I wonder who paid this newspaper off.

[YewNork]

So, a conservative British newspaper decides to publish a story about a child who died in the UK in October 2008, on the same day that
Obama is going to address Congress and the nation on health reform.

The child was born premature, at 21 weeks and 5 days into the mother's pregnancy. The mother asked that the child be put into the hospital's
neo-natal unit and the doctors refused on the basis that bioethical guidelines in Britain state that no intensive care should never be given to babies
below 22 weeks gestation, and rarely to those below 23 weeks. And because of this, the baby was allowed to die. There's no published input from
the doctors or any other information what else might have led the doctors to come to to this decision.

But, I've got a few comments to make:

First is my absolute sadness that any child born shouldn't at least be given the chance to live. They should have at least attempted to keep the child alive and done whatever was necessary to do this.

Second, however, is the fact that the article doesn't mention that these are medical guidelines, not unbreakable laws or rules. It also does not mention that these guidelines were not
established or put in place by Britain's National Health Service. They were created by the Nuffield Council on Bioethics, an independent body not associated with or funded by the
government. This child was not refused treatment due to any government decision or policy. The guidelines were further confirmed by the British Association of Perinatal Medicine,
another independent group, not associated with the National Health Service. The guidelines are not compulsory but most of all, they have nothing to do with the government - they're
established by doctors for doctors. The doctors could have chosen to put the child into intensive care, without any comment from the National Health Service.

Lastly, it's coincidental that a conservative British newspaper decides to to publish an eleven month old story on the same day that Obama is going to speak about health reform, isn't it.

[hedgehog]

1. Another story about the same case:

http://www.dailymail.co.uk/news/article-1211950/Premature-baby-left-die-doctors-mother-gives-birth-just-days-22-week-care-limit.html

Something is off here - this woman is 23, has a 5 year old daughter and had 5 previous miscarriages before she lost this child. That suggests to me five pregnancies between the ages of 18 and 22, all ending in miscarriage. When I had a second miscarriage, I was told to wait six months before attempting to get pregnant again, and I had testing done before I was given a go ahead. This was over 20 years ago. I have to believe this woman is ignoring medical advice and then blaming others when things go bad.

That said, note the quote from the second newspaper story:

"Medical experts say babies born before 23 weeks are simply too under-developed to survive, and that to use aggressive treatment methods would only prolong their suffering, or inflict pain."



All of medicine is based on making the best guess as to probable outcome. The odds were overwhelming that the kindest thing to do for the child was to let nature take its course. The choice wasn't between letting the child die or trying to save him, the choice was to let him die peacefully or after days or weeks of medical torture.

[YewNork]

3. But that's not how it's being presented, of course

Opponents of reform are all talking about how the rules of Britain's government run health care system refused to treat that child.

What they're not mentioning is that they were bioethical guidelines not rules and they were not set up by the British National Health service, but
rather by independent medical groups not associated with the government or the NHS.

Additionally, I can't see any doctor in the US flatly refusing to treat such a child if the parent requested it, without leaving himself open to a lawsuit.

Doctors in the US have said that if someone came into their office with a headache and said that they wanted an MRI, the doctor would order an MRI,
even if he knew that an MRI was not needed, just to protect himself from being sued.

Conservatives are all saying that they want Tort reform to be done as part of medical reform. Do they realize that if patients can no longer sue
a doctor at the drop of a hat then the doctors might start denying them treatments that the doctors feel are unnecessary?

[damntexdem]

2. At less than 22 weeks, the brain may not have started functioning.

There likely was no there there.

[elfrangel]

4. I work in a Neonatal Intensive Care Unit here in the states

When you consider that our survival rate for 23 week gestation preemies is somewhere in the 80th percentile. We are making great advances in prolonging life for premature infants. The fact that these babies are able to continue on and have productive somewhat healthy lives is amazing!

The odds of being able to successfully sustain life prior to 23 weeks is low. The policy at my hospital is to not intubate preemies less than 22 weeks gestation. This means inevitable death b/c they do not have the lung function to survive. According to studies, the infant mortality rate at 22 weeks is 98 - 100%. 94% having passed within 4 hours of birth. {http://fn.bmjjournals.com/cgi/content/abstract/88/3/F199 & http://www.statistics.gov.uk/pdfdir/hsqsb0509.pdf}

This infant was not going to live, and even if it had, the child would have had severe health complications. I hesitate to use the word kind in this - no one wants to lose a child. Ultimately, this babe's chances were slim for survival - even with the best of care provided.

[hedgehog]

5. What is hard to fathom is that the infant is still developing at an incredible rate

at this age. There is a significant difference between 22 weeks, 23 weeks, 24 weeks etc. What seems to be an arbitrary cut-off date is based on hard won experience.

[elfrangel]

7. Exactly so...eom

[LeftishBrit]

6. Both newspapers are very RW...

The story is very misleading, as the policy of not treating a baby born before 22 weeks is not restricted to the UK. Babies born that early don't just have a poor chance of survival, but virtually no chance. Their lungs have not developed to a point where they can survive even on a ventilator. Few babies even survive before 23 weeks, and those who do are usually girls: the fact that the baby in this story was a boy made the prognosis even more hopeless. All that treatment might do is prolong the suffering for a little while.

To the best of my knowledge, a baby born before 22 weeks would not receive intensive treatment in *any* country, unless there was some doubt about whether the dates were correct - or unless, to put it bluntly, the baby was being subjected to a medical experiment.

The grief-stricken parents were understandably trying to find some explanation for their baby's death, and the right-wing press were IMO exploiting their grief.

[YewNork]

8. Plus, the government did not make a decision that this child should die.

Of course, the Conservative opposition in the US are all playing it up as being a policy of Britain's Government Run health system that dictated that the child not receive treatment,
when in fact the doctor's made their decision based on independent bioethical guidelines.