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Source: (consider it)
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Thread: Purgatory: Who knows best - the state or the parents?
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by justlooking:
orfeo - the reason to fear for the child's safety was his need for specialised medical care which included being fed via a tube. In the absence of any information about how his parents intended to ensure his continued care and safety it seems reasonable to me that action was taken immediately to find him and make sure he was safe.
You've just reiterated one of my chief objections here - in the absence of any information the worst was presumed.
Again, I don't see any information about these parents that would justify presuming the worst about them, that they were anti-scientific kooks or reckless as to their child's welfare.
Nor, as seekingsister has pointed out, was there any justification for thinking that his parents were taking him out of reach of the medical care that he needed. He is now doing just as well in a Spanish hospital as he was doing in an English one.
It is simply not true that this child was going to be in medical danger the moment he left the hospital he was in. Yes, he needs medical attention, but the deep flaw here is the presumption that his ability to receive medical care was at risk.
I would have thought that taking these actions - ward of the Court, arrest warrants - required at least some positive evidence that his needs weren't going to be taken care of. That's the big difference from the case that bib has referred to, of parents who made positive statements that they were going to put their child on a sterile water diet as a cure. Making statements that you want your child treated by a clinic offering proton therapy is not remotely in the same category, not in a million years.
[ 03. September 2014, 09:05: Message edited by: orfeo ]
Posts: 18173 | From: Under | Registered: Jul 2008
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justlooking
Shipmate
# 12079
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Posted
quote:
.....in the absence of any information the worst was presumed.
Yes, because of the severity of the child's condition and the fact that he needed constant monitoring. He was not considered to be in a fit state to be discharged from hospital. Presuming the worst was the most effective way of safeguarding the child's interests.
Posts: 2319 | From: thither and yon | Registered: Nov 2006
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Jane R
Shipmate
# 331
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Posted
seekingsister: quote:
But given that Hampshire police have established that what the parents did is not illegal, why do they have to tell the hospital anything?
IANAL, but I would guess the hospital behaved like that because the parents are not the patient: the child is. The situation would be different for an adult who was considered capable of making his or her own medical decisions. In the case of a child or a vulnerable adult, where someone else is making medical decisions on their behalf, the hospital has an additional duty of care. That's why cases like this may end up in court, when the medical professionals' recommendations for treatment conflict with the wishes of the family.
I don't know any more than you do about this case, so I would not care to speculate about whether Mr King really was threatened with a court protection order. But I can understand why Southampton Hospital was reluctant to spend thousands of pounds on proton beam therapy if it is not significantly more effective than conventional radiotherapy.
[ 03. September 2014, 09:26: Message edited by: Jane R ]
Posts: 3958 | From: Jorvik | Registered: May 2001
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Erroneous Monk
Shipmate
# 10858
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Posted
quote:
Originally posted by orfeo:
quote:
Originally posted by justlooking:
orfeo - the reason to fear for the child's safety was his need for specialised medical care which included being fed via a tube. In the absence of any information about how his parents intended to ensure his continued care and safety it seems reasonable to me that action was taken immediately to find him and make sure he was safe.
You've just reiterated one of my chief objections here - in the absence of any information the worst was presumed.
Again, I don't see any information about these parents that would justify presuming the worst about them, that they were anti-scientific kooks or reckless as to their child's welfare.
Nor, as seekingsister has pointed out, was there any justification for thinking that his parents were taking him out of reach of the medical care that he needed. He is now doing just as well in a Spanish hospital as he was doing in an English one.
I disagree. The secrecy around removing the child from hospital was adequate justification for the hospital presuming the parents were taking action they did not want the child's doctors to know about. That behaviour was the "information" that justified the hospital's actions.
In my view, the hospital were absolutely acting in the child's best interests. Where things got out of hand was in arresting the parents and separating them from the child once he had been located, and was, clearly, receiving the medical attention he needed.
I am, I admit, biased, but having a number of relatives who do or have worked in the NHS and having been a patient myself for many many years, and now having to make decisions about my children's care, the idea that NHS doctors have any incentive not to be wholly open with patients about treatment options and prognosis seems strange to me.
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And I shot a man in Tesco, just to watch him die.
