Thursday, November 16, 2006
Nuffield council on bioethics (again)
Now the report has been published, The Times fails to mention it in print (haven't checked online). Fortunately The Daily Mail has given some balanced coverage and we have two relevant reports. The first here actually about the Nuffield council report.
From the article: "The report concluded that:
• Doctors should routinely give intensive care for babies with a gestational age of 25 weeks or above.
• For babies between 23 and 24 weeks, parents should get the final say on whether the baby should be resuscitated and given invasive intensive care.
• Between 22 and 23 weeks, doctors should not automatically resuscitate, and it should only be considered at the parents' request following a discussion about the risks and long-term outcomes.
• Below 22 weeks, a baby should not be resuscitated, except for research. "
So between 22 and 23 weeks you need a parents' request and a discussion. This is quite simply ridiculous. At what point is this discussion supposed to happen? At conception? Or when resuscitation is required? I must state that by the time you know you'll need the discussion, I don't think you'll have enough time to have it. So it just seems like an excuse not to resuscitate, I can see them saying: "Oh well while we were discussing resuscitation the baby passed away".
As for the 22 week recommendation, that is just disgusting. It is simply unacceptable that human life be prolonged for "research"; of course if you try to keep someone alive and gain valuable knowledge that is fine, but you are motivated by the desire to save life and the research benefit is incidental. What if a "research" baby survives, do we kill them off at say 30 weeks (the experiment being now ended)? Are the parents entitled to reject the baby? Does the baby automatically exist merely for research purposes and can be experimented on all its life?
This area is in many ways mirroring civil liberties and security arguments. Do we give up civil liberties in order to protect western values? Of course not is the only answer for then we won't be protecting but destroying our values. It is the same here, of course medical science should strive to relieve suffering, pain and disability, but it must do that within a framework of the sanctity of human life. If we cease to value human life for no other reason than it is human life then we lose something of ourselves. Nature provides pain and suffering and it is in the nature of mankind to attempt to conquer nature and attempt to conquer disease and pain and suffering, but we don't achieve that by killing off the patient or "allowing them to die". This argument does change as people get older and the "allowing to die" criteria dealing with an old person at the end of their life is different. It certainly doesn't apply to babies.
The Daily Mail their second story on this issue reported here; have a healthy normal girl born at 22 weeks. The story is one of hope, one of triumph over adversity. This is what life is about, struggle, doing your best, sometimes the story has a happy ending, sometimes it doesn't. The key though is to fight, to try, to strive, it's when we give up without trying that we atrophy into teletubbies. "Oh please take the decision away from us we can't decide, save us from responsibility."
People aren't really like that though; people should not have responsibility taken from them. The state should not be there to take moral or other decisions for them, they might not always make the "right" decisions, but who can really say, and anyway the state or other bodies or doctors have just as much chance of getting it wrong with more far reaching consequences.
For me these sorts of things strike at the essence of humanity, we must always respect the sanctity of human life and people should always be the ones to make decisions affecting their own lives, not doctors or committees or the state. These others can have a role in advising, possibly in recommending, but the decision should be taken by the people affected.
From the article: "The report concluded that:
• Doctors should routinely give intensive care for babies with a gestational age of 25 weeks or above.
• For babies between 23 and 24 weeks, parents should get the final say on whether the baby should be resuscitated and given invasive intensive care.
• Between 22 and 23 weeks, doctors should not automatically resuscitate, and it should only be considered at the parents' request following a discussion about the risks and long-term outcomes.
• Below 22 weeks, a baby should not be resuscitated, except for research. "
So between 22 and 23 weeks you need a parents' request and a discussion. This is quite simply ridiculous. At what point is this discussion supposed to happen? At conception? Or when resuscitation is required? I must state that by the time you know you'll need the discussion, I don't think you'll have enough time to have it. So it just seems like an excuse not to resuscitate, I can see them saying: "Oh well while we were discussing resuscitation the baby passed away".
As for the 22 week recommendation, that is just disgusting. It is simply unacceptable that human life be prolonged for "research"; of course if you try to keep someone alive and gain valuable knowledge that is fine, but you are motivated by the desire to save life and the research benefit is incidental. What if a "research" baby survives, do we kill them off at say 30 weeks (the experiment being now ended)? Are the parents entitled to reject the baby? Does the baby automatically exist merely for research purposes and can be experimented on all its life?
This area is in many ways mirroring civil liberties and security arguments. Do we give up civil liberties in order to protect western values? Of course not is the only answer for then we won't be protecting but destroying our values. It is the same here, of course medical science should strive to relieve suffering, pain and disability, but it must do that within a framework of the sanctity of human life. If we cease to value human life for no other reason than it is human life then we lose something of ourselves. Nature provides pain and suffering and it is in the nature of mankind to attempt to conquer nature and attempt to conquer disease and pain and suffering, but we don't achieve that by killing off the patient or "allowing them to die". This argument does change as people get older and the "allowing to die" criteria dealing with an old person at the end of their life is different. It certainly doesn't apply to babies.
The Daily Mail their second story on this issue reported here; have a healthy normal girl born at 22 weeks. The story is one of hope, one of triumph over adversity. This is what life is about, struggle, doing your best, sometimes the story has a happy ending, sometimes it doesn't. The key though is to fight, to try, to strive, it's when we give up without trying that we atrophy into teletubbies. "Oh please take the decision away from us we can't decide, save us from responsibility."
People aren't really like that though; people should not have responsibility taken from them. The state should not be there to take moral or other decisions for them, they might not always make the "right" decisions, but who can really say, and anyway the state or other bodies or doctors have just as much chance of getting it wrong with more far reaching consequences.
For me these sorts of things strike at the essence of humanity, we must always respect the sanctity of human life and people should always be the ones to make decisions affecting their own lives, not doctors or committees or the state. These others can have a role in advising, possibly in recommending, but the decision should be taken by the people affected.
