Caring for Premature Babies: Cruel?

[JoanREDirector]

To JoanREDirector,
So if your child could have been saved by medical procedures, you would have approved of them? 24 weeks is about 4 months premature, correct? Now we have the ability to save children that young, the procedures aren’t useless. I just think we should give children that chance.

It depends on what the odds are for success and how painful the treatment would be. If the odds were good and the treatment reasonable, I would have them done by all means. If the chances for my baby were miniscule and the treatment invasive and protracted (read prolonged pain) I would ask only for the care to make him comfortable.

He is in his heavenly Father’s hands. God can take him to his real home now or later. Why … why would anyone make their baby suffer?

 

[DeannaMarie]

I am the mother of nine children. Four were born prematurely [29 weeks (twins), 36 weeks, and 30 weeks] and spent between 2 1/2 weeks to 3 months in the NICU. A fifth child was born full term with a rare genetic disorder and spent 7 weeks in the NICU. When they were born, we did not know if they would live. Without ventilators, feeding tubes, heart surgery, etc., they would not have had any chance. I saw a lot of babies in the NICU - some lived and some died. And sometimes, it was the younger baby who lived and the older baby who died. I can’t criticize a mother for chosing to let her baby die peacefully, but I also can’t criticize a mother who wishes to give her child every chance to live. I think that this decision must be the parent’s because it is to the parents that God has given this child.

 

[larsenl1]

I am the mother of nine children. Four were born prematurely [29 weeks (twins), 36 weeks, and 30 weeks] and spent between 2 1/2 weeks to 3 months in the NICU. A fifth child was born full term with a rare genetic disorder and spent 7 weeks in the NICU. When they were born, we did not know if they would live. Without ventilators, feeding tubes, heart surgery, etc., they would not have had any chance. I saw a lot of babies in the NICU - some lived and some died. And sometimes, it was the younger baby who lived and the older baby who died. I can’t criticize a mother for chosing to let her baby die peacefully, but I also can’t criticize a mother who wishes to give her child every chance to live. I think that this decision must be the parent’s because it is to the parents that God has given this child.

Well said.

 

[jediliz]

app1.unmc.edu/PublicAffairs/TodaySite/sitefiles/today_full.cfm?match=5405

Would it have been better to let these quadruplets, born at 23 weeks, die?

 

[Calliso]

And once again this thread is mainly dealing with 21 week old premies maybe 22 week. The chances for survival of lets say a 24 week baby is much higher then that of a 21 week one.

 

[Rachele_Ann]

DOShea… thank you thank you for all of your kind and insightful words about NICU nurses. I think you summarize our experiences nicely. As a NICU nurse… (who had a bad night I might add)…

1. The particular case in question is from ONE point of view, the woman has suffered multiple losses, suffered a traumatic birth simply by virtue of it being so full of fear, and delivered a live fetus. She is suffering, she is also not a medical professional she is a mother, she only feels her loss… we might very much be missing some of the story. The reality is we don’t know how hard they tried to stop labor or what condition the neonate was in at birth… everyone is breathing until the moment they die… breathing does not mean you are going to live. We don’t know the size of the baby, if mom was infected, if there was significant compromise to the fetus during labor etc. We don’t know, we can’t judge this situation.
2. Resuscitation has nothing to do with money, it has to do with doing the right thing. We cannot give a lot of our micropreemies a good life or even any life but we can give them a good death.
3. These difficult decisions that need to be made are not decisions that can be made by generalizations or gestational ages. These decisions can only be made at the bedside. When you asses the baby, look at the labs, you know. As a fellow human being, you know when its too much… the sad reality is the strong fear of death and lack of respect for human life frequently leads us down this path of “too much”. Sometimes providing resuscitation is just giving the family a little time to say goodbye. The reality is that most days with extremely premature babies if feels like we are torturing them to death.
4. Every neonate gets standard resuscitation. Suction, dried, and placed on a warmer with a hat if the parents can’t or won’t hold. No resuscitation does not mean “no care”.

 

[stteresasgirl]

I don’t know if anyone has mentioned this yet, but as an ER nurse, anything 20 weeks or above is sent to OB to be treated as a delivery (I live in the US, the state of Indiana). Those under 20 weeks stay downstairs with the assumption they will miscarry. I have consulted 2 other nurses/friends in the areas of OB and NICU and both tell me that there are cases of 20 week gestation that do make it without any brain damage.

It is very hard to keep the emotion out of this especially when it is your own. These are definitely little souls! I try to remember even with the best life saving devices and technology, when God wants someone to go, they will go. NO MATTER WHAT WE DO. It is not ordinary or extraordinary lifesaving measures that ultimately decides if a human being lives…it is God. If we (healthcare professionals) think that we saved a person by what we implement, then we become the “god”.

To me, God allows these little ones to enter so early for His reasons, only reasons that He can understand. And it should be God who decides when they should go. As He does for the rest of us. What does God say when he allows a 20 week pregnancy to survive and thrive for all of us to see? Even if it is just one among the vast number who do not have such good outcomes? What a strong lesson on the theological virtues of Faith, Hope, and Love.