Posts: 2950 | From: I cannot tell you, for you are not a friar | Registered: Jan 2006
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Gracie
Shipmate
# 3870
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Posted
It seems to me that the doctor in question knew that the Kings are good, loving and caring parents and that he totally miscalculated the effect of his threat to get a protection order. Some doctors do not like to have their authority questioned and/or believe this to be a waste of their time. He probably thought that this threat would bring the parents in line with his plans, which it may well have done for the majority of parents.
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When someone is convinced he’s an Old Testament prophet there’s not a lot you can do with him rationally. - Sine
Posts: 1090 | From: En lieu sûr | Registered: Dec 2002
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Erroneous Monk
Shipmate
# 10858
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Posted
quote:
Originally posted by Jane R:
But I can understand why Southampton Hospital was reluctant to spend thousands of pounds on proton beam therapy if it is not significantly more effective than conventional radiotherapy.
I imagine the doctors were also reluctant to see the parents spend the kind of money involved in getting that treatment privately, since they genuinely believed the outcome would be no different.
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And I shot a man in Tesco, just to watch him die.
Posts: 2950 | From: I cannot tell you, for you are not a friar | Registered: Jan 2006
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North East Quine
Curious beastie
# 13049
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Posted
Originally posted by seekingsister:
quote:
Especially if Mr King's claim that they threatened him with a protection order if he continued to ask for a transfer to a proton therapy clinic is true.
Is there any evidence that this is true, beyond Mr King's own assertion?
Given that he openly contacted the Prague Centre on 20 August, it does seem that something happened for the family to switch from aiming for a managed hospital transfer to reckless flight.
I think this is the crux of the whole matter. If the family originally sought a managed hospital transfer and had a property which they could sell to finance treatment themselves, what made them sneak Ashya out of hospital and flee?
Posts: 6414 | From: North East Scotland | Registered: Oct 2007
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Jane R
Shipmate
# 331
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Posted
Who knows? Maybe the staff at Southampton Hospital said something that was misinterpreted. Maybe they thought Ashya was getting worse and time was running out. Maybe they had a buyer interested in their Spanish property and couldn't bear to be separated from each other while the property sale was going through.
What does seem clear is that everyone concerned was trying to do what they thought was best for Ashya. ![[Votive]](graemlins/votive.gif)
Posts: 3958 | From: Jorvik | Registered: May 2001
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Margaret
Shipmate
# 283
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Posted
quote:
Originally posted by North East Quine:
If the family originally sought a managed hospital transfer and had a property which they could sell to finance treatment themselves, what made them sneak Ashya out of hospital and flee?
I wonder if it had something to do with their faith? JWs believe that we live in a wicked system (which Jehovah is shortly going to put an end to) but while they're living under it they must render to Caesar's what is Caesar's, and they're generally scrupulous about obeying the law of the country in which they live, unless it conflicts with Jehovah's law. If Mr King believed that some sort of legal action was being threatened, that might have sharpened the family's dilemma and pushed them into the action they took.
We don't know if what a doctor at the hospital said was what Mr King understood - good doctors unfortunately aren't always good communicators, and stressed parents don't always hear clearly if they feel their child is being threatened.
Posts: 2456 | From: West Midlands UK | Registered: May 2001
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Eutychus
From the edge
# 3081
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Posted
If this case were to be construed as religious discrimination, the legal issues would change entirely.
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Let's remember that we are to build the Kingdom of God, not drive people away - pastor Frank Pomeroy
Posts: 17944 | From: 528491 | Registered: Jul 2002
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Erroneous Monk:
quote:
Originally posted by Jane R:
But I can understand why Southampton Hospital was reluctant to spend thousands of pounds on proton beam therapy if it is not significantly more effective than conventional radiotherapy.
I imagine the doctors were also reluctant to see the parents spend the kind of money involved in getting that treatment privately, since they genuinely believed the outcome would be no different.
It doesn't matter what the doctors genuinely believed.
A doctor is perfectly entitled to express their opinion on such a question. But they are not entitled to enforce that opinion. That's where this seems to have gone wrong.
Obviously we don't know exactly what was said, but currently the Kings are saying that the perception they got was that the doctors would take legal action to enforce their treatment plan.
No-one should have ever suggested such a thing. The law is only supposed to be there to step in when parents are acting entirely outside reasonable bounds, not when they are making a choice which is within the bounds of reasonableness. Opting for another medical treatment might not be what the doctors in Southampton recommended, but that's not the right question.
As for 'secrecy': Where's the obligation to give the hospital information? Given all the things that the hospital seems to have successfully worked out (he's gone, his parents have him, they have a feeding system, they want to take him to another clinic), what exactly were the parents supposed to tell the hospital?
