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Reply 40
frost105
Plus in nicu there is often than not a continuity of care so its the same doctors and nurses so they are seeing the full picture too.


On a shift basis - with days off during the week - unlike the parents.
Reply 41
yawn


What are we if not human? Are we robots devoid of emotion? There is no one in this particular case who could be said to be freer from emotion. Whether it's wanting the child to survive against all odds or maybe not wanting to admit that perhaps they got it wrong.

Ypur assuming that the doctors and nurses are heartless when actually its a tough job for them too. Nicu is the hardest and most stressful paeds nit to work in and often than not is very satisfying. However there are sad cases like Charlottes, its very sad but the medical team are trying to get the best for her.
Reply 42
yawn
On a shift basis - with days off during the week - unlike the parents.

But they are still seeing her a lot. Plus the parents are going home to sleep and rest and they still have to go to work too.
Reply 43
Howard
The parents DO NOT know more about her medical condition than the doctors. Period. The parents are waiting for a miracle that ain't gonna happen. Jesus IS NOT going to pay a visit and release this child from suffering.


Howard - I hope you or I are never put in this position. I disagree that the parents don't know more about her medical conditon than the doctors. You are putting the doctors in a position of omnipotence. They are human and liable to error.
Reply 44
yawn
Howard - I hope you or I are never put in this position. I disagree that the parents don't know more about her medical conditon than the doctors. You are putting the doctors in a position of omnipotence. They are human and liable to error.

Yes but they have been trained and will be specialised and have seen cases like charlottes.
Reply 45
frost105
But they are still seeing her a lot. Plus the parents are going home to sleep and rest and they still have to go to work too.



The mother does not work - the father has taken on the role of parenting full-time. The care is shared between the two. When one goes home to rest the other is there with their daughter. It is just becoming silly now to try and argue about which one person sees her most.

We really need to stand back and think through what is at play here. In the future does a doctor have a right to decide who lives and who dies? That is what is happening.
Reply 46
frost105
Yes but they have been trained and will be specialised and have seen cases like charlottes.


I am horrified at such simplistic trust. :eek:
Reply 47
yawn
Howard - I hope you or I are never put in this position. I disagree that the parents don't know more about her medical conditon than the doctors. You are putting the doctors in a position of omnipotence. They are human and liable to error.


So do I. Notwithstanding, doctors do tend to know more about medical conditions than non-doctors don't you think? That's why they spend years in medical school :rolleyes:

(I wonder if anybody spotted my non-doctor reference? :biggrin: )
Reply 48
yawn
Howard - I hope you or I are never put in this position. I disagree that the parents don't know more about her medical conditon than the doctors. You are putting the doctors in a position of omnipotence. They are human and liable to error.


He isn't putting the doctors is a position of omnipotence no one her is. However the doctors who are treating her have trained for most likely 12 years or more. They have a lot of medical knowledge. And while the parents do see the child every day they don't have this background knowledge. So while they may have a more personal relationship with their daughter (which is only to be expected) they aren't able to determine many things about their daughters condition that you can't tell just by spending time with the child and holding watching ect. I think you have a slightly overly negative view of the doctors in this case. The chances are that they want to be able to save this baby but they also don't want her to suffer they are trying to make a decision about a baby that they have probably seen a lot of and are probably attached to. I really doubt that they would be fighting so hard for this if they didn't think it was in her best interests. I know that the parents have spent more time with their daughter and are bound to have a closer relationship with her, however like I have said before their judgement is blurred by the fact that they don't want to loose their daughter.

We really need to stand back and think through what is at play here. In the future does a doctor have a right to decide who lives and who dies? That is what is happening.


