Pro-Lifers: Is Kyna Dismuke not as good as Terry Schiavo?

[Cat_Whisperer]

Good points, manhattan and Mr. Moto. For the record, I’m neither pro-life nor anti-life - I think each case has to be judged on its own merits. And also for the record, our family had to make this decision with my four year old sister who died of cancer.

I see what you’re saying about the analogy being poor, Mr.Moto. Terry could indeed have lived much longer, but her previously expressed wish was to not continue in that kind of state. Knya obviously has never stated any kind of wish like that, so her mother must look after her best interests, but in Knya’s case, there really is no hope, regardless of what her mother wants for her.

[theRanger]

Hey, my first visit to the Pit! (But only because they moved the thread.)

@catsix

Unless you have evidence that the sole reason this particular case did not receive the amount of media attention that the Terri Schiavo case did is because this baby is black, then yes it is unreasonable to suggest that [had this child been a blond blue eyed darling, with appropriate parents, the media might have latched on to it] and it is race baiting.

That seems an impossible standard. I very much doubt whether there is ever a sole reason for anything that happens in society. So unless your goal is to squelch all debate concerning race, you might want to back off a bit on that one.

@catsix

What I did say was that you don’t know that it’s a race issue, and unless you have some kind of factual reason to assume that it is, you’re being unreasonable to call it one. What evidence do you have about this case that says the lack of media attention is race based?

Would I be correct in presuming you’ve never spent much time in the United States? Because it’s obvious to attentive observers that ‘race issues’ permeate much of what happens here: socially, politically, economically, etc.

That’s not to say that every race issue is a case of or derives from hatred or prejudice. Read holmes’ story again:

@holmes

Slight hijack: Many, many years ago, I worked at a bodybuilding magazine and it was at the time when most of the Champions were African-Americans; but the only time they got on the cover was when they won a major championship. The rest of the time it was white guys and girls. So finally I asked, why do you keep pulling my covers and the publisher said, “The magazines don’t sell well, especially in the South, when we have black people on the covers, … and we have a business to run.” He had the number of returns and there it was…in black and white, you could see the newstands sales drop when there was a black person on the cover.

Right there, a race issue played out in the field of economics and media. Was the publisher a racist? Did he personally denigrate black bodybuilders? It looks like not from holmes’ telling, yet the effects of decision to run fewer black men on the cover than were represented at the top of the sport were certainly manyfold, including:

• harming those champions’ ability to make a fair income, based on the value of the publicity
• giving a false impression to casual observers and fans concerning the true makeup of the sport
• possibly giving a false impression to observers (like those who walk past the newstand) regarding what segments of society ‘have what it takes’ to excel
  …etc. The list could go on, and each point on the list could have multiple consequences in the mind and behavior of society and of individuals. It doesn’t require too much imagination to see how. And it is CERTAINLY not race baiting to be aware of these social truths–or to mention and ponder on them, if it’s done carefully.

Do the media outlets who are ‘ignoring’ Knya Dismuke do so because they hate her (whether or not because she’s black)? I sincerely doubt it. Is it proper to question what place race plays in events, here in these United States, without it necessarily being race baiting? Damn straight it is.

[manhattan]

@tomndebb

Actually, while manhattan brought up some good points, there is also one very large, clear (if contentious) difference. Those who argued for the parents’ side in the Schiavo case were in agreement with a basic principle laid down around 30 years ago: one does not starve to death a person although it is not necessary to perform invasive or extraordinary means (particularly painful ones) merely to prolong life.

Doh! That’s exactly right. I was thinking of the most vocal demonstrators, but yes, there are a large number of people who believe that the provision of “heroic measures” or similar is significantly different from the provision of basic nutritional necessities. Thank you for filling in the gaps in my post.

Still another group still would be those people who consider the pain and suffering of the patient. To my knowledge, all parties agreed that Ms. Schiavo was not suffering significantly at the time her care was discontinued, though some of those who argued for the continuance of that care argued that she would (or did) suffer as a result of that action.

