I specifically chose those examples because in fact the state won’t intervene. You cannot find an example of a civilized country taking a kid away from their parents for eating one fattening meal.
That would be a relevant bit of advice if I had weighed in with an opinion on the Alfie Evans case specifically, but I didn’t.
Yes, it would. Do you think this actually happens, or is in danger of happening, in the UK?
Be reassured, the professional judges whose job it is to think about these things have gone ahead and thought about these things:
Apologies for the quote within quote within quote but I think it helps establish that, astonishingly enough, the principle that:
is well-embedded in UK jurisprudence.
I’ve actually been following this for a bit on another forum that is predominantly UK populated (much like this one is US dominated).
Life is not a movie or TV. It is actually pretty common for someone to keep going for awhile after having a ventilator or other life support removed. Death isn’t usually instantaneous.
In fact, there were two prior occasions when the current hospital took him off the ventilator and it took nearly two weeks for him to deteriorate to the point they put him back on. I very much doubt any medical personnel expected him to expire immediately, that’s something coming from people outside the medical establishment. If the kid was brain dead yes, one would expect death to quickly occur but he’s not, he’s in a vegetative state with severe and irreversible brain damage. Such people can continue to breathe for quite some time on their own even if they are not optimally oxygenated and slow deterioration sets in.
My understanding (as always, subject to change with more information) is that Adler Hey wants to withdraw all life support, which will lead to death relatively quickly (but not instantaneously). Bambino Gesu will maintain life support, which could lead to Alfie living years in a vegetative state until something carries him off (most likely is pneumonia, but it could be some other infection).
Not exactly – the Italian hopsital Bambino Gesu has offered to take him in, and it’s a Catholic owned and run hospital so very pro-life. However – and this is important – Bambino Gesu has NOT offered a cure, it has only said that it will maintain him on life support. That’s it.
The family lives in the UK and don’t pay a dime out of pocket for health care. He’s on the NHS. On top of that, anything not covered by the NHS (such as air ambulance to Italy) has droves of donors lining up to give money. Financial considerations are not a factor here.
As I understand it, the rationale of the NHS (NOT the UK government) is that Alfie is never going to get better than he is right at this moment, and in fact can only get worse, and prolonging his life is now pointless. The rationale of Bambino Gesu (which is the Catholic Church’s institution, NOT the government of Italy) is that the boy is alive and should be kept alive on moral principles.
I don’t know for sure because I don’t know the details of the case, but having dealt with a number of terminal relatives it is NOT always possible to have a humane death at home.
And the hospital IS treating him – they are giving him what is known as “palliative care” which is where every possible treatment/procedure is scrutinized and only those providing comfort are given. What, exactly, those are is going to vary from patient to patient. It can range from stripping all machines and IV’s off the patient and just making sure they’re turned often enough not to have bedsores to extensive surgery and/or machinery if that relieves pain. Unfortunately, due to medical ignorance, a lot of people see palliative care as “giving up” and “not treating”. Such people, in the name of relieving suffering, might actually wind up causing it. This is why medical treatment decisions are made by, you know, actual medical personnel and ethics committees rather than public vote.
Nice slap in the face to every hospice worker ever. Also a nice slap in the face to palliative care specialists. What, you think having a tube down your throat while you’re on a ventilator is painless? Only if the person is drugged unconscious, otherwise it’s endless gagging – what, you think that’s reducing suffering? That’s why people who have to be permanently on ventilator get tracheostomies – because having a hole cut in your throat is less horrible than having that tube down your throat.
Your letting your emotions run away with you rather than looking at this rationally.
That is called murder. Doctors are not in the murder business. Again, I think you’re letting your emotions run away with you.
Please provide evidence that Adler Hey has tried to actively kill Alfie Evans. Please. I eagerly await your evidence.
I DO think the parents are in denial but that’s OK – under the circumstances denial is a perfectly normal reaction for the parents to have. What makes me want to vomit are the protesters hijacking this tragedy for their own agenda who don’t give a damn how many other people become collateral damage in their crusade.
But Shiavo’s parents were NOT OK with it, were in deep denial, and that’s why it wound up in the courts. And, again, outsiders hijacked the tragedy to promote their own agenda and damn anyone else hurt by them.
