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April 30, 2005

Another Texas Hospital Plans To Stop Treating Critically Ill Baby

Topics: News

Bloggers - please help to pass this around the Internet!!!

"Her mind is fully there," said the baby's mother, Tamiko Dismuke-Howard. "She knows when we are there. I can't give up because she won't give up."

Once upon a time you could go to a doctor and a hospital and count on them to do everything to save a life. That doesn't seem to be the case anymore, and "checkbook euthanasia" seems to be more and more the order of the day. That is something that all of us must do everything possible to reverse!

- Houston ABC13.com
The mother of a critically ill baby is trying to figure out where to take her child after being told by doctors at Memorial Hermann Hospital that they would stop treating her in 10 days.

The five-month-old little girl was diagnosed with leukemia just weeks after her birth. Since then, she's undergone a number of different medical treatments and contracted an infection. Doctors and her parents disagree on what should happen next.

[...]
"Her mind is fully there," said the baby's mother, Tamiko Dismuke-Howard. "She knows when we are there. I can't give up because she won't give up."

Tamiko picked up a letter from Memorial Hermann Thursday night. It says simply that doctors believe all medical treatment, other than to ease Knya's pain and suffering, would be useless. Her parents have 10 days to find another hospital for Knya or her medical care will stop.

"We will not give up," said Charles Howard, the baby's father. "We are going all the way."

Read more .....

Cross posted at Hyscience

Posted by richard at April 30, 2005 4:56 PM


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Comments

"The Futility Review Commission" -- My G-d, it's like something out of a bad futuristic novel. But it's real--this hospital has a "futility review commission." Shudder.

So, what does this mean? They're gonna dehydrate the baby to death? Does she need a feeding tube? Can mom take her home and at least give her a bottle, or handle the feeding tube herself?

I note the quotation from the hospital spokesman at the press conference referred to something like "no benefit from prolongation of life." So living itself isn't a benefit anymore. You have to get some _other_ benefit out of living, or we're gonna bump you off.

Posted by: Lydia at April 30, 2005 6:00 PM

Has anyone wondered why the Hippocratic Oath hasn't been adhered to? Did you know that doctors haven't had to swear in for a long time?

Excerpt From The American Thinker "Forcing Doctors to Kill" by Mary Davenport MD.: http://www.americanthinker.com/articles.php?article_id=3509

"There are several steps along the way before Netherlands-type medical killing could occur in the U.S, but we may be farther along that path than commonly appreciated. If involuntary euthanasia is to take hold here, first the moral and ethical foundations of valuing life within the medical professions must de undermined.

A major step has already taken place, almost unnoticed by the general public. The tepid modern alternatives to the Hippocratic Oath, such the World Medical Association’s Declaration of Geneva, came into widespread use in America after World War II. The now-unused original Hippocratic Oath was a covenant between the physician and patient. In addition to swearing to uphold patient confidentiality, and prohibiting sexual relations between physician and patient, the Oath specifically prohibited medical killing. Both abortion and physician-assisted suicide were violations of the Oath American physicians once affirmed. Unbeknownst to most Americans, U.S. physicians have not had to swear off medical killing for decades."

Posted by: Tom Spence at April 30, 2005 7:27 PM

Lydia:

I agree with your post in spirit. However, neither the article nor Blogs for Terri said anything about food/water deprivation in this case. It appears they are referring to _other_ treatments/care being denied (which still is wrong in my opinion).

Let's be careful to not suggest facts, issues or problems that do not fit a situation. We need to keep our credibility if we are going to continue helping future patients.

If I am wrong someone may correct or please provide additional information.

Keep the faith.

Posted by: Ellia at April 30, 2005 7:41 PM

Ellia--I have a couple of equally important comments in response to what you say.

1) I did place a question mark. I'd like more information myself. I hope my guess as to food and fluids is wrong, but it _is_ a guess and can be overturned by evidence to the contrary. That's why I asked rather than saying definitely. If someone knows one way or another, I'd like to know.

