The case of baby Joseph started out fairly clear, but as time has passed, many people have interpreted it as something it is not.
Joseph Maraachli was born without any problems. Then in May 2010, the Maraachli family brought Joseph to the Children's Hospital in Detroit because he was unable to breath. After several weeks of treatment, Joseph went home with his family in good health.
In October 2010, Joseph experienced a similar problem with breathing. His parents were driving home from Toronto and stopped at the hospital in Ingersoll Ontario. From there he was transferred to the Children's Hospital in London, where he remains.
The baby Joseph case concerns the question of who has the right to decide what is in the best interests of baby Joseph.
The hospital decided to withdraw the ventilator from Joseph, which would result in death, likely occurring, within a short period of time. Joseph would die while gasping for air.
The family decided that they wanted to bring Joseph home to die while in their care, in the same way that they cared for their first child who died of a similar condition more than 8 years ago. The family asked that a tracheotomy be done to allow Joseph to breath on his own, so they could bring him home.
The issue is who has the right to decide? Does the hospital and doctor or does the family have the right to decide on how to care for their terminally ill child?
Not about futile care.
This case is different from most of the similar cases because it is not about a family requesting treatment that is futile, burdensome or extra-ordinary.
The family is not asking for a portable ventilator to be set-up in their home, even though this would be a reasonable option. They are not asking for in-home nursing care to be provided. They did not ask for experimental treatment plans.
The family only asked to bring Joseph home, but to do so would require Joseph to be capable of breathing on his own. This is why they requested that a tracheotomy be done. A tracheotomy is not a difficult procedure, it is not futile, burdensome or extra-ordinary.
Not about euthanasia.
Some people have suggested that to withdraw the ventilator from baby Joseph would constitute an act of euthanasia. This is not true.
Euthanasia is an action or omission of an act that directly and intentionally causes the death of another person with the intention of relieving suffering. Euthanasia is a form of homicide.
If the ventilator is withdrawn from baby Joseph, he is likely to die, but he may survive. If he dies, his death would be caused by his medical condition and not a direct and intentional action or omission. Even if the intention is to cause his death, the reality is that his death would not be direct because it is caused by his medical condition and therefore is not euthanasia.
The precedent set by the baby Joseph case affects everyone.
If I had a massive stroke, I am not competent, I am unable to swallow effectively and I have not indicated in anyway what I would want in such a circumstance and my wife would like an intervention done to allow to be effectively fed, but the doctor says no, what will happen?
The precedents that have been set by the baby Joseph case and similar cases would force my wife to hire a high priced lawyer to defend her right to provide reasonable care for me. She would face a well paid lawyer who is financed by the hospital.
If the consent and capacity board sided with the hospital she would be forced to appeal the decision to the Superior Court, which would cost an excessive amount of money, simply to defend her right to have basic care provided for me.
In the courts, legal precedents, like the baby Joseph case, would be used to convince the judge that the decision of the doctor and the hospital is correct.
We are all at risk, unless decisions, like the baby Joseph case are not reversed or unless the legislation in the Province of Ontario is amended.
I continue to support the plight of baby Joseph and the Maraachli family and I continue to hope that the family and the hospital can achieve a mutual agreement. Maybe Joseph should be sent home and cared for on a portable ventilator?