Does a UK Court Plan to Kill Baby Jake?
A UK court has ruled that it would be lawful to withhold some medical treatments from the severely ill 10-month-old son of developmentally disabled parents, even if the baby dies after those treatments are withheld.
The baby's name is Jake, and it's a heartwrenching story. But is it a story about euthanasia?
I would like to set aside, as a separate issue, the question of whether the court or someone else ought to be making decisions about Jake's medical care. In this post, I will only address the issue of whether the care itself, as described in the news story, is ethical.
Since 10-month-old baby Jake is not expected to live long enough to enjoy his childhood, a UK court has decided that he could be killed.
The article uses the words "kill" and "death sentence" and "euthanize." Are these words accurate?
According to the Daily Mail UK, the baby was admitted to the hospital after suffering a series of epileptic seizures. He was released from the hospital into the care of foster parents. The paper says:
On March, 2, 2015, Jake was unresponsive when his foster carer tried to wake him. Eventually, after waking, Jake suffered 'a prolonged seizure' and was again admitted to hospital.
Jake has been receiving treatment from a pediatric neurologist since December of 2014. The child suffers from a progressive, degenerative, genetic neurological condition, and his specialist says he is not expected to survive early childhood, no matter what course of treatment he receives. According to the Daily Mail:
After accepting the medical evidence, [President of the Family Division of the High Court] Sir James ruled that several medical interventions can be withheld in Jake's 'best interests' if his condition deteriorates further.
He said it would be legal to withhold bag and mask ventilation as well as invasive or non invasive ventilation.
In the event of cardiac arrest 'it is lawful and in his best interests not to receive cardiac massage and resuscitation'.
The court also ruled that in the event of serious infection, doctors can withhold antibiotic treatment.
Based solely on the information provided in this article (which, as is always the case with stories reported in the news, may or may not be complete or accurate information), it may appear to readers that the court has overstepped its bounds, and that it is wickedly refusing to give Baby Jake the ordinary care that he is entitled to. But is this the case?
Many Catholics believe that the Church requires us to do everything possible to prolong the life of a patient. This is not so, and it would be a serious error to blur the lines between a "do not recuscitate" order and euthanasia.
The Church asks us to take into consideration the best interests of the patient, and draws a distinction between "ordinary care owed to a sick person" -- which includes nutrition and hydration, as well as other care -- and "burdensome, dangerous, extraordinary, or disproportionate ... [or] 'over-zealous' treatment."
We may not directly or indirectly deliberately bring about the death of a patient, but we may withhold treatment that would prolong the death process; and we may administer treatment that might hasten the death process, as long as pain reflief, and not death, is our goal.
According to the Catechism of the Catholic Church: (emphasis is mine):
2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.
2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.
In the case of the baby in this news story, the question is whether the court intends to withhold ordinary care, as well as extraordinary care. Giving the baby painkillers, even if they hasten his death, is legitimate, as long as the goal is to alleviate pain. Some of the treatments mentioned -- ventilation and cardiac resuscitation -- are certainly extraordinary treatment, and can legitimately be withheld from a patient judged to be dying.
But antibiotics, even when administered via IV, are not especially invasive, and do not generally increase discomfort in a patient. Would it be euthanasia if a doctor withheld antibiotics?
Antibiotics are usually considered ordinary care, not extraordinary; but these decisions ought to be made based on the individual situation, not merely on the medicine.
Weighing and determining whether a treatment is ordinary or extraordinary is not always a simple and straightforward task.
In order to decide whether a treatment is ordinary, we must also look at the particulars of the patient's condition, and not merely focus on the treatment, the medical device, or the medicine itself. So if a person were imminently dying from cancer, with but a few hours of life remaining, and the physician discovered that he had an infection in his lungs, the use of antibiotic medications would generally be extraordinary and optional in these circumstances, since their use would be largely ineffective to the patient's real-life situation.
Is this hypothetical situation he describes analagous to the choice Jake's doctor's might face, if his condition deteriorates? Considering the baby's complicated and severe disease, it might be analgous; and so antibiotics might be considered extraordinary care in some situations. It is impossible for a layman, who is neither trained in medicine nor directly familiar with the specifics of this case, to say that it would be euthanasia to deny Jake antibiotics.
Pro-lifers have good reason to be on the alert for offenses against human life. In countries such as Holland, doctors are administering true euthanasia -- deliberately, actively killing patients simply because they or their caregivers don't want them to be alive.
But pro-lifers must not, in our zeal to protect life, blur some important lines between unreasonable assaults on human life, and reasonable responses to heartwrenching situations.