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Real Life Ethical Scenario : 13 Year old Refuses Heart Transplant.

No Future

Is there not a distinction between euthanasia and withdrawal of treatment/not accepting treatment?

I think (please correct me if I'm wrong) that in some cases, withdrawal of treatment is passive euthanasia. But this case doesn't seem like euthanasia to me, I'm unsure why.

Reply 41

b9muslove

1

scaryhair

...in your opinion.

In my opinion, she is old enough to make a mature and informed decision on this. She's 13, not 3, and from what the articles state, she seems like a mature young woman. It looks like she's had more than her fair share of ill health, medication and surgery in life, I don't blame her for not wanting to have more if it means she might die on the operating table, when she'd rather make the most of the rest of her days and die peacefully at home.
I think it's an incredibly brave decision to make, I just hope she's making it for the right reasons.

Just out of curiousity, what would you consider the wrong reasons?

Reply 42

Wangers

16

scaryhair

I think (please correct me if I'm wrong) that in some cases, withdrawal of treatment is passive euthanasia. But this case doesn't seem like euthanasia to me, I'm unsure why.

Withdrawl of food and water could well be construed as passive euthanasia, yes.

Reply 43

scaryhair

12

b9muslove

Just out of curiousity, what would you consider the wrong reasons?

Something like being pressured into not having it done because her parents don't want her to.

Reply 44

jjkkll

OP

scaryhair

...in your opinion.

In my opinion, she is old enough to make a mature and informed decision on this. She's 13, not 3, and from what the articles state, she seems like a mature young woman. It looks like she's had more than her fair share of ill health, medication and surgery in life, I don't blame her for not wanting to have more if it means she might die on the operating table, when she'd rather make the most of the rest of her days and die peacefully at home.
I think it's an incredibly brave decision to make, I just hope she's making it for the right reasons.

Yes of course its my opinion, i am very opinionated and most of the time dont expand on statements i make.

but i can see and do appreciate other view points and all view points are seen as correct by some people.

Reply 45

crazyhelicopter

11

jjkkll

As Doctors our responsibility is to the patient, their best interests come first, this includes their medical and overall best interests.
In this case clearly the doctors believed she was too young to make a decision of such magnitude. Clearly they decided she was Fraser competent and as a result decided not to take her to court.

In my opinion, a heart transplant would have for sure increased both the quality and length of her life. But if the girl did not want to live then it would have possibly been a waste of an organ. Really? How do you know that?

I don't think you can force treatment on someone unless you can prove they are mentally incapacitated. (surely the stress the family were going through counts as a mental incapacitation, but anywho). This child/ her family are certainly competent enough to make the decision, they are certainly not medically incapacitated

Reply 46

annread

11

http://news.bbc.co.uk/1/hi/england/hereford/worcs/7721231.stm

listen to the Father of Hannah. He states very clearly how it was very much of Hannah's decision (based on professional advice and her feelings). He even states how the least advice she had was from her family, she made the decision on her own and they fully supported her decision.

I dont think people should be asking whether she is old enough to be able to make that decision or whether her parents should have made the decision. She has suffered from leukaemia for 8 years,and her heart has been weakened by drugs of her treatment. I feel in her case she fully understands the situation she is in, she has had 8 years experience going in and out of hospital, being pumped up with drugs. She knows the advantages and the risks of having the operation; but i think she has reached a point where she wants nature to take its own course to spend her last remaining months at home with her family. A heart transplant does not guarantee her a longer life expectancy, there are soo many risks esp. for her when she has sucha low immune system already. Consultants have advised her that the operation will not necessarily improve her situation- furthermore for the rest of her life she will be on immunosuppressive drugs and will be in and out of hospital. My opinion is Hannah is perfectly competent to make her own decision and i feel it is the right decision in her case.

Reply 47

rbilling

If a person has one right it should be the right to die.

Reply 48

jjkkll

OP

crazyhelicopter

Clearly they decided she was Fraser competent and as a result decided not to take her to court.

Its Gillick competent based on Fraser guidelines.

Reply 49

x.beth.x

11

jjkkll

Its Gillick competent based on Fraser guidelines.

I thought the Fraser guidelines applied only to giving contraception to under 16s.

Reply 50

jjkkll

OP

x.beth.x

I thought the Fraser guidelines applied only to giving contraception to under 16s.

But they are also used to determine Gillick competence.

Reply 51

Wangers

16

jjkkll

Its Gillick competent based on Fraser guidelines.

Not quite, craxy is right about this.
As I understand it, Gillick Vs ...NHS resulted in a 3:2 ruling. Out of the Majority came the Fraser Guildlines - which are overarching principles regarding medical treatment, consent and confidentiality. The Gillick competence test is to test whether a young person has the capacity for certain decisions.

Interestingly, the dissenting LJs were not too fond of Fraser because it could result in the absurd situation of a parent overruling a child who is competent, on the basis that for the Courts not to do so would constitute significant harm. (abortion for example) As it stands, the Fraser judgement has been weakened by subsequent cases, but the principles stand.

Reply 52

motiv3

9

Just one question tht i think is relevant to this.

How does one judge maturity?

Reply 53

jjkkll

OP

motiv3

Just one question tht i think is relevant to this.

How does one judge maturity?

finally someone with a brain.

Reply 54

crazyhelicopter

11

jjkkll

Its Gillick competent based on Fraser guidelines.

nope, apparently Gillick has asked to have her name removed. As a result it is Fraser competent based on the Fraser guidelines

Reply 55

Wangers

16

crazyhelicopter

nope, apparently Gillick has asked to have her name removed. As a result it is Fraser competent based on the Fraser guidelines

But its still 'Gillick' competence right? Because I thought Fraser was wider ranging then the actual Gillick competence.

Reply 56

crazyhelicopter

11

Wangers

But its still 'Gillick' competence right? Because I thought Fraser was wider ranging then the actual Gillick competence.

My understanding was that it was now Fraser competence- at least that's what our lecturers seem to be saying

not that this clears it up a huge amount but here

This concept - now known as Gillick competency - initially arose in the case of Gillick v West Norfolk & Wisbech HA in 1986.3 The term Fraser competency is also used in this respect (Lord Fraser was the judge who ruled on the case). It used to be said that Victoria Gillick objected to the use of her name in this connection, but she has since denied it. Some authorities refer to Fraser competency when talking about contraception, and Gillick competency when talking about wider areas of consent.4 In many cases the two terms are used interchangeably.

It would appear that everyone is right

Reply 57

randdom

20

I feel that as long as she has been assessed as being competent to make that decisions and has been spoken to about the implications of turning down the transplant then she should be allowed to say no if that is what she feels is best.

Reply 58

jjkkll

OP

randdom

I feel that as long as she has been assessed as being competent to make that decisions and has been spoken to about the implications of turning down the transplant then she should be allowed to say no if that is what she feels is best.

Agreed!

Reply 59

Huw Davies

11

My understanding (from our lecturer) was that Mrs Gillick disliked use of her name as the moniker for the term, as the decision was against her, so that of the judge (Fraser) is now preferred.

Real Life Ethical Scenario : 13 Year old Refuses Heart Transplant.

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