A Case Of Life Or Death In A Texas Hospital.

MayorBob.

Posted to SciTech on Tue Apr 10, 2007 at 08:20:24 AM EST (promoted by port1080). RSS.

By the time you read this story, Emilio Gonzales' life may be over. He is currently attached to a respirator which doctors and the hospital want to turn off. His mother Catarina Gonzales doesn't want that to happen but she's up against the medical community which has pronounced Emilio's situation "futile" and a Texas law which gives them the right to turn off the switch. Since early last month Catarina has been in pitched battle with the hospital and doctors intent on removing Emilio from life support.

16-month-old Emilio is the only child of the 23-year-old Lockhart, Texas woman. Ms. Gonzales says that, due to complications from delivering Emilio, she is not likely to have any other children. Emilio was diagnosed with Leigh's disease, a "rare inherited neurometabolic disorder" with no known cure. At most, Emilio could only look forward to another decade of life but, in all likelihood, will be dead before he reaches the age of seven. For the past few months, Emilio has remained alive hooked up to a respirator at Brackenridge Hospital in Austin, Texas. Gonzales believes that part of the reason Emilio is in a coma is because the doctors took him off his thiamine medicine. She contends that her son remains communicative with her at times. The doctors disagree and have pronounced his condition "medically futile."

What that diagnosis means is that under the Texas Advance Directives Act (pdf doc), the hospital gives Ms. Gonzales ten days to find another facility to place Emilio or his respirator gets turned off. The hospital says it has tried to find another place for him in Texas without any luck. According to Elizabeth Graham, director of Texas Right To Life, if Brackenridge would perform a tracheotomy and fit Emilio with a feeding tube, he would be eligible for a long term pediatric facility. The hospital has refused to do this.

Gonzales, represented by lawyers from the Alliance Defense Fund (ADF), filed a complaint (pdf doc) in federal court on April 4th. It sought to have the hospitals keep Emilio on life support and rule the Texas law unconstitutional. She got an answer back very quickly on all counts - no. Gonzales now has until April 10th to find a new facility to house Emilio before the doctors at Brackenridge pull the plug on him.

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Tags: edited by Port1080, written by MayorBob, medicine, kids, death, legal (all tags)

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1	Let the kid die, already. gerrymander. Tue Apr 10, 2007 at 10:34:57 AM EST 5.00 (astute)

Emilio Gonzales was dealt a poor genetic hand, and that sucks. In addition, it's a poor genetic hand which medicine isn't yet advanced enough to treat, and that sucks more. But let's review what his existence would be like, were it to continue:

In most children, the first signs may be poor sucking ability and loss of head control and motor skills. These symptoms may be accompanied by loss of appetite, vomiting, irritability, continuous crying, and seizures. As the disorder progresses, symptoms may also include generalized weakness, lack of muscle tone, and episodes of lactic acidosis, which can lead to impairment of respiratory and kidney function. Heart problems may also occur.

In other words, a short life of constant misery and pain.

This is a case where the mother's desires are clearly against what is best for the child. The hospital made the right choice. Let Emilio die.

2 1	Re: Let the kid die, already. pO157. Tue Apr 10, 2007 at 11:51:41 AM EST 5.00 (interesting)

I just wonder what would happen under this Texas law if the person in question was an 86 year old with a history of heart problems (or some chronic illness) that caused him to be stuck on a ventilator indefinitely in a vegetative state. Would that (something I would imagine is more common than a child born with an obscure but horrific illness) change the situation?

3 1	Re: Let the kid die, already. wetkarma. Tue Apr 10, 2007 at 01:45:08 PM EST none

This is a case where the mother's desires are clearly against what is best for the child. The hospital made the right choice. Let Emilio die.

Gerry,
I disagree.

I am very, very, very suspicious of any sort of framework (which you seem to be advocating) that would allow the state to euthanize anyone against the interest of their guardian. The presumption should always be that the guardian knows whats best for the kid, and that presumption should rarely be set aside.

Don't get me wrong -- I'm fine with killing the kid. But his quality of life is not the issue here. If as a parent my kid is in the same position and I want to spend millions of my money per year in keeping him alive -- that should be my option. First and foremost my desires direct what is in the kids best interest because I am the guardian. To put it in stark terms -- I should have the right to have a kid even if neonatal tests show that it will be born with down syndrome. [Correspondingly I as the parent should have the say in aborting].

This case is about how state medical resources are to be effectively allocated, and should not be confused with whether the state knows what is best for the kid more than the parent. If the state is to help out in medical cases, then the state (with limited resources) needs to do a cost/benefit analysis to see whether treatment is going to be effective. We can't spent millions on every kid no matter what John Edwards might tell us.

If the woman had the cash, she should be allowed the opportunity to keep her kid alive because she presumptively knows whats best for the kid. I see nothing in this case which shows that the state knows (more so than the parent) what the best course of action to take on this kid.

Memory is a strange bell, jubilee and knell.

4 3	Re: Let the kid die, already. thefadd. Tue Apr 10, 2007 at 02:18:02 PM EST none

Since she doesn't have the money, what are you saying, then?

escalators never fail; they just become stairs

6 4	Re: Let the kid die, already. wetkarma. Tue Apr 10, 2007 at 03:33:44 PM EST none

I'm saying its because she doesn't have the money that the state gets to kill the kid and NOT because the state knows better whats for the kid.

Memory is a strange bell, jubilee and knell.

8 6	Re: Let the kid die, already. ms sue. Tue Apr 10, 2007 at 05:30:35 PM EST none

Would you hold the same opinion if you had limited resources and a child of your own in this or a similar situation?

