Brain dead woman delivers baby.

[year2late]

Brain-dead Canadian woman taken off life support after giving birth to baby boy - CBS News

This is how rational decisions are made.

A woman complains of a headache. She was 22 weeks along.

Of course it was not just a headache. She suffered a fatal cerebral hemorrhage.

So how is this different than other cases?

The Texas case (Munoz). Was found down...well before fetal viability. The doctor's knew the fetus had catastrophic damage (assumed from the prolonged down time). The family desperately wanted her taken of support and buried. The hospital got crazy and pretended a crappy law that pertained to a living person - pertained to the dead woman. So dragging the case through court was not only unnecessary, it was cruel and unusual punishment for the family.

In the case in Ireland....again, the fetus was designated my doctors as not viable. The family wanted her OFF of "life" support and buried. This case again had to be dragged through the courts.

In this case, the fetus was found to be viable. The fetus was also 22 weeks gestation. The extra weeks in the uterus were not only wanted by the family, but would improve the quality of life for the baby when born.

The most important lesson is that these decisions are best left between the patient (or next of kin) and the doctor.

 

[Un biased]

The Husband wanted the female to be on life support

"Doctors in Victoria, British Columbia, kept her alive at her husband's request ..."

No need to cause him grief, also the fetus was incredibly close to the viability mark .

This is different as in the other cases the family wanted the female to be taken off of life support unlike this one

Reasonable indeed

 

[Removable Mind]

Brain-dead Canadian woman taken off life support after giving birth to baby boy - CBS News

This is how rational decisions are made.

A woman complains of a headache. She was 22 weeks along.

Of course it was not just a headache. She suffered a fatal cerebral hemorrhage.

So how is this different than other cases?

The Texas case (Munoz). Was found down...well before fetal viability. The doctor's knew the fetus had catastrophic damage (assumed from the prolonged down time). The family desperately wanted her taken of support and buried. The hospital got crazy and pretended a crappy law that pertained to a living person - pertained to the dead woman. So dragging the case through court was not only unnecessary, it was cruel and unusual punishment for the family.

In the case in Ireland....again, the fetus was designated my doctors as not viable. The family wanted her OFF of "life" support and buried. This case again had to be dragged through the courts.

In this case, the fetus was found to be viable. The fetus was also 22 weeks gestation. The extra weeks in the uterus were not only wanted by the family, but would improve the quality of life for the baby when born.

The most important lesson is that these decisions are best left between the patient (or next of kin) and the doctor.

The medical provider was able to determine that fetus to be viable and the family could was able be involved in the decision making process. All is good, right?

Well, in Canada, yes. In the US maybe not so good.

At only 22 weeks of development, we know that it still could have gone bad. In the States the medical provider and family would have fallen prey to the discretion of courts. Because the medical provider determined the fetus to be viable, even though its not common. It's chances of surviving would probably remain unknown. But one could almost bet that "Planned Parenthood v Casey" would have been most likely used to intervene in this case.

 

[year2late]

The medical provider was able to determine that fetus to be viable and the family could was able be involved in the decision making process. All is good, right?

Well, in Canada, yes. In the US maybe not so good.

At only 22 weeks of development, we know that it still could have gone bad. In the States the medical provider and family would have fallen prey to the discretion of courts. Because the medical provider determined the fetus to be viable, even though its not common. It's chances of surviving would probably remain unknown. But one could almost bet that "Planned Parenthood v Casey" would have been most likely used to intervene in this case.

If the mother to be dies and there is not a quick return of circulation - the fetus can suffer catastrophic injury/damage at any time - before or after 22 weeks. The fact that some want to take this out of the realm of a patient/next of kin/MD and into the court system is no more than political theater at the time that is terribly traumatic for the survivors.

 

[year2late]

The Husband wanted the female to be on life support

"Doctors in Victoria, British Columbia, kept her alive at her husband's request ..."

No need to cause him grief, also the fetus was incredibly close to the viability mark .

This is different as in the other cases the family wanted the female to be taken off of life support unlike this one

Reasonable indeed

No reason to cause him grief because it should be an informed decision between a patient(or next of kin) and the doctors involved.

 

[CanadaJohn]

Brain-dead Canadian woman taken off life support after giving birth to baby boy - CBS News

This is how rational decisions are made.

A woman complains of a headache. She was 22 weeks along.

Of course it was not just a headache. She suffered a fatal cerebral hemorrhage.

So how is this different than other cases?

The Texas case (Munoz). Was found down...well before fetal viability. The doctor's knew the fetus had catastrophic damage (assumed from the prolonged down time). The family desperately wanted her taken of support and buried. The hospital got crazy and pretended a crappy law that pertained to a living person - pertained to the dead woman. So dragging the case through court was not only unnecessary, it was cruel and unusual punishment for the family.

