Cardinal defends hospital in Alfie Evans case

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The UK doesn’t have euthanasia. What happens in cases like this is the extraordinary care is withdrawn and the symptoms are managed until a natural death.

Many people freak out (for want of a better expression) when a loved one is dying and I’ve had my share of aggressive phone calls. Most of these people I expect are nice normal folk who are polite to salespeople and waiters but this situation floors them. It’s much worse when the patient is young, the disadvantage of living somewhere with a low child mortality rate is that it’s something most are unprepared for.

The denial is very difficult to manage, I remember a case in paeds, an older child with severe disabilities who was dying from secondary complications, his doctors kept trying to explain the cumulative effects of repeat infection on his respiratory system and how he was deteriorating, his parents just kept saying how they were sure he would beat the odds.

It never went to the courts but was managed by meeting within the hospital, most disagreements are dealt with like this, legal action tends to be a last resort rather than something done as soon as there is a disagreement.

When their child passed the parents perspective was that the cruel doctors refused to save their child because he was disabled. The reality was the hospital cared for him as best they could but his condition ultimately wasn’t treatable even if his death was artificially drawn out.
 
Until a “natural” death against their will…nice. I wonder how many people could live their lives completely natural. I’m guessing not too many…being dependent on prescription drugs and what not. That being said pain medications are not natural, but are regularly provided in hospice situations, oftentimes dosed more than necessary.
 
ConfusedLucy said:
It never went to the courts but was managed by meeting within the hospital, most disagreements are dealt with like this, legal action tends to be a last resort rather than something done as soon as there is a disagreement.
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The fact that unjust and tyrannical laws (like most laws) do not always require active governmental involvement (because people know what the government would do if involved), does not make them any less unjust.
 
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ConfusedLucy said:
Doctors have always had to make these judgements and decisions on ceilings of care and appropriate interventions for dying patients. There is nothing new about that. Ideally these decisions are made with the patient and next of kin.
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I don’t think the important distinction is being made here. This was not simply a case where the parents and doctors disagreed about the usefulness of additional care. Everyone can appreciate the situation where parents simply refuse to accept the inevitable, but that’s not all that happened here.

This was literally a case of the government deciding that someone should die.

Yes, that sounds very stark, and it is surely true that Alfie probably wouldn’t have lived but… what? another few months? But that decision crossed the line between refusing to apply extraordinary care and refusing to allow extraordinary care. The former is justifiable, the latter is not.

In this case the UK faced a dilemma that had nothing to do with the effectiveness of medical treatment. Programs of socialized medicine simply cannot afford to assume the costs necessary to treat everyone with extraordinary problems. If they had treated Alfie they would have had no grounds for refusing to treat the next hard (and wildly expensive case), but if they didn’t treat him and he went somewhere else and continued to live for a meaningful period of time, their system is exposed as one where life and death decisions are basically bottom line choices: “Your treatment is too costly. We need you to die.”

I think this is why the government refused to allow Alfie to fly to Italy. They were not concerned that he might die, they were afraid that he might not.
 
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The decision to not continue treatment was not financial. We also have no idea what Alfie would have wanted, that’s why we have a system that considers his best interests.
 
ConfusedLucy said:
The decision to not continue treatment was not financial. We also have no idea what Alfie would have wanted, that’s why we have a system that considers his best interests.
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This is the another point insufficiently addressed. In addition to the government deciding who does or does not receive medical assistance - which is actually inevitable and necessary when the government is paying the bills - this government has now assumed the right to determine which lives are worth living.

This might seem like a simple and easy decision in this particular case, but the precedent has now been set that the government has the right to make such decisions, and there is nothing whatever to stop them from making that decision in any other situation as well. I would not trust any bureaucracy with such power.
 
A decision has to be made though. I mean we can’t keep everyone on extraordinary care.

I think cases like this really reflect how we struggle with the idea of terminal illness and death in children.
 
ConfusedLucy said:
A decision has to be made though. I mean we can’t keep everyone on extraordinary care.
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Absolutely a decision had to be made about whether or not to provide treatment, and as it is the government that pays the bills then ultimately the decision is theirs to make. That, however, justifies only their decision not to treat Alfie.

Nothing, however, justifies their decision not to allow him to receive treatment elsewhere, and that is really the overriding concern in this case.
 
Well I imagine if the transfer went wrong (people with more medical knowledge than myself have outlined the issues here) people would blame the hospital for letting it happen.
 
There are always risks one takes with a procedure-and sometimes the risks can even be probable. As long as the parents were informed of the risks, the hospital would not incur any liability.
 
The parents were the ones trying to prolong his life. The court were the ones trying to hasten it to its end by suffocating him. I’m not quite sure how Alfie would have “risked his life” anymore by taking a flight.
 
He would have risked a worse death. competant adults going against medical advice is one thing but people like Alfie cannot make that decision.
 
If one can perceive pain, asphixiation over the course of 5 days is pretty much the worst death I could imagine. The Court didn’t think he was even cognizant enough to perceive pain, so a flight wouldn’t have made a difference.

So it is clear the sole reason he was denied the flight was because the Court determined it was time to die and they wanted no one to stand in the way of their procedural-no other options for even possibly prolonging his life.
 
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Sometimes it is the right time to let a terminally ill patient go.
 
The doctor’s had a more realistic grasp of that poor boys situation than his parents.
 
Ideally a decision between all relevant parties. Sometimes families simply don’t have a realistic perspective on the situation or they panic and just want the person kept alive at all costs.
 
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