Brain-damaged baby to be taken off life support - I have questions about this news story

Thanks, MLS. I’m curious because I guess that whole “sitcom labor” thing seeps into your brain even if you know TV isn’t real, and you just assume it’s a lot of pain for a very long time. Whenever I’d hear someone mention, “Hours and hours of labor” I’d assume there was a lot of pain and agony and all that. Plus, I have a low pain threshold so I just figure multiply whatever a normal person is going through and a wuss like me has a LOT to worry about when the time comes.

This post brings up a lot of very good points - maybe the baby will be able to live off of life support, but like you say, the outlook does not look good for any quality of life for him. I was watching a story awhile ago about extremely premature babies, and one mother of a preemie said that if she had been told properly about what kind of life her preemie would have (severely multihandicapped), she would never have agreed to extreme measures to save her baby’s life. She of course didn’t want her baby to die, but she also admitted that she wouldn’t have chosen a life of looking after a severely multihandicapped child. You make me wonder if these parents have thought past, “We don’t want our baby to die.”

I wonder if that was just the lawyer in her speaking.

As far as I know (Canadian lawyer Dopers, please feel free to correct me), there will probably be an investigation to see if proper procedures were used at the hospital where the labour occurred (especially if the family insists), but the chances of the family suing and winning large amounts are small. Because the family is already covered for most (or all) of these hospital expenses, that shouldn’t be a factor in any lawsuits. My gut tells me that this will probably fall under the, “Bad things sometimes happen when people give birth” category, since some of you have indicated that a 40 hour labour with four hours of pushing is not that abnormal.

I would expect the knowledge of an umbilical cord wrapped around the neck would trigger serious discussions of a C-section. I don’t understand why the child was airlifted to another hospital so far away. If it’s a small town hospital I would expect a maternity wing capable of dealing with such a common problem.

As to the question of labor, at the end of the article it says she was actively pushing for 4 hrs. The question is how much “delivery labor” is too much and how is the baby monitored for umbilical cord complications.

Rocky Mountain House (where the labour and birth occurred) is a very small community. The nearest large facility would have been in Edmonton or Calgary - they’re about equidistant from Rocky Mountain House. It sounds like the hospital was able to accomplish the delivery, but when they realized how serious the baby’s condition was, he was taken to a larger centre for more complicated care.

That sounds about right. Generally speaking, if the medical folks were found negligent in some way, then a suit could be successful. But since most expenses are covered by Alberta Health, the actual amount of damages that could be claimed would likely be smaller than it would in jurisdictions without our kind of health insurance. Note that there may already be some expenses that fall outside Alberta Health’s schedule of benefits, which could be sued for; and certainly any similar predictable future expenses could be costed, indexed for inflation, predicted based on life expectancy, and sued for. But no lawsuit would include any costs of care if that care is something that is covered by Alberta Health.

Also, keep in mind that they need your consent to do a c-section and to do internal fetal monitoring. The doctor can tell you that you need a c-section Right This Second, but if you’re conscious, they can’t cut you open without your permission (or some sort of court order, I imagine). It’s possible that they were recommending a c-section earlier in the labor and she just didn’t give consent.

Someone with a medical background will have to answer the question of how deliveries are monitored. I would expect sonograms to be used to see if the cord is not obstructing anything. A cesarean section seems like the logical course of action in such a case and that should be routine surgery.

What if she were conscious but not completely there? Would the husband have been able to give consent?

I’m neither a lawyer nor a medical professional, just someone who has had one c-section and gave consent to a second that turned out to be unneeded, but yeah, I would imagine he’d be next in line to give consent if he was present. A c-section is surgery and all the normal rules of getting the patient’s consent are in place.

Way back in 1980, a coworker of mine had a baby under the same circumstances. The baby was able to survive without mechanical assistance, but was profoundly retarded. The last time I saw them the baby was about 7. She didn’t respond to anything except pain, would never recognize her mother’s face or voice, or even sit up on her own. Her mother was raising her as a single parent, since this circumstance destroyed her marriage. I hope to god that kid is not still alive; if she is, she’d be 30 now, and her mother in her late 50s. This is just so sad.

Some random thoughts:

This thread is a perfect illustration as to why it’s best to have experienced professionals attend births - you really can’t cookbook labor and delivery.

When I had my kids, there was no time table for first stage labor, but you only got 3 hours to push. Unless the baby was a hair away from being delivered, it’s time for a C-section after 3 hours second stage.

It is very possible to blink, swallow, react to painful stimuli by withdrawing the limb, and even track moving objects without being sentient. These are all lower brain and spinal cord functions. The fact the baby can do this in no way means that it is aware of its surroundings, and says nothing about it’s prognosis for improving.

In the U.S. there have been cases where the hospital pulled the plug over the wishes of the parents but according to the wishes of the parents (and baby’s) insurance company. I’m not sure I’d want my child in a hospital that would do that.

Perhaps that can even be used as a Republican talking point: In America the hospital will take your baby off life support against your wishes right away, in Canada they make you wait 6 months.

To me, this is the real issue:

So, unless I’m reading that wrong, they’re asking doctors to stop caring for other children so that they can go to Edmonton and look after the baby. I understand the need for medical professionals to give consults, but I can also see doctors and hospital officials feeling that the skills of those professionals would be better used elsewhere, in cases where there was a better chance of a positive outcome.

These parents may be putting the lives of other children at risk in a blind effort to save a life that is ultimately unsavable.

They very probably believe that there actually exists an omnipotent, omnipresent, omniscient being named God who gives all people souls at conception, who cares about each and every soul, and wants every soul to trust in him so that it can go to Heaven. Their desires for their son are no more ridiculous than their beliefs.

No medical background, but they could do fetal monitoring. In internal fetal monitoring, an electrode is attached to the baby’s scalp, to monitor the baby’s heartbeat. This often isn’t used unless it’s a high-risk birth, or they suspect the baby is in distress for some reason.

External fetal monitoring is basically a belt that goes around the mother’s abdomen, that measures the heartbeat. It’s not as accurate, but it’s also non-invasive and unlike the internal monitoring, can be taken off and put back on as necessary.

A normal birth probably wouldn’t be continuously monitored - a doctor/nurse would come in periodically and check how dialated you are and how far apart contractions are, but you’re not with medical staff constantly in the beginning.

They may have done one of these things, but there’s really no way of knowing from the article when the baby actually started to be in distress.

Could you direct me to news articles about some of those cases? I’m curious as to the circumstances.

cite. No doctor is going to risk losing his license by ignoring a parent’s directive. That would be like winning the lottery in the US because the doctor’s insurance company is going to pay.

Unless I’m reading this wrong it means Canadian doctors are in short supply and if even a couple of them take the afternoon off it will negatively affect health care.

A hospital in Texas tried. In that case state law allowed them to terminate care for patients deemed “futile” over the family’s objection with 10 days notice.

No, just that they aren’t going to tell all their patients they have to wait longer so they can fly to another city to look after another child. I’m sure they can shuffle around some patients but not all.

Last I read on CBC they found a specialist from Victoria but he can’t clear his schedule until the end of February.