Britain - The Official Thread

[Scaff]

It isn't the government who decided to switch off little Alfie's life support. It was the doctors at Alder Hey.

And then when through long and extensive legal checks, with the ultimate decision being made by a court, based on the best interests of the child.

Disturbing to see people attempting to use it as an argument against the health service, odd that the likelihood under a private system of his family now being bankrupt never makes it into that claim.

This is why America doesn't want the government running our medical system.

Odd as it seems that a number of Americans are starting to want exactly that.

 

[ryzno]

Odd as it seems that a number of Americans are starting to want exactly that.

And good number don't.
I'll say it again, I regret voting for the ACA...

 

[Scaff]

And good number don't.
I'll say it again, I regret voting for the ACA...

I'm aware of that, your post however was worded as if America was in single unified agreement on the subject.

 

[HenrySwanson]

Appeal failed yesterday. Father is to meet with doctors today about bringing Alfie home.

Not sure how to feel about this whole case. If the parents had the means to look after him someplace else is it right for doctors and the judiciary to intervene..

 

[Spurgy 777]

From listening to the BBC yesterday, doesn't even seem as though the Italian hospitals are even offering much other than to extend Alfie's life a bit. They can't cure him or do anything about his condition so I fully understand the hospital he's currently at not allowing him to be taken aboard for more invasive treatment that won't really do anything at all and runs the risk of increasing his suffering (assuming he can even feel anything which they say is unlikely but can't really know for sure).

 

[TenEightyOne]

If the parents had the means to look after him someplace else is it right for doctors and the judiciary to intervene..

If it doesn't prolong/extend/increase his suffering then it would seem to be the right thing to do in this particular case.

It still has to be remembered that in this case the person who is dying is the one who (rightly) is under the protection of the doctors, not the people who have an emotional attachment to that person.

 

[HenrySwanson]

If it doesn't prolong/extend/increase his suffering then it would seem to be the right thing to do in this particular case.

It still has to be remembered that in this case the person who is dying is the one who (rightly) is under the protection of the doctors, not the people who have an emotional attachment to that person.

And that's the crux of it. How do we define "suffering"

Do we say that suffering is the physical sensation of pain? If it is how can we assess pain in a comatose child?

Is suffering prolonging life when the quality of life is low and there is no chance of a cure? In that case what do we say about the giving of IV fluids and PEG feeding (through a tube to the stomach) of dementia patients. From my experience they've shown much more outward expressions of suffering, sometimes looking as if they are living through the worst nightmares imaginable. As for knowing that there is no chance of a cure, it is known doctors are fallible when assessing patients on end of life care: http://www.dailymail.co.uk/femail/a...evealed-heart-warming-Louis-Theroux-film.html

But say we agree on a definition of suffering, would a transfer cause undue suffering? How would this suffering be any different to the withdrawal of treatment that has now been applied.

Yes the state has a duty of care to a child, but in grey areas such as this do we default to the position of trusting the state over two loving parents? And when the state is relying on a hospital with a questionable track record:

one behind a massive organ harvesting scandal:
https://en.wikipedia.org/wiki/Alder_Hey_organs_scandal

or one that has been accused of neglecting the patient in question:



Is the decision so easy?

 

[TenEightyOne]

Do we say that suffering is the physical sensation of pain? If it is how can we assess pain in a comatose child?

Normally through EEGs. In the case of this little boy there has been a progression of brain scans that have showed accumulation of water in the brain tissues which are rapidly degenerating.

one behind a massive organ harvesting scandal:
https://en.wikipedia.org/wiki/Alder_Hey_organs_scandal

One of several hospitals that fell foul of a lack of organ regulation - iirc the rogue consultant at Alder Hey was banned from practising medicine and new, far stricter laws were introduced to make mortuary's duties clear. It seems vanishingly unlikely that the consultant was suddenly re-employed for this case, no?

or one that has been accused of neglecting the patient in question:

We can only wait to see what the result of those accusations is. We should be mindful of the fact that this child's body is degenerating horrendously.

Is the decision so easy?