Right or wrong…we could go back and forth. However, in the end, God will judge each of us on the intentions within our hearts at the moment we make any choice based on our own freewill.

Praise God for His justice and Praise God for His mercy!
st.teresasgirl

 

[soflochristmas]

Two thoughts.

1. this is what we have to look forward to if Obama/Democrat “Care” gets inacted…any they say there will be no “death squads”.
2. this is why U.S. infant mortality rates are lower than most countries…just don’t count the born babies as “babies” and like magic…your infant mortality rate is higher. Ahhh, viva Fidel and socialized medicine.

 

[JMJ_coder]

Why … why would anyone make their baby suffer?

This is a false question – like asking why would any father want to punish their child (like grounding them for a week)?

No sane parent would want to make their child suffer. Sometimes it’s the price that must be paid for life and being human.

What husband or wife would want to have their spouses chest ripped open? But, if there is some serious defect with the heart it becomes necessary to go through the pain of open heart surgery. What sane person would want to purposefully poison another? But if cancer is present it become necessary to absorb highly toxic chemicals into the body.

No parent wants to have their little one suffer, but what parent wants to bury their child? Sometimes pain is the price we pay for life.

 

[JMJ_coder]

Right or wrong…we could go back and forth. However, in the end, God will judge each of us on the intentions within our hearts at the moment we make any choice based on our own freewill.

The road to hell is paved with good intentions.

 

[JMJ_coder]

These decisions can only be made at the bedside.

And that is the crux of the complaints over this story – the decision wasn’t made at the bedside with the consultation of the patient (in this case the guardian of the patient), but in a policy that didn’t care about anything other than the bottom line.

 

[dixieagle]

I have personally seen a baby who was born at 24 weeks, at an adjusted age (how old they would be had they been born at the proper time) of 6 months, he was a little small, but perfectly normal other than that (and I know this because I was observing testing and discussion about his health status). And people don’t want to say that we should treat babies born that early. What about babies born on time who require just as much care, such as a child born tangled in the umbilical cord and was oxygen deprived? And what becomes the cut-off? I believe most babies born at 7mo survive, so what about a 6 1/2 mo? It becomes a dangerous line to draw.

If you read through the thread, and do a little googling, you will see that 22 weeks is generally considered the current point beneath which there is virtually no chance of survival. I think there have been a very few 21.5 week babies who have made it. Any baby born alive, no matter how early, should be given warmth, oxygen, etc.

I have read that about 47% of 24 week babies currently survive.

 

[dixieagle]

My darling little saint was born four months too early in 1968 at a crowded military hospital in Hawaii. He struggled for breath for about six hours before he died. In those days, not much could be done for him. My husband and I were young and dumb. I wish we had known that we had the right to be with him for those few hours but we stayed away as we were told. I’m not angry with the hospital staff. They thought they were doing the kindest thing for everyone. A compassionate Catholic nurse baptized him before the umbilical chord was cut and we gave him back to God.

Never, never would I have tormented him with useless medical procedures, poor little soul. Why ever would I make my own baby suffer? If there was any chance that his life could have been saved, we would have spent all the money we had and stayed by his side for as long as it took, but I know our decision was the best one for our baby.

After forty years I’m weeping over my keyboard as I type, but I am happy to think that he died with dignity and peace.

I’m so very sorry for your loss; I had 3 early miscarriages myself, but never experienced your situation. It must have been so hard.

 

[dixieagle]

app1.unmc.edu/PublicAffairs/TodaySite/sitefiles/today_full.cfm?match=5405

Would it have been better to let these quadruplets, born at 23 weeks, die?

Who on this thread has suggested it would be?

Though the chance is slim, at 23 weeks there is, at least, a chance. Every day past 22 weeks increases the chance for survival; it mainly has to do with development of the lungs.

 

[dixieagle]

DOShea… thank you thank you for all of your kind and insightful words about NICU nurses. I think you summarize our experiences nicely. As a NICU nurse… (who had a bad night I might add)…

1. The particular case in question is from ONE point of view, the woman has suffered multiple losses, suffered a traumatic birth simply by virtue of it being so full of fear, and delivered a live fetus. She is suffering, she is also not a medical professional she is a mother, she only feels her loss… we might very much be missing some of the story. The reality is we don’t know how hard they tried to stop labor or what condition the neonate was in at birth… everyone is breathing until the moment they die… breathing does not mean you are going to live. We don’t know the size of the baby, if mom was infected, if there was significant compromise to the fetus during labor etc. We don’t know, we can’t judge this situation.
2. Resuscitation has nothing to do with money, it has to do with doing the right thing. We cannot give a lot of our micropreemies a good life or even any life but we can give them a good death.
3. These difficult decisions that need to be made are not decisions that can be made by generalizations or gestational ages. These decisions can only be made at the bedside. When you asses the baby, look at the labs, you know. As a fellow human being, you know when its too much… the sad reality is the strong fear of death and lack of respect for human life frequently leads us down this path of “too much”. Sometimes providing resuscitation is just giving the family a little time to say goodbye. The reality is that most days with extremely premature babies if feels like we are torturing them to death.
4. Every neonate gets standard resuscitation. Suction, dried, and placed on a warmer with a hat if the parents can’t or won’t hold. No resuscitation does not mean “no care”.

