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The Alfie Challenge

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The Alfie Challenge

Old 29th Apr 2018, 19:24
  #101 (permalink)  
 
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Originally Posted by VP959 View Post
I don't know enough about it, but in the legal arguments in the judgements from various courts that were linked to earlier in this thread, the point was made that pain is something that may be felt with only a partially functional brain stem, and no cerebellum
It's true, and reflex reactions to pain will still occur even under heavy sedation. For example, a fully anaesthetised patient will still exhibit autonomic responses to the cutting and pain-inducing aspects of surgery to the extent that analgesia is still required to prevent the body unconsciously spiking the blood pressure etc.

With that in mind, is surgery performed under full anaesthetic 'causing pain and suffering?'
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Old 29th Apr 2018, 21:00
  #102 (permalink)  
 
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Originally Posted by DaveReidUK View Post

There are more than enough instances on record of the Government being held to account by the courts to demonstrate that that's simply not the case.
so, too here in the US; witness, Watergate trials, Pentagon Papers, Citizens United case. It isn’tt politicians exerting influence on the judiciary, US or UK, it’s that judges have an inherent bent toward using law as a means to an end. This is a case where they, IMO, remained “hands off”; let the parents decide upon advice of the medical staff. I also recognize that financial facts pertain. If the NHS, Medicare, insurers reach their contractual or political limits on providing money, the burden transfers for any further care to the family.

In this case, it would be government physically stopping the parents from removing the child to other medical care—they weren’t neglecting the child, refusing to care for him, they wanted to act as responsible parents, but government syelled and used its powers of coercion to remove the decision from them. That, IMHO, is a wrong use of government. Just as it is for various religious organizations using this dire situation to advance an agenda far removed from the parent angle.

GF
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Old 29th Apr 2018, 21:08
  #103 (permalink)  
 
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Originally Posted by Lascaille View Post
With that in mind, is surgery performed under full anaesthetic 'causing pain and suffering?'
Having read the various Judgements listed earlier this thread, the 'pain and suffering' referred to as reason to prevent travel is primarily that potentially caused by the brain spasms that would (the credible doctors on both sides agreed) likely arise in transportation to another hospital for the surgery (which in any event the doctors agree would have made no difference to Alfie's prognosis).

It was a desperately sad situation, in which Alfie would inevitably have passed away regardless of the outcome of the various legal battles. I commend a reading of the Judgements to those on here who think the wrong decision was made.
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Old 29th Apr 2018, 23:05
  #104 (permalink)  
 
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Originally Posted by galaxy flyer View Post
In this case, it would be government physically stopping the parents from removing the child to other medical care—they weren’t neglecting the child, refusing to care for him, they wanted to act as responsible parents, but government syelled and used its powers of coercion to remove the decision from them. That, IMHO, is a wrong use of government.
Have you any evidence at all to suggest that those weren't the decisions of an independent judiciary ?

If so, would you like to share it ?
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Old 30th Apr 2018, 00:32
  #105 (permalink)  
 
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I already agreed your judiciary, as is ours, independent of direct political influence. The PM is t calling in a favor from the judge. The problem I have is that, in the absence of malice on the parents’ part, they are put in the position to make any decisions regarding the child—it’s the parents’ call. In any case, it is government’s responsibility to enforce the judge’s opinion.

How did the judge become involved in what should should have been a parental decision? Once the judge made an opinion, I presume it would be the government carrying it out. Could the parents have removed the child without the police stopping them?

GF
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Old 30th Apr 2018, 00:45
  #106 (permalink)  
 
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With that in mind, is surgery performed under full anaesthetic 'causing pain and suffering?'
One difference is that in surgery, the brainstem is anaesthetised to some extent. Alfie was apparently able to breathe spontaneously, but a person having surgery would generally not be able to, even if they were still exhibiting autonomic responses to pain. Anaesthesia is not an 'all or nothing' endeavour.

Is a cortex necessary for sentience? Certainly it's true that when areas of cortex are damaged, this seems to selectively impair awareness. On the other hand lots of non-mammals seem to manage well without a cortex - whether they have any form of consciousness or not I don't know, but I would look unfavourably on anybody who chose to mistreat a fish or bird on the grounds that they have no cortex and must therefore be non-sentient.

