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Clinically dead pregnant woman being kept alive

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    #32
    pwurple
    Closed Accounts Posts: 12,449 ✭✭✭✭pwurple


    Orion wrote: »
    That's just facetious. The woman is dead - keeping her hooked up to machines in a facsimile of life is not medicine - it's wrong.

    Are all organ donations also "wrong" then by that definition though?


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    #33
    Viper_JB
    Registered Users Posts: 1,260 ✭✭✭Viper_JB


    There's some good reading here about it, child has very low chance of survival, probably less then 10% and a very high chance of a severe health/developmental problems if it does survive, it's sick and will be incredibly painful for everyone involved the longer this drags on, only serves the law....


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    #34
    pwurple
    Closed Accounts Posts: 12,449 ✭✭✭✭pwurple


    Viper_JB wrote: »
    There's some good reading here about it, child has very low chance of survival, probably less then 10% and a very high chance of a severe health/developmental problems if it does survive, it's sick and will be incredibly painful for everyone involved the longer this drags on, only serves the law....

    There isn't enough data to draw those conclusions. This kind of event is (thankfully) extremely rare. The couple of cases that were referenced by the wikipedia page are about women who were in accidents, or their heart stopped... so there was oxygen deprivation or other injury to the foetus. That doesn't seem to be the case here. Indeed the quote is
    at present, it seems that there is no clear lower limit to the gestational age which would restrict the physician's efforts to support the brain dead mother and her fetus


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    #35
    Viper_JB
    Registered Users Posts: 1,260 ✭✭✭Viper_JB


    pwurple wrote: »
    There isn't enough data to draw those conclusions. This kind of event is (thankfully) extremely rare. The couple of cases that were referenced by the wikipedia page are about women who were in accidents, or their heart stopped... so there was oxygen deprivation or other injury to the foetus. That doesn't seem to be the case here. Indeed the quote is

    Even so, you're talking about leaving a live baby in a brain dead body that won't control hormone levels correctly. The fetus would realistically need to be practically fully developed for this not to have a negative effect on it, there may not be a huge number the draw on but for mothers being put on support at 14-17 weeks, the statistics are very grim, all evidence points towards there being an incredibly high chance of there being complications, I mean the next line after the one you quoted states....
    "Indeed, "[a]t 24, 28 and 32 weeks, a fetus has approximately a 20-30%, 80% and 98% likelihood of survival with a 40%, 10% and less than 2% chance of suffering from a severe handicap, respectively."[2][3]"
    If the fetus had a high likelyhood of success my view's on this would be very different, but this will be dragging on for months and things don't look good.

    So at 24 weeks a 20% chance or survival, so far less then 20% chance.
    But even aside from that it seems very wrong to me that the state can do this, take ownership of your dead body against your family (possibly your own wishes) so that no laws might be broken...


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    #36
    mikom
    Closed Accounts Posts: 16,391 ✭✭✭✭mikom


    I's say the child will be old enough to play for the international soccer team before a decision is made on this.
    It's dragging on already, probably in the hope that the unborn gets to 24 weeks and the decision will be already made for everybody.


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    #37
    dahorseboy
    Registered Users Posts: 12 ✭dahorseboy


    What I'm wondering is if the child will develop as normal.


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    #38
    Chemical Byrne
    Banned (with Prison Access) Posts: 1,311 ✭✭✭Chemical Byrne


    Although we don't know the detail, but lets assume the baby was known not to have suffered any hypoxia and was expected to be healthy and that hormone levels remained normal.

    Then, if I was the father in that case I'd be pretty sure that I'd want her to be kept alive for the sake of the baby. It's bad enough in itself that my partner/wife was effectively dead without having my baby die also when there was a realistic prospect of it being OK.

    I dunno, maybe here the father is just a dead-beat and not in the picture and the grandparents are elderly and would not be able to care for a baby.

    It's a horrible horrible state of affairs.

    I wonder in the case of stroke is it possible that the hormone producing/regulating parts of the brain might remain intact & functional despite a major cerebral infarct of other parts of the brain rendering a person brain dead.


