Clinicaly dead pregnant woman on life support

conorh91

ProfessorPlum wrote: »

The point is that this child has about as much chance as a snowball in a very fiery place of 'making it'.

If that's the case, the courts will allow the artificial ventilation to be removed, and recognize the right to a dignified death (of the foetus) as they have done in the past in other cases.

But I think you're exaggerating the statistical likelihood of viability there. I guess we'll find out after the substantive hearing when the medical evidence is produced.

Sugar Thief

Shrap wrote: »

That was not an argument. That was a fact.

If your argument for compelling all pregnant women to remain pregnant against their will is that Ireland has a shortage of young people (most of whom have moved to Oz or Canada due to the shortage of opportunities for them here), then I consider that to be a very stupid argument also.

No one said all pregnant women, din'the put words in people'say mouths.

ProfessorPlum

conorh91 wrote: »

Says who?

Jurisprudence on the right to life of the unborn did not begin in 1983.

1983 elevated and clarified the foetal right to life. But it existed prior to that.

Every lawyer in the country is familiar with McGee v AG [1974] and G v An Bord Uachtala [1980], and the lawyers advising the HSE most certainly are too.

Like I already said, beaumont hospital and the HSE.

Decisions are made every hour of every day to discontinue medical treatment and allow people - both adults and children to die. Despite their protection of their right to life.
It is the 8th amendment that is the cause for the current debate. If this was a born child with such a pesimistic prognosis, there would be no issue in allowing treatment to be withdrawn.

BarneyThomas

ProfessorPlum wrote: »

The point is that this child has about as much chance as a snowball in a very fiery place of 'making it'. Everyday that the mothers body is kept oxygenated and perfused is using a very valuable resource in our over stretched health system. Because of this, people who require that ICU bed are having their surgery cancelled. The rather conservative estimate of €2,500 a day that it costs to fund this care (and that is for the basics, not including treating the inevitable complications that have and will arise) could be better spent on care for others. We are not living in a vacuum. What we allocate to this situation, we are taking from another.

I know exactly what chance the child has of making it. Because of my job, probably more than many here do i would think.

I know how the medical system works, and I know what the need is and I know that the equipment that is used is part of a set which is not near 100% capacity at the moment.

I also know that one phonecall (i could make it myself even) will bring in that exact same equipment from elsewhere should the need for the current equipment in use arise elsewhere.

So your argument about bed-blocking and holding equipment back from others is smoke and mirrors.

Shrap

BarneyThomas wrote: »

But I can see why you might to be fair. Because you will be one of those who comes out the other end of this who will have to try to forgive themselves when they look at hopefully a healthy child.

Gosh, I'm glad you can see into my future emotional state better than myself. How will I even live with myself when I will see the happy product of an enforced pregnancy bouncing around in state care (Ms. Y, anyone?)? You can't have any idea how bloody angry I am about the trauma that the 8th causes to people, but you are right - I should stop talking to muppets and let you off on your crusade.

What the clinically dead woman's family are going through NOW is awful enough without prolonging it. I do not have any sentimental attachment to anybody's foetus unless I know that they want it. Therefore, I would vote to follow this poor misfortunate family's wishes and let the doctors turn off the machines, letting the foetus die and them both to be buried.

I can't understand people who act like everyone should be imagining what all these little kiddies would be like if only they weren't killed off by flippant women having flippant abortions. Mental.

BarneyThomas

Shrap wrote: »

Gosh, I'm glad you can see into my future emotional state better than myself. How will I even live with myself when I will see the happy product of an enforced pregnancy bouncing around in state care (Ms. Y, anyone?)? You can't have any idea how bloody angry I am about the trauma that the 8th causes to people, but you are right - I should stop talking to muppets and let you off on your crusade.

What the clinically dead woman's family are going through NOW is awful enough without prolonging it. I do not have any sentimental attachment to anybody's foetus unless I know that they want it. Therefore, I would vote to follow this poor misfortunate family's wishes and let the doctors turn off the machines, letting the foetus die and them both to be buried.

I can't understand people who act like everyone should be imagining what all these little kiddies would be like if only they weren't killed off by flippant women having flippant abortions. Mental.

Sorry. Just saying what i see. You are very abusive, but i am just putting that down to your obviously emotional attachment to this situation. Nothing I havent seen before.