Last edited by abgd; 30th Apr 2018 at 00:56.
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Old 30th Apr 2018, 00:55
  #107 (permalink)  
 
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How did the judge become involved in what should should have been a parental decision?
My understanding is that when parents and doctors differ substantively regarding treatment, they must seek a judicial opinion. If the judges agree that parents should have autonomy to make particular decisions for their children, then they can and the doctors would be forced to acquiesce.
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Old 30th Apr 2018, 06:42
  #108 (permalink)  
 
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Originally Posted by galaxy flyer View Post
The PM is calling in a favor from the judge.
So Theresa May has Mr Justice Hayden (High Court), Lady Justice King (Court of Appeal), Lord Justice McFarlane (Court of Appeal), Lord Justice McCombe (Court of Appeal), Lady Hale (Supreme Court), Lord Kerr (Supreme Court), Lord Wilson (Supreme Court), Lord Justice Davis (Court of Appeal), Lady Justice King (Court of Appeal) and Lord Justice Moylan (Court of Appeal) in her pocket ?

Not to mention three unnamed ECHR judges ?

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Old 30th Apr 2018, 08:29
  #109 (permalink)  
 
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Looking at these cases purely logically, and I speak as someone with a brain damaged at birth great nephew who us unable at nine years old to do anything other than make unintelligible noises and has the prospect of possibly making his teenage years at best, I would argue that it is unfair on the rest of society to spend millions on scarce resources that could have a hugely beneficial effect on the lives of many, less severe cases.

My niece would argue strongly the reverse case. But as someone once said on the subject of animal experimentation when asked if they would agree with it if it was going to save their child's life. " If it was going to save my child's life I would agree with them experimenting on you". Parents are too close to make rational judgements.
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Old 30th Apr 2018, 11:17
  #110 (permalink)  
 
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Originally Posted by Effluent Man;1013398[left
Looking at these cases purely logically, and I speak as someone with a brain damaged at birth great nephew who us unable at nine years old to do anything other than make unintelligible noises and has the prospect of possibly making his teenage years at best, I would argue that it is unfair on the rest of society to spend millions on scarce resources that could have a hugely beneficial effect on the lives of many, less severe cases.
If you go down that path it is not too long before you start "bumping off" other "non-productive" members of society. Pensioners and the unemployed spring too mind....!! Not a world I wish to inhabit. Best to leave those type of decisions to God....

The situation we now have, thanks to the intervention of medical science, is we can sustain a life which in earlier times would have been extinguished naturally. Oh, and I speak as someone who has a daughter who was born two months premature, some 34 years ago. The intervention of medical science saved her. We were warned she would be handicapped, which she is to an extent but she lives in her own home and has a part time paid job dealing with the public.

Last edited by Planemike; 30th Apr 2018 at 18:20.
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Old 30th Apr 2018, 11:20
  #111 (permalink)  
 
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Originally Posted by DaveReidUK View Post
So Theresa May has Mr Justice Hayden (High Court), Lady Justice King (Court of Appeal), Lord Justice McFarlane (Court of Appeal), Lord Justice McCombe (Court of Appeal), Lady Hale (Supreme Court), Lord Kerr (Supreme Court), Lord Wilson (Supreme Court), Lord Justice Davis (Court of Appeal), Lady Justice King (Court of Appeal) and Lord Justice Moylan (Court of Appeal) in her pocket ?

Not to mention three unnamed ECHR judges ?

If there is *one* thing we have learnt from this tragic case, it's how many ignorant mouth breathers are infesting society - unable to process a single rational comment.
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Old 30th Apr 2018, 13:08
  #112 (permalink)  
 
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Must admit the whole medical ethics thing is initially you think easy when it starts out a doctor shouldn't treat their own family and then rapidly goes down hill from their.

Another one again which has links with the pro-life lot and a few others is the testing for downs syndrome.

Being of an age where mates started reproducing late in life a couple of mates have a kid that rocks the extra DNA. Lovely kids happy contented in a loving family but mum and dad is over 40 not far off 50 and the kid is heathy as any thing looking at another good 60 years but can't look after themselves and isn't likely to be able to either.

The testing and stopping such pregnancy's is getting a bit heated since that new test came out. Some of the mums especially are very against this test or testing full stop. On discussion in the pub with dad it appears the underling concern is that the test becomes standard as well as normal to abort and the number of downs kids goes down.

Which you would initially think is a good thing away from the situation. But the mums are very scared that if the numbers of downs kids goes down the funding and support setup will get taken away. Its truly staggering the amount of funding that's required. And when mum and dad kick the bucket or become unable to look after them it really becomes messy.

