Alfie and Care of the Sick

[RWStanding]

Alfie
The issues over Alfie, and care of the sick, would be clearer if people realized it has two levels.
The first level is that of the kind of society we believe in.
What is ‘right’ or ‘wrong’ is then determined on that foundation.
Politics and ethics is not linear – we live in a three-dimensioned world in all things.
It is clear that with the disposition of Alfie being ultimately decided by the hospital and courts, we are in what I term as at least a marginally altruistic democracy [not a love-in] of corporate responsibility.
Those who are vociferous about the paramount rights of the parents to decide, believe in a purely individual based society – rather akin to the USA. This can mean respect for life at any cost to the patient.
There is in fact a third social wing of those who believe in religious-political authoritarian law. They tend to refer to rule as provided, and only rationalise about ‘right’ and ‘wrong’ on that foundation. This may at times be altruistic in form.

[commonsense]

I am interested in this thread, especially as a retired USA healthcare worker. I can speculate that I am familiar with the case, but not by name. If possible, would you please provide Alfie's surname?

[uwot]

I am interested in this thread, especially as a retired USA healthcare worker. I can speculate that I am familiar with the case, but not by name. If possible, would you please provide Alfie's surname?

Alfie Evans, whose tragic life is now over: http://www.bbc.co.uk/news/uk-43933056

[commonsense]

Those who are vociferous about the paramount rights of the parents to decide, believe in a purely individual based society – rather akin to the USA. This can mean respect for life at any cost to the patient.

You are absolutely right.

To my knowledge, neither of Alfie’s parents was ever declared mentally incompetent to make medical decisions; the power to request or refuse medical care should not have been stripped from them.

When the doctors denied a de facto request for Alfie to receive continued life support, the court should have compelled the doctors to either comply with the parents’ request or to arrange for life support to be continued at another facility.

When the doctors warned of the risks of transferring Alfie, the parents should have been permitted to take that risk anyway if they chose to.

Preventing Alfie from being transferred should have been deemed by the court to be illegal imprisonment. The doctors should have been ordered by the court to facilitate the transfer by providing care to reduce risk during transport.

I can only conclude that the British government does indeed own the British citizens.

[vegetariantaxidermy]

Those who are vociferous about the paramount rights of the parents to decide, believe in a purely individual based society – rather akin to the USA. This can mean respect for life at any cost to the patient.

You are absolutely right.

To my knowledge, neither of Alfie’s parents was ever declared mentally incompetent to make medical decisions; the power to request or refuse medical care should not have been stripped from them.

When the doctors denied a de facto request for Alfie to receive continued life support, the court should have compelled the doctors to either comply with the parents’ request or to arrange for life support to be continued at another facility.

When the doctors warned of the risks of transferring Alfie, the parents should have been permitted to take that risk anyway if they chose to.

Preventing Alfie from being transferred should have been deemed by the court to be illegal imprisonment. The doctors should have been ordered by the court to facilitate the transfer by providing care to reduce risk during transport.

I can only conclude that the British government does indeed own the British citizens.

Parents don't own their children. The decision was based on what was best for the little boy, based on the medical evidence. If parents want something that is going to cause needless suffering to a child then someone has to step in on the child's behalf. There are an awful lot of whacked-up parents out there with bizarre ideas.

[-1-]

Do you remember (without checking on the Internet, or going back on any sort of recordskeeping) the woman who lived for fifteen or so years in a coma?

Yes? No? Do you even have an idea what I am talking about, the specific case? Yes? No?

If you don't remember, then to you this sort of wirtschaft is purely tabloid shit. A reason to get upset, and a reason to saddle up your stick-horse.

If you remember the case of the woman who lived fifteen years in a coma, then I condone your making an opinion about Alfie's case. I appreciate nobody needs my approval to get upset about anything, Alfie's case included.

There is always a Mother Theresa, there is always a Terry Fox, there is always an Alfie, there is always a Princess Di. What makes them memorable is people's remembering the facts, loud and clear; once you forget the facts, the whole thing has lost its usefulness to humanity.

[commonsense]

Parents don't own their children. The decision was based on what was best for the little boy, based on the medical evidence. If parents want something that is going to cause needless suffering to a child then someone has to step in on the child's behalf. There are an awful lot of whacked-up parents out there with bizarre ideas.

