Skip to main content

Difficult ethical issues in Charlie Gard case

The news of death threats sent to staff at Great Ormond Street Hospital is disturbing. Whatever the opinion held on the issues surrounding the care of baby Charlie Gard, it has to be acknowledged that these are complex.

It would be easy enough to adopt the position that it should always be the parents choice to decide on the best treatment for their child, but this cannot always trump the legitimate concerns and responsibilities of doctors and nursing staff. It would of course be ideal if all choices on treatment, or of withdrawal of treatment and life support, could be made with agreement of both parents and doctors. But this cannot always be the case.

In the most difficult cases where there is disagreement about life support it will inevitably be decided by judges and through the legal process.

When the case was first heard I was asked as a medical ethicist to make a comment to the media. I chose not to do so because I could not know the full details of the case. This is true for most of us, and for many of those who chose freely to comment on it.

I can only comment in general terms, and not about a specific case. The facts need to be considered with compassion and understanding for all those involved - the medical staff and the parents, and of course baby Charlie.

We cannot expect doctors and nurses simply to provide treatment regardless of the overwhelming balance of probability that the treatment will cause more harm than it would relieve suffering. What we do understand about this particular case is that the treatment available in the USA has only a small chance of success.  Yes, that chance should be considered.

We might consider that any chance should be taken, but this would ignore the potential for needless suffering.

It is often said that the first rule in medicine is to do no harm. This is of course overly simplistic. It is often the case that treatment has both the potential for harm as well as for benefit. It is then a question of the balance of that benefit to harm.

These can be difficult to assess,  and the more so when dealing with the care of a baby. It is certainly the case that the progress in neonatal care and the improved outcomes would not have occurred if doctors had not pushed boundaries.

Whatever the 'rights' and 'wrongs' in the case of baby Charlie Gard, the staff at Great Ormond Street Hospital have legitimate concerns and are acting ethically in respect of their duties and responsibilities. They do not deserve to be threatened and abused.

Meanwhile our thoughts must be with the parents and with their baby. The parents, Connie Yates and Chris Gard are acting with great dignity and love for their child. They did not condone abuse and have also faced "nasty and hurtful remarks". They deserve to be heard and respected. So also do the doctors and nurses. Abuse of parents or doctors does not serve the interests of this baby, and it is unclear what the motives are of those behind the abuse.




Comments

Popular posts from this blog

Ian Duncan-Smith says he wants to make those on benefits 'better people'!

By any account, the government's austerity strategy is utilitarian. It justifies its approach by the presumed potential ends. It's objective is to cut the deficit, but it has also adopted another objective which is specifically targeted. It seeks to drive people off benefits and 'back to work'.  The two together are toxic to the poorest in society. Those least able to cope are the most affected by the cuts in benefits and the loss of services. It is the coupling of these two strategic aims that make their policies ethically questionable. For, by combining the two, slashing the value of benefits to make budget savings while also changing the benefits system, the highest burden falls on a specific group, those dependent on benefits. For the greater good of the majority, a minority group, those on benefits, are being sacrificed; sacrificed on the altar of austerity. And they are being sacrificed in part so that others may be spared. Utilitarian ethics considers the ba

The secret life of Giant Pandas

Giant pandas, Ailuropoda melanoleuca , have usually been regarded as solitary creatures, coming together only to mate; but recent studies have begun to reveal a secret social life for these enigmatic bears.  GPS tracking shows they cross each others path more often than previously thought, and spend time together.  What we don't know is what they are doing when together.  Photo by  Sid Balachandran  on  Unsplash For such large mammals, pandas have relatively small home ranges. Perhaps this is no surprise. Pandas feed almost exclusively on bamboo. The only real threat to pandas has come from humans. No wonder then that the panda is the symbol of the WWF.  Pandas communicate with one another through vocalization and scent marking. They spray urine, claw tree trunks and rub against objects to mark their paths, yet they do not appear to be territorial as individuals.  Pandas are 99% vegetarian, but, oddly, their digestive system is more typical of a carnivore. For the 1% of their diet

Work Capability Assessments cause suffering for the mentally ill

People suffering from mental health problems are often the most vulnerable when seeking help. Mental health can have a major impact on work, housing, relationships and finances. The Work Capability Assessments (WCA) thus present a particular challenge to those suffering mental illness.  The mentally ill also are often the least able to present their case. Staff involved in assessments lack sufficient expertise or training to understand mental health issues and how they affect capability. Because of  concerns that Work Capability Assessments will have a particularly detrimental effect on the mentally ill,  an  e-petition  on the government web site calls on the Department of Work and Pensions to exclude people with complex mental health problems such as paranoid schizophrenia and personality disorders. Problems with the WCA  have been highlighted in general by the fact that up to 78% of 'fit to work' decisions are  being overturned on appeal. It is all to the good that they