That isn't what is happening here. When it comes to treating patients there may one day come a time where you have to say enough is enough there is no more that can be done in good conscience. This is especially important when you are looking at a child who can not make that decision for herself. Would it really be good moral judgement for the doctors to prolong her life when she is suffering? Note I use the word prolong because all evidence at the moment is showing that she is not going to survive. What you seem to be suggesting is that a parent should get to decide weather a child lives or dies. I don't see how this can be fair either. It isn't the doctors who are deciding it is a court. Both sides submitted their evidence and explaned their reasoning and then a judgement was made. This is a very sad case and I really do feel for the parents however I think that you have to really think what is best for the child and that is what the court has done. If there is some suddent improvement then I am sure the doctors will be the first to inform the court. However as it stands now the decision wasn't made by a single doctor but by a group plus a court.
Reply 49
yawn
I am horrified at such simplistic trust. :eek:

If Charlottes parents had looked into her illness they will find there is no hope for a full recovery from her illness. I trust doctors completely though I would look into any perscribed treatments as most people would however there is no hope for Charlotte and her parents need to be helped to understand that.
yawn
The parents. Remember, the professional is not the expert on the particular child - how could they be? The expert is the one who nurtures, lives with, feeds, clothes and looks after the child 24/7. The professional get a 'pen picture' at that point in time.

Medicine is not a finite science. Professionals cannot and do not know all the answers. Their opinions are just that - opinions. Therefore those opinions have not more validity that the intimate knowledge that the parents have on their child.

There really should be more humility amongst the medical profession imo.

Um...
Need more humility yes
Everything else you said - rubbish.
"Their opinions are just that - opinions. Therefore those opinions have not more validity that the intimate knowledge that the parents have"
Do you honestly believe this? Does the intimate knowledge of a parent allow them to recommend the correct procedure for an infection? No. Does it allow them to point out the doctor that they baby has been crying much more than normal. yes.

But I think the validity of your argument is a bit stretched in this case, because the baby has never left the hospital.
Frost105 said "Plus in nicu there is often than not a continuity of care so its the same doctors and nurses so they are seeing the full picture too."
Now this of course makes no sense, but what i think she means is that there isn't a continuity of care in ICU, which is actually about as wrong as you can be. In ICU there are specialist doctors and nurses, and so you get a high level of continuity. Plus it tends to be the same 2/3 nurses assigned to each patient (on 8-12 hour rolling shifts though) on a 1-1 basis. Of course im speaking for adult ICU, but i would imagine paediatric ICU being a similar story.
yawn
Howard - I hope you or I are never put in this position. I disagree that the parents don't know more about her medical conditon than the doctors. You are putting the doctors in a position of omnipotence. They are human and liable to error.

Dude, you can have a hundred children, and STILL not be able to tell the difference between a headache and meningitis.
yawn
The mother does not work - the father has taken on the role of parenting full-time. The care is shared between the two. When one goes home to rest the other is there with their daughter. It is just becoming silly now to try and argue about which one person sees her most.

We really need to stand back and think through what is at play here. In the future does a doctor have a right to decide who lives and who dies? That is what is happening.

Do you know what 'parenting' is in this case? For gods sake the baby's head is in an O2 box all the time to help it actually breathe.
Parenting in this case is sitting by the cotside, hoping for the best, and perhaps holding up the food bag.
yawn
I am horrified at such simplistic trust. :eek:

I'm horrified at such suspicion and distrust.
Reply 54
foolfarian
Dude, you can have a hundred children, and STILL not be able to tell the difference between a headache and meningitis.


Neither can doctors in many cases. Have you not seen all the publicity over the years where parents have entrusted their children/families to A&E's only to be told their child has a virus etc - take them home and give them some calpol - and the child has meningococcal septacaemia - and loses a limb or their life?

Too many parents allow their own instincts to be overruled by someone who doesn't have the correct diagnosis - because of this myth that is perpetuated by the medical profession that they know best.

You wouldn't get away with the myth in the US as most patients are encouraged to have input into their own health - probably because health care is not free and not adequately covered by health insurance.
Reply 55
randdom
He isn't putting the doctors is a position of omnipotence no one her is. However the doctors who are treating her have trained for most likely 12 years or more. They have a lot of medical knowledge. And while the parents do see the child every day they don't have this background knowledge. So while they may have a more personal relationship with their daughter (which is only to be expected) they aren't able to determine many things about their daughters condition that you can't tell just by spending time with the child and holding watching ect. I think you have a slightly overly negative view of the doctors in this case. The chances are that they want to be able to save this baby but they also don't want her to suffer they are trying to make a decision about a baby that they have probably seen a lot of and are probably attached to. I really doubt that they would be fighting so hard for this if they didn't think it was in her best interests. I know that the parents have spent more time with their daughter and are bound to have a closer relationship with her, however like I have said before their judgement is blurred by the fact that they don't want to loose their daughter.