2) My guess, however, _is_ based on evidence, and this evidence includes material that you should be aware of if you haven't come across it. "Artificially administered" food and fluids _are_ legally and medically called "treatment" all around the country. Therefore, statements that a hospital, nursing home, or other medical entity is going to stop all "treatment" often _does_ mean the administration of food and water, especially if the person has had a tube inserted, sometimes even if the tube is not absolutely necessary. Furthermore, the hospital spokesman made it clear that it was the "prolonging of her life" that was deemed not to confer any benefit, not some specific actual medical treatment. This is ominous. Finally, the article expressly says that the doctors believe "_all_ medical treatment, other than to ease Knya's pain and suffering, would be useless" (emphasis added). This is medical jargon that *usually does* mean withdrawal of ANH (artificial nutrition and hydration). Again, recall that food and fluids are now called "medical treatment," especially if given artificially. The reference to "easing pain and suffering" is _not_ generally taken to require giving food and water but rather usually refers to giving medication, often to ease the pain of dehydration itself. This is exactly the language that has been used in other cases (including Terri's) when the person was indeed dehydrated to death.

One other piece of evidence: Sun Holden did indeed die rapidly from the removal of his ventilator. But if he had been able to breathe, he would not have continued to receive food and fluids. It was pretty clear that his feeding tube was to be withdrawn as well under the same type of "guidelines," in the same state, being followed here. He was lucky that he didn't live long enough, as it were, to die of dehydration.

I hope I'm wrong. And I don't know if this little girl requires a ventilator and will also die quickly without it. But the language *does not look good* for what they intend vis a vis food and fluids.

If someone can add specific information about this case on this point, I'll be glad to hear it.

Posted by: Lydia at April 30, 2005 8:51 PM

Frankly, in my mind, it doesn't matter if the cessation of "treatment" is referring to food & water or medicine or high tech equipment. The issue is that who died and made the Fitulity Review Commission god, and how much money does it take to buy continued "treatment?" When we rationalize the intentional killing of the infirmed (Terri) or the ill (baby Knya) we have crossed into the land where human life isn't worth the paper it's printed on.

Posted by: Tom Spence at April 30, 2005 9:06 PM

I should add that in today's medical milieu, the question I have raised should be the _first_ thing that pops into the mind of anyone--including the mother--who wants to protect this child from a particularly gruesome death and who receives a letter worded this way. Terminal dehydration is becoming incredibly widely accepted in the medical ethics community and the medical community, and naive people who do not know this and who think "treatment" just means what it sounds like it means are often not aware that terminal dehydration is, say, what the doctor means if he says he doesn't think Grandma in the nursing home should have any more "treatment." Families can find themselves consenting to things they never realized they were consenting to.

Furthermore, if there is any ambiguity as to whether the child can eat by mouth, this needs to be pressed _now_, so that if the hospital _does_ stop her other treatment her mother can still insist on her being fed on the grounds that she doesn't absolutely need a feeding tube (if she doesn't) and should not have "NPO" (nothing by mouth) written on her chart. Also, if there is any possibility of her being taken home, she might well be treated more humanely there, especially as regards fluid administration in the last days of her life. A lot of people don't realize this. All this needs to be thought of _now_, and if the mother doesn't realize that this even _might_ mean that they will stop feeding her, she needs to know that and to start pushing: "Okay, what _exactly_ does this mean? How can I make _sure_ my baby will be fed until she dies?" And so forth. She might even find it easier to find a transfer facility if she could specify some more minimal level of care that she was seeking for the child.

If the baby has been taking a bottle right along, that may help in drawing the line just there. But the line will *have to be drawn by an advocate for the baby*. It is absolutely naive, considering the language used and the increasing commonness of terminal dehydration under the heading of "stopping all treatment but comfort care," to _assume_ that all will be well in this regard.

Frankly, if I were the mother, I would be seeking avenues for bringing the child home where, if she is to die, she can at least die a _really_ natural death. The mother shouldn't place all her eggs in the basket of finding another facility.

Posted by: Lydia at April 30, 2005 9:14 PM

One more thing--_If_ the intention here is to withdraw food and fluids (and I stress, I don't *know for sure* that it is, I'm only making an educated guess), then the intention is to kill. The one thing about not giving a baby anything to eat and drink...it's always fatal. That little girl could fight off her skin infection and not be dying yet of her leukemia, and if they just leave her with nothing to drink, she'll die in 10-14 days regardless. So I think the intention there is more murderous even than in withdrawing other treatments, although I agree that stopping treatment of her skin infection is certainy also wrong.