That's a medical decision despite your insistence on somehow binding it up with the state. The child has been seen by a large number of consultants and experts from both sides of the argument due to the protracted legal goings-on. You make it seem as if you're trying to say the hospital have had a temp-nurse tick "nearly dead" and shove him in a cupboard with little further thought.

 

[Liquid]

What's everyone's thoughts on the Alfie Evans case?

A lot of dumb things are being said. That's pretty much the nub of the matter.

 

[UKMikey]

A lot of dumb things are being said. That's pretty much the nub of the matter.

What is he going to do... threaten the doctors at gunpoint?

This has to be a parody account... OMG no, he was a congressman.

 

[MatskiMonk]

What is he going to do... threaten the doctors at gunpoint?

Injection of hot lead at 3,300 feet per second to euthanize the child.... cure things the 'murican way.

 

[TenEightyOne]

The newest lizard baby is back in the news - she's called Louise. So that's nice.

 

[Liquid]

Louis? Nice of the spoilt family to go back to their roots.

Vive la France!

 

[HenrySwanson]

Normally through EEGs. In the case of this little boy there has been a progression of brain scans that have showed accumulation of water in the brain tissues which are rapidly degenerating.

Interesting - can they differentiate seizure activity from "pain spikes". Would you happen to have a paper on this subject as it would be good to learn.

One of several hospitals that fell foul of a lack of organ regulation - iirc the rogue consultant at Alder Hey was banned from practising medicine and new, far stricter laws were introduced to make mortuary's duties clear. It seems vanishingly unlikely that the consultant was suddenly re-employed for this case, no?

Hmmm but what about those other headlines of mess-ups by the hospital

We can only wait to see what the result of those accusations is. We should be mindful of the fact that this child's body is degenerating horrendously.

Doubtful anything will happen. I did read on another forum that there was some rumour that he was double dosed on medication before he deteriorated but can't find anything to corroborate that.

That's a medical decision despite your insistence on somehow binding it up with the state. The child has been seen by a large number of consultants and experts from both sides of the argument due to the protracted legal goings-on.

Let's backtrack a bit.

Doctors act in the best interests of the child and sometimes this goes against the parents wishes, but they have an obligation to do this on behalf of the state.
Laws are created to ensure doctors can do this by people on behalf of the state
These laws are acted out by the judiciary....on behalf of the state
If a parent was to, say ignore said law, and in this case try to flee with Alfie to another country they would be arrested by police enforcing the law acting on, you guessed it....behalf of the state.

May I suggest it is you who are ignoring the state's influence rather than me trying to bind it to the state.

You make it seem as if you're trying to say the hospital have had a temp-nurse tick "nearly dead" and shove him in a cupboard with little further thought.

Where did you get that from

Let's ask a simple question:

Alfie's parents have the means to transport him to a hospital where he can be continued to be cared for. Who are we to stop them, and why?

 

[Tired Tyres]

The newest lizard baby is back in the news - she's called Louise. So that's nice.

He's got a cool song though.

 

[Mr Tree]

Interesting - can they differentiate seizure activity from "pain spikes". Would you happen to have a paper on this subject as it would be good to learn.


Hmmm but what about those other headlines of mess-ups by the hospital


Doubtful anything will happen. I did read on another forum that there was some rumour that he was double dosed on medication before he deteriorated but can't find anything to corroborate that.



Let's backtrack a bit.

Doctors act in the best interests of the child and sometimes this goes against the parents wishes, but they have an obligation to do this on behalf of the state.
Laws are created to ensure doctors can do this by people on behalf of the state
These laws are acted out by the judiciary....on behalf of the state
If a parent was to, say ignore said law, and in this case try to flee with Alfie to another country they would be arrested by police enforcing the law acting on, you guessed it....behalf of the state.

May I suggest it is you who are ignoring the state's influence rather than me trying to bind it to the state.


Where did you get that from

Let's ask a simple question:

Alfie's parents have the means to transport him to a hospital where he can be continued to be cared for. Who are we to stop them, and why?

The doctors do this on behalf of the state without interferrence of said state.