ProfessorPlum

conorh91 wrote: »

If that's the case, the courts will allow the artificial ventilation to be removed, and recognize the right to a dignified death (of the foetus) as they have done in the past in other cases.

But I think you're exaggerating the statistical likelihood of viability there. I guess we'll find out after the substantive hearing when the medical evidence is produced.

There is very little evidence in the medical literature to support anything other than a very poor outcome in cases similar to this, so no, I don't think I'm exaggerating. I would be confidant that the court will find that the means used here are extraordinary and exceed the 'as far as is practable' condition, and will allow the withdrawal of support.

conorh91

ProfessorPlum wrote: »

Like I already said, beaumont hospital and the HSE.

Link to their legal advice citing the lack of a right to life pre-1983 please?

Practicing lawyers do not brief their clients on legal history. The advices given to the HSE undoubtedly cite the elevation of the right to life that arose in the 1983 amendment, but would be unlikely to go into extraneous detail on whether there was a right to life prior to 1983.

It's an obscure fact of legal history I suppose. The unborn had a right to life prior to 1983, but it wasn't as strong as the right that was codified by the 8th amendment. There's no way the HSE's written legal advice would need to cite that, but it is relevant to the discussion of the 8th amendment here.

BarneyThomas

Shrap wrote: »

I can't understand people who act like everyone should be imagining what all these little kiddies would be like if only they weren't killed off by flippant women having flippant abortions. Mental.

Well it looks like the day might be coming where people dont have to "imagine" anymore.
They will be able to see a child and all the posts and articles on the web.
As I said. It will be powerful stuff.

Sugar Thief

Shrap wrote: »

Gosh, I'm glad you can see into my future emotional state better than myself. How will I even live with myself when I will see the happy product of an enforced pregnancy bouncing around in state care (Ms. Y, anyone?)? You can't have any idea how bloody angry I am about the trauma that the 8th causes to people, but you are right - I should stop talking to muppets and let you off on your crusade.

What the clinically dead woman's family are going through NOW is awful enough without prolonging it. I do not have any sentimental attachment to anybody's foetus unless I know that they want it. Therefore, I would vote to follow this poor misfortunate family's wishes and let the doctors turn off the machines, letting the foetus die and them both to be buried.

I can't understand people who act like everyone should be imagining what all these little kiddies would be like if only they weren't killed off by flippant women having flippant abortions. Mental.

You don't seem to believe the life of a foetus is very important, others do, I believe it's life is just as important as anyone else's.

conorh91

ProfessorPlum wrote: »

I would be confidant that the court will find that the means used here are extraordinary and exceed the 'as far as is practable' condition, and will allow the withdrawal of support.

Yes, if the medical evidence shows non-viability.

If the unborn is viable, there is clearly a right to life. That right does not compete with any other rights, since the dead cannot claim personal rights. There is no balancing act to be achieved, unlike classic 8th-amendment cases.

There is zero jurisprudence on the "as far as is practicable" test, so there is no way on earth anyone can claim to be "confident" of such a thing, unless they are bluffing.

Shrap

BarneyThomas wrote: »

Sorry. Just saying what i see. You are very abusive, but i am just putting that down to your obviously emotional attachment to this situation. Nothing I havent seen before.

Ah here. Abusive? Show me where I have been more abusive than your comment to me saying that you doubted I was concerned for that poor family's feelings at all. Take the log out of your own eye first before looking in mine.

ProfessorPlum

BarneyThomas wrote: »

I know exactly what chance the child has of making it. Because of my job, probably more than many here do i would think.

I know how the medical system works, and I know what the need is and I know that the equipment that is used is part of a set which is not near 100% capacity at the moment.

I also know that one phonecall (i could make it myself even) will bring in that exact same equipment from elsewhere should the need for the current equipment in use arise elsewhere.

So your argument about bed-blocking and holding equipment back from others is smoke and mirrors.

Please inform us all, with reference to current medical literature as to the likely outcome in this case.

ICU beds are an expensive resource in short supply. The college of anesthetists agree with me, so do the RCSI, so there's no smoke and mirrors. This treatment costs, is unlikely to have a positive outcome, and others not having needed treatments due to budget constraints.

