Friday, April 22, 2011

Baby Joseph is home and breathing on his own

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Baby Joseph with his father.
Now that baby Joseph is home, having had a tracheotomy and breathing on his own without a ventilator, it is important to once again consider why this legal battle occurred and why the Ontario government needs to change the Health Care Consent Act. The fact that Joseph is breathing on his own, without a ventilator, proves that the request that a Tracheotomy be done was appropriate and was not extra-ordinary, excessive or burdensome. It would be good to find out why the hospital actually refused to do a Tracheotomy when their proposed plan of treatment was to cause him to die of asphyxiation?

The Euthanasia Prevention Coalition (EPC) became involved in the baby Joseph case because of the way that the Consent and Capacity board and the Ontario Superior court decided to withdraw the ventilator from baby Joseph without the consent of his parents. The error in judgment by these legal bodies affects us all.

The meaning and value of life cannot be assessed by medical tribunals and the court and it is not measured in years, months, or days. It is measured in the giving and receiving of love. Love is the greatest quality of life that there is. This is the lesson that the Ontario/Canadian medical system needs to learn. This is what they are blind to.

Who has the right to decide?
The baby Joseph case was about who has the right to make medical treatment decisions and what is in the best interest of baby Joseph. The Children's hospital in London Ontario wanted to withdraw the ventilator from Joseph, which would likely have resulted in him dying, grasping for air. The family wanted to bring Joseph home to care for him in the same way that they cared for their first child who died of a similar condition 9 years ago. The family asked that a tracheotomy be done to allow Joseph to breathe on his own, so they could bring him home.

The Baby Joseph case was not about futile care.
The baby Joseph case was different than previous cases because the family was not requesting treatment or care that was futile, excessive, extra-ordinary or burdensome. The family simply wanted to bring Joseph home, which required that a Tracheotomy be done to enable Joseph to breath.

The Baby Joseph case was not about euthanasia.
Some people have suggested that withdrawing the ventilator from baby Joseph would constitute an act of euthanasia. 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 had been withdrawn from baby Joseph, he was likely to die, but he might have survived. If he died, his death would have been caused by his medical condition and therefore it is not euthanasia.

The legal system in Ontario is unfair.
A significant problem in Ontario is that the legal system is loaded against families. When a family and the doctor/hospital disagree about the treatment plan for a person, these cases are sent to the Consent and Capacity board for a decision. This is where the inequality begins. The doctor/hospital have nearly unlimited financial resources to hire a top lawyer who has experience in this area of law. The family often has limited resources and sometimes hires a legal aid lawyer who lacks experience in this area of law. When the Consent and Capacity board sides with the doctor/hospital, often the family will give up, but sometimes they appeal the decision to the Superior Court. It is prohibitively expensive for the family to bring a case to the Superior Court and yet the doctor/hospital has no fear of the cost because the health care institution has significant legal resources provided by the taxpayer. Because of the inequity in the legal defense, case after case has resulted in decisions by the Consent and Capacity board or the Superior court supporting the doctor/hospital. The law's inequality has resulted in a growing body of precedent-setting cases that have increased the power of the doctor/hospital to make medical decisions against the wishes of the family. The Ontario government must change the Health Care Consent Act.

It is unreasonable that families are required to spend an incredible amount of money in order to defend their rights. If doctors/hospitals have access to huge legal budgets that are from the taxpayer, that is spent to fight families (taxpayers) who are simply attempting to make medical care decisions on behalf of family members, then the system should also pay the cost for the family. Ontario citizens should recognize that the great majority of precedent-setting legal cases have given more power to the doctors/hospital. The rights of each citizen in Ontario to make medical treatment decisions have been eroded. We hope that the energy that has been created around baby Joseph can be used to help other people by changing our health care statutes.

The Rasouli case
This is why EPC sought and become an intervenor in the Rasouli case. The Rasouli case will determine if doctors are required to obtain consent before withdrawing life support. This means that the Rasouli case will determine that a doctor is required to obtain consent to withdraw a respirator, or even fluids and food. It is euthanasia to cause a persons death by withdrawing fluids and food when that person is not otherwise dying. Death is then caused by dehydration.

You also need to protect yourself. You can protect yourself by contacting EPC and ordering the Life-Protecting Power of Attorney for Personal care. The cost for this legal document is only $10.00.


Anonymous said...

If there's ever any kind of petition to sign I'm all for it! About making a health directive: Even though it is a good idea to make one I have heard that sometimes they are over rode as well! What do we have to do to get the point across! and parents should have total legal say over the wishes for their child until age 18.

J.M. Joseph said...

