By Hilary White
GORLESTON, UK, September 9, 2009 (LifeSiteNews.com) - A young British mother has criticized medical guidelines that, she said, resulted in doctors refusing treatment and leaving her newborn premature son to die. 23 year-old Sarah Capewell told media that her son Jayden, born at 21 weeks and five days gestation, was refused intensive care because he was two days under the limit set by Nuffield Council on Bioethics, a UK bioethics think tank that creates guidelines for medical practice.
Capewell said that her son Jayden cried and lived for two hours before dying in her arms. During that time, his mother took photos of him and pleaded with doctors that he be admitted to the special baby unit at James Paget University Hospital (JPH). Staff at the hospital, in Gorleston, Norfolk, told her that had Jayden been born two days later they would have helped him.
Since her son's death, Capewell has launched an internet campaign to change the guidelines and says that she has received messages of support from around the world.
Guidelines set down by the Nuffield Council on Bioethics in 2006 say that intensive care should never be given to babies below 22 weeks gestation, and rarely to those below 23 weeks. In secular bioethics, this is called Futile Care Theory, which holds that in cases where there is no hope for improvement of an incapacitating condition, such as extreme prematurity, no treatment should be offered.
A spokesman for the Nuffield Council told LifeSiteNews.com that "resources are not covered in the guidelines". The guidelines, said Catherine Joynson, communications manager of the Nuffield Council on Bioethics, "state that doctors caring for premature babies should not be driven by the resource implications of their decisions. those decisions should be determined by clinical judgements of priority." Nevertheless, while preterm babies often suffer long-term health effects, some born before 22 weeks survived in the US and Canada with intensive perinatal care. In 1987, James Elgin Gill was born at 21 weeks and 5 days gestation and survived. In 2007, Amillia Sonja Taylor, born in October in Miami, Florida, at less than 21 weeks and six days gestation and under 10 ounces, survived to go home with her parents in March that year.
In the case of Sarah Capewell' son, the Nuffeld Council guidance that staff reportedly cited was backed up by advice published by the British Association of Perinatal Medicine (BAPM) last year. The BAPM paper itself, however, does not mandate the refusal of treatment, saying only, "This is not a set of instructions, but a framework to highlight the range of evidence and opinion that needs to be considered by staff and parents."
"The care of the mother, her fetus and the baby, will always need to be individualized and should be led by senior staff in all disciplines. The parents' hopes and expectations need to be explored with honesty and compassion in a realistic way, drawing upon the available evidence."
The BAPM paper says that in cases where children are born before 23 weeks gestation, "it would be considered in the best interests of the baby, and standard practice, for resuscitation not to be carried out." It continues, however, "If the parents wish they should have the opportunity to discuss outcomes with a second senior member of the perinatal team."
But Capewell reports that her wishes were ignored by hospital staff. "When I asked about my baby's human rights," she said, "the attitude of the doctors seemed to be that he did not have any. They said before 22 weeks he was just a fetus."
Under British criminal law, an unborn child can be killed by abortion up to 24 weeks gestation without any cause being stated and up to the time of full gestation if he is suspected of suffering from some disability.
The British national health care rationing body, the National Institute of Health and Clinical Excellence (N.I.C.E.), has plainly stated that such guidelines are based on financial motives, in consideration of how expensive a treatment will be compared to the "quality of life years" it can provide. This is an expression of a new utilitarian trend in the philosophy of medical care that has replaced classical medical ethics in recent decades.
In traditional medical ethics, the governing principle, according to the ancient Hippocratic Oath, is to "do no harm" to the patient. In modern utilitarian bioethics, the guiding principle is to produce "the greatest good for the greatest number," whether that good benefits the patient or not.
Under this principle, which has swept the medical world in most western countries that have adopted government socialized medical care, it is increasingly common for medical guidelines to allow doctors to decide, against a patient's wishes or those of his family, that further medical treatment is "futile" and can be discontinued. In countries such as Britain and Canada, where the provision of food and water are considered "medical treatment," this can mean that a patient can be legally dehydrated to death, often while being placed in permanent sedation.
*This article edited on Sept. 10, 2009 at 4:22pm EST.
