Features Australia

Little Alfie

12 May 2018

9:00 AM

12 May 2018

9:00 AM

The questions around little baby Alfie’s death aren’t going to go away. They raise a timely and extremely important issue. Who basically ‘owns’ – i.e. has the ultimate authority  over and care of a child  – the parents or the State? – and related troubling issues.

Moreover, the fact that hospitals, at least in New Zealand, now have a practice of deliberately withholding both water and nutrition for three days at least, while waiting to see if a patient recovers from a severe injury, parallels a growing reluctance to put the right to life of the patient first – and even of family determined to care for him or her. Current thinking to overrule any power of attorney provisions to try to ensure this indicates a situation which should concern us all.

Individuals recovering from a dramatic injury and surviving against the odds have told of the considerable pain they were in with both nourishment and fluid withheld, an increasingly common practice. So an outstanding question needs to be asked: when it was obvious that this little boy was managing to breathe on his own, and might have a chance of survival, was he supplied with the nourishment vital for his body to draw upon? If not, in what sense was this UK hospital under the socialist NHS system not actually euthanising this child? Given that reports stated water and oxygen were restored, when he was taken off life support and breathing on his own, how long in fact had nourishment been withheld?

There is no disputing the fact that little Alfie had become very ill. However, there is no evidence whatsoever that his parents were negligent or abusive – that there was anything at all which would even reluctantly persuade us that the State should step in to assume over-all authority – as has become the practice with negligent or unfit parents. On the contrary, there was no doubting the love they held for their child.

So questions need to be asked about the intransigence of the hospital involved, particularly, as Australian commentator Bill Muehlenberg pointed out, in relation to the words of German doctor Professor Nikolaus Haas, head of the Child Cardiology Paediatric Intensive Medicine Unit at Munich University Hospital: ‘We have learned in Germany, because of our history, that there are things you do not do with severely disabled patients. Our ethical understanding in Germany is different, I mean – thank God. The [Alder Hey] hospital’s logic that it is better for the child to die than someone else looks after it – and even to sue for that at the court: this is unimaginable behaviour for me.’

The fact that the child had been given Italian citizenship, and transport had already been provided to take it to a hospital prepared to look further into its care – and that this option was determinedly rejected, has raised long over-due questions. No doubt one of the reasons for the public outcry against this hospital’s determined stance, with palliative care professionals deploring the reaction of the community at large, and disparaging the thousands who supported Alfie’s parents’ right to make their own decision, is that the hospital still maintains the rightness of its decision. But should it be its right to make this? At what point do professionals become semi-gods, overruling the rights of those under their care – or those of the families who most care for them – if the perception of the community at large is that their stance is over-authoritarian?

A reply received from the General Medical Council in the UK, referring to the legal and ethical framework it recommends for doctors, states that ‘doctors should always try to work in partnership with parents to try to reach a shared view about the best course of action. Where there is significant agreement and this can’t be resolved between the medical team and family, then we say it may be necessary to seek an independent review by the courts. Approaching the court should be seen as a constructive way of thoroughly exploring the issues and providing reassurance that the child’s interests have been properly considered in the decision.’

All very fine – and some ‘shoulds’ which still leave too many questions unanswered, including why courts, which are now considered as prone to activism as many other sectors of the state bureaucracy, should be given the right to determine questions of life-and-death?

Nigel Farage presents a point of view which would reflect that of many parents in similar circumstances. ‘Any parent in the world who’s got a child that’s sick would move heaven and earth if somebody else could offer them a different treatment. And yet what happens here is our state-run medical system decides there is nothing else that can be done, and, backed up by the state courts, they make a decision that those parents are not fit to move the child somewhere else. So this gets to the absolute heart of how much freedom does the individual have; how much decision-making process do the parents have; or are our children now owned by the state?’

It’s a question long overdue. How many are aware that over this side of the Tasman, at least, when patients suffer a debilitating stroke, relatives such as husbands or wives are heavily pressured to agree to water and food being withheld – although it is recognised that stroke patients require optimum nutrition to help nourish the brain after such a trauma. This pressure is kept up with a ‘Are you sure this is what he/she would want? Are you sure this isn’t just your opinion?’ After three days the pressure stops, because if the patient has survived as long as this, apparently a duty of care at last takes over.

Correspondingly, physicians in charge of wards are constantly now pressured by management to ‘move patients on’ – i.e. discharge them from hospital. As my own dedicated doctor husband remarked to me – on finding increasing difficulty in getting very needy patients of his admitted, ‘Hospitals don’t seem to actually want patients any more…’

Moreover, discharged patients are routinely shunted out at all hours when discharged, even in the early hours of the morning, when they have no transport available.

Hard to get in? It seems to now work both ways – with one common factor; it is  hospital  management which now assumes a superior authority – posing troubling questions for the ability of individuals, and/or their care-givers, to remain free of what many now regard as the creeping tentacles of the state.

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