I think you need to study Catholic Theology as your claim that removing Baby Joseph from the ventilator would not be Euthanasia is false. You are making a value judgement yourself and have from the beginning because you (nor anyone else for that matter) did not even know the exact disease that Joseph had; therefore, if doctors could not determine what he had (at first), then how could you make the claim that he would most likely die from his disease if removed from the ventilator? Also, the intent of or the act of the removal would also determine Euthanasia and doctors said, (as well as all who testified in support of the removal) that it would be best for Joseph and relieve his suffering.
I wish you would also be honest and put your ego aside as to why you got involved - since you have stated personally did not believe it would be a case of Euthanasia, you had to be talked into supporting this case from the very beginning. Of course, with the impending election, the health care act controversy was on your own agenda - not a bad thing to change but you utilized this case (after the fact) to push this to the forefront. I think it would be imperative that instead of sending mass e-mails to try to get people to vote against Euthanasia in various corners of the world and going on various talks yourself(which is where most of the money you raise goes to) you should inform yourself about the Catholic Church's teachings on Euthanasia so that you can be a proper activist - such as the end does not justify the means. Perhaps when you do this, Mr. Schadenberg, you will come to the realization that using pro-aborts in your fight against Euthanasia such as the lawyer Mark Handelman is wrong (something your faith teaches), and then you would be humble enough to acknowledge that it was the involvement of pro-life American activists such as Bobby Schindler, and Br. Paul O'Donnell from the Terri Schiavo Life and Hope Network who made the real difference in this case both financially (by giving this case international exposure), and in saving Baby Joseph from Euthanasia and - not you, nor Mark Handelman who did nothing really and eventually was released of his services.

Anonymous said...

I totally disagree that Joseph case is not about euthanasia for the following reasons:
Euthanasia is the putting to death, by painless method, of a terminally-ill Euthanasia is the putting to death, by painless method, of a terminally-ill or severely debilitated person through the omission (intentionally withholding a life-saving medical procedure, also known as passive euthanasia) or the commission of an act (active euthanasia).

Canadian Criminal code:
"241. Everyone who counsels a person to commit suicide or aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years." |

. Section 215 of the Criminal Code says that:

"... every one is under a legal duty to provide necessaries of life to a person under his charge if that person is unable, by reason of (...) illness, mental disorder or other cause, to withdraw himself from that charge and is unable to provide himself with the necessaries of life."

Dr. F applied to the Board to determine if the refusal of JM’s parents was in accordance with the principles for giving or refusing consent to treatment as set out in The Health Care Consent Act (HCCA).

The consent and capacity board
granted Dr. F's application and determined that the refusal by MM and SN of accepting Dr. (breathing tube) without replacement, a do not resuscitate order (DNR) and palliative care.

Anonymous said...

You have stated that euthanasia is an act or omission that causes death. Why then is the act of removing a ventilator without consent with the knowlege that it will cause death not euthanasia? Or, does the word "homicide" better define that action?

Advance directives? What is the value? In the Rasouli case the doctors have taken the position that they already have the legal right to withhold/withdraw treatment based on their unilateral determination of benefit, without consent. The 2006 College of Physicians and Surgeons End of Life Policy permits doctors to withhold/withdraw treatment without consent if the doctors believes there is no "permanent benefit." Note: the College does not define "permanent" or "benefit". It seems to me that arguably anyone can fit under that definition. None of us will live forever.

Alex Schadenberg said...

The reason I state that it would not be euthanasia to remove the ventilator is that the removal of the vent would not be the cause of death, but rather his medical condition.

The other factor is that Joseph might have survived the removal of the vent, whereas in acts of euthanasia you are dead.

No one was planning to put a bag or a pillow over Baby Joseph's head, therefore oxygen was available to him.

It cannot be euthanasia if the act is not the cause of death.

I have always stated that the act was wrong because it denied Joseph the opportunity to live and it deprived his parents the right to make medical decisions for him. Just because a medical act is wrong and the likely outcome is death, does not make it euthanasia.

Where we agree is the intention of the doctors was for Joseph to die, but intention alone does not make it euthanasia.

If the parents had agreed to withdraw the vent would it be euthanasia? No, but not because they consented, but rather because it wasn't euthanasia in the first place.

Alex Schadenberg said...

Euthanasia is an act or omission of an act that causes death, but it is not based on consent, even though the Dutch define it as requiring consent.

The fact is that if the vent had been pulled from Joseph he may or may not have died. If he lived, it could not be euthanasia. If he died, the question is what caused his death? The removal of the vent would not have been the cause of his death but rather his death would have been from his medical condition.

The act of removing the vent from baby Joseph was wrong but not euthanasia.

Veronica Abbass said...

Alex Schadenberg

Has anyone told you to mind your own business? If not, I'm telling you now: "Mind your own business!"

According to a CTV News article, you worry “that seriously ill people -- particularly the elderly -- could be pressured into committing suicide by family members who consider them to be burdens.”

That is classic slippery-slope reasoning. Why don’t you worry about family members mistreating their elderly relatives or forcing their elderly relatives to sign over power of attorney, so these family members can benefit financially?

Stop trolling the newspapers for names of people you can report. Stop interfering in other people’s business and stop trying to overturn individuals' right to chose how and when to die.

Find something worthwhile to do with the money you scam from gullible people; use it to help the elderly and the needy.

PS J.M. Joseph says "you need to study Catholic Theology," but he is wrong. You have aligned yourself with the ghouls at Priests for Life, so you have all the access to the craziness of Catholic theology you need.

Alex Schadenberg said...

Dear Veronica:

If you read my articles you would notice that I identify the problem of people forcing elderly family members to sign over their power of attorney and then scamming them. Its called elder abuse.

The ultimate form of elder abuse is euthanasia and assisted suicide, because now people are pressuring family and friends to "choose" death.

This whole concept of euthanasia demeans the lives of people by telling them they are better off dead and then causing their death when they have been pressured by society that life is no longer worth living.