The judiciary system does this on behalf of the state without interferrence of said state.

The police would be arresting them on behalf of the state without interferrence of said state. On the 'orders' of a judge not the state.

There are walls put in between all these branches as to make sure it's done on behalf of the state but the state has no say in it.

From my point of view it seems you're implying they're acting on bevalf of the state due to direct orders of said state, which is just wrong.

Could you elaborate on your position considering this subject?

 

[Johnnypenso]

The doctors do this on behalf of the state without interferrence of said state.

The judiciary system does this on behalf of the state without interferrence of said state.

The police would be arresting them on behalf of the state without interferrence of said state. On the 'orders' of a judge not the state.

There are walls put in between all these branches as to make sure it's done on behalf of the state but the state has no say in it.

From my point of view it seems you're implying they're acting on bevalf of the state due to direct orders of said state, which is just wrong.

Could you elaborate on your position considering this subject?

The "state" makes the rules therefore anyone acting on behalf of the state is taking direct orders of said state. There is no leeway for independent decision making. Follow the rules or get fired.

 

[Mr Tree]

The "state" makes the rules therefore anyone acting on behalf of the state is taking direct orders of said state. There is no leeway for independent decision making. Follow the rules or get fired.

That's a ery unnuanced way of looking at lawmaking.

For starters lawmakers are not allowed to make laws that are in conflict with it's state's constitution. When they do the judicial branch can overrule said law. On top of that there are ways to change the constitution but that should and most often does involve a 'super' mahority or some nind of hurdles before you can change it.

So no it's not just the rules of those in power now. It's the rules of those in power now combined with human rights and a constitution.

Am I missing something?

 

[TenEightyOne]

Interesting - can they differentiate seizure activity from "pain spikes". Would you happen to have a paper on this subject as it would be good to learn.

Patents go back years and the practice is well-developed.

Hmmm but what about those other headlines of mess-ups by the hospital

I challenge you to find any hospital that's never had a procedural error. However (as I explained) this case has surely had more judicial and expert oversight than almost any other.

Doubtful anything will happen. I did read on another forum that there was some rumour that he was double dosed on medication before he deteriorated but can't find anything to corroborate that.

No, and we don't have the facts to corroborate any of those accusations. Better leave it to the experts in both camps. Ignore forum rumours - that's generally good advice.

Doctors act in the best interests of the child and sometimes this goes against the parents wishes, but they have an obligation to do this on behalf of the state.
Laws are created to ensure doctors can do this by people on behalf of the state
These laws are acted out by the judiciary....on behalf of the state
If a parent was to, say ignore said law, and in this case try to flee with Alfie to another country they would be arrested by police enforcing the law acting on, you guessed it....behalf of the state.

You make it sound as if the child is somehow a lesser class of person than the parent? Why shouldn't the laws of the state protect every person?

The "state" makes the rules therefore anyone acting on behalf of the state is taking direct orders of said state. There is no leeway for independent decision making. Follow the rules or get fired.

The law that doctors operate to within any given state is not necessarily entirely provided by the state. You'll find plenty of cases where hippocratic malpractice has led to the disbarrment of doctors who committed no criminal offence. In fact there are times when doctors in the UK have felt that their duties under the oath and under the guidance of the BMA have been at odds with British law.

Where did you get that from

The general attitude of your posts on the subject.

Let's ask a simple question:

Alfie's parents have the means to transport him to a hospital where he can be continued to be cared for.

He can't be cared for. His physical state is degenerating and there's no working brain left. Prolonging life in the remains of the organism would be cruel and wouldn't serve that person at all - it would be a sop to the emotions of other people.

Who are we to stop them, and why?

Dudes on an internet forum... why would we stop a person being treated in the most sympathetic way by their hospital just because some other people would be upset if they died? Not our place.

 

[Moglet]

What's everyone's thoughts on the Alfie Evans case?

