Viability

The recent news involving President Trump and the Pope raise questions not often discussed in the popular media. What are the relevant ethics around preserving life? For the Pope this is no surprise, for President Trump it might be a bit out of character.

This controversy involves a British couple whose infant son was born with a rare genetic disorder where the child cannot move or produce enough energy to keep his own organs functioning. Fifty years ago, the child would have simply gotten weaker and weaker, and died a natural death. Today, doctors have advanced diagnosis techniques and have managed to keep the child alive using heroic means (life support and special feeding). Without these measures doctors say the child would have died.

In the case of this infant with a “un-curable”genetic order, the hospital’s argument is somewhat different. The hospital contends the child’s situation is hopeless and continued heroic efforts, in essence, will be both fruitless and take medical resources away from other sick patients who could use them. In other words, the ethics of continuing heroic efforts is “unethical” towards others. Why, because the patient’s life is not viable on its own and continued medical care is highly unlikely to change the condition.

Oddly President Trump and the Pope have offered help to keep the infant alive.

Many of us are familiar with certain religions who argue that all efforts should be employed to keep life going, and less frequently, others which do not believe in medical healing, let alone heroic measures. For these latter religions, prayer alone is enough.

Consequently hospitals often have to go into court seeking the right to proceed with life saving treatments which the individual or his/her guardian has opposed. The hospital argues that science and medical ethics compels them to seek court approval to treat.

In general, this type of medical situations bring out advocates on both sides. IMO, those choosing no medical intervention, for example for themselves, when making an informed decision, are on ethically sound footing. Those choosing to deny (or employ) medical methods for others, however, must be viewed cautiously around what right do they have to intercede.

In the case of the British child, the Hospital seems on sound grounds to deny continued heroic efforts but why should the parents not be able to seek heroic methods from other sources? Hmmm.

One way to resolve this dilemma is to ask, will the child’s life meet a “viability” standard, that is, could the child now, or in the foreseeable future, be able to live without heroic measures? If the answer is no, then the hospital should be completely in the clear to deny heroic measures. But does it follow that the parents are free seek other hospitals to take over?

The simple answer should be, yes they should be able since they are the guardians. But, as humans, the “viability” ethic standard ought to apply to them too.

Unless the State steps in and makes the calculated decision that parents have no right to use limited resources, namely heroic medical care, especially if there is no hope of attaining viability, then a dependent child is subject to what ever the society (family, local government, or higher government unit) decides.   Politics could be a real factor.

Love and blind hope are powerful stimulants.  The British parents are holding out against the odds that their child might be saved.  And, who knows, maybe a cure might be found.  But the odds do not support this hope.  In a world of limited resources, both the seeker and those provided with life saving resources must consider where these resources will be most productive.

President Trump is most likely looking for a positive reaction from his supporters and nothing more.  The Pope is most likely motivated by his religious beliefs but may also want to send a dogmatic statement about life in general.  Economics, which are inescapable, sends the warning of how important it is too allocate scarce resource.

Hmmm.

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