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    #39
    pwurple
    Closed Accounts Posts: 12,449 ✭✭✭✭pwurple


    Viper_JB wrote: »
    All evidence points towards there being an incredibly high chance of there being complications
    Yes, but the range of complications are vast. I have a godchild who was born at 24 weeks. She has poor eyesight. That is her prematurity complication.

    Viper_JB wrote: »
    But even aside from that it seems very wrong to me that the state can do this, take ownership of your dead body against your family (possibly your own wishes) so that no laws might be broken...
    I agree here, next of kin consent is certainly required here, even by my own notion that this is a donor uterus.


    I wonder is this overlapping with an unmarried father situation as well in some way. If the father of the children has a different opinion to the parents, what is the right thing to do? As he is not mentioned, we can only also assume they are not married, and in his unmarried situation he has no legal rights either as next of kin to the woman, or as guardian to any child, all rights revert to her parents.


    There's a lot here. There's the ethics surrounding possibly
    -Death and life support... When is dead, actually dead?
    -The rights of an unborn child
    -Consent for medical intervention
    -Unmarried fathers rights.


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    #40
    seamus
    Registered Users Posts: 68,317 ✭✭✭✭seamus


    Viper_JB wrote: »
    Even so, you're talking about leaving a live baby in a brain dead body that won't control hormone levels correctly.
    That's actually a great point that I hadn't really considered.
    We can keep someone on life support by artificially causing their blood to circulate and lungs to respire, but the somatic nervous system does more than breathe and pump blood. This woman's endocrine system is not functioning. And hormones are pretty damn crucial during the first two trimesters.

    If the pregnancy was 24 or 28 weeks, then keeping her alive to get it over the line seems more reasonable, but at 17 weeks it's complete folly. In the event that a child does grow, I would put very poor odds on a viable child emerging, never mind a healthy one.

    At 17 weeks this isn't a medical treatment, it's a medical fncking experiment. There are no guarantees that keeping the body alive will help the child at all. It's literally crossing your fingers and hoping for the best. It's sick, actually.

    I do understand though that the doctors aren't doing this because they think it's the right thing to do, they're doing it because they don't know if they have any other legal choice. I'm sure if they had the option, they wouldn't hesitate to go with the NOK's wishes.


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    #41
    mikom
    Closed Accounts Posts: 16,391 ✭✭✭✭mikom


    pwurple wrote: »
    Yes, but the range of complications are vast. I have a godchild who was born at 24 weeks. She has poor eyesight. That is her prematurity complication.

    Was her mother dead since 17 weeks?
    7 weeks before she was born.


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    #42
    The Corinthian
    Closed Accounts Posts: 19,777 ✭✭✭✭The Corinthian


    Orion wrote: »
    No. I'm saying that at 16 weeks even an incubator wouldn't help.
    That's not what I asked. You gave a definition of what makes a 'person' and I pointed out how that definition is, when you look at it, daft.
    Yet you have no problem keeping the body "alive" indefinitely? She does still have rights - in this case a right for her body to die.
    Where did you get the idea I'd keep the body 'alive' indefinitely?
    That's just facetious. The woman is dead - keeping her hooked up to machines in a facsimile of life is not medicine - it's wrong.
    Not facetious, just responding to what you said.


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    #43
    Chemical Byrne
    Banned (with Prison Access) Posts: 1,311 ✭✭✭Chemical Byrne


    pwurple wrote: »
    ........we can only also assume they are not married, and in his unmarried situation he has no legal rights either as next of kin to the woman, or as guardian to any child , all rights revert to her parents.

    And that there is something about this country that really grinds my gears in a big way. Imagine how it would be to be a father at in this situation with the baby at say 23 weeks and to be powerless and have absolutely no say over whether your child lives.

    OT, but in general, the bolded part is warped and backward IMO. But it's not a straightforward thing to change either as granting such rights would be open to abuse by unscrupulous dead beat fathers seeking to use such rights to exact revenge or hardship upon an ex partner. How can the legal system differentiate between a genuine father who wants the best for his child and the preceding unsavoury character? I'd say it'd be next to impossible.
    This woman's endocrine system is not functioning. And hormones are pretty damn crucial during the first two trimesters.

    Do we know her endo system is not working? Might she have lost all conciousness & sentient function but retained those hormone regulating parts of the brain in a functional state.