I think there are a lot of bored "full time mums" jumping on the AlfiesArmy hashtag spouting hyperbolic nonsense on Twitter and egging each other on to show off how sympathetic they are. It seems to be bringing out a lot of anger in people and causing them to make judgements based on emotions rather than fact. Which is exactly why the doctors want to keep him in hospital; they're basing the situation on fact rather than emotion.

In the real world it seems like his parents now just want him to be able to go home without the press interfering or people protesting on their behalf, which is fair enough as it must be a very difficult time for them.

 

[HenrySwanson]

Just to update that Alfie Evans passed away earlier this morning

The doctors do this on behalf of the state without interferrence of said state.

The judiciary system does this on behalf of the state without interferrence of said state.

The police would be arresting them on behalf of the state without interferrence of said state. On the 'orders' of a judge not the state.

There are walls put in between all these branches as to make sure it's done on behalf of the state but the state has no say in it.

From my point of view it seems you're implying they're acting on bevalf of the state due to direct orders of said state, which is just wrong.

Could you elaborate on your position considering this subject?

Which subject, state involvment or the Alfie Evans case?

Patents go back years and the practice is well-developed.

That's talking about a device in development. Interesting though it is it's not really showing how pain is checked for in comatose children.

I challenge you to find any hospital that's never had a procedural error. However (as I explained) this case has surely had more judicial and expert oversight than almost any other.

I never said other hospitals didn't have problems, I was talking about those headlines speciffic to Alder Hey.

No, and we don't have the facts to corroborate any of those accusations. Better leave it to the experts in both camps. Ignore forum rumours - that's generally good advice.

I don't even completely trust the CQC based on past experience.

You make it sound as if the child is somehow a lesser class of person than the parent? Why shouldn't the laws of the state protect every person?

Huh? Where does that come from by showing the state's influence in this case??

The general attitude of your posts on the subject.

I like to think I've only provided facts

He can't be cared for. His physical state is degenerating and there's no working brain left.

Huh? Now you're saying PICU nurses can't care for comatose children

Prolonging life in the remains of the organism would be cruel and wouldn't serve that person at all - it would be a sop to the emotions of other people.

So says you. Are the parents not allowed to disagree with that?
What if this case was about Dylan Askin, and the parents had disagreed with the doctors?
http://www.dailymail.co.uk/news/art...kes-coma-parents-agree-turn-life-support.html

Dudes on an internet forum... why would we stop a person being treated in the most sympathetic way by their hospital just because some other people would be upset if they died? Not our place.

So it's not our place but the place of the state?

Interesting

And who decided it's the most sympathetic way of treatment? What if doctors in ten years time decide euthanasia is the most sympathetic way of treatment in certain cases and the state (yes, the state) enact laws decrying as such?

 

[Mr Tree]

@HenrySwanson stateinvolvement in the process that the alfie evans case is in but this doesn't has to be specific to the alfie evans case as said involcment would be universal I geuss.

 

[HenrySwanson]

@HenrySwanson stateinvolvement in the process that the alfie evans case is in but this doesn't has to be specific to the alfie evans case as said involcment would be universal I geuss.

I think it's necessary that the state do this, but that they shouldn't have the ultimate decision making ability in all cases. Cases such as a Jehovah's Witness denying their child a life saving blood transfusion being over-ruled (only if the child isn't Gillick competent) I agree with, but in grey areas such as the Alfie Evans case, who is the state to say they can't take him for palliative treatment in Italy.

 

[Mr Tree]

I think it's necessary that the state do this, but that they shouldn't have the ultimate decision making ability in all cases. Cases such as a Jehovah's Witness denying their child a life saving blood transfusion being over-ruled (only if the child isn't Gillick competent) I agree with, but in grey areas such as the Alfie Evans case, who is the state to say they can't take him for palliative treatment in Italy.

But that's what i disagree with the state had no say in it. The state made rules so the doctors can go through court to end someones suffering when he/she can't themself. But the state has no say in who this should be. That's for experts to deceide who need not to listen to what the state want as long as he follows the rules. I don't see the grey area the doctors don't need think about the parents not the state, they need to do what's best for the patient.