Posted by: Lydia at April 30, 2005 9:22 PM

Lydia: I understand what you are saying. I just want to be careful until we do know all the facts of the situation, and take care not to even _suggest_ things lest someone misunderstand, pick up wrong information and pass it on. Anyway, we do agree. There needs to be vigilance, and for good reason. I have not found anything else just yet on this family's case, though I am against how the hospital is handling this. It certainly is a pro-death determination, in any event.

Posted by: Ellia at April 30, 2005 10:24 PM

Since the child has a terminal illness, that is leukemia, one has to think about what is best for the child. Depending upon the type of Leukemia there is only a remote possibility that the child would be able to recover from the illness. The stopping of treatment might be the stopping of the treatment for the leukemia.

We do not know enough about the condition of the child to give a judgement call on whether or not what is proposed is the stopping of all nutrition and hydration. It might be a case of the child would be better off it was taken home by the parents.

Terminal illness, such as cancer is very different from Terri's situation. There is a point where the continuation of treatment can be considered futile. This applies not just to infants and children but also to adults.

I am speaking here from the point of view that my own sister's life is in the balance because she has received a diagnosis of terminal cancer. It is in her bones and she is so fragile that the doctors at Peter McCallum clinic have informed her that they will not be giving her chemotherapy because of the fragility of her health. Hers is a case where doctors had failed to diagnose the cancer before it was too late. From what I understand she was going from one doctor to another seeking help for her pain. They were all acting way too slow considering the emergency of the situation. In her case the doctors are correct in denying her the chemotherapy. She would not be able to withstand the effects of the treatment and for that reason it would be considered futile treatment.

Posted by: Maggie4life at May 1, 2005 6:32 AM

Maggie: Thank you for sharing your experience and perspective.

Posted by: Ellia at May 1, 2005 6:54 AM

Maggie--I actually agree with you about stopping chemotherapy. I'm not a big fan of chemotherapy myself.

Note, though, that this says stopping _all_ treatment, and since the article expressly mentions a skin infection, presumably that means at least stopping treatment for the skin infection. Now that is clearly wrong. She'll be likely to die of sepsis if they do that. And treatment for the skin infection, unlike chemo., wouldn't be harmful in itself.

I still have the gravest suspicions about food and fluids, however. That bit about "except to ease pain and suffering" is absolutely _standard_ terminology for sedating people who are being given no fluids.

I wish we could find out more.

Posted by: Lydia at May 1, 2005 12:03 PM

I sent an email to Miya Shay the reporter for ABC 13 and told her to get this contact information to the the Hnya Howard's family...

Miya
I do hope that you are in contact with the leukemia baby Knya Howard's family.
They must call the Live Call Center at the Leukemia and Lymphoma Assoc. and another resource is the StJude Research Hospital in Memphis....These 2 agencies know how to help people in situations like the Howard's.
Please do what you can to get this information to them. It could save Knya! I have a cousin who was given 6 months to live with leukemia...he had a 2 year old daughter. He went in for experimental treatment at Roswell Memorial Hospital in NY and ....well he is a grandfather today. His 2 year old daughter is grown with children of her own. Miracles can happen.

The Leukemia and Lymphoma Association has a Call Center for families and patients of Leukemia. They make referrals for treastment. I STRONGLY suggest that the family get in touch with this organization...they have Financial Services also.They have a live call center.

http://www.leukemia-lymphoma.org/all_page?item_id=4591

Also there is St Judes's Leukemia Research Hospital in Memphis
http://www.stjude.org/referringmds

I would call but I have no contact information for the family
JoMarley

Posted by: JoJoFox at May 1, 2005 12:06 PM

Ellia--we do just have a slight disagreement on strategy. I think this mother has to be warned. If I knew her personally I'd be sitting down with her and urging her to stride around the hospital ward, talk to the doctor, talk to everybody, to find out if stopping food and fluids is part of what they have in mind and to make sure it doesn't happen. Since Blogs for Terri has often had people who manage to get in touch with the actual parents and family members involved, I think it's useful to make it clear what "stopping all treatment" could very well mean in this context so that perhaps someone can warn the mother to check into this. She may have no idea that it could mean that.