    If it's the case where there will be a substantial chance of severe disability, the yes, I agree that pulling the plug is probably the "kindest" thing to do. I know this is horrible to say but sometimes when one sees extremely disabled persons with probably little or no consciousness or quality of life I can't help but think that it's a sort of cruelty in a way and it might be kinder to.............


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    #44
    seamus
    Registered Users Posts: 68,317 ✭✭✭✭seamus


    Chemical Byrne wrote: »
    Do we know her endo system is not working? Might she have lost all conciousness & sentient function but retained those hormone regulating parts of the brain in a functional state.
    Brain death typically means the entire brain is shut down including the autonomic functions (I did erroneously say "somatic" in my last post, which is the exact opposite), hence why life support is required to keep blood flow and breathing going.

    But you're right in that it's not guaranteed that these systems in fact have shut down. However ultimately even if they haven't, you're still basically experimenting. You have no idea if they're functioning in the correct way for a pregnancy.


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    #45
    Chemical Byrne
    Banned (with Prison Access) Posts: 1,311 ✭✭✭Chemical Byrne


    Well perhaps we would need to determine whether it's actual brain death or brain stem death. In the latter, consciousness and ability to breathe are lost but the rest of the brain remains intact and functional to a degree.


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    #46
    Rips
    Registered Users Posts: 416 ✭✭Rips


    Similar situation in Texas, the woman was allowed to die after a 2 month court battle:

    http://edition.cnn.com/2014/01/26/health/texas-pregnant-brain-dead-woman/
    Harrowing testimony from her husband

    Foetus was distinctly abnormal
    http://edition.cnn.com/2014/01/22/us/pregnant-life-support-texas/index.html


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    #47
    Aka Ishur
    Registered Users Posts: 740 ✭✭✭Aka Ishur


    Doesn't Ireland have rules against desecrating a corpse? The idea that organ donors are kept alive for a few hours at most to harvest organs, in an operation they have specifically consented for, somehow equates with keeping a dead body going for up to 8 weeks, without consent, is horrific. This is nothing short of a medical experiment. Next question is how far along does a woman have to be to warrant this 'treatment'. If a patient is declared brain dead are they going to keep her warm for 3 months? 4? 5? Are we going to need it defined in law? How can you say 1 month is ok, but 3 months is not ok?

    Truly disgusted with this poor women's doctors, who, instead of doing what is clearly and naturally right, were either (a) too concerned with covering their own asses, (b) too interested in unethical experimentation, or (c) too ready to put their religion first. I hope to feck it is merely ass covering.


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    #48
    pwurple
    Closed Accounts Posts: 12,449 ✭✭✭✭pwurple


    Chemical Byrne wrote: »
    And that there is something about this country that really grinds my gears in a big way. Imagine how it would be to be a father at in this situation with the baby at say 23 weeks and to be powerless and have absolutely no say over whether your child lives.

    OT, but in general, the bolded part is warped and backward IMO. But it's not a straightforward thing to change either as granting such rights would be open to abuse by unscrupulous dead beat fathers seeking to use such rights to exact revenge or hardship upon an ex partner. How can the legal system differentiate between a genuine father who wants the best for his child and the preceding unsavoury character? I'd say it'd be next to impossible.
    The answer is marriage. As an unmarried father you are completely screwed in this situation with an unborn child. By not marrying the father, the woman has effectively given all guardianship rights to her own parents.

    I understood that most (all?) hospitals have an ethics group for cases of this nature. In my opinion, this is where the decision on cases like this should lie, not the court system. These specific cases are far too unusual and nuanced for laws to be made for each and every eventuality. There should be the freedom for an ethics board in a hospital to make decisions. The courts grind along extremely slowly, it's not fit for this kind of thing.


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    #49
    katydid
    Banned (with Prison Access) Posts: 6,351 ✭✭✭katydid


    Aka Ishur wrote: »
    Doesn't Ireland have rules against desecrating a corpse? .

    She's not a corpse.


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    #50
    Aka Ishur
    Registered Users Posts: 740 ✭✭✭Aka Ishur


    katydid wrote: »
    She's not a corpse.