I'm not sure about the matter of ownership, but parents are legal agents for their children unless that status has been removed. When it becomes apparent that parents are wacked-up, legal action should be taken to remove them from the decision-making process. To my knowledge, neither Tom Evans nor Kate James were ever subject to a competency evaluation.

On my side of the Atlantic, there are mechanisms in place whereby the law can be applied to the situation, resulting in legal agency (power of attorney) being turned over to the doctors. In that way, someone can step in on the child's behalf without stepping on the parents' right to be stupid.

I wholly endorse what you are saying. I'm just saying that the law, at least American-style, could have been utilized in full support of Alfie's best interests. That's all.

[vegetariantaxidermy]

Do you remember (without checking on the Internet, or going back on any sort of recordskeeping) the woman who lived for fifteen or so years in a coma?

Yes? No? Do you even have an idea what I am talking about, the specific case? Yes? No?

If you don't remember, then to you this sort of wirtschaft is purely tabloid shit. A reason to get upset, and a reason to saddle up your stick-horse.

If you remember the case of the woman who lived fifteen years in a coma, then I condone your making an opinion about Alfie's case. I appreciate nobody needs my approval to get upset about anything, Alfie's case included.

There is always a Mother Theresa, there is always a Terry Fox, there is always an Alfie, there is always a Princess Di. What makes them memorable is people's remembering the facts, loud and clear; once you forget the facts, the whole thing has lost its usefulness to humanity.

Not sure who you are talking to, but I presume you are referring to cases where people wake up after years in a coma. There have been a few, so a name might help. Could you say what your point is?

[-1-]

Not sure who you are talking to, but I presume you are referring to cases where people wake up after years in a coma. There have been a few, so a name might help. Could you say what your point is?

The case I am referring to (without naming it) is the one where the person after 16 years spent in a come was taken off life support and died.

This created a big hoolabaloo, just like Alfie. I find the whole thing nothing more than an exercise to vent one's own indignation. Those who see lessons other than sources of indignation, I support. Indignation alone is not a virtue in these cases, because, frankly, their moral qualities can't be decided by philosophical (speculative) means. You might as well get indignated by abortion, by global warming, by gun violence, by social inequities, by the rich getting richer and the poo getting pooer. Which is precisely what people do who don't have anything more valuable to say.

I'm thinking of your archtypical couch potatoes, armchair philosophers, hockey-mums, etc. People who value their own opinion ONLY because it's their own, and because they have a number of other people to support them who have the same opinion, but basically the opinion is worth- and/ or useless in and by itself. (It may not be worthless, but it still could be and is useless.)

One way to make a useless argument useful is to work out from the past mistakes how we will attack a similar challenge in the future. But without remembering the past mistakes, we can't possibly work out an approach to meet the future challenges.

THIS is why I said, those who remember the sixteen-year-old veggie (sorry, no reference to you, VT), have the moral right (in my own private opinion, supported by the above argument) to make an opinion on Alfie: those ones with a memory of what the proper action would have been, could work out a solution, but those who did and do not remember the past event that was similar to Alfie's, are just wasting their breaths because they don't learn from the past to correct the future.

Not sure who you are talking to

I am not sure, either. It's only those who remember the sixteen-years of comatose woman, and only those who don't remember it know. I don't know who remembers it and who does not. It's up to the individual reader to decide on him/herself, and then they can keep the knowledge (of whether they remember or not) to themselves, it's not required of them to disclose it.

[vegetariantaxidermy]

Not sure who you are talking to, but I presume you are referring to cases where people wake up after years in a coma. There have been a few, so a name might help. Could you say what your point is?

The case I am referring to (without naming it) is the one where the person after 16 years spent in a come was taken off life support and died.

This created a big hoolabaloo, just like Alfie. I find the whole thing nothing more than an exercise to vent one's own indignation. Those who see lessons other than sources of indignation, I support. Indignation alone is not a virtue in these cases, because, frankly, their moral qualities can't be decided by philosophical (speculative) means. You might as well get indignated by abortion, by global warming, by gun violence, by social inequities, by the rich getting richer and the poo getting pooer. Which is precisely what people do who don't have anything more valuable to say.

I'm thinking of your archtypical couch potatoes, armchair philosophers, hockey-mums, etc. People who value their own opinion ONLY because it's their own, and because they have a number of other people to support them who have the same opinion, but basically the opinion is worth- and/ or useless in and by itself. (It may not be worthless, but it still could be and is useless.)