Posted by: Lydia at May 1, 2005 12:06 PM

Lydia: No disagreement at all. We should contact and advise the family, as well as actively seek to define the hospital's actions as to its idea of treatment withdrawal. I only addressed above the care needed in how we present information, to prevent confusion or misunderstanding. I have no doubt we do agree on all points. :)

Posted by: Ellia at May 1, 2005 1:09 PM

I sent an e-mail earlier to a reporter covering this story, asking his assistance in reaching Knya's parents to let them know of CURE's desire to assist them in caring for and protecting their daughter.

Frankly, the above discussion re food and water puzzles me, as I did not find any mention of such minutae in Richard's report.

In any event, Tom Spence is absolutely right about the irrelevance of the means employed by the "futility gods" who are conspiring to end Knya's life.

While it is true that, as Lydia reminds us, starving and dehydrating someone to death is 100% fatal, just because a few victims may survive a little longer when other forms of life support are denied them does not make such attempted murder a jot less heinous, especially, when one considers that for every euthanasia victim starved to death there are thousands on whom death is imposed by lethal nontreatment, generally, through what Richard aptly calls "checkbook euthanasia."

Posted by: Earl Appleby at May 1, 2005 10:19 PM

Earl,

I agree with your take on this subject. I agree that there is a real problem. I am constantly reminded of what happened when my father had his second serious stroke. Since I live interstate I was not involved in the decision-making concerning the life and death decisions. However, I was told that pressure had been put on my family to put on the DNR. My mother refused to follow the advice. Then the welfare staff at Monash hospital got in the act with similar advice and again my mother resisted. They told her she had to choose a nursing home because she could not look after him (my mother has Parkinson's Disease) and he was placed in a home until his death. Dad had a PEG and at no time was he deprived of nutrition and hydration.

I can think of no reason in such circumstances to request the tube comes out. When spouses make this request it is usually because they fear the years ahead looking after the husband or wife and running out of funds. I suspect that there is also a lot of selfishness involved when those requests are being made.

My niece faced a life and death decision when a doctor did not send her for a caesarian section when her first child had been struggling to be born. The umbilical cord strangled him to death. The doctor allowed him to die because his heart was weak. That is a disgusting decision.

Posted by: Maggie4life at May 2, 2005 3:52 AM

Earl--The food & water issue was brought up by me in the first comment on the thread. You're right that Richard says nothing about it. I think the language of the letter quoted sounds exactly like the language used when such denial is intended, at least if the patient is using a feeding tube.

I do think the parents need to be warned about this possibility, if for no other reason than this practical one: They might be able to find a transfer facility that would at least do that much for their daughter. Also, they could manage a tube themselves. Regardless of relative wrongness or rightness, administration of food and water is at least lower tech than other forms of intervention and is inexpensive in itself, and the child might be spared its withdrawal more easily than the withdrawal of other things, even in this "checkbook" society.

I should add that I do think that refusal of antibiotics for the skin infection would be very heinous here, as the antibiotics are presumably doing no harm and may do good for the infection. And that sounds like it is intended as well. The whole tone of the quotations from the hospital seems to be that treating her in any way is harmful _because_ it is keeping her alive, which is a perverse way to think.

Posted by: Lydia at May 2, 2005 7:18 AM

Earl, thank you so, so very much for working to contact the parents in this case. God bless you for every single one you work to help.

Lydia, I agree there is a new 'code' that we are starting to recognize in the wording, which usually means cessation of all treatment, including nutrition/hydration, and you have pointed out some of the terms of possible danger, being used in this case.


This is a special prayer request - would you please all pray for Dr. Paul Byrne today. He told me Friday evening that he had to rush out of town this weekend on the news that his cousin, Cathy, in another city had been put into a hospice, and fluids were being withheld from her. Dr. Byrne is a prolife doctor who has been so helpful in talking with us about some of the cases we have been discussing on BlogsforTerri. He rushed to where Cathy was to try to help.

However, Cathy died, this weekend.