I am sitting on the fence on this one as well as the wee mans case. Its way way more complicated than it initially looks.

BTW I really don't have a clue what the current PC term is for down syndrome so if anyone gets offended by me using it I do apologise, please let me know what the correct way of describing the condition is these days.
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Old 30th Apr 2018, 13:35
  #113 (permalink)  
 
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Quoted elsewhere from Facebook"

So far I've been quiet over the tragic case of Alfie Evans, but as a doctor, a father of four and a former intensive care doctor I feel I have a duty to speak.

Firstly, no child is the property of their parents. As parents our own anguish, emotion and needs are entirely and utterly secondary to the best interests of our children. We do not own them. We can't make demands on what happens to them like a piece of furniture. Furthermore, as parents we are naturally conflicted in deciding what is best for them in times of dire crisis. Because of the unconditional love we have for our children we will naturally cling to hope even where there is none. Despite being a doctor I find it impossible to objectively medically assess my own children, because I'm their Daddy, not their doctor.

Secondly, doctors and nurses act in the best interests of their patients - not the parents, not the press, not some feral "army," not politicians, not the Pope, the PATIENT. The first line of the modern Hippocratic Oath is "Make the care of your patient your first concern." The staff at Alder Hey were working under incredibly difficult conditions even before a mob started accusing them of murder. Now their job is impossible.

Thirdly, Alfie Evans has an irreversible, catastrophic degenerative neurological disorder with no hope of recovery. The brain does not regenerate. Respiratory function and other basic physiological reflexes are literally, neurologically nothing whatsoever to do with sentience, consciousness or self awareness. Death, surrounded by those who love Alfie, peacefully, quietly, in dignity is in his best interests, this has been affirmed not just by his doctors but by the highest Court in the land. Having pictures of him in intensive care plastered all over the press, or being used as a political and religious football, or having people scream outside his hospital room is NOT in his best interests.

Finally, the behaviour of "Alfie's Army" is, to be frank, disgusting. Threatening doctors and nurses by name such that they fear for their lives is disgusting. Threatening to storm a children's hospital is disgusting. Threatening to pull fire alarms when other children are on the operating table having life saving surgery is worse than disgusting. Piggy-backing onto the grief of the parents of a baby you have never even met is flagrant grief tourism and an ultimate act of selfishness. Furthermore, veiling such aggressive and malignant behaviour behind a pretense of faith could not be further from what it means to be a Christian.

If you believe there is a conspiracy among the medical profession, or a cover up, or you believe parents own their children, or that the parents' feelings are more important than the dignity of their child, or if you are a member of Alfie's army then please do me a favour and remove yourself from my friends list.

God Bless you, Alfie.
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Old 30th Apr 2018, 13:44
  #114 (permalink)  
 
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Interesting post tescoapp.

Trying not to be heading off on a thread drift, we had a very similar situation. My wife had a routine blood test at 16 weeks pregnant - neither of us really considering the implications of anything but a normal result - which came back at an incredibly high risk of Downs which was a complete shock as she was only 31. We talked it through and, after much emotion, decided that we would go through an amniocentesis text and if the result was positive, we would opt for termination. It wasn’t an easy choice and not undertaken lightly. We got a lot of uninvited opinions from a few people; one that sticks in my mind was, “Downs children are very lovable you know.” Which is fine when they’re 4 years old but when they are 24, and depending on severity, not so endearing or appealing. We also, like yourself, considered the impact on our other children. Whilst they were young it would have taught them to be open minded, tolerant and supportive but once we were gone, I was adamant I didn’t want to leave a responsibility on the siblings that they had no choice over.

In the end, the result came back clear and our son was born with no developmental issues at all. It seems that every so often, these false positives are thrown up by these screening procedures. I would not judge anyone who has toface this dilemma. Incidentally, one of the options instead of termination we were given at the time was to give birth and put the affected child up for adoption. That seems even more bizarre to me as ultimately, if you make the choice to proceed, you cannot then pass your responsibility to a third party. Contentious but true.
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Old 30th Apr 2018, 14:38
  #115 (permalink)  
 
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It is a wee bit of thread drift but its all revolving round the ethics of first of all the situation and secondly the process. Something to be honest with a technical back ground I am ill equipped to ponder. And I know in myself I would tend to go for the economic over the feelings side of things.

Thankfully mine came out low risk so we didn't bother and everything went well.