One way to make a useless argument useful is to work out from the past mistakes how we will attack a similar challenge in the future. But without remembering the past mistakes, we can't possibly work out an approach to meet the future challenges.

THIS is why I said, those who remember the sixteen-year-old veggie (sorry, no reference to you, VT), have the moral right (in my own private opinion, supported by the above argument) to make an opinion on Alfie: those ones with a memory of what the proper action would have been, could work out a solution, but those who did and do not remember the past event that was similar to Alfie's, are just wasting their breaths because they don't learn from the past to correct the future.

Not sure who you are talking to

I am not sure, either. It's only those who remember the sixteen-years of comatose woman, and only those who don't remember it know. I don't know who remembers it and who does not. It's up to the individual reader to decide on him/herself, and then they can keep the knowledge (of whether they remember or not) to themselves, it's not required of them to disclose it.

Is philosophy any less valid when done on an armchair?
I don't see how the doctors could have come to any other decision. Did the parents think his brain was suddenly going to regenerate and he would be normal? It wasn't normal right from the start of his life and continued to deteriorate.

[-1-]

I don't see how the doctors could have come to any other decision. Did the parents think his brain was suddenly going to regenerate and he would be normal? It wasn't normal right from the start of his life and continued to deteriorate.

I think parents just simply don't want to see their kids die. It's a biological-social-DNA-Darwinism issue. If the kid is a three-headed space goat that eats planets, the parents still want to see it mature to reproductive age and make its own babies. Even if that is impossible.

Is philosophy any less valid when done on an armchair?

In a way, yes. At least in my case. My best "Aha!" experiences and personal philosophical revelations come to me while sitting on the toilet (water-flushing), and pausing between two consecutive squeezes as I'm pinching a loaf.

EDIT: Imagine me doing the precisely same thing on an armchair. Ah, perish the thought.

[commonsense]

It seems to me that the case was of a woman in Florida. I have a very vague recollection that her name was not uncommon nor unusual, possibly Terri or Sarah or Susan. The comatose state was not the result of a congenital condition, but I don’t recall what kind of illness or injury was involved. I remember that the doctors and the medical facility wanted to discontinue life support. It was her family’s belief that life support should be continued. Their reasons for feeling so were that 1) she was still alive, 2) they loved her and 3) they hoped she might wake up.

The case was similar to Alfie’s, however this woman was an adult (26yo???) at the time the case came to a head. As such, no family member had power of attorney (POA) over her because no one had been designated prior to her becoming comatose and unable to express her wishes. I believe the courts awarded power of attorney to the doctors because the judge allowed that medical opinion was in the best interests of the patient (which is common when doctors apply for POA in the US).

I have stated that Alfie’s parents should not have been stripped of their legal authority to make medical decisions for their child. It is no business of mine, nor anyone else’s, what Tom and Kate want to do for their child. However, society does have an interest in the treatment decisions to the extent that the cost is paid, in part or on the whole, by taxes or some form of societal burden. In that case, society may challenge the parents’ wishes based on whether their wishes are reasonable. No matter how strange or how costly their decisions may be, no matter how public opinion is inclined, unless their judgment has been found incompetent by credible 3rd party, the parents should be allowed to choose.

One important solution to the dilemma depends on how effectively advance directives are obtained, on a timely basis. Hospitals encourage this upon routine admission. There is a need, however, for a campaign to move people to prepare an advance directive and review it from time to time.

I will research the actual details of the case as soon as I will have posted this.

[commonsense]

It seems to me that the case was of a woman in Florida. I have a very vague recollection that her name was not uncommon nor unusual, possibly Terri or Sarah or Susan. The comatose state was not the result of a congenital condition, but I don’t recall what kind of illness or injury was involved. I remember that the doctors and the medical facility wanted to discontinue life support. It was her family’s belief that life support should be continued. Their reasons for feeling so were that 1) she was still alive, 2) they loved her and 3) they hoped she might wake up.

The case was similar to Alfie’s, however this woman was an adult (26yo???) at the time the case came to a head. As such, no family member had power of attorney (POA) over her because no one had been designated prior to her becoming comatose and unable to express her wishes. I believe the courts awarded power of attorney to the doctors because the judge allowed that medical opinion was in the best interests of the patient (which is common when doctors apply for POA in the US).