I do not yet have the details to share - I do have his permission to share about his cousin at this site. But he left a voicemail message saying that, he and his wife "got there in time to see her while she was still alive, but she did die at 8:30 pm on Saturday evening."

I have a bad feeling about this, especially since fluids were being withheld from her in hospice...if she was dehydrated to death, this is horrible.

I did ask several people to pray for her here at my home, and acquaintances by phone, and I am sorry that I did not make it to the blogs to ask for prayer for her and for Dr. Byrne.

Dr. Byrne is such a good man, and this is horrible that this would have to happen to a cousin of his and before he had word of it in time. I say this because I have been seeing a definite attack on our group of good people standing for life. I would say a satanic attack.

As a result, I am standing in prayer for God's powerful protection for us.

Dr. Byrne is grieving today. Would you please uphold him in your prayers, for God's tender mercies and grace to surround him and his wife this week, and to comfort him and to protect him from any evil thoughts which might be visited upon him at this hour?

Thank you so much. God is more powerful than any evil thing which raises itself against Him.

Posted by: juleni at May 2, 2005 12:05 PM

Lydia - I agree, I am seeing a clear pattern of speech that has developed regarding cueing that cessation of all treatment including nutrition/fluids is to take place with a patient. In all the many cases we have now been reading about, the speech pattern of "stopping all treatment other than to ease pain and suffering" is occurring again and again, and the further story of the patient concerned, includes removal of feeding, of fluids, and of any and all treatments.

We need to voice that there is an incredible danger of this very thing happening whenever hospitals/hospices begin to speak of "stopping all treatment other than to ease pain and suffering". I think that is exactly the 'code words' being used for cessation of everything including hydration/nutrition. "Only ice chips now" might be exactly what that means.

Maggie - I understand your sister's position with her doctors completely, that in her case her fragility may not withstand the rigors of chemo right now - I think it is different than what Knya's doctors are saying, just due to the wording her health care practitioners are using.

I am praying for your sister, and for you right now. I am so sorry she is and you, too, are facing this....I don't even know the right words to say, except that I have had you on my mind since you told us, and have been praying.

Just want to say, with Knya, I agree with Lydia that the hospital has stated that it is not only treatment for cancer that they are stopping with her, but 'all treatment', which is more and more the case in 'futility' cases. This would include everything - liquids, feeding tubes (if she had one), treatment of her skin condition, oxygen, if she should need it. I think the rhetoric of hospice/hospital terminology is turning strongly in the direction of 'futility' involving considering even the humane measures of nutrition and hydration as treatment, allowed to be removed.

This very thing is what brought us here together to begin with, with Terri. However I think it is becoming much broader than even the situation which Terri was involved in....I think even that it has been becoming that way for some time, without us noticing it. Now we are playing catch-up with what has been in the works of how things are worded, for a while.

Actually, checking into whether nutrition and fluids are to be withheld, or urging the parents to, when the wording of "stopping all treatment other than to ease pain and suffering" is being used, IMHO is the most important thing that we should in fact do, because I believe as I said that this is the code of killing - terminating before natural death - that is being coined in our healthcare system today. I think it imperative, not to say we are completely certain that they will remove nutrition/hydration, but that we can make a pretty well educated guess based on the cases that we have seen, that removal of nutrition/hydration is exactly what we must inquire about.

Because someone should be hydrated clear until their last breathing, heart-beating moment. There is never a reason to bring someone into a torture, called dehydration, ever. And also, there still is occasionally that miracle, that turn around. Let a hospital not kill someone by dehydration, lest some miracle might have occurred. Nevertheless, even if they should pass away, no hospital should torture someone with dehydration prior to their natural death.

Knya's parents do need to check this very thing out....

Posted by: juleni at May 2, 2005 2:15 PM

I'm very curious as to what sort of support Knya needs. What happened with Sun Holden was that there was no opportunity to press on the food/fluids issue because he died right away when they took him off the ventilator. Now I'm not saying that was right. That's not my point. My point is that they may be starting out doing this sort of thing against parents' wishes with babies who are *in fact* on ventilators so that we aren't _yet_ seeing the spectacle of a child dehydrated to death against parents' wishes in a hospital, since they die so quickly without a ventilator.

