"I would like to say 'This book is written to the glory of God', but nowadays this would be the trick of a cheat, i.e., it would not be correctly understood."--Ludwig Wittgenstein
"Life can only be understood backwards, but it must be lived forwards."--Soren Kierkegaard
Showing posts sorted by relevance for query gard. Sort by date Show all posts
Showing posts sorted by relevance for query gard. Sort by date Show all posts
Tuesday, July 25, 2017
Rest of their bones
So, Charlie Gard.
Let me first say that, despite the existence of the European Court of Human Rights (or whatever it is called; I'm frankly too lazy to do the due diligence this story deserves), legally Charlie Gard's case would be the same in America as in Britain.
That is: the courts would have been empowered to decide what was in the best interests of the child. There are some perfectly ignorant comments at this Salon article about "single-payer" systems and even how "Government doesn't get to decide what the child's best interests are, you sick, self-righteous Commie." But that's precisely what courts (government) do every time there is a family law case in court involving minor children.
QED.
The parents of Charlie Gard acted perfectly reasonably: it is an impossible thing to accept that your child must die, especially within the first year of life. Ironically, the very argument against abortions, that the fetus can feel pain, were the arguments by the hospital to discontinue Charlie's life support: it was just prolonging his agony. He could, the hospital argued, feel pain, even if he couldn't express or communicate his pain. The humane thing is to let him go.
Which, by the way, is all the Pope and the Church in Rome ever offered: easing his pain and allowing his passage to occur naturally.
This case was about the hard nature of life and the tough questions our technology raises. It was not about euthanasia, or saving money, or "death panels." It also wasn't about over-reaching government trying to deny parents the ability to treat their child as they saw fit. It was, as it should have been, about the best interests of the child. Just as we don't allow parents to abuse children, or withhold medical care from them (with rare and often foolish exceptions, like vaccinations), we shouldn't allow parents to refuse to let their children die when the time comes, simply because a machine can keep them breathing, or an experimental treatment can teach us something about experimental treatments (the danger of treating people like experimental subjects rather than like people is real).
The parents have finally accepted that their child will not live long, or be cured. That is a very hard acceptance, and we should honor it and, if so inclined, pray for them in their suffering. We should also consider how easily we turn people into objects, and use them for social experiments of our own.
The danger of treating people like experimental subjects rather than like people is real. I've mentioned before a family member, dying of cancer, who agreed to an experimental treatment rather than disappoint the family and not "try everything." This was in the days before hospice care, but that is exactly what hospice care is about: not trying everything. Later, everyone in the family agreed the experiment never should have been undertaken, that it wasn't worth the pain and suffering added to the loved one's days. But accepting that even modern medicine is not magic, and that doctors are not priests and supplicants of the God Medicine (truly one of the "American Gods" Neil Gaiman should have put in his modern pantheon; but who would have appreciated it?), whose beneficence can be invoked with the right "treatment," is not something we are willing to do.
Because: "What if?" The thing about that "what if?" is that we don't ask it for the patient; we ask it for ourselves, the ones who know we aren't going to die. It is the primary reason I oppose euthanasia, too. Far too many people think the "easy death" will make things easier for....someone else. Pain and suffering is not just something the patient has to live with, and wants relief from. But on what grounds do we decide we are the god of death as well as life? I'm reading this article at Slate and remembering when a "cure" for cancer was available in Mexico, from a substance derived from apricot pits (Laetrile; I almost remembered too late). That was a cruel hoax, but probably no less so than interferon, which was supposed to be cancer's silver bullet. The cruelty, though, is played on us by us. As this Slate article notes, many of us think the FDA only approves drugs that are "extremely effective." There is no such drug, of course. I am resistant, for one reason and another, to most antihistamines and decongestants. Some patients go into remission after chemotherapy; others, with the same cancer, die anyway.
But what if?
It is ultimately a spiritual question: why should we die, and when should we accept it? "My death; is it possible?" No; anymore than the death of a child is possible. I've buried other people's children, and after each funeral I never wanted to go through that again. I've buried the adult children of friends, I've buried the infants of strangers: one was no easier than the other. God willing, that's as close as I'll ever get to burying a child. It was perhaps easier to "memento mori" when people died so young and easily (John Donne lamented to a friend at one time that he had lost so many children he couldn't afford another coffin, yet if the child ill at the time he wrote died, it would relieve him of further expense. He told death not to be proud because he saw too much of it.). Donne is perhaps an example. He wore his shroud in the pulpit as he preached, to remind himself of his own mortality (because he drew crowds, and needed the humility? Probably one answer.) But he wrote the most beautiful and paradoxical of his sonnets: "Death, be not proud," which ends with the greatest paradox of all: "One short sleep past, we wake eternally,/And death shall be no more, death, thou shalt die." Perhaps death is easier to countenance when you can put it in the context of something other than the brutality of mortality. In a different context, but from no less religious a writer, J.K. Rowling's tale within the tale about the three items owned by three brothers (the ring, the wand, the invisible cloak) ends happily for one brother, who uses his cloak to evade death and live a long life (IIRC), but in the end he "greets death like a brother." I cannot now remember how it gets to that point, but I do remember the beauty of those words.
Perhaps, even now, the parents of Charlie Gard can take comfort at least in the time they had with their child, and in the time they have left with him, and take comfort too that, in the end, they did the best they could for him, to give him finally ease from his pain, and rest of his bones, and his soul's delivery. Until all tears are wiped away, and mourning and crying are no more because death is no more, and pain is no more, because former things have passed away.
Monday, July 03, 2017
Call next time you're in town!