No, I don’t know what’s best for the kid – that’s why I’m happy to let medical personnel who actually know the facts to make that decision. Even the hospital willing to take him in, Bambino Gesu, is only offering palliative care (just that they’re more likely to be more aggressive at maintaining life – how much or how little to intervene at the end of life is open to some differences of opinion).
Because the hospital in Italy is only offering palliative care – their experts don’t think there is anything else to do, either, other than ease the boy’s final days. NO ONE with medical training is expecting this kid to do anything other than deteriorate with time. He has extensive brain damage and that is not fixable. His brain will not spontaneously regrow. Given that Bambino Gesu is a Catholic institution they’ll probably pray for a miracle, that’s the only difference.
He’s not “failing to die”. Dying can take a surprisingly long time, that’s all. Of course his parents don’t want him to die, but there’s nothing humanity can do to prevent that, at most it can only be delayed.
That’s your opinion and it’s pretty obvious to me you’re no doctor. People who are in their final days often do not feel hunger – everything is failing, including mechanisms that regulate hunger, thirst, and other basic body processes. As I have said, I have been present for the final days of several people, including some still capable of speech very near the end, and they all stopped being hungry days before they finally died. It’s actually pretty common for the dying to stop wanting food. It’s not so much “depriving” someone of food as not jabbing tubes into people to pump them full of food whether they’re hungry or not.
On this we agree – in my case, I think that there is so much brain damage the boy is not capable of suffering and if it would help the parents’ then send him to Italy. His parents are the ones suffering at this point, and if taking the boy to Italy makes them believe everything is truly being done and that helps them then so be it.
And here we disagree – I think false hope is exceedingly cruel.
^ This. The really horrible people here are those hijacking the Evans family for their own purposes.
Wow. I don’t even have kids and I find that cold bordering on cruel. Telling someone who’s kid died “you’re young, you can have another” is NOT helpful. People are not replacable.
Ashtura, you’re really having problems with this, aren’t you?
It’s actually unlikely that he’d die on the way to Italy, especially since there’s no life support equipment he was on that couldn’t travel with him or be provided on an air ambulance.
As I said, the kid could linger for awhile. I wouldn’t assume he’s got only “hours” left, there’s no way for any of us to know that. And no, it’s not an “organ donor thing”, it’s a disagreement about whether or not the kid is dying with the medical people saying “yes he is” and his parents, backed by a bunch of people who can not possible have access to all the facts, saying “no he is not”.
From a BBC report:
So, what the comes down to is that Catholic guys are proposing a trachostomy for long-term ventilation and a feeding tube into the stomach to keep Alfie’s body alive and the UK folks are recommending against that because those interventions have side effects and problems, too. NO ONE is saying this kid is going to get better. Bambino Gesu is advocating performing a couple of surgeries on this kid, none of which will cure him or make him better, and Adler Hey is saying let’s stop performing procedures on the kid and let him die. (NOT actively kill him, or let him suffer)
It may sound contradictory, but I think that the government taking control of these situations away from the parents, is actually highly beneficial to the parents as well. If the child dies according to the orders of the state, then it is the states responsibility. The parents may feel anger towards the state, but it is literally the case that there is nothing they could have done to save their child. If the parents take over his care, then they also take over the responsibility for his fate. Again, the child is going to die and there is nothing that they could do about it, but when he dies they will regret that they should have done more. If only they had sold off their 401K (or British equivalent) they could have gotten him better care. Surely they don’t need their car. Is a car more valuable than their child’s life? and even if they bankrupt themselves going to all of the best doctors in Italy, when he dies they may wonder whether maybe if instead of going to Italy they had tried taking him to a healing Shaman in Africa. What if we had …
Having someone who can firmly say to them, “You have done all you can, there is nothing more you can do, it is out of your hands now” is actually a great kindness.
Okay, he’s not suffering. So send him to Italy. We agree on this, maybe? They’re happy to take him and any expense. If I wanted to send my non-suffering to child to Italy, I could send him to Italy. At this point it’s not about the kid, it’s about parental rights in regard to their child. There is nothing inherently cruel about sending a non suffering person to Italy.
Shut up? Seriously?
I am not accusing anyone of murder. You have already established, in your first point, that Alfie not suffering. Therefore, no quick kill is necessary. I’m pro-euthanasia, when there is actual irreversible, hopeless, suffering going on. A death that takes minutes, not hours. That’s not murder, and any place that defines it as such, needs to reevaluate.