9 8	Re: Let the kid die, already. thefadd. Tue Apr 10, 2007 at 08:41:27 PM EST none

I wouldn't expect him or anyone else to. But that's why it's not an individual's decision.

escalators never fail; they just become stairs

10 9	Re: Let the kid die, already. ms sue. Tue Apr 10, 2007 at 09:06:01 PM EST none

Oh, but it is an individual's decision, if that individual has the financial means to back it up.

10

Re: Let the kid die, already.

thefadd.

Wed Apr 11, 2007 at 12:30:06 PM EST

none

When you have more money, you have more options open to you. That is a cold, bare fact of existence. Even the most communist country which promises unlimited equal healthcare to all would, at some point, have to decide they couldn't put anymore money into it and pull the plug. But an individual of immense wealth would have the option of pouring the entirety of their wealth into it. So, yes.

escalators never fail; they just become stairs

11 8	Re: Let the kid die, already. wetkarma. Wed Apr 11, 2007 at 08:39:37 AM EST none

Would you hold the same opinion if you had limited resources and a child of your own in this or a similar situation?

Hi Ms Sue,
I think that if this particular kid were my child, I'd probably 'pull the plug' based on a) the lack of viable long term options and b) the age of the kid (a few weeks old) i.e. I have less of a strong connection.

However this is not what you are really asking ..I suspect what you are asking is if when I'm vested, when its my 1 year old baby (lets say) or my wife would I hold the same opinion? And the answer of course is fuck no. Were I in that position, it would no longer be a policy opinion, it would be -personal-. It would be about me and what was best for me. If society has to suffer, then to hell with society. I'd move heaven and earth to ensure that every possible option was exhausted and only when I was convinced (Terry Schiavo style) that the person was truly gone and only the body remain...only then would I -begin- to entertain the option of ceasing my efforts.

This is the sort of "what would you do if someone raped your X" question people against capital punishment tend to receive. My answer is the same as theirs -- what I would do out of emotion and desperation, is starkly different from what a society should do out of a sense of fairness and justice.

We don't build our justice system around the urge to vengeance and rage, we shouldn't build social medical care around emotional arguments either.

Memory is a strange bell, jubilee and knell.

11

Re: Let the kid die, already.

ms sue.

Wed Apr 11, 2007 at 09:37:32 AM EST

none

We don't build our justice system around the urge to vengeance and rage, we shouldn't build social medical care around emotional arguments either.

I absolutely agree. But I guess my concern was more with the financial disparity in your comment. I have no solution to that, but it bothers me greatly.

5 3	Re: Let the kid die, already. gerrymander. Tue Apr 10, 2007 at 03:32:44 PM EST none

I don't think we're disagreeing much here, wetkarma. I would also distrust euthanasia decisions being made without a guardian's consent, but that's not the case here. (I don't consider withholding expensive life-extension medical assistance from certainly-terminal disease patients to be the same as active steps to kill.)

Likewise, I agree in principle (and apart from ethical decisions I might personally make) that a guardian who wants to continue expensive medical treatment, on their dime, for someone in their care should be allowed to do so. But as you note, that's not a concern here.

The one point I would contend with is where you claim quality of life isn't an issue. I can't see how any decision made by a state authority to allocate limited medical resources would be able to isolate the question to exclude quality fo life as a factor.

7 5	Re: Let the kid die, already. wetkarma. Tue Apr 10, 2007 at 03:48:08 PM EST none

Certainly the state can (and should) use whatever factors it feels are relevant in its cost/benefit analysis. However at the end of the day its still a cost/benefit analysis grounded in state interest and NOT in the interest of whats best for the child.

I don't object to the state using quality of life as a factor in making its decision, I object to the idea that the mother's desire to keep the kid alive is "clearly against what is best for the child". I don't see where thats true and I think if we start superceding the decisions of the guardian on the basis that the state has a "greater best interest" in the kid, we lead ourselves into a fascist dystopia.

Memory is a strange bell, jubilee and knell.

This story: 13 comments (3 from subqueue)

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MayorBob.

Posted to SciTech on Tue Apr 10, 2007 at 08:20:24 AM EST (promoted by port1080). RSS.

Let the kid die, already.

gerrymander.

Tue Apr 10, 2007 at 10:34:57 AM EST

5.00 (astute)

1

Re: Let the kid die, already.

pO157.

Tue Apr 10, 2007 at 11:51:41 AM EST

5.00 (interesting)

1

Re: Let the kid die, already.

wetkarma.

Tue Apr 10, 2007 at 01:45:08 PM EST

3

Re: Let the kid die, already.

thefadd.

Tue Apr 10, 2007 at 02:18:02 PM EST

4

Re: Let the kid die, already.

wetkarma.

Tue Apr 10, 2007 at 03:33:44 PM EST

6

Re: Let the kid die, already.

ms sue.

Tue Apr 10, 2007 at 05:30:35 PM EST

8

Re: Let the kid die, already.

thefadd.

Tue Apr 10, 2007 at 08:41:27 PM EST

9

Re: Let the kid die, already.

ms sue.

Tue Apr 10, 2007 at 09:06:01 PM EST

10

Re: Let the kid die, already.

thefadd.

Wed Apr 11, 2007 at 12:30:06 PM EST

8

Re: Let the kid die, already.

wetkarma.

Wed Apr 11, 2007 at 08:39:37 AM EST

11

Re: Let the kid die, already.

ms sue.

Wed Apr 11, 2007 at 09:37:32 AM EST

3

Re: Let the kid die, already.

gerrymander.

Tue Apr 10, 2007 at 03:32:44 PM EST

5

Re: Let the kid die, already.

wetkarma.

Tue Apr 10, 2007 at 03:48:08 PM EST