Shrap

Sugar Thief wrote: »

You don't seem to believe the life of a foetus is very important, others do, I believe it's life is just as important as anyone else's.

Importance is relative. Before 3 months, so many pregnancies end in miscarriage that it should be clear to everybody that the undeveloped and unsentient foetus is only a potentially born human and is much more expendable naturally, never mind by choice, than all these folk wringing their hands about one minute foetus seem to think. Let it go, for the sake of this woman's family. You cannot save all the foetuses.

BarneyThomas

Theses are roughly the chances of survival for a premature birth

23 weeks 17%
24 weeks 39%
25 weeks 50%
26 weeks 80%
27 weeks 90%
28-31 weeks 90-95%
32-33 weeks 95%
34+ weeks 99%


When I first used to see babies born very prematurely it was a very low chance of survival even at 30 weeks.

Things have moved on. And the chances of severe disability are not near what they were then either.

It has not yet been decided what stage this child is to be born at (if it even makes it that far), so its impossible at this stage to give any odds on any outcome.
Anyone who tries to is just blowing smoke.

BarneyThomas

Shrap wrote: »

Ah here. Abusive? Show me where I have been more abusive than your comment to me saying that you doubted I was concerned for that poor family's feelings at all. Take the log out of your own eye first before looking in mine.

If I upset you so much just click the ignore button on me. Id prefer that tbh.

Sugar Thief

Shrap wrote: »

Importance is relative. Before 3 months, so many pregnancies end in miscarriage that it should be clear to everybody that the undeveloped and unsentient foetus is only a potentially born human and is much more expendable naturally, never mind by choice, than all these folk wringing their hands about one minute foetus seem to think. Let it go, for the sake of this woman's family. You cannot save all the foetuses.

I believe a no human life is inherently more valuable than any other. You can't save all humans, that's a fact of life, but if you can save one then you should.

bogwalrus

Shrap wrote: »

OMG!! The horror of the idea!! :eek::eek::eek: Oh wait...... that's what already happens, except for those who can't afford to go abroad, or who aren't allowed because of travel restrictions. The fcuking hypocrisy is endless :mad:

I'm out of here before someone ties me down in case I get pregnant and might want to decide if that's ok with me. Jesus H. Effing Christ.

I think you are missing my point. Sorry for getting you angry.

here are the two points:

1. I have a body and society says I am not allowed to murder.
   
2. A woman is pregnant. If society recognises the fetuses right to life the woman can only abort under certain conditions. These reasons could be far ranging from emotional to medical.

So in both cases society is saying what we can and cant do with our bodies.

conorh91

Note, this article is 25 years old, from 1989

http://www.ncbi.nlm.nih.gov/pubmed/2761925

A 30-year-old woman suffered massive brain injuries after a motor vehicle accident at 15 weeks' gestation. The patient was diagnosed as brain-dead on her tenth hospital day. She was supported with intensive care for 107 days after this diagnosis, and a normal 1555-g male infant was delivered at approximately 32 weeks' gestation by repeat cesarean section. The child is developing normally at 11 months of age. This represents the longest reported case of prolongation of pregnancy after brain death.

Now, I'm not convinced that there are enough women suffering from braint-stem death during gestation to produce reliable aggregate statistics.

However, the above 25-year-old article implies that a foetus can indeed be maintained by aggressive intervention at an early gestational age if maternal brain death occurs.

Shrap

Sugar Thief wrote: »

I believe a no human life is inherently more valuable than any other. You can't save all humans, that'sounds a fact of life, but if you can save one then you should.

At the expense of the emotional and mental health of those who are actually involved with the outcome? Not me. I think more of born humans, with all their cares and worries and real life humanity.

BarneyThomas

ProfessorPlum wrote: »

Please inform us all, with reference to current medical literature as to the likely outcome in this case.

ICU beds are an expensive resource in short supply. The college of anesthetists agree with me, so do the RCSI, so there's no smoke and mirrors. This treatment costs, is unlikely to have a positive outcome, and others not having needed treatments due to budget constraints.

You are proving nothing by stating that treatment costs money.
You need to prove that this situation is blocking treatment from someone else who needs this specific equipment. Then you have an argument.
So, you first. Prove to us that there is another patient being blocked from treatment because of this. Then I can go and get some facts for you.