 

[Famine]

the state had no say in it. The state made rules

That's a contradiction. If the state can make rules about it, the state has a say in it. And who enforced the rules? What's to prevent someone from defying the rule and doing it anyway? If it's "armed agents of the state", that's the state having a say in it. Well, the only say in it.


The question is what you define as "the state". Is "the state" exclusively the elected politicians who create the laws and vote them into existence? Does it include the unelected politicians and royals who ratify the laws? Does it include the judiciary who decide if a particular situation meets the laws or not?

they need to do what's best for the patient.

What is best for a patient who the doctors no longer feel they can treat? Is it always "make them pain free until they die from starvation"?

 

[Mr Tree]

That's a contradiction. If the state can make rules about it, the state has a say in it. And who enforced the rules? What's to prevent someone from defying the rule and doing it anyway? If it's "armed agents of the state", that's the state having a say in it. Well, the only say in it.


The question is what you define as "the state". Is "the state" exclusively the elected politicians who create the laws and vote them into existence? Does it include the unelected politicians and royals who ratify the laws? Does it include the judiciary who decide if a particular situation meets the laws or not?

What is best for a patient who the doctors no longer feel they can treat? Is it always "make them pain free until they die from starvation"?

I see now people consider the judiciary system the state.

I seem to disagree with the idea that therefor the stage can just arrest someone because they want to or simply make a rule. Yet that process is protected by checks and balances.

So while I can now see why people call it the state I still disagree with the insinuation that they do it on behalf of the elected politicians.

On ypur last point well you've got me there I have no.idea how painless said death was and if there where better alternatices but I still think short suffering is better then prolongued suffering?

 

[Famine]

I see now people consider the judiciary system the state.

I seem to disagree with the idea that therefor the stage can just arrest someone because they want to or simply make a rule. Yet that process is protected by checks and balances.

So while I can now see why people call it the state I still disagree with the insinuation that they do it on behalf of the elected politicians.

But you've rather missed the point.

The judges judged that the doctors were abiding by the rules. The rules that allow the doctors to do it were set in place by the politicians. If the parents decide that the doctors are wrong and want to take their child from their care to the care of someone else they think is better able, the judges' judgement will be enforced by the police.

That's the state's enforcement body enforcing a judgement made by the state's judiciary body that the doctors - who in this case are employed by the state - are abiding by the rules set by the state's legislative body. The wishes of the child's parents - who were seeking better care, lest we forget, rather than seeking to deny the child care - are completely overridden by the state's wishes to allow its doctors to have the final say.

In this case, that say was "We can't treat this child any more, so he should be allowed to die". Which leaves the question if that is always the patient's "best interests" still open.

I have no.idea how painless said death was and if there where better alternatices but I still think short suffering is better then prolongued suffering?

Define "suffering".

But the question remains: is making someone pain-free until they die always the best option for someone who a doctor feels they can no longer treat?

Only that sounds awfully close to euthanasia. What's the difference between giving someone analgesia until they die and giving someone enough analgesia that they die? The only one I can see is "time", and if you're arguing that, for someone who is terminally ill, a quicker death is better than a longer death, euthanasia should be the best possible option.

But the UK does not legally support euthanasia. In fact it's illegal, and anyone found helping someone to die even if they want it can be prosecuted (for manslaughter). So the argument that removing life-prolonging support, effectively starving the child to death in order to shorten their "suffering", is not one that our state can use...

 

[TenEightyOne]

But you've rather missed the point.

The judges judged that the doctors were abiding by the rules. The rules that allow the doctors to do it were set in place by the politicians.

And the BMA.

That's the state's enforcement body enforcing a judgement made by the state's judiciary body that the doctors - who in this case are employed by the state - are abiding by the rules set by the state's legislative body.

Of all the doctors who've agreed that this person was suffering an incurable, degenerative disease with no chance of further life only some were employed by the NHS. Some were employed as private consultants (ie self-employed) and some by Christian charities.

The wishes of the child's parents - who were seeking better care, lest we forget, rather than seeking to deny the child care - are completely overridden by the state's wishes to allow its doctors to have the final say.