    Really? Is she alive? A human being who has been declared dead is a corpse. Its the definition of the word for fecks sake


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    #51
    Macha
    Moderators, Science, Health & Environment Moderators Posts: 6,376 Mod ✭✭✭✭Macha


    As an Irish woman, I find this case fascinating and terrifying in equal measure.

    Every day, people die because the deceased didn't give consent for their organs to be donated when they were alive. In fact, medical professionals have to have clear evidence of consent to take anything from a dead body for science, let alone saving a life.

    Yet this woman is legally obliged to donate her whole body to save a foetus. In other words, pregnant women have less right to bodily integrity than corpses in this country, even when they're clinically dead.


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    #52
    gozunda
    Registered Users Posts: 18,996 ✭✭✭✭gozunda


    Macha wrote: »
    As an Irish woman, I find this case fascinating and terrifying in equal measure.

    Every day, people die because the deceased didn't give consent for their organs to be donated when they were alive. In fact, medical professionals have to have clear evidence of consent to take anything from a dead body for science, let alone saving a life.

    Yet this woman is legally obliged to donate her whole body to save a foetus. In other words, pregnant women have less right to bodily integrity than corpses in this country, even when they're clinically dead.

    Sadly it all reminds me of the Monthy Python Organ Donation sketch. I won't post it but if you havn't seen it I suggest you check it out ...

    The numbers of women that are in effect becoming prisoners of the state due to pregnancy is now truly scary.

    Perhaps this should be brought to its logical end and the state should incarcerate / lock up / detain all pregnant women / potentially pregnant women justin case something may happen or they injure themselves etc. Effectively women can be wired up as automoton surrogates to ensure that the ovum / foetus survives above all else and triumphs the mothers right to bodily integrity and self determination ...

    It should always be about the quality and not quantity of life. That goes for both the mother and foetus.


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    #53
    Macha
    Moderators, Science, Health & Environment Moderators Posts: 6,376 Mod ✭✭✭✭Macha


    gozunda wrote: »
    Sadly it all reminds me of the Monthy Python Organ Donation sketch. I won't post it but if you havn't seen it I suggest you check it out ...

    The numbers of women that are in effect becoming prisoners of the state due to pregnancy is now truly scary.

    Perhaps this should be brought to its logical end and the state should incarcerate / lock up / detain all pregnant women / potentially pregnant women justin case something may happen or they injure themselves etc. Effectively women can be wired up as automoton surrogates to ensure that the ovum / foetus survives above all else and triumphs the mothers right to bodily integrity and self determination ...

    It should always be about the quality and not quantity of life. That goes for both the mother and foetus.

    Well, let's not go overboard -the constitution guarantees a woman's right to travel since 1992 (so for 9 years that right was not explicit). But of course the reality is this option is only available to those who are physically and financially able to travel.


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    #54
    katydid
    Banned (with Prison Access) Posts: 6,351 ✭✭✭katydid


    Macha wrote: »
    Well, let's not go overboard -the constitution guarantees a woman's right to travel since 1992 (so for 9 years that right was not explicit). But of course the reality is this option is only available to those who are physically and financially able to travel.

    Or legally able to; asylum seekers can't travel out of the country.


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    #55
    gozunda
    Registered Users Posts: 18,996 ✭✭✭✭gozunda


    Macha wrote: »
    Well, let's not go overboard -the constitution guarantees a woman's right to travel since 1992 (so for 9 years that right was not explicit). But of course the reality is this option is only available to those who are physically and financially able to travel.

    Overboard regarding state control? Seriously?

    A recent selection of the 'care and treatment' (sic) of pregnant women in this country ...

    Forced C Section ...

    http://www.belfasttelegraph.co.uk/news/local-national/republic-of-ireland/forced-csection-case-revives-irish-abortion-debate-pregnant-suicidal-woman-was-legally-forced-to-have-a-caesarean-section-30515441.html

    Forced birth despite miscarriage

    http://m.independent.ie/irish-news/pregnant-woman-died-after-hospital-denied-abortion-28901352.html

    Lack of post natal care following Caesarean section

    http://m.rte.ie/news/2014/0922/645492-inquest/


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    #56
    gozunda
    Registered Users Posts: 18,996 ✭✭✭✭gozunda


    The Corinthian wrote: »
    Are you saying that a premature baby that cannot survive without an incubator is not a person, or that the available technology to keep that baby alive is what defines it as a person?Better still, were we to develop an artificial uterus in the future, it would no longer be possible to terminate a pregnancy as all fetuses would be able to survive outside of the womb?