The scenario as currently presented doesn't really have the hospital in the dark about much. The main thing missing is an opportunity for the hospital to act to prevent the child's removal. That's not a piece of information.
[ 03. September 2014, 10:25: Message edited by: orfeo ]
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Jane R
Shipmate
# 331
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Posted
I don't think the moral issues change. The basic issue is how far the state (or its representatives) are entitled to go in defence of the rights of a minor child to medical treatment, if there is reason to believe the parents are not acting in the child's best interests. Being a JW is only one possible reason why you might decline medical treatment. Someone with no religious objections to radiotherapy might still want proton beam therapy because they don't believe the doctors' assurances that it isn't any more effective than conventional radiotherapy.
The basic principle in UK law is that children are not the property of their parents, and their right to appropriate medical treatment trumps their parents' right to practice their religion. Teenagers might be allowed to refuse medical treatment if they are considered mature enough to understand the implications, even if they are underage; five-year-olds would not be, although a court would be expected to consult them before coming to a final decision.
Posts: 3958 | From: Jorvik | Registered: May 2001
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Justinian
Shipmate
# 5357
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Posted
quote:
Originally posted by orfeo:
I stand corrected on my misuse of terminology. However...
What good reason to fear for his safety?
You're seriously asking what good reason there is to fear for the safety of a patient who needs continual medical care and is not returned to any hospital at all?
quote:
They clearly didn't think he had been abducted by a stranger. That's inconsistent with referring to his parent's intentions and obtaining an arrest warrant for his parents.
And I haven't seen the slightest bit of evidence that his parents were considered a danger to him.
A danger through malice? We have absolutely no idea - the hospital has not (and indeed can not and should not) released the medical notes. A danger through not understanding the issues involved, and not having adequate medical care laid on or anyone, so far as I can tell, with any actual medical training present to care for him?
quote:
There's no suggestion that I've seen that they were abusive, violent, failed to provide him with food or shelter, or anything else that would suggest a child is 'at risk'.
Other than medical care from anyone with training. When found he wasn't in a hospital and there's no mention of nursing care laid on for him. The parents were gambling that they understood all the issues and would see and be able to cope with any further symptoms.
quote:
No, the sole basis for "fearing for his safety" is that his parents wanted a different medical treatment in a different location.
Had this been the case the kid would have been transferred straight from Southampton to Prague. The part you miss is that he was taken to Spain, outside a hospital, where the father was trying to sell the house to raise money for the Proton Beam Therapy. Note the gap.
quote:
The implications are pretty staggering. What's next? What happens to adults who say they want a second opinion?
They get one. Without the scaremongering as here. There is an absolute right under the NHS to a second opinion.
What there isn't a right to is to decide your own treatment.
quote:
I wouldn't be surprised if what the hospital said to the police was "THEY'VE TAKEN HIM OUT OF TREATMENT!". Because if they'd added "to take him to different treatment", the cause for alarm would have evaporated.
But they didn't take him to different treatment. The different treatment is a potential future event. Had they said they were taking him to different treatment this would have not been true.
quote:
There is absolutely no fear for the safety of a child involved in switching doctors.
And if that's what the parents had done this would be an entirely relevant point. The kid was in Spain, the Proton Beam the parents are talking about is in the Czech Republic - over 1000 miles away. The kid was not in a Spanish hospital until after he was found, and there was no transfer of doctors.
quote:
I'm not required to consult my GP or optometrist before trying a different GP or optometrist, any more than I'm obliged to notify my hairdress or gardener.
You also are an adult. A child is not property of their parents.
The family's heart is definitely in the right place. But the timeline for cancer treatment is tight (62 days from referral to the start of first definitive treatment) - and the family's preferred timeline involves selling a house in the middle of the pathway.
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Eudaimonaic Laughter - my blog.
Posts: 3926 | From: The Sea Coast of Bohemia | Registered: Dec 2003
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justlooking
Shipmate
# 12079
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Posted
quote:
Originally posted by Jane R:
....
The basic principle in UK law is that children are not the property of their parents, and their right to appropriate medical treatment trumps their parents' right to practice their religion. Teenagers might be allowed to refuse medical treatment if they are considered mature enough to understand the implications, even if they are underage; five-year-olds would not be, although a court would be expected to consult them before coming to a final decision.
