'Do not revive' earliest babies

[Lace Neil Singer]

http://news.bbc.co.uk/1/hi/health/6149464.stm

Old article I know, but still good for discussion. Do you think that premature babies of 22 weeks or less should be allowed to die in peace, or resuscitated regardless of life expectancy? Has anyone had to make this decision?

By the way, just for clarification; the preemies that the article talks about are 22 week old babies. I'm saying this cuz last time I saw this topic discussed on a message board, loads of people chimed in with "But I was 24 weeks premature and I lived!" Two weeks is a long time in a developing fetus's life.

[crazylegs]

The article states that babies born at 22 weeks have a 1% chance of survival, I'd suggest this is a bit of a moot point really, and seeing as at 21 weeks none survive...

[Flyndaran]

The article states that babies born at 22 weeks have a 1% chance of survival, I'd suggest this is a bit of a moot point really, and seeing as at 21 weeks none survive...

It is not a moot point. The enormous amount of effort, time, and expense "wasted" on fighting a losing battle is not limitless.
Lfie and death are measured, quantified, and given a monetary value in all aspects of reality. We just don't like to see it being done. We like to pretend that money grows on trees and that help abounds.
It doesn't. I would prefer most such decisiions of euthanasia, or "letting nature takes its course" (I nearly burst something posting that expression) to be left to the guardians of said child. Any dirty looks given by staff should result in immediate dismissal.

[BlaqueKatt]

I think this story (http://www.llerrah.com/thestarfish.htm) sums up my feelings on this issue

[AdminAssistant]

I say it's up to the parents. I don't like the thought of doctors having that kind of guideline for action without talking to the guardians. It seems a bit fishy.

[Lace Neil Singer]

I personally think it should be done on a case by case basis, and definitely with the parents fully involved. But in some cases, the baby is not developed enough to exist outside the womb for longer than a few hours, even with medical intervention. Should it really be put thru all that torment, when the end result will be the same, regardless? Wouldn't it be better for the child to die in peace with its parents?

By the way, I mean babies that are so premature, their eyes are fused together, their skin is transparent and like tissue paper, and their organs are not developed.

[Sylvia727]

It should always be the parents' decision, whether it is better to let the baby have a chance at life or have some peace before he dies. This is an ethical question, not a medical one, and role of the doctors and the hospital staff is simply to advise the family. To have a guideline in place sounds to me as if the hospital is trying to make spiritual decisions for the families.

[DesignFox]

I think the decision should ultimately be in the hands of the parents.

That article mentioned that there are organizaions trying to lobby for legislation that says that no matter what you have to try and save that baby's life. Where others are lobbying for the cause of making baby euthanasia legal...(not mandatory, just legal) To me, it's all the parent's decision. If they want to fight a losing battle, let them. If they don't think it's worth it. Also, let them make that decision. If they fight and it works out...also great.

No one should tell the parents what they HAVE to do in regards to an undeveloped/underdeveloped baby. Frankly, if the baby is pre-mature that if it's lucky enough to survive, it will be horridly malformed or gravely disabled- it isn't worth it. If the baby is merely going to suffer, and then die anyway...why waste the time, effort and money?

I guess I'm a heartless bitch, never having been pregnant and not currently wanting any children...but it just seems so ridiculous. We put our animals down if we know they are going to have a shitty quality of life...why do we force our fellow human beings to suffer? I would let the baby die in peace if its option for survival was so low...or if its chances of leading a normal life were so slim.

I believe it is a personal choice that each set of parents should be able to make for themselves, based upon the discussions that they have with their physician.

[crazylegs]

This is an ethical question, not a medical one,

You're quite right, is in an ethical one, however as we know the parental bond can be immense and some parents will not allow their child to die even though causing them to live involves massive amounts of pain and distress.

Who then looks at the ethics?

[Sylvia727]

Who then looks at the ethics?

The parents. Yes, they may be overwhelmed with the gravity of the situation. Who wouldn't be? But it's still their call. They're the ones closest to the infant, they're the ones responsible for his life, and they should be the ones to make that horrible decision. It's the responsibility of the doctors to advise them. Their families and spiritual advisors may be able to help, as well. But when it comes down to it, the parents have the right and the responsibility to protect the child's best interests. An outsider will not be as able to make the right call, whatever that call might be.

[Flyndaran]

You're quite right, is in an ethical one, however as we know the parental bond can be immense and some parents will not allow their child to die even though causing them to live involves massive amounts of pain and distress.

Who then looks at the ethics?

It is not ONLY an ethical question, unless you live in the land of infinite money. All the dollars spent trying to save the unsaveable may have been used for more effective treatments for already living people.

Doctors are guided by ethics, despite what much of the public may believe. Many medical decisions are, and must be, based on the physician's ethics as well as mecial knowledge.

The only argument is about how much power should doctors have in such situations. They must have some if only to keep ignorant parents from "trying to save" never weres like anecephalics or other grossly deformed almost babies.

[Sylvia727]

... if only to keep ignorant parents from "trying to save" never weres like anecephalics or other grossly deformed almost babies.

I read this as if you were saying that premies aren't real people, that they are less than people. Please tell me I'm wrong and clarify your position.

[Flyndaran]

I read this as if you were saying that premies aren't real people, that they are less than people. Please tell me I'm wrong and clarify your position.

Anecaphalics have no brain other than minimal brain stems. They never were babies. There are other gross deformities that render survival let alone a real life impossible even with the most advanced technology.