    Well where a 'foetus' cannot survive without artificial intervention then it is apparently not an independent entity and the argument whether it is a 'person' or not boils down to the philosophical - that's a discussion for maybe a whole other raft of threads.
    As to the future of medical science akin to Aldous Huxleys 'Brave New World' where 'babies' are decanted from bottles - then I would add that if wishes were fishes, we'd all cast nets in the sea. In essence that argument remains in the realms of science fiction not fact ...
    The Corinthian wrote: »
    No, but most of the philosophical and moral arguments surrounding this case would be common to the abortion debate. The only real difference is that the rights of the woman are no longer relevant as she's dead.

    Not so. In the case of a dead person leaving a will relating to their property or the disposal of their remains to medical science then there is a very valid case for a dead persons rights to be treated as very relevant.
    The Corinthian wrote: »
    Well we can give up on three thousand years of medicine then.

    'Medicine' pertains to the treatment of the sick or injured. The patient in this case is primarily the mother who has been acknowledged to be clinically dead and therefore no longer in need of treatment or 'medicine'. An otherwise unviable foetus whose artificial gestation and eventual enforced birth is not 'medicine' per se but rather resulting from a legal status which carries with it significant concerns for the future health and viability of any the foetus which survives to term


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    #57
    The Corinthian
    Closed Accounts Posts: 19,777 ✭✭✭✭The Corinthian


    gozunda wrote: »
    Well where a 'foetus' cannot survive without artificial intervention then it is apparently not an independent entity and the argument whether it is a 'person' or not boils down to the philosophical - that's a discussion for maybe a whole other raft of threads.
    Well, actually that's the entire point of the Humanities forum - to have precisely those sort of conversations.

    As for independent entity, it is. By definition, once a zygote it is an organism. It still requires an environment to survive, but don't we all? The only difference is that environment cannot be artificially replicated as yet.
    As to the future of medical science akin to Aldous Huxleys 'Brave New World' where 'babies' are decanted from bottles - then I would add that if wishes were fishes, we'd all cast nets in the sea. In essence that argument remains in the realms of science fiction not fact ...
    Not the point. I asked that if the only thing that defines a human is the ability for medical science to keep it alive, then should we not be questioning this definition? After all, it would mean that once we do develop an artificial uterus (which is hardly science fiction, but a likely reality within the next few decades) it would mean that suddenly all fetuses would by that definition be people and no termination could be carried out.

    All before we consider that one day someone is considered a ball of cells and the next day a human being, not because they have changed, but because medical science has - which is a bit bizarre, you'd have to admit.
    Not so. In the case of a dead person leaving a will relating to their property or the disposal of their remains to medical science then there is a very valid case for a dead persons rights to be treated as very relevant.
    Except she did not leave a 'will' that we are aware of, and if (as the State holds) the fetus is a human being, then the rights of a living human being would typically trump the rights of a dead one.

    Having said that, without the permission of the deceased, you cannot harvest their organs, even if it were to mean saving the life of another. This would be the principle reason I'd edge towards the side of letting her die in this case as it would be consistent with how we deal with similar cases in organ transplant.

    TBH, I find the whole 'it's not a person' approach to the question little more that self deception by those who lack the mental strength to admit it is, but still has no absolute right to life.
    'Medicine' pertains to the treatment of the sick or injured. The patient in this case is primarily the mother who has been acknowledged to be clinically dead and therefore no longer in need of treatment or 'medicine'.
    I'm afraid that your definition fails given medicine regularly deals with organ transplant from brain dead subjects. Indeed, it's a bit silly to suggest that the knowledge involved in keeping such a body 'alive' is somehow unrelated to medicine.


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    #58
    Peregrinus
    Registered Users Posts: 26,056 ✭✭✭✭Peregrinus


    gozunda wrote: »
    'Medicine' pertains to the treatment of the sick or injured . . .
    If that were true, abortion wouldn't be a medical matter, since pregnancy is neither a sickness nor an injury. And contraception wouldn't be a medical matter either; fertility is not a disease.


