I personally feel very uncomfortable about the case in question. As an ITU nurse I have a lot of experience with brain dead patients being prepared for organ donation. Even for the few hours (sometimes days) while we care for the dead patient in such a meticulous and rigid fashion in order to maintain the organs at their optimum, it is heart wrenching to watch the family's reactions to their loved one who still appears 'alive' while we obsess over preserving all vital signs within rigid parameters. I really cannot imagine what that would be like over the course of several months or even how it would be really possible? Patients who are brain stem dead have a very labile/ swinging blood pressure and we find it difficult enough maintaining it and keeping it stable with drugs for even a few hours, let alone for several months. Also, patients on ventilators for just a week are prone to developing VAP (ventilator associated pneumonia) so I foresee lots of complications ahead for this poor young woman, and the foetus, and I would be very surprised if this ends well for the baby. There are so many powerful drugs needed to maintain 'life' (it's not just machines) that surely will not benefit the developing foetus.........
If this was happening in the hospital where I work I believe the majority of the staff in ITU (even though most of us are Catholics) would find it unethical as well as desperately sad. It would be completely different if the foetus was developed to the point where it could be delivered but this is a long way from being the case.
As an ex-midwife these are exactly my concerns. I highly doubt this is going to be a favourable outcome for a healthy baby.
The complex hormonal levels required to fully develop/mature a fetus may not be fully present - is her pituitary damaged? The drugs required to stabilise her BP, maintain kidney function etc are generally not recommended in pregnancy, if she then develops diabetes insipidus that adds further complications. The risk of skin breakdown and resulting infection, the risk of pulmonary infection....the list goes on.
They can deliver at 24 weeks, but the mortality/morbitidity rate for premmies born at 24-25 weeks really hasn't improved over the past 10 years - the majority of babies born at that gestation are severly compromised (physically and developmentally). Ideally you would want to get to 28 weeks before delivering, and even then the risks are high.
All this in a situation where the fetus may have already sustained brain damage (intra-ventricular haemorrage) during the incident when the mother sustained her brain stem injury. If it was an anoxic brain injury (lack of blood flow, hence lack of O2 to the brain, it's likely the blood flow to the placenta and therefore the baby was compromised). Even if it was a traumatic brain injury there is likely to have been some placental disruption.
Now the fetus is being maintained in an environment where the mothers body is deteriorating around it.
As a mother I can honestly say, if that was me in that position I wouldn't want them to continue ventilatory/'life' support.
There still seems to be slight confusion re brain death, it's not a little bit dead, it's not being in a coma, it's not being in a PVS - you are dead. This fetus is contained within a dead body.
I'm sorry if this has been answered before, but who will legally have to take care of the child, if it survives and is born? Are the parents of the dead woman responsible? Or will the child be handed to the social services?
There still seems to be slight confusion re brain death, it's not a little bit dead, it's not being in a coma, it's not being in a PVS - you are dead. This fetus is contained within a dead body.
Yes but there are different ways that people die. You couldnt compare it to someone who has deteriorated and gone into multiple organ failure. She has had bleeding in her brain which has damaged her brain stem (as far as i can gather) so there will not be any problems with her body unless her heart stopped and she was revived (no detail) I cant see there being any problem with perfusion of her placenta at any point (although I am no expert). Of course however, there will be risk of infection should they continue treatment
Dr Peter McKenna said the chances of the baby being born alive are small and the chances of intact survival are “even smaller”.
Her eyes were so swollen they do not close, she said. The woman’s little girl, when she saw her for the first time, was distressed, she said.
this woman had shown signs of pneumonia and other infection, she added.
“The heart will stop, there is no machine in the world that will maintain the heart beat indefinitely,” she said. The woman’s brain is also rotting and she is being treated for a form of meningitis.
The woman is also suffering from hypertension, high blood pressure, which is unusual and very worrisome, she added. This was “uncharted territory” in her experience. The possible effects of the drugs on the woman’s pregnancy are uncertain, she said
There are continuing unusual fungal infections in this patient and they are unlikely to result in a positive outcome, she said.
The effect of the woman’s high temperature of some 37 and 38 degrees on the foetus is worrying, he said.
For Gawds sake it's completely hideous. What about the rights of the living not to suffer.
All you agreeing with this medical intervention, how would you feel if it was your relative lied there, their brain rotting, liquifying. What about the rights of the living. Could you cope with that?
I find the whole thing staggering and I'm saddened this is happening so close to me.
Dr Peter McKenna said the chances of the baby being born alive are small and the chances of intact survival are “even smaller”.
Her eyes were so swollen they do not close, she said. The woman’s little girl, when she saw her for the first time, was distressed, she said.
this woman had shown signs of pneumonia and other infection, she added.
“The heart will stop, there is no machine in the world that will maintain the heart beat indefinitely,” she said. The woman’s brain is also rotting and she is being treated for a form of meningitis.