Of course premature infants are people, more or less, depending on the stage of development. If it's far enough along to survive even a few moments of life in the open, then it qualifies as a person, just barely, but a person none the less.

[Sylvia727]

Ah. I see your point.

[anriana]

From my understanding of the article and the NHS, it's not just an issue of whether or not the parents want to keep the child alive - there is also the monetary cost to consider.

"The inquiry also looked at longer-term support for families, and resource implications for the NHS. "

[Rapscallion]

Resource isn't just money. There are also human resources. How about the emotional impact on the nurses who have to look after children they know aren't going to survive? We also have just about enough beds in hospitals over here - take one up with a no-chance of survival or with someone with a chance of survival?

Rapscallion

[BlaqueKatt]

Anecaphalics have no brain other than minimal brain stems. They never were babies. There are other gross deformities that render survival let alone a real life impossible even with the most advanced technology.

Nicole Trease's (http://www.omaha.com/index.php?u_pg=57&u_sid=2209347) mother would like a word with you-Nikki is 7, born with no brain-There was also a girl on the Montel Williams show that only had a brain stem-she was 14 at the time-severely mentally handicapped-but she could read at a kindergarden level, and speak.


They used to say the same thing about certain types of illnesses that are now treatable-maybe we should just let people with HIV die it's expensive to keep them alive, my mom has had 5 heart attacks-she has an implantable defibulator-10 years ago they would have "let her die" rather than keep her alive with the horrible pain.

How can you put a monetary cost on a life?

What is the monetary worth of yours?
can't do it can you, but you can to someone else's child-maybe they just want a little time-who is anyone to tell someone else how to grieve?

[suchislife2]

I think at the end of the day, it really should be up to the parents what happens to the baby. The bond between baby and parent is so strong that I'm sure if one doctor was to say no, and say there are no resources or so on to save the baby the parents would do everything in their power to save the baby no matter what.

I mean, this is a tad off topic, but sort of the same, see these parents http://au.youtube.com/watch?v=Vs_LoWaAGb0 they have a baby that is extremely deformed, yet decide to keep the baby, and do everything in their power to give her a better life. They won't and have not given up.

Now some of you may say that the girl (or the babies below) will suffer. I don't doubt this, and this raises more ethical issues. But with the increase in technology some say that a lot of these babies are being born, and grow up and lead normal lives.

Wrong or right? Well, look at my mothers friend, he has one eye missing, deformed jaw, fingers missing on both hands that are deformed, one leg missing, toes missing on the other foot. He's now 40 something. He is severely depressed and has attempted suicide on more than one occasion. He's lonely as anything because, well, a lot of woman don't really find him attractive, even if he has a great personality. His birth mother doesn't want to know him at all, and his foster family don't contact him at all. He feels rejected, shunned. Is this fair? Ultimately life is what you make it, but yeah, doesn't make it right.


http://au.youtube.com/watch?v=_ssFda00gko

http://au.youtube.com/watch?v=vlZnqLKDRlo

[Lace Neil Singer]

Nicole Trease's (http://www.omaha.com/index.php?u_pg=57&u_sid=2209347) mother would like a word with you-Nikki is 7, born with no brain-There was also a girl on the Montel Williams show that only had a brain stem-she was 14 at the time-severely mentally handicapped-but she could read at a kindergarden level, and speak.

I find that very hard to believe.

http://www.anencephalie-info.org/e/faq.php

Life expectancy:
About 25% of anencephalic children who live to the end of the pregnancy die during delivery; 50% have a life expectancy of between a few minutes and 1 day, 25% live up to 10 days (Jaquier 2006)
Get more information: Report about the birth and life of babies with anencephaly

Can an anencephalic child sense or do anything?
Doctors will tell you that an anencephalic child can neither see nor hear, nor feel pain, that he or she is a vegetable. However, that does not match up with the experience of many families who have had an anencephalic child. The brain is affected to varying degrees, according to the child; the brain tissue can reach different stages of development. Some children are able to swallow, eat, cry, hear, feel vibrations (loud sounds), react to touch and even to light.

[Boozy]

Nikki Trease is hydranencephalic, not anencephalic.

Do not ask me to explain the difference, but obviously there is one.

[Pedersen]

Anencephaly (http://en.wikipedia.org/wiki/Anencephaly) Anencephaly is a cephalic disorder that results from a neural tube defect that occurs when the cephalic (head) end of the neural tube fails to close, usually between the 23rd and 26th day of pregnancy[citation needed], resulting in the absence of a major portion of the brain, skull, and scalp. Children with this disorder are born without a forebrain, the largest part of the brain consisting mainly of the cerebral hemispheres (which include the isocortex, which is responsible for higher level cognition, i.e., thinking). The remaining brain tissue is often exposed - not covered by bone or skin.

Hydranencephaly (http://en.wikipedia.org/wiki/Hydranencephaly): Hydranencephaly is a type of cephalic disorder. This is a rare condition in which the cerebral hemispheres are absent and replaced by sacs filled with cerebrospinal fluid. Usually the cerebellum and brainstem are formed normally, although in some cases the cerebellum may also be absent. An infant with hydranencephaly may appear normal at birth or may have some distortion of the skull and upper facial features due to fluid pressure inside the skull. The infant's head size and spontaneous reflexes such as sucking, swallowing, crying, and moving the arms and legs may all seem normal, depending on the severity of the condition.

Major differences between the two. Hydranencephalic can actually live (obviously). Anencephalic is, at longest lived, dead in very short order, and with current technology cannot live past that time frame.