I have stated that Alfie’s parents should not have been stripped of their legal authority to make medical decisions for their child. It is no business of mine, nor anyone else’s, what Tom and Kate want to do for their child. However, society does have an interest in the treatment decisions to the extent that the cost is paid, in part or on the whole, by taxes or some form of societal burden. In that case, society may challenge the parents’ wishes based on whether their wishes are reasonable. No matter how strange or how costly their decisions may be, no matter how public opinion is inclined, unless their judgment has been found incompetent by credible 3rd party, the parents should be allowed to choose.

One important solution to the dilemma depends on how effectively advance directives are obtained, on a timely basis. Hospitals encourage this upon routine admission. There is a need, however, for a campaign to move people to prepare an advance directive and review it from time to time.

I will research the actual details of the case as soon as I will have posted this.

This much was correct:

It seems to me that the case was of a woman in Florida. I have a very vague recollection that her name was not uncommon nor unusual, possibly Terri or Sarah or Susan. The comatose state was not the result of a congenital condition, but I don’t recall what kind of illness or injury was involved.

[jayjacobus]

It seems to me that the case was of a woman in Florida. I have a very vague recollection that her name was not uncommon nor unusual, possibly Terri or Sarah or Susan. The comatose state was not the result of a congenital condition, but I don’t recall what kind of illness or injury was involved. I remember that the doctors and the medical facility wanted to discontinue life support. It was her family’s belief that life support should be continued. Their reasons for feeling so were that 1) she was still alive, 2) they loved her and 3) they hoped she might wake up.

The case was similar to Alfie’s, however this woman was an adult (26yo???) at the time the case came to a head. As such, no family member had power of attorney (POA) over her because no one had been designated prior to her becoming comatose and unable to express her wishes. I believe the courts awarded power of attorney to the doctors because the judge allowed that medical opinion was in the best interests of the patient (which is common when doctors apply for POA in the US).

I have stated that Alfie’s parents should not have been stripped of their legal authority to make medical decisions for their child. It is no business of mine, nor anyone else’s, what Tom and Kate want to do for their child. However, society does have an interest in the treatment decisions to the extent that the cost is paid, in part or on the whole, by taxes or some form of societal burden. In that case, society may challenge the parents’ wishes based on whether their wishes are reasonable. No matter how strange or how costly their decisions may be, no matter how public opinion is inclined, unless their judgment has been found incompetent by credible 3rd party, the parents should be allowed to choose.

One important solution to the dilemma depends on how effectively advance directives are obtained, on a timely basis. Hospitals encourage this upon routine admission. There is a need, however, for a campaign to move people to prepare an advance directive and review it from time to time.

I will research the actual details of the case as soon as I will have posted this.

This is a tough decision for the doctors not because they don't know what's right but because they must destroy the parents' hope. But if there is no hope, they are not harming the child although they are harming the parents' minds. That's a tough position to be in.

[-1-]

It seems to me that the case was of a woman in Florida. I have a very vague recollection that her name was not uncommon nor unusual, possibly Terri or Sarah or Susan. The comatose state was not the result of a congenital condition, but I don’t recall what kind of illness or injury was involved. I remember that the doctors and the medical facility wanted to discontinue life support. It was her family’s belief that life support should be continued. Their reasons for feeling so were that 1) she was still alive, 2) they loved her and 3) they hoped she might wake up.

The case was similar to Alfie’s, however this woman was an adult (26yo???) at the time the case came to a head. As such, no family member had power of attorney (POA) over her because no one had been designated prior to her becoming comatose and unable to express her wishes. I believe the courts awarded power of attorney to the doctors because the judge allowed that medical opinion was in the best interests of the patient (which is common when doctors apply for POA in the US).

I have stated that Alfie’s parents should not have been stripped of their legal authority to make medical decisions for their child. It is no business of mine, nor anyone else’s, what Tom and Kate want to do for their child. However, society does have an interest in the treatment decisions to the extent that the cost is paid, in part or on the whole, by taxes or some form of societal burden. In that case, society may challenge the parents’ wishes based on whether their wishes are reasonable. No matter how strange or how costly their decisions may be, no matter how public opinion is inclined, unless their judgment has been found incompetent by credible 3rd party, the parents should be allowed to choose.

One important solution to the dilemma depends on how effectively advance directives are obtained, on a timely basis. Hospitals encourage this upon routine admission. There is a need, however, for a campaign to move people to prepare an advance directive and review it from time to time.

I will research the actual details of the case as soon as I will have posted this.

Very well, Commonsense. You remembered even more details than I have.