The woman is also suffering from hypertension, high blood pressure, which is unusual and very worrisome, she added. This was “uncharted territory” in her experience. The possible effects of the drugs on the woman’s pregnancy are uncertain, she said
There are continuing unusual fungal infections in this patient and they are unlikely to result in a positive outcome, she said.
The effect of the woman’s high temperature of some 37 and 38 degrees on the foetus is worrying, he said.
For Gawds sake it's completely hideous. What about the rights of the living not to suffer.
All you agreeing with this medical intervention, how would you feel if it was your relative lied there, their brain rotting, liquifying. What about the rights of the living. Could you cope with that?
I find the whole thing staggering and I'm saddened this is happening so close to me.
That is horrific, her poor family. Very disturbing
Hope the High Court sees sense too - I cannot imagine there are many in the country who who would dispute the need to respect the families wishes now. Awful and tragic case.
Judgement now expected St. Stephen's Day (Boxing Day)
Hope the High Court sees sense too - I cannot imagine there are many in the country who who would dispute the need to respect the families wishes now. Awful and tragic case.
Judgement now expected Stephen's Day (Boxing Day)
I thought you were in favour of keeping her going. Have you changed your mind?
I thought you were in favour of keeping her going. Have you changed your mind?
Not now - I had thought that this child could have been born healthy.. This is now obviously not the case and it's highly likely the child won't even take a breath in this world - the families and fathers wishes should now be respected.
Not now - I had thought that this child could have been born healthy.. This is now obviously not the case and it's highly likely the child won't even take a breath in this world - the families and fathers wishes should now be respected.
I agree. It's sad for all concerned but this pregnancy never had a chance. Just too early. It's horrific to think she's rotting around it. It might have been different if the pregnancy was even just ten weeks further on. They should cease trying to maintain the mother's corpse & let the foetus quietly die in peace
I agree. It's sad for all concerned but this pregnancy never had a chance. Just too early. It's horrific to think she's rotting around it. It might have been different if the pregnancy was even just ten weeks further on. They should cease trying to maintain the mother's corpse & let the foetus quietly die in peace
The high court judge has already said this has nothing to do with abortion so he is IMO giving himself more legroom to coming down on the families side. If the high court does not the country will go absolutely mad, there was big support in keeping this woman alive when everyone thought the baby could be born healthy but now everyone I have met agrees with the family.
I hope this ends soon. Keeping a braindead, decomposing woman functioning on machines because of the "right to life" of something that isn't even a person? What a grotesque sideshow. It makes me sick thinking about what her family must be going through. This should not be happening in supposedly civilized countries.
The high court judge has already said this has nothing to do with abortion so he is IMO giving himself more legroom to coming down on the families side. If the high court does not the country will go absolutely mad, there was big support in keeping this woman alive when everyone thought the baby could be born healthy but now everyone I have met agrees with the family.
Tbh, I don't understand how abortion was ever a factor in this. How can it be, if a foetus dies inside its dead mother?
I hope this ends soon. Keeping a braindead, decomposing woman functioning on machines because of the "right to life" of something that isn't even a person? What a grotesque sideshow. It makes me sick thinking about what her family must be going through. This should not be happening in supposedly civilized countries.
It is a civilised country in every single aspect - among the most educated and successful in the world but the placing of the rights the unborn in our constitution (meant to protect children from harm) means these kinds of cases will crop up from time to time.
Tbh, I don't understand how abortion was ever a factor in this. How can it be, if a foetus dies inside its dead mother?
Yes and that was what the judge in the case has said - some in Ireland were trying to use this case to promote their own abortion agenda ... That was wrong, very wrong.
It is a civilised country in every single aspect - among the most educated and successful in the world but the placing of the rights the unborn in our constitution (meant to protect children from harm) means these kinds of cases will crop up from time to time.
These cases should not crop up at all. This case isn't even about abortion. It's like something from a horror movie.
Yes and that was what the judge in the case has said - some in Ireland were trying to use this case to promote their own abortion agenda ... That was wrong, very wrong.
Yes, very wrong. It seems like the judge is leaning toward switching her off then. I hope it's sooner, rather than later, to minimise any foetal distress. (I assume 'putting it to sleep' inside her would be out of the question)
These cases should not crop up at all. This case isn't even about abortion. It's like something from a horror movie.
You see if this child could be born healthy and the doctors shut the machine off they would have been on very uncertain ground - this has to go to the high court for judicial review.
I suspect the abortion aspect is raised because Article eight that protects the unborns right to life and was initiated predominantly to prevent abortion, not foreseeing the wider picture of what could occur through it.
Yes, very wrong. It seems like the judge is leaning toward switching her off then. I hope it's sooner, rather than later, to minimise any foetal distress. (I assume 'putting it to sleep' inside her would be out of the question)
We will know St. Stephen's Day in any case what the high court decides.
I suspect the abortion aspect is raised because Article eight that protects the unborns right to life and was initiated predominantly to prevent abortion, not foreseeing the wider picture of what could occur through it.