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    #59
    Macha
    Moderators, Science, Health & Environment Moderators Posts: 6,376 Mod ✭✭✭✭Macha


    This is just another constellation of tragic circumstances, which proves once again that we have to repeal the 8th. Putting the value of a fully grown woman on a par with a foetus is disgusting.

    I am currently pregnant and thank my lucky stars every day that i will receive my prenatal care in Belgium, not Ireland.


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    #60
    gozunda
    Registered Users Posts: 18,996 ✭✭✭✭gozunda


    The Corinthian wrote: »
    Well, actually that's the entire point of the Humanities forum - to have precisely those sort of conversations.

    But not this thread as far as I can see. I was referring to this particular case and as the law currently stands.
    The Corinthian wrote: »
    As for independent entity, it is. By definition, once a zygote it is an organism. It still requires an environment to survive, but don't we all? The only difference is that environment cannot be artificially replicated as yet.
    So yes still in the realms of science fiction in that case
    The Corinthian wrote: »
    Not the point. I asked that if the only thing that defines a human is the ability for medical science to keep it alive, then should we not be questioning this definition? After all, it would mean that once we do develop an artificial uterus (which is hardly science fiction, but a likely reality within the next few decades) it would mean that suddenly all fetuses would by that definition be people and no termination could be carried out.

    Again postulation of some future reality. Let's get there and see if we can decant foetuses.
    The Corinthian wrote: »
    All before we consider that one day someone is considered a ball of cells and the next day a human being, not because they have changed, but because medical science has - which is a bit bizarre, you'd have to admit.

    No I don't believe it is bizarre tbh. Plenty of fertilised ovums ( bunch of cells) get ejected and flushed down the toilet without a women been ever aware of it. Should we then start a emergency response team to rescue all potential ovums from such jeopardy?
    The Corinthian wrote: »
    Except she did not leave a 'will' that we are aware of, and if (as the State holds) the fetus is a human being, then the rights of a living human being would typically trump the rights of a dead one.

    The rights descend to the immediate family and they have made their opinion quite clear. As to the other point then No again because the foetus is not capable of independent survival and to enforce such survival is both questionably moral and carries with serious concerns for the health of any resulting 'baby' post birth. More importantly if as you claim the "rights of a living human being would typically trump the rights of a dead one" then how is it Savita Halappanavar did not meet the criteria for such consideration from the state health services or is it that only foetuses that trump the right of life of the mother?
    The Corinthian wrote: »
    Having said that, without the permission of the deceased, you cannot harvest their organs, even if it were to mean saving the life of another. This would be the principle reason I'd edge towards the side of letting her die in this case as it would be consistent with how we deal with similar cases in organ transplant.

    Then in this we agree
    The Corinthian wrote: »
    TBH, I find the whole 'it's not a person' approach to the question little more that self deception by those who lack the mental strength to admit it is, but still has no absolute right to life.

    Personhood is still a matter for debate. But do clarify what "still has no absolute right to life."
    The Corinthian wrote: »
    I'm afraid that your definition fails given medicine regularly deals with organ transplant from brain dead subjects. Indeed, it's a bit silly to suggest that the knowledge involved in keeping such a body 'alive' is somehow unrelated to medicine.

    But in context with your point it remains it is neither 'medicine' or treatment of the individual concerned.


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    #61
    Glinda
    Registered Users Posts: 223 ✭✭Glinda


    It's interesting to discuss and mull over what each of us would do ourselves in this awful situation but it seems to me that this is clearly missing the real question.

    The actual dilemma here is to identify who, in such an unbelievably tragic and impossible set of circumstances, should get to make the decision? Whose wishes should be paramount?

    Is it the mother herself (assuming her wishes are known which they aren't in this case)?

    Is it her next of kin, who don't consent to keeping her on life support?

    Is it the father of the baby (who I read this morning agrees with the family)

    Or does the State step in and take over against the wishes of everyone who knew and loved this lady.

    I think the last shred of respect remaining to her is to allow the decision to be made by her next of kin and respect that.


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