Yes. And in the case of a baby or a child unable to express a view the judge or court appointed guardian ad litem must consider what the child would want if he or she could express a view. In other words they have to try to put themselves in the child's position and see how it looks from that vantage point.
Posts: 2319 | From: thither and yon | Registered: Nov 2006
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Justinian:
You're seriously asking what good reason there is to fear for the safety of a patient who needs continual medical care and is not returned to any hospital at all?
Yes, I'm seriously asking. Because it's a false equivalence. Needing medical care is not equal to needing to be in a hospital at all times.
It was known that the parents had the vital piece of equipment that was needed. Maybe it wasn't known they had a charger - but then the question becomes, why was this presented as "when the battery runs out, it will be a disaster"? Why did no-one think, well if there's a problem, his parents will take him to another hospital?
They'd already taken him to hospital once. This is why I keep emphasising that there is no evidence that these parents weren't monitoring their child's condition or in any way neglectful, or were unable to recognise when assistance was needed.
They clearly demonstrated the capacity to understand he needed a feeding tube. They had a feeding tube.
Saying that "he needed continual medical care" rather obscures the fact that he successfully survived the period out of hospital, and that there is no evidence that he has been harmed by the experience. He "wasn't returned to any hospital at all" because he didn't need to be. You cannot presume that if his condition had deteriorated he still wouldn't have gone to hospital. To presume so goes against the demonstrated capacity of his parents to take him to hospital when it was needed.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
To put it another way, there isn't any evidence of child endangerment. If there was, the legal action wouldn't have been dropped.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
Well except for the fact that the Telegraph is reporting his transfer back is now being delayed by medical issues (not not treatment choice.)
The amongst the biggest risks to child outside hospital in this state (having had a tumour removed from his brain in the last few weeks) - would be things like infection, MRSA at the tube site, unmonitored changes in intercranial pressure, intestinal blockage due to lack of gut motility - taking the child to a hospital *after* he has gone into crisis means that the crisis has not been prevented.
Seriously, how do you think you monitor intercranial pressure in a family car ? He initially went into a high dependency unit in Malaga - that is only one step down from Intensive Care,
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
quote:
Originally posted by orfeo:
To put it another way, there isn't any evidence of child endangerment. If there was, the legal action wouldn't have been dropped.
That does not follow at all.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Doublethink:
Well except for the fact that the Telegraph is reporting his transfer back is now being delayed by medical issues (not not treatment choice.)
Who is trying to transfer him?
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Jane R
Shipmate
# 331
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Posted
orfeo: quote:
To put it another way, there isn't any evidence of child endangerment. If there was, the legal action wouldn't have been dropped.
It looks to me as if the legal action has been dropped partly as a result of the Internet outcry (mob rule, don't you just love it?) and partly to spare Ashya the distress of being separated from his parents. As Doublethink has already pointed out, subjecting a child who has just had an operation on his brain to a long journey across Europe by car and ferry is not a good idea and may have delayed his recovery from the operation.
Posts: 3958 | From: Jorvik | Registered: May 2001
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Gracie
Shipmate
# 3870
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Posted
quote:
Originally posted by Jane R:
Someone with no religious objections to radiotherapy might still want proton beam therapy because they don't believe the doctors' assurances that it isn't any more effective than conventional radiotherapy.
Except here the issue for the parents as stated by them was not the effectiveness of one treatment over the other, but rather the perceived devastating side effects of conventional radiotherapy compared to those potentially caused by proton bean therapy.
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When someone is convinced he’s an Old Testament prophet there’s not a lot you can do with him rationally. - Sine
Posts: 1090 | From: En lieu sûr | Registered: Dec 2002
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Jane R:
orfeo: quote:
To put it another way, there isn't any evidence of child endangerment. If there was, the legal action wouldn't have been dropped.
It looks to me as if the legal action has been dropped partly as a result of the Internet outcry (mob rule, don't you just love it?)
The majority is not always wrong.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Justinian
Shipmate
# 5357
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Posted
quote:
Originally posted by Doublethink:
Seriously, how do you think you monitor intercranial pressure in a family car ? He initially went into a high dependency unit in Malaga - that is only one step down from Intensive Care,
This.
For those who aren't aware, Intensive Care is for the most ill patients in the hospital. It's the scary, sterile place with the ventilators. And by British standards it has a ratio of one nurse to one patient at almost all times. The only difference HDU has from Intensive Care is that it's one nurse to about two patients rather than one to one. (Indeed HDU is often put in the same ward as Intensive Care).