If we can help little #CharlieGard, as per our friends in the U.K. and the Pope, we would be delighted to do so.— Donald J. Trump (@realDonaldTrump) July 3, 2017
I wasn't even aware of this story until TC brought it up. It has echoes of two previous fights in American politics, and underlines how dangerously clueless Donald Trump is.
Charlie Gard suffers from a rare condition, and the British courts have ruled that, since his chance of survival is zero, he should be removed from life support. There's the first echo: the Terri Schiavo case.*
The second is a plane crash during Reagan's administration, which occurred, if memory serves, in the Potomac. A passing motorist jumped into the water and rescued a few people before rescue services could arrive to save the rest. The motorist was rightly praised as a hero, but Reagan used him as an example of the volunteer nature of Americans, and how much better that was than relying on government. Except, of course, it was government who saved the other passengers on the plane from the river, not a lone individual saving one or two people before other help could arrive. Why the echo?
“This bill (to repeal the ACA) puts the protections and peace of mind that come with comprehensive health insurance out of reach for millions of people—including children, the elderly and those with disabilities,” said Dr. Richard Besser, CEO of the Robert Wood Johnson Foundation.So we have to dump millions of Americans from health insurance, but we can get 8000 tweets about helping a child in Britain with almost no hope of recovery. And now for the cruelty: beyond a tweet, what is Trump going to do about this? Authorize the money to fly the family to America, put them up and get a hospital room for the child, pay for the experimental treatment, and fly the family back for the almost inevitable funeral? Will he pay for this himself? Get the money from Congress? Redirect public funds for this very private charitable service?
The Los Angeles Times noted that under a Trumpcare amendment, maternity benefits required by former President Barack Obama’s Affordable Care Act (ACA) will join mental health benefits, addiction and recovery treatment, pediatric dental benefits and more on the chopping block.
Massive cuts to Medicaid and Planned Parenthood will add to the burdens faced by women of childbearing age who need reproductive care and services.
Charlie Gard and his reality TV sweepstakes-style story of being rescued by a wealthy benefactor may tug at the heartstrings, but millions of vulnerable Americans with chronic or pre-existing conditions will probably never be lucky enough to find their own billionaire patron.
The Senate healthcare bill “rolls back expansion of coverage under the Affordable Care Act, which helped millions of people become insured,” said Besser. “It shifts responsibility to cash-strapped states for covering healthcare for the poor. It turns the financial support that made health insurance affordable for millions of people into tax cuts for the wealthiest among us.”
Do nothing at all? Experienced observers can safely bet on the last answer as the most likely. Does Trump care about this child? No; Trump cares about Trump, and beyond the response he gets on Twitter, he won't give this matter a second thought. Not soon enough to save the child from losing life support in Britain, anyway.
Last week, his parents lost their appeal to the European court of human rights (ECHR), the final stage in a long legal fight to take him to the US for trial therapy, meaning Great Ormond Street hospital (GOSH) could withdraw his life support and allow him to die.Beyond a tweet, what is Trump doing about it? Tweeting about job numbers and the DOW numbers, so far.
As I say, I know little about this case, but this is the summary of events per the Guardian:
His parents, from Bedfont in west London, want to take him to the US to undergo an experimental treatment but doctors at GOSH said that, given Charlie’s condition, the therapy was unlikely to have a beneficial outcome.Not dissimilar, then, in any significant regard, to the Schiavo case. The hospital is acting with compassion and humanity, but as even the Pontifical Academy of Life says:
British courts ruled that it would be lawful for the hospital to withdraw life-sustaining treatment because it was highly probable Charlie would suffer significant harm if his life was prolonged without realistic prospect of an improvement. They cited established human rights law, which dictates that the rights of a child should take precedence over the rights of a parent.
In the final ruling on Tuesday, the ECHR said it had, by a majority of the seven judges who considered the written arguments, declared the application inadmissible. It “endorsed in substance the approach” taken by the British courts and declared “the decision is final”.
It added: “Consequently, the court also considered that it was appropriate to lift the interim measure.” That measure required doctors to continue providing life support treatment for Charlie.
Responding to the judgment, a spokesperson for Great Ormond Street hospital for children NHS foundation trust said: “Our thoughts are with Charlie’s parents on receipt of this news that we know will be very distressing for them.
“Today’s decision by the European court of human rights marks the end of what has been a very difficult process and our priority is to provide every possible support to Charlie’s parents as we prepare for the next steps.
“There will be no rush by Great Ormond Street hospital to change Charlie’s care and any future treatment plans will involve careful planning and discussion.”
“We do, sometimes, however, have to recognise the limitations of what can be done, while always acting humanely in the service of the sick person until the time of natural death occurs.”There is life support and there is life perpetuation. Such is the state of our powers in this land of medical technology. I've seen people undergo experimental treatment when all hope of recovery was lost. I cannot recommend it. It can have a cruelty all its own.
*More like the Schiavo case than I realized:
Numerous courts have ruled that any experimental therapy would not help Charlie get better and would only increase suffering of a baby who can’t see, move, hear, cry or swallow and has irreversible brain damage.
At some point you have to realize this case has been through several courts and numerous people are more familiar with the facts than any random group of American readers.
The president of a Vatican-owned hospital in Rome has said the doors of the facility are open to Gard’s parents if they want to transfer Charlie there. “We know that it is a desperate case and that there are no effective therapies,” Mariella Enoc, the head of the Bambino GesΓΉ Hospital, said. “We are close to the parents in prayer and, if this is their desire, willing to take their child, for the time he has left to live.”
Which is not that different from what GOSH is offering the family. I don't know the legal status of the case, or what authority the family would have to bring Charlie to America, where I'm quite sure the treatment would benefit the researchers far more than it would the child. I am, as I said, quite sure Trump will do nothing about it beyond the tweet he wrote.
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