That isn't what is happening here. When it comes to treating patients there may one day come a time where you have to say enough is enough there is no more that can be done in good conscience. This is especially important when you are looking at a child who can not make that decision for herself. Would it really be good moral judgement for the doctors to prolong her life when she is suffering? Note I use the word prolong because all evidence at the moment is showing that she is not going to survive. What you seem to be suggesting is that a parent should get to decide weather a child lives or dies. I don't see how this can be fair either. It isn't the doctors who are deciding it is a court. Both sides submitted their evidence and explaned their reasoning and then a judgement was made. This is a very sad case and I really do feel for the parents however I think that you have to really think what is best for the child and that is what the court has done. If there is some suddent improvement then I am sure the doctors will be the first to inform the court. However as it stands now the decision wasn't made by a single doctor but by a group plus a court.


I think, Randdom, your attitude may be influenced by your own personal circumstances - and that is quite understandable.

I am more pragmatic because I am not personally involved in this sort of scenario. That does not mean that I cannot empathise with the trauma Charlottes parents are going through. As I said before the video of her gives a totally different picture to that painted by the staff of the hospital. I don't know if you saw the programme on TV last night about the man who was in a coma for 19 years. The doctors said he would never recover - that the man the family knew was no longer there! His mother refused to accept that - she said she knew he was aware of his surroundings and the doctors maintained that this apparent awareness was only a 'reflex' reaction. He is now fully aware and talking - although he had problems with memory (understandably) which will resolve with time! That is the crux of what I am saying - no one, I repeat, no one can say definitively that a person have no chance of long-term survival. Therefore heroic efforts should be made to ensure this child has that chance.
Reply 56
foolfarian
Do you know what 'parenting' is in this case? For gods sake the baby's head is in an O2 box all the time to help it actually breathe.
Parenting in this case is sitting by the cotside, hoping for the best, and perhaps holding up the food bag.


You haven't seen the video have you? The little girl sits in a reclining chair, looking around her, responding to clapping etc. Her head in NOT in an oxygen box all the time - she wears an oxygen mask (as do many children suffering from CF) so it shows there are signs of improvement, does it not?
Reply 57
foolfarian
I'm horrified at such suspicion and distrust.

No, not suspicion and distrust - just an acceptance that they don't know/have all the answers.
Reply 58
yawn
The parents. Remember, the professional is not the expert on the particular child - how could they be? The expert is the one who nurtures, lives with, feeds, clothes and looks after the child 24/7. The professional get a 'pen picture' at that point in time.
Hardly; charlotte is continually in hospital, remember, where the care staff can observe her all the time. The staff are the people who can compare Charlotte with other children as well.

Medicine is not a finite science. Professionals cannot and do not know all the answers. Their opinions are just that - opinions. Therefore those opinions have not more validity that the intimate knowledge that the parents have on their child.

Surely you mean medicine is a finite science? The opinions of the hospital staff are informed opinions, from people who have seen many children and do not have the desperate hope of Charlotte's parents.
There really should be more humility amongst the medical profession imo.
It is the parents who believe the doctors are not doing what they think the doctors can do. Medical arrogance more often takes the form of imposing life and suffering when the two are synonymous on people from curiosity and an overvaluation of what they can do than refusing to perform futile operations.
Reply 59
foolfarian
Um...

Frost105 said "Plus in nicu there is often than not a continuity of care so its the same doctors and nurses so they are seeing the full picture too."
Now this of course makes no sense, but what i think she means is that there isn't a continuity of care in ICU, which is actually about as wrong as you can be. In ICU there are specialist doctors and nurses, and so you get a high level of continuity. Plus it tends to be the same 2/3 nurses assigned to each patient (on 8-12 hour rolling shifts though) on a 1-1 basis. Of course im speaking for adult ICU, but i would imagine paediatric ICU being a similar story.

Hi foolfarian I prob didnt phrase it well. I meant that there is a continuity of care in nicu, i worked in bristol childrens hospital for a year and although I never worked in nicu i had many friends that did and the nicu there was very well run and staffed and it was a goal to have the same medical team throughout the childs stay in the hospital.

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