There isn’t any suffering, so that’s a moot point.
Thank you to everyone who has responded on the thread. Now that I understand more about the case, I understand the decision. I must admit that I have a gut reaction, perhaps similar to RickJay’s, that the State should not be interfering but I also acknowledge this is hypocritical. For example, were Alfie a boy with cancer who was being denied medical treatment by his parents, I would expect the State to step in.
I also believe that the bone-deep need to save children at all costs comes to play in situations like this. It’s irrational, but instinctual, and hard to step back from. I admire the court’s compassion in dealing with the father. It’s a horrible situation all around.
Oh, yes, I already stated that. I feel that right now the people most in need of compassion and relief of suffering are his parents. I see no harm in having Alfie end his days in Italy rather than the UK.
From my viewpoint, actively causing the death of another human being is murder, so, from my viewpoint you are advocating murder. I understand that you feel differently, but I continue to disagree with you.
I’m anti-euthanasia and there are damn few instances where suffering can’t be alleviated even if the underlying cause(s) can’t be fixed.
Doing something that actively promotes death is murder for many and is, in fact, a fear of apparently both the Evans family and some of the “Alfie’s Army”, all of whom are also anti-euthanasia.
When you advocate active euthanasia you are actually advocating something contrary to the wishes of the Evans family and something they fear may occur so I don’t see where that’s helpful.
IF Alfie is incapable of suffering (let’s presume that’s the case) then it doesn’t matter how long his body keeps going. If euthanasia is going to traumatize his parents then I have to oppose it on the basis it would cause suffering, not prevent it (aside from the fact that I’m anti-euthanasia on moral grounds and consider it murder).
On the subject of euthanasia - I might, very very reluctantly, tolerate it (not be OK with it, not advocate it, just tolerate it) if any adult of sound mind made it very clear in advance (probably in a legal document of some sort) that under X circumstance they want their life terminated if there is no hope of recovery. But Alfie has never been and never will be such a person.
I don’t think he should be euthanized by judge edict. I think it should be an option for the parents to consent to. One, that, obviously, they would not take. Alfie cannot consent, and he could not consent even if he had a functioning brain, which he doesn’t. So if the parents were okay with it, I’d be okay with it, and I’d be especially okay with it if there was demonstrable evidence that Alfie was experiencing suffering. If they opted to take him to Italy, I’d respect that too.
And I’d be happy to agree to disagree with you on the topic of euthanasia. Obviously that’s a controversial subject. I didn’t really have a problem with the Schaivo case, because the next of kin (the husband) consented. The parents weren’t the next of kin, so while I sympathize with them, it was not their call to make. It also is an excellent example of why one should have a living will.
I would have preferred a quicker death for her than removing the feeding tube and having her starve to death over the course of two weeks. I know “starving to death” sounds emotional and makes people feel uncomfortable and maybe makes the caregivers look bad when they shouldn’t, but let’s not mince words - that’s what happened.
The fact that there are people out there being assholes about this, Christian or not, sucks, but that is a separate issue. I think he should be allowed to go to Italy, even if none of that was occurring.
I think Shodan is spot on. The parents are in denial. I’d be all in favor of letting the kid die at home if that’s what the family wants. Still, if they’re hell bent on spending their money on a desperate trip to Italy, I don’t see why that should be denied.
I’m interested as to whether this would go down any differently in the US. Wouldn’t the courts step in to if they thought the parents were prolonging the suffering of their kid?
Just to point out everyone, money is no object here. His care isn’t costing his parents a penny and it never does. Should he be able to travel to Italy that would not cost them anything either. At least that complicating factor plays no part in this.
This case is a little different, in that nobody stopped them from taking the child to Central America. The UK won’t allow this, and this is where I think they are overreaching.
Jahi McMath. Only in this case, she has been declared legally dead, as she’s completely brain dead. Her family, however, refuses to accept it, and for about five years now, has had her on “life support”.
(And from what I can see, after reading various news articles AND her mother’s own social media accounts, they’re a real bunch of assholes too. So, mind you, I’m not just pulling that from rumors on the internet. The woman has demonstrated that behavior first hand.)
Starving to death generally takes longer than two weeks even for an active person, I doubt lack of food was the primary cause of death for Schiavo.
