Adam said-
By suggesting these children were trying to convince medical staff not to administer blood product, you implied it was the medical staff's decision, if only the treating doctors could be convinced that they were mature. Wrong. In most cases, it's not up to the treating doctors to decide.
Justitia said-
I must disagree Adamah. If a pediatric provider determines that a minor is a "mature minor," s/he can make the decision to 'respect' the child's decision making by not seeking a court order. As BOTR noted, I posted regarding just such a controversial JW case, a case that was discussed as a recent bioethics conference.
In the video case you cited, the treating doc obtained a bioethics consult, which was the entire POINT of the video, and exactly what I said above.
You cherry-picked from what I wrote above:
Adamah said-
By suggesting these children were trying to convince medical staff not to administer blood product, you implied it was the medical staff's decision, if only the treating doctors could be convinced that they were mature. Wrong. In most cases, it's not up to the treating doctors to decide.
That's what you posted (and note, the "In most cases" bit). However, I continued with another sentence, which you may have missed?
Adamah said-
In most cases, a judge has to be convinced (or at the very least, a hospital panel of bioethicists are consulted, and are generally NOT the same people involved in providing care to the patient, precisely to avoid any appearance of impropriety or conflict of interest).
In the video, the WA bioethics committee was consulted (and it recommended a blood transfusion), but disregarding their recommendations, the attending physician consulted with "five other senior oncologists", and all unanimously agreed NOT to transfuse the pt, i.e. they informally granted him 'mature minor' status AGAINST the advice of the bioethics panel and despite the fact that WA state hasn't recognized the doctrine of 'mature minors' (as the JD pointed out in the video).
The treating physician's anomalous decision was discovered AFTER a supervisor from Child Protective Services (an arm of the State) checked on his welfare after being tipped off by someone in the hospital, and they escalated the situation to a County judge, who ruled that 'comfort (palliative) care' should proceed (i.e. the judge didn't force a transfusion). The child died a few hours later, I believe (and the young man repeatedly threatened that he'd resist a BT with "every ounce of strength he had" i.e. ripping the lines out, etc).
The treating physician who made the determination of a 'mature minor' even AFTER seeking an 'independent' bioethics consult was going out on a limb, making a determination while being directly involved in the patient's care. It's questionable behavior which likely brought him up on the radar of the WA State medical board to investigate, and even possibly censure him (and he at least had the forethought to obtain the opinions of other oncologists, to seek a sort of consensus opinion).
As said in the video, healthcare providers are not policemen or judges, and aren't expected to act in that role. The judge who heard the case consented with the young man's wishes, but it comes back to, "you can lead a horse to water, but you cannot force them to drink". As the speaker said, "there's a moral and ethical side to it, and then there's the practical side to it", i.e. were the nurses going to call hospital security to strap down the young man, etc?
And sure, we can cite how Dr Kevorkian played "mercy killer" by making ethical decisions on his own, but his act of going beyond what State law allowed him to do as a licensed physician didn't represent anything but his personal choice to practice beyond what the scope of his State laws allowed (and playing God doesn't fly). Providers are licensed by the State, and can only act within the limits that the State allows or risk exceeding therapeutic/surgical limits. As a retired physician, I'm fully aware of doctors who may at times exceed their authorized scope of care, but it doesn't mean they're not playing with their own livelihood by pushing limits of their authority, and risk losing their license by doing so.
And honestly, as someone who understands how 'natural selection' operates, I see this as ultimately a self-correcting problem: if a fringe group decides to tell their own to commit hari-kari in a deluded belief that it'll assure some reward that the rest of us will die in a painful death to acheive, the problem will fix itself, given enough time. Frankly, I wish MORE dogmatic thinkers had similar anachronistic and dangerous beliefs that were so resiliant to ALL challenges from counter-evidence, since the problem of dogmatism would go away (if only the selection pressure were a bit stronger).
Adam