Yes exactly.. The "where practical" in article 8 will IMO lead the judge to side with the family.
You see if this child could be born healthy and the doctors shut the machine off they would have been on very uncertain ground - this has to go to the high court for judicial review.
You could understand if it was a later stage in the pregnancy but not this time. Think it would be horrendously cruel on everyone (including the unborn child) if the High Court ruled in favour of the doctors.
However it is two lives tragically lost (as people say, it's not 29 people who died in Omagh in 1998, it's 31).
You could understand if it was a later stage in the pregnancy but not this time. Think it would be horrendously cruel on everyone (including the unborn child) if the High Court ruled in favour of the doctors.
I don't think it's a case of being 'in favour of the doctors'. They don't seem to want to be doing this.
Comments
Completely horrendous situation.
As an ex-midwife these are exactly my concerns. I highly doubt this is going to be a favourable outcome for a healthy baby.
The complex hormonal levels required to fully develop/mature a fetus may not be fully present - is her pituitary damaged? The drugs required to stabilise her BP, maintain kidney function etc are generally not recommended in pregnancy, if she then develops diabetes insipidus that adds further complications. The risk of skin breakdown and resulting infection, the risk of pulmonary infection....the list goes on.
They can deliver at 24 weeks, but the mortality/morbitidity rate for premmies born at 24-25 weeks really hasn't improved over the past 10 years - the majority of babies born at that gestation are severly compromised (physically and developmentally). Ideally you would want to get to 28 weeks before delivering, and even then the risks are high.
All this in a situation where the fetus may have already sustained brain damage (intra-ventricular haemorrage) during the incident when the mother sustained her brain stem injury. If it was an anoxic brain injury (lack of blood flow, hence lack of O2 to the brain, it's likely the blood flow to the placenta and therefore the baby was compromised). Even if it was a traumatic brain injury there is likely to have been some placental disruption.
Now the fetus is being maintained in an environment where the mothers body is deteriorating around it.
As a mother I can honestly say, if that was me in that position I wouldn't want them to continue ventilatory/'life' support.
There still seems to be slight confusion re brain death, it's not a little bit dead, it's not being in a coma, it's not being in a PVS - you are dead. This fetus is contained within a dead body.
Yes but there are different ways that people die. You couldnt compare it to someone who has deteriorated and gone into multiple organ failure. She has had bleeding in her brain which has damaged her brain stem (as far as i can gather) so there will not be any problems with her body unless her heart stopped and she was revived (no detail) I cant see there being any problem with perfusion of her placenta at any point (although I am no expert). Of course however, there will be risk of infection should they continue treatment
Her eyes were so swollen they do not close, she said. The woman’s little girl, when she saw her for the first time, was distressed, she said.
this woman had shown signs of pneumonia and other infection, she added.
“The heart will stop, there is no machine in the world that will maintain the heart beat indefinitely,” she said. The woman’s brain is also rotting and she is being treated for a form of meningitis.
The woman is also suffering from hypertension, high blood pressure, which is unusual and very worrisome, she added. This was “uncharted territory” in her experience. The possible effects of the drugs on the woman’s pregnancy are uncertain, she said
There are continuing unusual fungal infections in this patient and they are unlikely to result in a positive outcome, she said.
The effect of the woman’s high temperature of some 37 and 38 degrees on the foetus is worrying, he said.
http://www.irishtimes.com/news/crime-and-law/courts/high-court/continuing-to-treat-woman-on-life-support-grotesque-1.2047808?page=2
For Gawds sake it's completely hideous. What about the rights of the living not to suffer.
All you agreeing with this medical intervention, how would you feel if it was your relative lied there, their brain rotting, liquifying. What about the rights of the living. Could you cope with that?
I find the whole thing staggering and I'm saddened this is happening so close to me.
That is horrific, her poor family. Very disturbing
That is abhorrent. I very much hope the High Court see sense in this.
Judgement now expected St. Stephen's Day (Boxing Day)
I thought you were in favour of keeping her going. Have you changed your mind?
I agree. It's sad for all concerned but this pregnancy never had a chance. Just too early. It's horrific to think she's rotting around it. It might have been different if the pregnancy was even just ten weeks further on. They should cease trying to maintain the mother's corpse & let the foetus quietly die in peace
Tbh, I don't understand how abortion was ever a factor in this. How can it be, if a foetus dies inside its dead mother?
These cases should not crop up at all. This case isn't even about abortion. It's like something from a horror movie.
Yes, very wrong. It seems like the judge is leaning toward switching her off then. I hope it's sooner, rather than later, to minimise any foetal distress. (I assume 'putting it to sleep' inside her would be out of the question)
You could understand if it was a later stage in the pregnancy but not this time. Think it would be horrendously cruel on everyone (including the unborn child) if the High Court ruled in favour of the doctors.
However it is two lives tragically lost (as people say, it's not 29 people who died in Omagh in 1998, it's 31).
I don't think it's a case of being 'in favour of the doctors'. They don't seem to want to be doing this.