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

Maternal depression can impact child mental and physical health

Maternal depression has been repeatedly linked with negative childhood outcomes, including increased psychopathology.  Now, a new study shows that depression in mothers may impact on their children's stress levels,  as well as their physical and mental well-being throughout life.

In the study, published in the journal  Depression & Anxiety,  the researchers followed 125 children from birth to 10 years.

At 10 years old, the mothers’ and children’s cortisol (CT) and secretory immunoglobulin (s-IgA)—markers of stress and the immune system (see below)—were measured, and mother-child interaction were observed.
Psychiatric assessment  The mothers and children also had psychiatric diagnoses, and the children's externalising and internalising symptoms were reported.



Internalising disorders include depression, withdrawal, anxiety, and loneliness. They are often how we 'feel inside', such as  anger, pain, fear or hurt, but may not show it.  In contrast, externalising symptom…

Palm Oil production killing the planet

Bad trade and bad products are killing our planet. We have said this before on The Thin End. There is no better example than that of palm oil. It is used ubiquitously in so many products, and its production is a major factor destroying rainforests and threatening precious species.

Demand for palm oil is 'skyrocketing worldwide'. It is used in packaging and in so much of our snack foods, cookies, crackers, chocolate products, instant noodles, cereals, and doughnuts, and the list goes on.
Bad for the planet So, why is this so bad for the planet?

The oil is extracted from the fruit of the oil palms native to Africa. It is now grown primarily in Indonesia and Malaysia, but is also expanding across Central and West Africa and Latin America.

Palm oil production is now one of the world's leading causes of rainforest destruction, and this is impacting adversely some of the world's most culturally and biologically diverse ecosystems. Irreplaceable wildlife species like t…

Clear blue lakes turning murky in USA

New research reveals that many lakes in the continental United States are becoming murkier, with potentially negative consequences for water quality and aquatic life. These are the findings of a study published in Limnology and Oceanography.

From blue, clear lakes to greenish brown In the 5 years between 2007 and 2012, the dominant lake type in the United States shifted from clear, blue lakes to greenish-brown, murky lakes. Blue lakes declined by 18% while murky lakes increased by 12%. 



Overall, “blue” lakes decreased by ~ 18% (46% of lakes in 2007 to 28% in 2012) while “murky” lakes increased by almost 12% (24% of lakes in 2007 to 35.4% in 2012).  So, the majority of lakes are now murky.

Regionally, murky lakes significantly increased in the Northern Appalachian, Southern Plains, and Xeric ecoregions.

In the Northern Appalachians, blue lakes decreased by 41.4%, brown lakes increased by 17.8%, and murky lakes increased by 26.8%. In the Northern Plains, green lakes significantly increas…