In the case in Ireland....again, the fetus was designated my doctors as not viable. The family wanted her OFF of "life" support and buried. This case again had to be dragged through the courts.

In this case, the fetus was found to be viable. The fetus was also 22 weeks gestation. The extra weeks in the uterus were not only wanted by the family, but would improve the quality of life for the baby when born.

The most important lesson is that these decisions are best left between the patient (or next of kin) and the doctor.

To be fair, the family, the husband in particular, agreed with leaving the mother on life support until the child was more viable outside the womb. What would be your position if the husband had wanted the life support removed and the hospital refused because of the viability of the fetus?

 

[Removable Mind]

To be fair, the family, the husband in particular, agreed with leaving the mother on life support until the child was more viable outside the womb. What would be your position if the husband had wanted the life support removed and the hospital refused because of the viability of the fetus?

John, see post #4. I think that might answer your question.

 

[Scrabaholic]

To be fair, the family, the husband in particular, agreed with leaving the mother on life support until the child was more viable outside the womb. What would be your position if the husband had wanted the life support removed and the hospital refused because of the viability of the fetus?

My position would be that the hospital should honour the family's request. The impression I get from this article is that doctors were going to take her off life support, which is why the husband requested that they not do so.

 

[CanadaJohn]

John, see post #4. I think that might answer your question.

Well, that doesn't answer the question I posed. But you can try again, if you'd like.

Let's expand on that, to make it clearer. Suppose the husband objected to the pregnancy before his wife became ill and passed. Would you object to the husband wanting to end the life of the fetus even though the doctors knew the fetus was still viable and would be appreciably more viable the longer the mother stayed on life support? Do you believe, in such a scenario, that the fetus is a "patient" at this point, or still just part of the dead mother? Do you believe the father could deny approval for the hospital to birth the child even though it may be risky? Do you believe the hospital should not go to court to protect the life of the child when it's their view that the father is intent on ending the life of a viable child, past the time when a legal abortion could be performed?

My point is that it's not as simple a discussion as the OP leads us to believe. It just so happened, in this case, all parties were in favour of doing what was best for the fetus.

 

[CanadaJohn]

My position would be that the hospital should honour the family's request. The impression I get from this article is that doctors were going to take her off life support, which is why the husband requested that they not do so.

So, in effect, you don't believe the fetus could ever be a patient whose rights must be protected. 22 weeks is pretty borderline as to viability - but not impossible. But for argument's sake, let's say it was 30 weeks - should the husband be able to deny the hospital saving the child and simply agreeing to his demand that life support be removed?

 

[joG]

Well, that doesn't answer the question I posed. But you can try again, if you'd like.

Let's expand on that, to make it clearer. Suppose the husband objected to the pregnancy before his wife became ill and passed. Would you object to the husband wanting to end the life of the fetus even though the doctors knew the fetus was still viable and would be appreciably more viable the longer the mother stayed on life support? Do you believe, in such a scenario, that the fetus is a "patient" at this point, or still just part of the dead mother? Do you believe the father could deny approval for the hospital to birth the child even though it may be risky? Do you believe the hospital should not go to court to protect the life of the child when it's their view that the father is intent on ending the life of a viable child, past the time when a legal abortion could be performed?

My point is that it's not as simple a discussion as the OP leads us to believe. It just so happened, in this case, all parties were in favour of doing what was best for the fetus.

Is an abortion permitted in the US, when the fetus is viable?

 

[Removable Mind]

My position would be that the hospital should honour the family's request. The impression I get from this article is that doctors were going to take her off life support, which is why the husband requested that they not do so.

I agree.

It's a high risk situation as Y2L pointed out in post #4, but that type of issue shouldn't be in the hands of the court. Sadly, it would be in the court here - if a doctor declared a fetus to be even marginally viable - despite the brain death of the to be mother.

 

[CanadaJohn]

Is an abortion permitted in the US, when the fetus is viable?

Well, I don't believe it would be characterized as an abortion if life support was simply removed and the fetus died along with the mother.

 

[joG]

Well, I don't believe it would be characterized as an abortion if life support was simply removed and the fetus died along with the mother.

It is hard to say how to treat it. Turning of viable humans is not an easy ethical question.

 

[Removable Mind]

Well, that doesn't answer the question I posed. But you can try again, if you'd like.