But im sorry, its impossible for me to prove the absence of a situation.
You must prove the presence of the situation.

What I have just found out though is that the call has been made to bring in extra equipment if necessary. It is possible and it is fully financed by an outside party should it be needed. But its unlikely it will come to that as the equipment being used is not at even 75% used.

Sugar Thief

Shrap wrote: »

At the expense of the emotional and mental health of those who are actually involved with the outcome? Not me. I think more of born humans, with all their cares and worries and real life humanity.

That's where we differ then, no life is superior to another in my eyes.

BarneyThomas

conorh91 wrote: »

Note, this article is 25 years old, from 1989

ncbi.nlm.nih.gov/pubmed/2761925

A 30-year-old woman suffered massive brain injuries after a motor vehicle accident at 15 weeks' gestation. The patient was diagnosed as brain-dead on her tenth hospital day. She was supported with intensive care for 107 days after this diagnosis, and a normal 1555-g male infant was delivered at approximately 32 weeks' gestation by repeat cesarean section. The child is developing normally at 11 months of age. This represents the longest reported case of prolongation of pregnancy after brain death.

Now, I'm not convinced that there are enough women suffering from braint-stem death during gestation to produce reliable aggregate statistics.

However, the above 25-year-old article implies that a foetus can indeed be maintained by aggressive intervention at an early gestational age if maternal brain death occurs.

Imagine if you had all of the voices who wanted to terminate that pregnancy handily available from something like - oh, the internet. You print them all out on paper and stack them all beside the baby, who is cooing away. As I said before. Seismic. Thats what a lot of people are worried about now.

Shrap

bogwalrus wrote: »

I think you are missing my point. Sorry for getting you angry.

here are the two points:

1. I have a body and society says I am not allowed to murder.
   
2. A woman is pregnant. If society recognises the fetuses right to life the woman can only abort under certain conditions. These reasons could be far ranging from emotional to medical.

So in both cases society is saying what we can and cant do with our bodies.

And my point is that you don't see a lot of women killing their born babies, but you see 12 a day from this country alone making the distinction between unborn foetuses and born babies. Therefore, no matter what the law says, and it could outright say that abortion is murder for what it's worth, it ain't worth the paper it's written on. There will always have to be the choice to carry out a pregnancy - women will take the choice, regardless of the law.

Thanks for your apology. I think I took you up wrong in the first place, so I'm also sorry

Sugar Thief

bogwalrus wrote: »

I think you are missing my point. Sorry for getting you angry.

here are the two points:

1. I have a body and society says I am not allowed to murder.
   
2. A woman is pregnant. If society recognises the fetuses right to life the woman can only abort under certain conditions. These reasons could be far ranging from emotional to medical.

So in both cases society is saying what we can and cant do with our bodies.

That's it really, no one has the right to do whatever they want with their own body, much less the right to force someone else to perform an operation on themselves. I can't just walk in to a hospital and demand to have my liver removed, it's not a right.

Shrap

Sugar Thief wrote: »

That's it really, no one has the right to do whatever they want with their own body, much less the right to force someone else to perform an operation on themselves. I can't just walk in to a hospital and demand to have my liver removed, it's not a right.

But if you were so desperate to have your liver removed that you attacked yourself with a coat hanger or chucked yourself down the stairs in an attempt to remove it....well, than you could call that an analogy for abortion.

bogwalrus

Shrap wrote: »

And my point is that you don't see a lot of women killing their born babies, but you see 12 a day from this country alone making the distinction between unborn foetuses and born babies. Therefore, no matter what the law says, and it could outright say that abortion is murder for what it's worth, it ain't worth the paper it's written on. There will always have to be the choice to carry out a pregnancy - women will take the choice, regardless of the law.

Thanks for your apology. I think I took you up wrong in the first place, so I'm also sorry

I totally agree that if a woman wants an abortion she can have an abortion using other methods.

Sort of like the situation with suicide. You can make suicide illegal but that is not going to stop someone from killing themselves.

Or even drugs. You can illegalise drugs but that wont stop people from taking drugs.

