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Suffer the Little Children

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From a medical study at Mediscape, excerpted at First Things

Neonatal survival after withdrawal of artificial hydration and nutrition can last up to 26 days, according to a case series presented here at the 18th International Congress on Palliative Care. Although physical distress is not apparent in the infants, the psychological distress of parents and clinicians builds with the length of survival, said Hal Siden, MD, from Canuck Place Children’s Hospice in Vancouver, British Columbia.

“These babies live much, much longer than anybody expects. I think that neonatologists and nurses and palliative care clinicians need to be alerted to this,” he said. “The time between withdrawal of feeding and end of life is something that is not predictable, and you need to be cautioned very strongly about that if you are going to do this work.” He presented a series of 5 cases that clinicians at his hospice had overseen over a 5-year period. Two infants had severe neurologic impairment, 2 had severe hypoxic ischemia, and 1 had severe bowel atresia.

Despite this, there is one factor that medication cannot alleviate, and that is the visual signs of emaciation, said Ms. Keats. “The longer a child lives, the more emaciated he or she becomes. This is something that we as clinicians need to anticipate. You can alleviate some of the physical symptoms, but this is one symptom, or result of our action, that we can’t relieve. A critical factor for counseling is to anticipate the kind of suffering that comes with witnessing the emaciation. It isn’t something people can prepare themselves for.”  Autopsies are often encouraged in such neonatal palliative care cases to help both parents and medical staff gain a better understanding of the reasons for the death, said Dr. Siden. Parents should be warned that the report will document the technical cause of death as “starvation” — a loaded word for all concerned. It is important that parents separate this word from any notion of suffering, he said.


“All of the children we’ve cared for have been in a very quiet, low metabolic state — not an agitated state — with no overt signs of hunger behavior. Whether they are neurologically capable of hunger behavior is another question, and I don’t know the answer. That’s why I am trying to understand better what they are going through, because I don’t want them to suffer,” Dr. Siden explained.

He emphasized the importance of more research into the physiologic processes that occur after withdrawal of fluids and nutrition so that clinicians can both inform and reassure parents. “There’s an ethical component to doing research. If you don’t do research yourself, you need to support those who do, because we desperately need to know more,” Dr. Siden asserted. “There’s a technical aspect to what we do, and we need to become really good at that because we need to be able to say to people, without a doubt, that we are going to do this and there is not going to be any kind of suffering. You’ve got to be very on top of your game.”

* * *

By all means, let us distance ourselves from the implications of that loaded term "death by starvation."  After all, these are infants who are severely defective.  They have what the Germans used to call lebensunwertes Leben, or "life unworthy of life."  What comment is necessary beyond the mere posting of this mengelestic research? 


( 11 comments — Leave a comment )
Oct. 25th, 2010 12:16 am (UTC)
They do the same to the elderly who have outlived their convenient life spans and need feeding tubes.
Why aren't these "people" brought up on charges? How could parents give permission for this?
Oct. 25th, 2010 01:26 am (UTC)
There have been parents who have gone to court to force the hospitals to do this and refused offers to have their baby adopted.
Oct. 26th, 2010 01:38 pm (UTC)
How can they live with themselves?

To me, one of the most disturbing things about having religion not acknowledged as part of societal morality is that it's all too easy to take the cost-effective way out. Of course, it's not cost effective in human terms any more than abortion is. The sanctity of human life is something atheists do not respect because the concept of sanctity implies a belief in God. Too easy to turn it into a spread sheet.
Oct. 26th, 2010 04:06 pm (UTC)
They blame the offers of adoption for their suffering. I wish I were kiddiing, but I have read of parents speaking of the cruelty of those who offered to adopt their Down Syndrome child.
Oct. 25th, 2010 04:34 am (UTC)
And when the child has no real hope of survival?
Oct. 25th, 2010 04:05 pm (UTC)
And when the child has no real hope of survival?

Strangle it? Leave it exposed on a windswept crag? Throw it into the ravine called Apothete? Smother it? Bash its head against a rock?

Endless possibilities.
Oct. 26th, 2010 01:40 pm (UTC)
If all medical help has failed, how about cradling her in your arms and singing her a lullaby as she passes?
Oct. 26th, 2010 04:15 pm (UTC)
That was in fact what my great-grandmother did. My grandfather told me that the doctor had come to the house to examine his sick 4-yr old brother. Doctors did that back then. He wrote a prescription and gave it to my grandfather and told him to run as fast as he could to the pharmacy and give it to the pharmacist. In those days, too, pharmacists were chemists, not simply emptiers of big jugs into small pill bottles. When he got there, he was out of breath and simply shoved the script at the pharmacist, who then quickly prepared the medicine. My grandfather then ran back to the house, and the doctor gave his brother the medicine - Martin was the boy's name.

Great-grandmother was rocking Martin in the big rocking chair. Martin looked up at her and said in a weak voice, "Sing 'Pony Boy' for me."

Part-way through, he said, his mother stopped in the middle of the line and began to cry. Then in silence, she carried Martin up the stairs.

And never since then has anyone in our family been named Martin.
Oct. 25th, 2010 04:45 am (UTC)
(here through mutual friends)

Why don't they just give the baby an overdose of morphine? If it's really morally OK to withdraw support (and I don't think it is) then it should be even more moral to make the death as quick and painless as possible, shouldn't it?

If we are going to treat the terminally ill as if they were household pets, then they should be getting put to sleep like dogs, not starved over long periods of time.

Ugh. I hate the sanitizing language of that article.
Oct. 26th, 2010 04:05 pm (UTC)
Probably that's what they're after, by presenting a false dilemna: kill the child slowly or quickly.

Then they have vapors if you point that the Nazis didn't start with the Jews, they started with the handicapped.
Oct. 28th, 2010 02:46 am (UTC)
You've named the source, but not provided any links. It's one thing to tell horror stories, it's another to only tell half of it.

Charles Pergiel

( 11 comments — Leave a comment )


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