Let's expand on that, to make it clearer. Suppose the husband objected to the pregnancy before his wife became ill and passed. Would you object to the husband wanting to end the life of the fetus even though the doctors knew the fetus was still viable and would be appreciably more viable the longer the mother stayed on life support? Do you believe, in such a scenario, that the fetus is a "patient" at this point, or still just part of the dead mother? Do you believe the father could deny approval for the hospital to birth the child even though it may be risky? Do you believe the hospital should not go to court to protect the life of the child when it's their view that the father is intent on ending the life of a viable child, past the time when a legal abortion could be performed?

My point is that it's not as simple a discussion as the OP leads us to believe. It just so happened, in this case, all parties were in favour of doing what was best for the fetus.

I personally don't believe the court should be involved under that particular circumstance. 22 weeks survival rate is really rare. That would be a significant risk. But apparently the husband had the willingness to take the risk. Had he not....well, let the survival rate history speak for itself. He should have the final say. Not the court.

If we were talking about say a 28 week old fetus that has the known physical maturity to survive outside the womb - even if it requires mechanical assistance... then in the US...based on survival rate histories of that stage of development then it's possible to use legal force to attempt to save its life. In this case, I would probably be for trying to say the fetus. But that's just me.

 

[Removable Mind]

Is an abortion permitted in the US, when the fetus is viable?

No...not usually. But then again, when the fetus is inside a woman who's died...too many variables involved just to say "it's viable". 22 weeks is so very marginal in terms of viability. It's not at all common. But if a doctor believes it can survive on assisted life support...???? Don't know. That's the risk the husband was willing to take.

And I can't say what I would do in that situation. It's a tough call. The statistics are against a 22 week old fetus' survival even if removed by C-section and put on life support.

I just don't want government involved in every aspect of reproduction. In fact, none at all. I support Canada's perspective (legally).

 

[CanadaJohn]

I personally don't believe the court should be involved under that particular circumstance. 22 weeks survival rate is really rare. That would be a significant risk. But apparently the husband had the willingness to take the risk. Had he not....well, let the survival rate history speak for itself. He should have the final say. Not the court.

If we were talking about say a 28 week old fetus that has the known physical maturity to survive outside the womb - even if it requires mechanical assistance... then in the US...based on survival rate histories of that stage of development then it's possible to use legal force to attempt to save its life. In this case, I would probably be for trying to say the fetus. But that's just me.

That's fair - but I'm looking at what should be the legal position of a viable fetus when its host has died but can be maintained until a less dangerous birth can be performed. The only "patient" in my view, at this point, is the fetus. The mother's life and rights are not harmed. The only questions, in my view, are a) is there a reasonable expectation that the fetus may survive and be birthed alive if the host is maintained on life support and b) if a) is yes, does the husband have a right to, in effect, end the life of the fetus when he didn't have that right while his wife was alive?

 

[Scrabaholic]

So, in effect, you don't believe the fetus could ever be a patient whose rights must be protected. 22 weeks is pretty borderline as to viability - but not impossible. But for argument's sake, let's say it was 30 weeks - should the husband be able to deny the hospital saving the child and simply agreeing to his demand that life support be removed?

Yes. In all cases, it should be the decision of the next of kin.

 

[CanadaJohn]

Yes. In all cases, it should be the decision of the next of kin.

So then, by extension, you must believe that the next of kin, in all cases, should have the right to withdraw life support even against the recommendations of medical staff. Forget the fetus for the moment - this implies that next of kin, in the absence of a patient being able to speak for his/herself, should have the right to remove life support in all cases, absent a living will on the part of the patient. In effect, in your mind, incapacitation renders the life of the patient disposable at the discretion of the next of kin. That's a giant step beyond a woman's right to choose and extends to the broader public.

 

[year2late]

To be fair, the family, the husband in particular, agreed with leaving the mother on life support until the child was more viable outside the womb. What would be your position if the husband had wanted the life support removed and the hospital refused because of the viability of the fetus?

If the mother is dead and the fetus isn't viable?

I think it is tragic, but the physicians have no obligation to give care that is not appropriate to the situation.

I think I would handle it like Children's Hospital did in the McMath case (although clearly there was no fetus in her case). Emotionally support the family as much as possible. Allow for multiple opinions of specialists. But when all is said and done, pronounce dead and let the family grieve - if the family cannot accept reality, they can get a lawyer.

Leaving dead people on life support for prolonged period is a misuse of valuable ICU beds and ICU RNS. Those beds and nurses should be used for the living. If your wife had to lay in an ER for hours and/or days because there was no space or nurse due to a corpse on life support, how would you feel?

In the Canadian woman's case, the fetus was viable, so keeping a dead woman on support (supported by the family's wishes) to help that viable fetus get a few more weeks of in utero development was a clinically reasonable decision. One based on medical fact.