It mates that have started a family late, mostly they are extremely well off, both have successful careers. Desperate to have kids. Didn't want to even know what the risks were.

Now one of them has given up working and retirement is a dream of the past.

As you say I wouldn't judge anyone either way. Same in this case. I can't judge and won't judge either the parents/doctors or legal types.

Its the ethics and the repercussions of doing things differently which tickles my brain cells. Yes they could have just said take the kid but then what does that set a precedence for...
Every kid that's a Jehovah witness that needs a blood transfusion gets taken out the country so one can't be given to satisfy the beliefs of the parents?
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Old 30th Apr 2018, 16:46
  #116 (permalink)  
 
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Good debate on an emotive subject. I'm puzzled as to why the OP started it then hasn't been seen since.

Questions answered to his satisfaction, or just trolling?
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Old 30th Apr 2018, 18:02
  #117 (permalink)  
 
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Originally Posted by Toadstool View Post
Good debate on an emotive subject. I'm puzzled as to why the OP started it then hasn't been seen since.

Questions answered to his satisfaction, or just trolling?
We can only assume that we have satisfactorily answered his question:

Originally Posted by KenV View Post
please explain how the UK government's, UK medical system's, and UK court's treatment of Alfie Evans is indicative of a much more "civilized", and "enlightened" society. Give us your best shot.
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Old 30th Apr 2018, 18:23
  #118 (permalink)  
 
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It has been an interesting debate, not least because it's a topic where it's pretty much impossible not to let your personal views intervene, and so cause a degree of bias. If we'd had a child with Down's, frankly we'd have loved it like any other, and every child or young person I've ever met with Down's has been, if anything, more lovable than most.

However, friends of my mother's (same generation, now passed, but they'd be in their early 90's if still alive) had a daughter who was born with a severe mental disability (not Down's Syndrome). Physically there was nothing at all wrong with her, but when I first met her, when she was in her mid-20's, she had a mental age of around 4 or 5, and still had to carry her favourite toy around everywhere, plus a portable radio. Once you've adapted to the disparity between her physical appearance and her true mental age she was great fun, but it was clear that she'd needed a lot of love and support from her parents. Even in though she was in her mid-20's they were still having to take her to the toilet, bathe her etc, and she'd apparently gone through a terrible time when she reached puberty, as the combination of her body changes, hormonal changes and her inability to understand what was happening at all, made her a bit of a handful.

However, the real dilemma came when her parents, by then in their late fifties, decided to go on holiday with my mother, and accept an offer of respite care from the local authority. Their daughter went to stay in a local authority care home, and they had a great holiday with my mum. However, a few weeks after they came back, they realised that their daughter was pregnant. No amount of investigation revealed who the father was, or when it had happened, their daughter just had no understanding at all of sex, and just didn't know whether she had done something wrong or not, or with whom.

Their dilemma was that they were strict Catholics, so the idea of a termination was abominable to them. Doctors tried to persuade them that their daughter just didn't have the mental capacity to care for a child, and they were unlikely to be able to cope if caring for her and her child. Fate intervened and she had a miscarriage, but then they faced another dilemma. Their faith meant that they could not sanction birth control for their daughter, nor could they agree to the suggestion that she be sterilised. They continued to look after her until they were physically unable to, when the state intervened, with their agreement. By this time their daughter was in her 40's, and they were in their 70's, but I believe that they had aged prematurely from the effort of caring for their daughter. I remember going to see them not that long before they both died (within a week of each other, just from old age), and they were still following the nightly routine one would with a 4 or 5 year old child, getting her bathed, put to bed, reading her a bedtime story etc, and doing all the inevitable cleaning up after her.

When they died she went into local authority care, and one of the first things they did was put her on contraception, followed by sterilisation. My mother (also Catholic) went ballistic, but frankly, I think the local authority made the right decision. As far as I know this lady is still alive, as she's only a few years younger than me, and always seemed very healthy. She needs practically 24 hour care, as she has all her life, but always seemed happy enough whenever I saw her.

The problem we have to deal with is that there are a lot of people like her, who aren't fortunate enough to have parents that are prepared to give up their own lives in order to provide care. Even those who are, will probably end up in local authority care eventually, something that we, as a society, have to accept and make provision for, including making some challenging moral decisions that the parents might not have agreed with.
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Old 30th Apr 2018, 18:58
  #119 (permalink)  
 
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The sterilisation ethics is also an interesting one.
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