All the doctors who've been involved were ethically bound to consider the state of the patient, not of grieving relatives.

In this case, that say was "We can't treat this child any more, so he should be allowed to die". Which leaves the question if that is always the patient's "best interests" still open.

It seems that the say was, more specifically, this person will die regardless of any treatment, whether simply palliative or otherwise. It's a tragedy when that's the medical outcome for anybody - but sometimes it is. The best interest might be the only course of action. If I reach a point where my body tissue continues to pump oxygenated blood around a lump of person-less meat then I hope that nobody will bother with keeping that process going artificially.

Define "suffering".

But the question remains: is making someone pain-free until they die always the best option for someone who a doctor feels they can no longer treat?

If the only alternative is leaving them in pain until they die then yes.

 

[Mr Tree]

But you've rather missed the point.

The judges judged that the doctors were abiding by the rules. The rules that allow the doctors to do it were set in place by the politicians. If the parents decide that the doctors are wrong and want to take their child from their care to the care of someone else they think is better able, the judges' judgement will be enforced by the police.

That's the state's enforcement body enforcing a judgement made by the state's judiciary body that the doctors - who in this case are employed by the state - are abiding by the rules set by the state's legislative body. The wishes of the child's parents - who were seeking better care, lest we forget, rather than seeking to deny the child care - are completely overridden by the state's wishes to allow its doctors to have the final say.

In this case, that say was "We can't treat this child any more, so he should be allowed to die". Which leaves the question if that is always the patient's "best interests" still open.

Define "suffering".

But the question remains: is making someone pain-free until they die always the best option for someone who a doctor feels they can no longer treat?

Only that sounds awfully close to euthanasia. What's the difference between giving someone analgesia until they die and giving someone enough analgesia that they die? The only one I can see is "time", and if you're arguing that, for someone who is terminally ill, a quicker death is better than a longer death, euthanasia should be the best possible option.

But the UK does not legally support euthanasia. In fact it's illegal, and anyone found helping someone to die even if they want it can be prosecuted (for manslaughter). So the argument that removing life-prolonging support, effectively starving the child to death in order to shorten their "suffering", is not one that our state can use...

Ow I see now the argument isn't about the state having 'ultimate' authority, but rather if it is a good rule the doctor can deceide wheter it's been enough or not to stop the treatment in the place of a patient who can no longer do so themself.

Well ok that's an entirely diffrent discussion but due to lack of a better idea on my behalf I still think they are in the best position to do so.

Do you have a better suggestion?

 

[Famine]

Ow I see now the argument isn't about the state having 'ultimate' authority, but rather if it is a good rule the doctor can deceide wheter it's been enough or not to stop the treatment in the place of a patient who can no longer do so themself.

No, not really.

I'm pointing out why it's very easy to see this case as "parents seeking life-saving treatment" vs. "state that thinks this child can't be treated and should die".

And the BMA.

Of all the doctors who've agreed that this person was suffering an incurable, degenerative disease with no chance of further life only some were employed by the NHS. Some were employed as private consultants (ie self-employed) and some by Christian charities.

All the doctors who've been involved were ethically bound to consider the state of the patient, not of grieving relatives.

Nevertheless, the situation remains that the state enforce's the state's judgement on the state's rules. That's why it's rather easy to see the point that this is the state saying that (the doctors judgement that) death is the best interest of the patient, contrary to the wishes of the parents.

And in this case the parents were seeking alternatives to "no treatment" (beyond palliative), rather than the usual thing that crops up in this situation which is parents seeking to prevent treatment.

It seems that the say was, more specifically, this person will die regardless of any treatment, whether simply palliative or otherwise. It's a tragedy when that's the medical outcome for anybody - but sometimes it is.

Indeed - and it's natural for parents particularly to have trouble with that conclusion.

The best interest might be the only course of action. If I reach a point where my body tissue continues to pump oxygenated blood around a lump of person-less meat then I hope that nobody will bother with keeping that process going artificially.

I volunteer. Crossbow do you?

If the only alternative is leaving them in pain until they die then yes.

That rather leaves the question of euthanasia back open.