@CrankyAsAnOldMan

My god, you should hear how I gripe when I have to do an analysis on a piece of legislation in my own area of supposed expertise for my job. Now you want to me to wade through a public act dealing with the medical field, and on my own unpaid time?

Sorry about that. My other choice at the time was listening to some suit drone on about what a good job he did because his company lost “only” 10,000 customers. Surely you can agree that only paying half-attention to someone’s pointy-headed boss is an important priority, particularly because my Buzzword Bingo card somehow got misplaced.

[RTFirefly]

@manhattan

Those who wanted to continue treatment fall into three camps. One camp disagreed with the diagnosis and therefore thought she was not dead. Another disagreed that the diagnosis was permanent. Still another group disagreed that mere loss of higher brain function is “death” – lower brain functions were working just fine, she didn’t need a respirator, etc. With nothing but food and minimal care Ms. Schiavo had a “life” expectancy not materially different from non-injured people of her age and general physical health. By contrast, in the current instance pretty much everybody save the mother agrees that death, by any definition at all, is inevitable and in the near future.

With those differing definitions of what “life” is, it’s no surprise to me that many abortion opponents came believe that care to Ms. Schiavo should be continued. They would fall into the third of those groups and simply have a broader definition of what “life” is than the majority of people. Those from the disabled community who believed that care should have been continued would mostly fall into one of the first two. And with Knya’s death inevitable and soon, it’s also no surprise that none of the groups who advocated continued care for Ms. Schiavo find an interest in this case.

OK, I see your point. You’re right - given the circumstances (and thanks for the update on Kyna’s situation), it wouldn’t be inconsistent of pro-lifers to fight for Schiavo’s life but not Kyna’s.

[Cat_Whisperer]

RT, it’s actually Knya. Yes, I know that is very nit-picky. I happen to be a nit-picky person.

[Blalron]

One thing I simply don’t get is how the “culture of life” people are the same ones who fight tooth and nail against Universal Healthcare. You’d think those two ideas would go together. Or is it just a “culture of life” if you have money?

I can’t understand it. Could somebody explain it to me?

[Clothahump]

It’s a moot point. She died this morning according to Channel 2 News.

[rjung]

That doesn’t make the hypocrisy go away.

[villa]

@catsix

Unless you have evidence that the sole reason this particular case did not receive the amount of media attention that the Terri Schiavo case did is because this baby is black, then yes it is unreasonable to suggest that and it is race baiting.

Wondering why, or even trying to find out why, seems reasonable. Assuming that race had anything to do with it, absent some kind of evidence, does not seem remotely reasonable. It’s the race card that’s been played and played out.

Not sure I agee with you here. You are basing this on the assumption that the pre-existing baseline is one of racial neutrality. Were that to be the case, then of course those alleging racial bias would have to provide evidence of that.

However, if it is the case that the pre-existing baseline here is one of racial bias, then would it not be encumbent on those denying a racial aspect to provide evidence of it? Call me pessimistic, but I simply don’t believe America is yet in a place where we can assume a baseline of racial neutrality. Now, you might then say there is a burden to supply evidence that the baseline is one of bias not neutrality, but that is a very different question than suplying evidence of bias in each and every case.

[Scarface_Z]

Umm, I don’t have much to add, but did anyone else notice that they had planned to stop treatment on Mother’s Day?
Anyone else see that as an unneccessary bit of tragic irony?

[edwino]

I’m on a Pediatrics clinical clerkship at the hospital next door. We had a conference on this this morning. We are getting ethics lectures on it tomorrow. I’m going to try and approach this from a medical/ethics point of view.

The head pediatrician at our hospital, a blatant liberal Democrat (joy!), said he would respect Sheila Jackson Lee’s attempt to circumvent the Texas Futile Care Act if she set out a federal fund to pay for futile care. Then again, we are the county hospital and don’t have dollars to pay for anything. Every year, health care gets more expensive and there are fewer dollars around for funding community hospitals. Insurance companies won’t pay for futile care when they barely pay for needed care, so where are the dollars going to come from?

