For years I have been predicting that futile care treatment withdrawals will become the next big bioethics agenda issue to roil the public and involve the courts. Now, the futile care imposers are beginning to roll out the agenda. This Michigan case may be one. Emmie-Rose Yannella, a prematurely born infant with an often fatal medical condition in which bowel tissue dies, is being denied wanted life-sustaining treatments.
Doctors at the University of Michigan Medical Center predicted that the child would only live for a few days—two weeks ago. Now, the ethics committee has determined that the baby will be denied blood transfusions and sustenance containing fat and nutrition, replacing it with a sugar and salt solution, because to do otherwise will “only delay” the date of death. But isn’t delaying death a proper purpose of medicine? And haven’t the doctors’ predictions already been proved to have been mistaken?
If you read the story, it is striking how vague the parties are about how the decision to unilaterally withhold treatment was made. But such life and death decision cannot be allowed to be so apparently ad hoc or based solely on secret internal administrative deliberations.
If the treatment is physiologically inappropriate or useless, let the doctors tell a judge. But if their decision to overrule the parents is based on their values—the treatment should be ordered continued. In any event, it would seem that due process of law would require a public process, the right of the patient/family to representation, an accurate record to that it can be determined the bases upon which the refusal of wanted treatment decision was made, and a right to appeal. In other words, transparency, the very thing futilitarians seemed bent upon refusing to permit.
This may be another case that the proposed Nebraska Humane Care Amendment would partially prevent. It would not impact the blood transfusion issue, but it probably would prevent sustenance from being denied from the child if it could nourish the baby and if the intent behind the removal is to cause death.
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