In its 16-page ruling, the Court of Appeal upheld the decision of the Superior Court of Quebec. In early November Sainte-Justine Hospital was able to permanently remove the breathing tube from the child because the risks associated with intubation were deemed to outweigh the expected benefits.
The boy had been in a coma since June 12, when he went into prolonged cardiac arrest after being found at the bottom of the family pool. Doctors believe the child will be able to breathe on his own, but he struggles with a number of complications, including acute respiratory distress syndrome, heart failure and episodes of seizures.
Sainte-Justine Hospital has gone to court because the child’s parents refuse to consent to the procedure unless doctors consider resuscitating the child if something goes wrong.
After hearing the opinions of several doctors and parents, the appellate court Concludes that there is consensus among the experts heard: The proposed treatment plan is in the child’s best interest […] and corresponds to good medical practice, although presumably leading to death
of the child.
” Although this observation is obviously difficult for parents to accept on a human level, it is in accordance with the law, because it is above all, according to the medical evidence presented, in the best interest of the child. »
Health professionals have repeatedly argued that This mechanical ventilation is inconsistent with his condition
. This can cause serious harm or even death to the baby.
However, if the child is unable to breathe without assistance, doctors say they should seek end-of-life care, the hospital argues.
In her testimony to the appeals court, a pediatrician on a team of 14 intensive care specialists, Dr. Baruch Toledano confirms that the baby can breathe on its own. presence of pipe Not only does it put him at risk for major complications like muscle wasting, pressure sores, inflammation of the vocal cords, pneumonia and bronchitis, but it also causes him discomfort and pain.
.
According to him, The benefits of evacuation are many, as the child can be particularly mobilized, making the parents consider returning home as desired.
.
Ethically acceptable
The trial judge also sought the expert opinion of medical ethicist Marie-Claude Levasseur, whose report concludes. Given the severe and irreversible damage to the child if evacuation fails, it is ethically acceptable not to re-occupy the child.
.
According to court documents from the Court of Appeals, the child’s parents They testified very openly about their hopes and hopes of seeing their child alive and coming out
from his coma.
However, adding the text, Despite all the sympathy we may feel for them, their beliefs are not based on any scientific data, while all the medical evidence shows that assisted ventilation is causing their child suffering. […] Inevitably, the child, whether intubated or re-infused, dies within a short time.
.
” The consideration here is not to keep the child alive at all costs, but to live in unacceptable conditions, even if he is interested in survival because they are suffering. »
Finally, the ruling recalls that, according to doctors, the risk of a child’s death is not directly linked to discharge.
Unfortunately, when this happens, death is the inevitable result of severe irreversible neurological damage to the child, and extubation is not a removal of the mechanical ventilation device, but a maneuver to confirm whether or not his condition is stable.
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