Anyway, I’m real tired and I can’t make a cohesive argument right now, so I’ll just give a bit of background as I understand it. My tiredness will come out in my rambling, I apologize in advance.

This is the third case in Houston of this law being applied. In terms of race, two have been African-American babies and one a 68 year old IIRC Greek man in a persistent vegatative state.

First, you must know that it isn’t just the doctors that make this decision – it is a decision made with an ethics team and with social work and if at all possible, the involvement of the family. These include outside experts: our chief of staff is a world-reknowned expert in pediatric tuberculosis, and he has advised Memorial Hermann against enacting the futile care law in other cases.

At some point, our medical science ends and care only prolongs suffering. This law, viewed by the hospital physician and ethicist, can really be seen as patient advocacy. Buy the spin if you want to but in the end the physicians, entrusted with care of a patient, really ought to know what is best. I don’t know where the 5% number for Knya’s survival comes from in the OP link, but you must know that this case has been seen by dozens of doctors and ethicists before the law is applied, and I seriously doubt that futile care would be applied to a 1:20 case. For the other two cases, it was truly futile care. Sun Hudson had profound congenital abnormalities with no hope for recovery and the other case was quite similar to Schiavo.

The baby Sun case (at the same time of Schiavo) was handled by our system, and I am a lot more familiar with that one. Texas Children’s went above and beyond anything required by the law – they contacted 42 hospitals to try and place the child, they paid for the family’s lawyers, they prolonged the 10 day period mandated by the law to months and months. In the end, care was withdrawn and he died. The other case, with the 68 year old man, I believe the family found place for him in a nursing home in Dallas or Austin.

I’m pretty liberal, but I’m also in medicine. No matter how often we try to tell ourselves that we have endless resources in this country, we need to open our eyes to limitations, both in money (the obvious point) and in more practical things, like ICU beds. At our hospital, we have 6 pediatric ICU beds. If futile care kids started getting stuck in our ICU, it becomes easier for us to get to capacity. Then we start transfering kids, who really can use the help, to other hospitals without the ICU care, ancillary staff, diagnostic tools, etc. that we have at our Level I facility. This happened a few years ago – we capped out at the Texas Medical Center, and had to start transfering critically ill kids to Nagodotches, Texas. These kids received a lower quality of care than could be delivered in the TMC. And some died.

So, in the end, take your pick. Baby Sun and Baby Knya, or a kid who is status post induction chemotherapy for leukemia and develops pneumonia and requires ventilator support for a week until he shakes off the infection and goes on to make a full recovery. Or a kid from an auto accident with a liver laceration who will be no worse for the wear after a week of post surgical monitoring. We are talking about the sickest of the sick. We are talking about those that show no improvement after months, or have reached the limits of medical treatments. We are often talking about families with profound socio/psychologic issues and failure to deal with end-of-life issues. And politicians want us to side with these patients and families over the 10 year old kid chasing a soccer ball in the road who gets hit by a car.

This is not euthanasia; this is common decency and common sense.

[Cat_Whisperer]

Great post, edwino. Does an ethics committee also make decisions on very premature babies (the ones that even if they live, they are guaranteed to have serious health problems for life)? I watched a programme that featured a woman here in Canada who was not informed of all the long-term ramifications of heroic measures being used to keep her preemie alive, and says that if she had known, she would not have agreed to it.

[edwino]

It’s a good question – I do neonatology next month. I assume that an ethics committee looks into it, or at least they have a standardized protocol for dealing with those situations. I can ask tomorrow.

[RTFirefly]

I expected this thread to die once I threw in the towel, but since it hasn’t:

edwino, I just want to make clear that (even when I wrote the OP) I didn’t expect anything more of the hospital. I personally think there comes a point at which heroic efforts to try to save someone who almost certainly can’t be saved are pointless. I just couldn’t understand why the pro-lifers weren’t pestering y’all about this the way they made a big deal out of Terry Schiavo.

Anyway, manny gave me a convincing explanation of their behavior, and I never had a problem with the hospital’s.