Yes, but as I noted for people very near the end of life, particularly those with extensive brain damage there is no perception of hunger or thirst and therefore no suffering.
Again, I agree - I see no harm occurring by him going to Italy and it may help his parents.
Perhaps, but I think the US courts would be more inclined to let the parents move the child to another facility that was willing to take on long-term care/life support of such a patient.
UPDATE
BBC news: Alfie passed away in the early hours. RIP
My sympathies to Alfie’s family.
I hope the disreputable band that built up around them melts away and their better friends and family give them the support they need.
An article in the Guardianthis morning gives more information on the characters who are seeking to politicise this and it doesn’t make palatable reading. As you’d imagine, religious and pro-life nutjobs abound.
Hi, religious nut job here.
I am not a doctor and I have no standing to say whether there were any viable treatments that might have helped Alfie Evans. Perhaps he was doomed all along, and nothing was likely to have helped.
If that’s the case, I have no principled objection to the National Health Service making the tough decision to stop paying for futile treatments.
That sound reasonable? Can we all agree at this point? Good.
BUT… even though the NHS had a right to say they wouldn’t pay for experimental or extreme treatments they thought were unlikely to work, they had NO right to take Alfie from his parents. They had NO right to declare that his parents couldn’t seek treatment elsewhere. They had NO right to post armed guards at the hospital to keep his parents from whisking Alfie off to Italy. Letting Alfie die might have been the right decision, but it wasn’t the British government’s decision to make. It was his parents’ decision.
What the British government did was disgusting. It was evil. It was fascistic. And if you don’t see that, there’s something wrong with you.
And don’t you dare laugh next time Sarah Palin warns about “death panels.”
Hello, pleased to meet you, Pagan whacko here. Welcome to the argument. 
The issue wasn’t “extreme” or “experimental” treatments but rather life-sustaining treatments. Had Alfie had a trachesotomy and a feeding tube, as apparently Bambino Gesu was proposing, his body might have been maintained for years (or died very soon, it’s a bit of a crapshoot). When Adler Hey decided they no longer wanted to provide life support I think they should have let Alfie be transported to Bambino Gesu in accordance with his parents’ wishes.
BTW - the armed guards were at least as much to protest staff and other patients at Adler Hey as to prevent the “abduction” of Alfie. Hospital staff have been subjected to threats, and protesters had been blocking both parents of other patients and patients from trying to get into the hospital. That is wrong, and shows how morally bankrupt many of “Alfie’s army” were - in an attempt to push their agenda they were willing to jeopardize other people - patients, staff, and relatives. That is also wrong and evil.
We have death panels in the US, too - they’re called insurance companies. Instead of the government or the medical industry making these decisions we have bean counters in private companies doing it.
This will end well
Correct, correct and correct. Read the court transcripts to bring yourself right up to speed.
“Paying” for anything was not and is not the point. Cost was not a factor at all. Why even bring it up unless you want to paint the NHS clinicians as penny-pinching misers.
about the payment? no we don’t agree.
at the risk of repeating myself stop with the cost shtick
read the transcripts
read the transcripts
cite?
It wasn’t the government it was an independent judiciary on the advice of medical and ethical experts. Read the transcripts. And no, the law can and should step in to act behalf of individuals unable to speak for themselves, regardless of what relatives say. The legal process in this case was centred completely on what was best for Alfie and balancing that with the needs of the family.
The government played no part in this decision. Read the transcripts. “evil and fascistic”? bullshit.
We don’t have death panels, The USA most certainly does have something far closer to that. You’ll note, once again I’ll say it, that cost played no part in this…none. nada, zip, zilch. As terrible as it is, the only thing his family had to worry about was Alfies pain and suffering. How much more evil would the system be if they knew that they were going to be homeless and penniless at the end of it all?
That is factually wrong, as the court cases showed. Maybe you think it should be the right of the parents, but it isn’t.
I would say that, ultimately, the main point of having a government - indeed, the main point of having a society - is to protect those too weak to protect themselves. That includes protecting children from their parents when the parents would do them harm. Parents do not own their children and have unlimited rights over them, and neither should they.
Alfie’s case was exhaustively investigated from a legal, medical, and moral perspective, and it was clear that there was no possibility of treatment, and the correct course of action was to let him die.