Waiting for miracle cure 'inhumane'
PROLONGING the life of a terminally-ill child in the hope of a miracle, prompted by parents' deeply-held religious beliefs, can be "inhumane", doctors have claimed.
Continuing aggressive treatment, even when doctors say there is no hope of recovery, is not in the best interests of a sick child, according to the article published in the Journal of Medical Ethics.
The authors, two doctors from London's Great Ormond Street Hospital and the hospital's senior chaplain, said doing so can cause "needless suffering" and have called for a review of the law where such cases are concerned.
Citing Article 3 of the Human Rights Act, which prohibits torture, inhumane or degrading treatment or punishment, they said: "Spending a lifetime attached to a mechanical ventilator, having every bodily function supervised and sanitised by a carer or relative, leaving no dignity or privacy to the child and then adult, has been argued as inhumane.
"Repeated tracheal suctioning and bladder catheterisation are accepted as painful."
Dr Joe Brierly, Dr Andy Petros and the Rev Jim Linthicum's report was based on a review of 203 cases over a three-year period, all of which involved decisions about withdrawing "aggressive, but ultimately futile" treatment for a child.
The parents and doctors reached agreement in 186 of the cases but in the remaining 17, they disagreed about the best course of action.
Out of those, 11 sets of parents expressed religious views, saying "intensive care should not be stopped because of the expectation of divine intervention and a complete cure".
The parents, whose faiths included Christian fundamentalism, Islam, Judaism and Roman Catholicism, resolved their differences with medical staff after speaking to religious leaders in five of the 11 cases and one case went to the High Court, after which intensive care was withdrawn.
But there were five cases where intensive treatment continued. Four of the children died and one survived with profound neurological disability.
The authors said: "In the remaining five, all Christian, no resolution was possible due to expressed expectations that a 'miracle' would happen."
The remaining cases, where no religious views were expressed, were all resolved and intensive care was eventually withdrawn from each of the six children.
The authors of the report said: "While it is vital to support families in such difficult times, we are increasingly concerned that deeply held belief in religion can lead to children being potentially subjected to burdensome care in expectation of 'miraculous' intervention."
They concluded: "We suggest it is time to reconsider current ethical and legal structures and facilitate rapid default access to courts in such situations when the best interests of the child are compromised in expectation of the miraculous."
Dr Steve Clarke of the Institute for Science and Ethics at Oxford University suggested that medical staff should seek to resolve disagreements with parents "on their own terms".
He said: "Engaging with devout parents on their own terms and asking them to consider the point of waiting for a miracle, when there is no obvious reason to think that waiting will make it more likely that a miracle will occur, may prompt devout parents to reconsider their opposition to withdrawing treatment, or encourage them to agree to a limit on the period of continued medically futile treatment."
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