But in this discussion we are not talking about illegalising abortion. It is about figuring out whether we want to be a society that does or does not recognise a fetuses right for life. And at the same time deciding whose has the authority to choose whether a fetus should die. If the decision is solely the womans then is that fair on the father? What if the father wants the child? Just because it is her body does that mean she can decide?

Sugar Thief

Shrap wrote: »

But if you were so desperate to have your liver removed that you attacked yourself with a coat hanger or chucked yourself down the stairs in an attempt to remove it....well, than you could call that an analogy for abortion.

Good luck to anyone who wants to do that, but I wouldn't assume I have the right to force anyone to perform that operation.

ProfessorPlum

BarneyThomas wrote: »

Theses are roughly the chances of survival for a premature birth

23 weeks 17%
24 weeks 39%
25 weeks 50%
26 weeks 80%
27 weeks 90%
28-31 weeks 90-95%
32-33 weeks 95%
34+ weeks 99%


When I first used to see babies born very prematurely it was a very low chance of survival even at 30 weeks.

Things have moved on. And the chances of severe disability are not near what they were then either.

It has not yet been decided what stage this child is to be born at (if it even makes it that far), so its impossible at this stage to give any odds on any outcome.
Anyone who tries to is just blowing smoke.

Your cases are those of premature birth. If you think this case is a simple as a premature birth, you know less than you think. There are all manner of physiological reasons that make this case so much more than keeping the woman hooked up.

There is a national shortage of ICU beds. They cost money. The health budget is underfunded. All facts. To be fair, there is less demand in regional hospitals for ICU beds than in the tertiary referral centres, which is part of the reason why this patient was transferred out of Beaumont. Beaumont ICU is running at maximum capacity, and patients are transferred out to the ward earlier than is ideal.

conorh91 wrote: »

Note, this article is 25 years old, from 1989

http://www.ncbi.nlm.nih.gov/pubmed/2761925

A 30-year-old woman suffered massive brain injuries after a motor vehicle accident at 15 weeks' gestation. The patient was diagnosed as brain-dead on her tenth hospital day. She was supported with intensive care for 107 days after this diagnosis, and a normal 1555-g male infant was delivered at approximately 32 weeks' gestation by repeat cesarean section. The child is developing normally at 11 months of age. This represents the longest reported case of prolongation of pregnancy after brain death.

Now, I'm not convinced that there are enough women suffering from braint-stem death during gestation to produce reliable aggregate statistics.

However, the above 25-year-old article implies that a foetus can indeed be maintained by aggressive intervention at an early gestational age if maternal brain death occurs.

There are a total of 2 cases in the medical literature where a foetus of a similar gestation or earlier survived to term. 2. In total. The usual outcome is not to survive.

BarneyThomas wrote: »

You are proving nothing by stating that treatment costs money.
You need to prove that this situation is blocking treatment from someone else who needs this specific equipment. Then you have an argument.
So, you first. Prove to us that there is another patient being blocked from treatment because of this. Then I can go and get some facts for you.

But im sorry, its impossible for me to prove the absence of a situation.
You must prove the presence of the situation.

What I have just found out though is that the call has been made to bring in extra equipment if necessary. It is possible and it is fully financed by an outside party should it be needed. But its unlikely it will come to that as the equipment being used is not at even 75% used.

Proof? It should be obvious to anyone, especially someone who works in the health service that treatments are not afforded to patients due to cost constraints. I really don't see why I need to itemise the problems.
If the funding is coming from an outside party, that raises other issues, but I'm not sure I'm totally comfortable with the idea. (For various reasons that I'm not going to go into here)

conorh91

Ok now I'm really skeptical about earlier claims that a foetus has a snowball's chance in Hell of reaching viability in circumstances where the brain-dead mother is maintained on life-support during the pregnancy.

This paper cites foetuses between the gestational ages of 6 weeks and 27 weeks who were maintained in-utero and later delivered following irreversible brain injury to the mother.
http://www.ncbi.nlm.nih.gov/pubmed/11075735

None of the 11 foetuses were reported as suffering from major developmental problems. Others are reported as being "alive and well" after birth.

The most adverse neonatal outcome was that one child had to stay in hospital for two months after birth, but that's probably because he was delivered at 27 weeks.

I previously in this thread cited another study where a 15-week-old foetus was maintained in the uterus of his brain-dead mother until birth, and was reported as being alive and well after birth.