Keeping a corpse with a nonviable fetus on life support is just plain wrong.

 

[year2late]

I personally don't believe the court should be involved under that particular circumstance. 22 weeks survival rate is really rare. That would be a significant risk. But apparently the husband had the willingness to take the risk. Had he not....well, let the survival rate history speak for itself. He should have the final say. Not the court.

If we were talking about say a 28 week old fetus that has the known physical maturity to survive outside the womb - even if it requires mechanical assistance... then in the US...based on survival rate histories of that stage of development then it's possible to use legal force to attempt to save its life. In this case, I would probably be for trying to say the fetus. But that's just me.

It is very possible that if a woman died while pregnant - a crash C-section could occur. The baby could be delivered in minutes.

 

[CanadaJohn]

If the mother is dead and the fetus isn't viable?

I think it is tragic, but the physicians have no obligation to give care that is not appropriate to the situation.

I think I would handle it like Children's Hospital did in the McMath case (although clearly there was no fetus in her case). Emotionally support the family as much as possible. Allow for multiple opinions of specialists. But when all is said and done, pronounce dead and let the family grieve - if the family cannot accept reality, they can get a lawyer.

Leaving dead people on life support for prolonged period is a misuse of valuable ICU beds and ICU RNS. Those beds and nurses should be used for the living. If your wife had to lay in an ER for hours and/or days because there was no space or nurse due to a corpse on life support, how would you feel?

In the Canadian woman's case, the fetus was viable, so keeping a dead woman on support (supported by the family's wishes) to help that viable fetus get a few more weeks of in utero development was a clinically reasonable decision. One based on medical fact.

Keeping a corpse with a nonviable fetus on life support is just plain wrong.

Sorry - you missed my question. My question was, would you support the husband or the hospital if the fetus was viable but needed a little more time in the host and the husband wanted life support removed and the hospital wanted to give the fetus the best chance at survival? And as asked of others, if the husband has the right to end the life support and refuse "birth" of the child, regardless of its viability, would he have the same right at 30 weeks, as an example?

 

[year2late]

Sorry - you missed my question. My question was, would you support the husband or the hospital if the fetus was viable but needed a little more time in the host and the husband wanted life support removed and the hospital wanted to give the fetus the best chance at survival? And as asked of others, if the husband has the right to end the life support and refuse "birth" of the child, regardless of its viability, would he have the same right at 30 weeks, as an example?

If the dead woman was 30 weeks along and the fetus was clearly viable several possibilities could occur.

If she was pronounced dead (and the heart had stopped) it is likely that a crash C-section would have occurred (it would be an emergency situation not requiring consent)

In the case of brain death, where a fully viable fetus at 30 weeks should do well. I will take a roe v wade type of stance - after the point of viability, the state may have a more compelling interest in the pregnancy. It would be reasonable for this situation to go to court to decide. Has this actually ever occurred? A next of kin of a brain dead patient refusing to allow a fully viable 30 week old fetus to be delivered? I just do not see this as ever being an issue. But perhaps you will surprise me.

 

[CanadaJohn]

If the dead woman was 30 weeks along and the fetus was clearly viable several possibilities could occur.

If she was pronounced dead (and the heart had stopped) it is likely that a crash C-section would have occurred (it would be an emergency situation not requiring consent)

In the case of brain death, where a fully viable fetus at 30 weeks should do well. I will take a roe v wade type of stance - after the point of viability, the state may have a more compelling interest in the pregnancy. It would be reasonable for this situation to go to court to decide. Has this actually ever occurred? A next of kin of a brain dead patient refusing to allow a fully viable 30 week old fetus to be delivered? I just do not see this as ever being an issue. But perhaps you will surprise me.

That's fair - and no, I don't have a similar situation to cite and I don't know if such has happened. But it would be possible if a husband didn't want to child and his wife did - one way to avoid the birth would be to deny all medical treatment for his wife and let them both die. My issue was with the "state" having a duty of care to the most vulnerable in the situation and the ability to override next of kin's wishes if those wishes jeopardize the well being of the most vulnerable.

 

[year2late]

That's fair - and no, I don't have a similar situation to cite and I don't know if such has happened. But it would be possible if a husband didn't want to child and his wife did - one way to avoid the birth would be to deny all medical treatment for his wife and let them both die. My issue was with the "state" having a duty of care to the most vulnerable in the situation and the ability to override next of kin's wishes if those wishes jeopardize the well being of the most vulnerable.

I just do not see this ever occurring. 30 weeks is pretty late. And if the fetus seems healthy and viable, my guess is that the hospital/doctors would be quickly consulting their lawyers. I would have no problem with that if it ever occurred.