Wonderful post!

We have been praying and following the progress of a friend’s 24-25 week preemie who is still in the NICU - six months today. She is now over 10 lbs, but hasn’t yet been able to stay on the nasal cannula; she was on a ventilator forever, and has been on CPAP for a while now.

What a long, hard row to hoe she and her parents have had. They are hoping for a Halloween homecoming, but that may be pushed back. But, there is light at the end of the tunnel. God bless the nurses and doctors who’ve brought her to this point, with God’s help.

 

[AutumnSakura]

I have not had a chance to read every reply to the OP, but I think that most medical interventions are not extraordinary when it comes to saving a life, whether of an infant or of an adult. I do, however, believe in palliative care when, save an act from God, the child will clearly die very soon (eg, anencephaly, where the baby has no brain). Most premature babies do not have these kinds of birth defects, though, so every possible avenue should be taken to prolong their lives. Who are we to say who “suffers” and who does not? Don’t we all suffer in life? Medical care is, ultimately, a futile endeavor, since we will all die, either now, or tomorrow. My dear grandmother suffered tremendous pain at the end of her life, but I do not think it was cruel to take her to the doctor and ensure that she received her medication. When she knew it was time, she decided to have a ‘Do Not Resuscitate’ order, and moved into hospice, where she received palliative pain treatment until she passed peacefully away into the arms of God. The same can be said for an infant: physicians and nurses should give them the best possible treatment, and when death is imminent, should provide hospice care for the child.
Personally, I think the “let them die” approach is horrifically cruel, and a direct outgrowth of our abortive culture. The difference between this approach and the hospice approach is that hospice acknowledges that all best efforts have been tried to heal the person and save their life, but that there is a reasonable belief that death is imminent, and so only palliative care is given. Without trying as much as possible to save the person, “letting them die” is euthanasia.

 

[dixieagle]

I have not had a chance to read every reply to the OP, but I think that most medical interventions are not extraordinary when it comes to saving a life, whether of an infant or of an adult. I do, however, believe in palliative care when, save an act from God, the child will clearly die very soon (eg, anencephaly, where the baby has no brain). Most premature babies do not have these kinds of birth defects, though, so every possible avenue should be taken to prolong their lives. Who are we to say who “suffers” and who does not? Don’t we all suffer in life? Medical care is, ultimately, a futile endeavor, since we will all die, either now, or tomorrow. My dear grandmother suffered tremendous pain at the end of her life, but I do not think it was cruel to take her to the doctor and ensure that she received her medication. When she knew it was time, she decided to have a ‘Do Not Resuscitate’ order, and moved into hospice, where she received palliative pain treatment until she passed peacefully away into the arms of God. The same can be said for an infant: physicians and nurses should give them the best possible treatment, and when death is imminent, should provide hospice care for the child.
Personally, I think the “let them die” approach is horrifically cruel, and a direct outgrowth of our abortive culture. The difference between this approach and the hospice approach is that hospice acknowledges that all best efforts have been tried to heal the person and save their life, but that there is a reasonable belief that death is imminent, and so only palliative care is given. Without trying as much as possible to save the person, “letting them die” is euthanasia.

No, “euthanasia” is the direct killing of an individual (administering a lethal dose of morphine, withholding fluids and nutrition, etc.).

The “letting them die” that you speak of could include warmth, fluids, oxygen (“ordinary means”.) It is exceedingly rare that a preemie of less than 22 weeks has any chance at all; however, if upon assessment, it is determined that the baby seems to have a chance, then the parents should have the option to employ more aggressive means of treatment.

 

[Rachele_Ann]

Personally, I think the “let them die” approach is horrifically cruel.

Not to sound snippy or unkind, but I strongly suspect that is because you have never seen how cruel it can be to force them to live.

 

[mgbenner]

In what world are you living in that giving someone air to breath is NOT an ordinary means of preserving life?

\Giving someone air to breathe is an ordinary means of preserving life…however, using a machine to breathe FOR someone because their necessary organs do not function properly to do it on their own would be, I think, considered extraordinary.

 

[DeannaMarie]

No, “euthanasia” is the direct killing of an individual (administering a lethal dose of morphine, withholding fluids and nutrition, etc.).

The “letting them die” that you speak of could include warmth, fluids, oxygen (“ordinary means”.) It is exceedingly rare that a preemie of less than 22 weeks has any chance at all; however, if upon assessment, it is determined that the baby seems to have a chance, then the parents should have the option to employ more aggressive means of treatment.

As the mother of four children born prematurely and one child with special needs, this conversation is very disturbing to me. Upon who’s assessment? The doctor? The nurse? The insurance company? The state? It is the parents’ RIGHT to seek and to receive treatment for their child; it is not an OPTION given to them after someone else has determined that their child has a chance (or a right) to live.