Miaow
07-02-2007, 09:08
Just wondering what people feel about this?
Doctors ready to defy law to speed death of ill newborns
Clara Pirani, Medical reporter
February 07, 2007
ONE in three medical specialists is prepared to break the law by using painkillers or sedatives to hasten the death of a baby born with a severe life-threatening disability.
An anonymous survey of neonatologists in Australia and New Zealand also found almost half were willing to use medication to speed up death in critically ill newborns for whom further treatment was considered hopeless.
Peter Barr, a senior physician at the Children's Hospital at Westmead, Sydney, who conducted the study, said the desire to alleviate a baby's pain and suffering sometimes outweighed doctors' concerns about the law.
"This was a self-reporting questionnaire where neonatologists responded to hypothetical situations, so we don't know exactly what they do in practice, but we know what their preferences are," Dr Barr said. "They were presenting their views, knowing that they were not lawful."
While neonatologists commonly withdraw or withhold treatment in newborns with a terminal disease or severe disability, it is illegal to use medication to hasten a person's death.
However, doctors reported that they would prefer to use painkillers or sedation to hasten death, rather than withholding oxygen or nutrients.
"For example, if further medical treatment has been deemed therapeutically non-beneficial or overly burdensome, then neonatologists may consider it more compassionate and humane to purposefully hasten death unlawfully with analgesia-sedation than, for instance, to forgo gastric tube feeding, which may be lawful," the study found.
"Hence neonatologists seem to support the moral notion that it is sometimes 'better to kill than let die' - even though the former is unlawful and seems not to respect the 'sanctity of life'." Dr Barr also discovered there was a link between doctors' personal fear of death and their ethical beliefs.
"Neonatologists who said that they were prepared to hasten death when death was inevitable had a greater of fear of death than those who thought that it was unacceptable," Dr Barr said.
"Fear of the dying process and premature death may unconsciously motivate these neonatologists to do what they can to ease the baby's suffering and hasten their death, and that takes priority over the legal implications."
University of Queensland professor of medical ethics Malcolm Parker told The Australian doctors who chose to break the law were motivated by compassion.
"It's never easy for clinicians faced with that situation but I'm sure they feel compelled in very severe cases to do what they believe is the most humane thing," he said.
"In that sense, ethically they may not find it a difficult decision to make but I'm sure the idea of breaking the law would not be easy."
The study, published in the Archives of Disease in Childhood, asked doctors to respond to hypothetical scenarios and measured their responses against a "fear of death" scale.
In an accompanying editorial, Martin Ward Platt, a leading neonatology researcher from the Royal Victoria Infirmary in Newcastle, England, said the medical profession needed to acknowledge that doctors' attitudes to death could influence their treatment of patients.
"Barr's paper shows us that in relation to neonatal death and dying, doctors' fear, or lack of it, matters," Dr Ward Platt said. "It matters because it can influence clinical judgments. Recognising this influence is an important aspect of self-knowledge."
Professor Parker said the debate about assisted death, which is usually focused on terminally ill adults, would in the future examine the treatment of seriously ill babies.
"In Holland, where euthanasia is legal for adults, there is certainly a strong movement towards making active assistance to die legal in the neonatal cases, so I think we will see a gradual movement in that direction."
http://www.theaustralian.news.com.au/story/0,20867,21184501-2702,00.html
Doctors ready to defy law to speed death of ill newborns
Clara Pirani, Medical reporter
February 07, 2007
ONE in three medical specialists is prepared to break the law by using painkillers or sedatives to hasten the death of a baby born with a severe life-threatening disability.
An anonymous survey of neonatologists in Australia and New Zealand also found almost half were willing to use medication to speed up death in critically ill newborns for whom further treatment was considered hopeless.
Peter Barr, a senior physician at the Children's Hospital at Westmead, Sydney, who conducted the study, said the desire to alleviate a baby's pain and suffering sometimes outweighed doctors' concerns about the law.
"This was a self-reporting questionnaire where neonatologists responded to hypothetical situations, so we don't know exactly what they do in practice, but we know what their preferences are," Dr Barr said. "They were presenting their views, knowing that they were not lawful."
While neonatologists commonly withdraw or withhold treatment in newborns with a terminal disease or severe disability, it is illegal to use medication to hasten a person's death.
However, doctors reported that they would prefer to use painkillers or sedation to hasten death, rather than withholding oxygen or nutrients.
"For example, if further medical treatment has been deemed therapeutically non-beneficial or overly burdensome, then neonatologists may consider it more compassionate and humane to purposefully hasten death unlawfully with analgesia-sedation than, for instance, to forgo gastric tube feeding, which may be lawful," the study found.
"Hence neonatologists seem to support the moral notion that it is sometimes 'better to kill than let die' - even though the former is unlawful and seems not to respect the 'sanctity of life'." Dr Barr also discovered there was a link between doctors' personal fear of death and their ethical beliefs.
"Neonatologists who said that they were prepared to hasten death when death was inevitable had a greater of fear of death than those who thought that it was unacceptable," Dr Barr said.
"Fear of the dying process and premature death may unconsciously motivate these neonatologists to do what they can to ease the baby's suffering and hasten their death, and that takes priority over the legal implications."
University of Queensland professor of medical ethics Malcolm Parker told The Australian doctors who chose to break the law were motivated by compassion.
"It's never easy for clinicians faced with that situation but I'm sure they feel compelled in very severe cases to do what they believe is the most humane thing," he said.
"In that sense, ethically they may not find it a difficult decision to make but I'm sure the idea of breaking the law would not be easy."
The study, published in the Archives of Disease in Childhood, asked doctors to respond to hypothetical scenarios and measured their responses against a "fear of death" scale.
In an accompanying editorial, Martin Ward Platt, a leading neonatology researcher from the Royal Victoria Infirmary in Newcastle, England, said the medical profession needed to acknowledge that doctors' attitudes to death could influence their treatment of patients.
"Barr's paper shows us that in relation to neonatal death and dying, doctors' fear, or lack of it, matters," Dr Ward Platt said. "It matters because it can influence clinical judgments. Recognising this influence is an important aspect of self-knowledge."
Professor Parker said the debate about assisted death, which is usually focused on terminally ill adults, would in the future examine the treatment of seriously ill babies.
"In Holland, where euthanasia is legal for adults, there is certainly a strong movement towards making active assistance to die legal in the neonatal cases, so I think we will see a gradual movement in that direction."
http://www.theaustralian.news.com.au/story/0,20867,21184501-2702,00.html