But that just softens people up so they aren't expecting it. If that is what they have meant all along by "stopping all treatment," etc., then they will act like there is nothing to get upset about when a case comes up of a baby who does breathe on its own but needs ANH. It's just a matter of time, in my opinion. And if parents also think they have to leave the baby in the hospital (this is an important issue as well), then there will be this kind of helplessness--"Well, what could we do? We couldn't find a transfer facility. We had to leave her there until she died"--even if perhaps it would have been better to take the child home. Same with people in nursing homes. Just this weekend I read a story ("Grandpa is Dead"--I can post an Internet link at some point) about an old man, fully conscious and with it, dehydrated to death in the Netherlands in a nursing home in 1997, apparently against his wife's wishes. The article tells of her running down the hall begging for help and crying. Well, why didn't she check him out and take him home? He was able to eat and drink by mouth. But I think people get paralyzed into thinking their only resource is a full-fledged medical facility.

I just don't _know_ what the situation is here with Knya. The food/fluids thing may end up being moot if she needs a ventilator and dies within minutes of being taken off one. And in that case she really does need to be in a hospital. I did a full Google search and could get no further info except a reference to "removing her from life support" which, considering the quality of our MSM reporting, could mean just about anything.

Posted by: Lydia at May 2, 2005 3:30 PM

Your point is well taken, Lydia, in that the parents must be vigilant on every front. The Arabs have a saying, there is one door that let's life in, but a thousand doors that let it out. We must work to close every door to euthanasia.

Lydia also raises an important point about hospitals. They are among the most dangerous places for a vulnerable person to be unless he needs care that only a hospital can provide--a catch-22 of the Culture of Death.

Posted by: Earl Appleby at May 2, 2005 8:24 PM

This morning I sent a message to Knya's parents, offering the assistance of CURE in any way possible. I assured her that Knya has many friends who love her and are eager to help. Pray that they will grant us that privilege.

Posted by: Earl Appleby at May 3, 2005 10:45 PM

Knya passed away this morning naturally, without the removal of life support. http://straightupwsherri.blogspot.com/2005/05/loss-of-baby-knya.html Let's keep her family in our prayers.

Posted by: purple_kangaroo at May 4, 2005 1:51 PM

Baby Knya has passed away....see Sherri's blog at Straight up with Sherri.

Her passing so quickly after the hospital announcement to withhold all treatment, while she may have passed on eventually from leukemia, does not bode well.

It has the scent of removal of something vital, for her to pass so quickly.

Posted by: juleni at May 4, 2005 2:27 PM

Juleni--As you know, I'm the major pessimist around here, but in this case I think we've lucked out. It looks like she died naturally. I take this from the fact that a) the ten days weren't up, so the hospital would be very careful not to discontinue anything during that time for legal reasons, b) the article said (first info. I've gotten on this issue) that she was on a ventilator and was still on it when she died, so I can't see that they would have removed anything else--food or whatever--while keeping her on the ventilator, and c) it expressly mentions cardiac arrest, so that looks like her heart stopped while she was on the ventilator.

Requiescat in pacem. May God take her to Himself.

Posted by: Lydia at May 4, 2005 6:02 PM

It seems that God has been merciful and has not allowed this baby to continue in her suffering. From what has been described she was suffering quite a bit because the leukemia had continued to cause a spread of cancer.

The signs of her dying were there in the description given by the hospital, for her organs were beginning to break down. It is a real mercy that she has not been allowed to continue to linger.

My sister is getting closer and closer to dying. My son has informed me that her condition has continued to worsen and that she is now slipping in and out of a coma. My niece, bless her, acted upon my advice and made contact with a priest. He was there within 15 minutes. Whatever passed between the priest and my sister has led to her being at peace, and she is passing through the final phases before dying.

My son seemed to think that my sister might not make it through the night. I can only pray at this point in time that God will, in His infinite Mercy grant her eternal rest very soon.

Posted by: Maggie4life at May 6, 2005 6:20 AM

Maggie, I just saw your post on another blog that your sister passed away. My prayers are with you and your family.

Posted by: purple_kangaroo at May 8, 2005 3:31 AM