach him so that he can go home or to long term care.Further, some of the information you are discussing–though distorted–does not appear to come from the media reports. This leads me to wonder if you are receiving HIPAA protected information in a distorted form.Are you?

    Posted by Jerri Lynn Ward, J.D. | March 22, 2007, 5:16 am

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