That was the medical decision the Spanish hospital made as soon as he was admitted. Not the English one. One specialist nurse to two patients. If you need HDU then the feeding tube is just the tip of the iceberg - it's just a particularly obvious means of saying things.
Given that the Spanish didn't just admit him, they put him straight into the second most intensively nursed (and expensive) area they had, they definitely thought he had an urgent problem that needed intensive nursing. And hadn't been taken to another hospital.
(By American standards where he went would be termed Level II PICU.)
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My real name consists of just four letters, but in billions of combinations.
Eudaimonaic Laughter - my blog.
Posts: 3926 | From: The Sea Coast of Bohemia | Registered: Dec 2003
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
quote:
Originally posted by Gracie:
quote:
Originally posted by Jane R:
Someone with no religious objections to radiotherapy might still want proton beam therapy because they don't believe the doctors' assurances that it isn't any more effective than conventional radiotherapy.
Except here the issue for the parents as stated by them was not the effectiveness of one treatment over the other, but rather the perceived devastating side effects of conventional radiotherapy compared to those potentially caused by proton bean therapy.
What evidence there is, doesn't suggest much if any difference and that evidence is not very strong see here
quote:
A 2009 systematic review found that "No comparative study reported statistically significant or important differences in overall or cancer-specific survival or in total serious adverse events."[1][2]
quote:
Two prominent examples are pediatric neoplasms (such as medulloblastoma) and prostate cancer. In the case of pediatric treatments, a 2004 review gave theoretical advantages but did not report any clinical benefits.[18][19]
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by orfeo:
quote:
Originally posted by Jane R:
orfeo: quote:
To put it another way, there isn't any evidence of child endangerment. If there was, the legal action wouldn't have been dropped.
It looks to me as if the legal action has been dropped partly as a result of the Internet outcry (mob rule, don't you just love it?)
The majority is not always wrong.
Let me just add to that by saying that, while looking for this report about transfer being delayed, I found this piece on the Telegraph website.
Yes, I know it's just a newspaper, but it makes a couple of salient assertions. First, that those involved in seeking the legal orders ended up admitting it was a mistake. Second, that everyone involved ended up agreeing that the Kings wanted the best possible medical treatment for their son.
Now, they might well have been forced to re-examine the case as a result of internet pressure. But that's very different from the idea that they only changed their minds just because of internet pressure.
In an open society, bureaucratic decisions must be open to question. That's precisely because it's possible for the bureaucracy to get things wrong. And I say that as a bureaucrat.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Matt Black
Shipmate
# 2210
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Posted
Whilst it does seem that the PTB overreacted after the removal from the hospital - and possibly before - someone raised the question on page 1 as to why it was apparently necessary for the both parents, plus Ashya, to go to Spain for apparently the sole purpose of selling a property. I can understand them removing him to take him to Prague, but this is the part on the parents' side that makes no sense to me.
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"Protestant and Reformed, according to the Tradition of the ancient Catholic Church" - + John Cosin (1594-1672)
Posts: 14304 | From: Hampshire, UK | Registered: Jan 2002
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Justinian:
quote:
Originally posted by Doublethink:
Seriously, how do you think you monitor intercranial pressure in a family car ? He initially went into a high dependency unit in Malaga - that is only one step down from Intensive Care,
This.
For those who aren't aware, Intensive Care is for the most ill patients in the hospital. It's the scary, sterile place with the ventilators. And by British standards it has a ratio of one nurse to one patient at almost all times. The only difference HDU has from Intensive Care is that it's one nurse to about two patients rather than one to one. (Indeed HDU is often put in the same ward as Intensive Care).
That was the medical decision the Spanish hospital made as soon as he was admitted. Not the English one. One specialist nurse to two patients. If you need HDU then the feeding tube is just the tip of the iceberg - it's just a particularly obvious means of saying things.
Given that the Spanish didn't just admit him, they put him straight into the second most intensively nursed (and expensive) area they had, they definitely thought he had an urgent problem that needed intensive nursing. And hadn't been taken to another hospital.
(By American standards where he went would be termed Level II PICU.)
When he was first admitted, all they knew was what they'd been told.
They then had to assess him.
The next day, they moved him to the lower dependency unit.
I don't draw the same conclusion from that that you appear to. I draw the conclusion that once they'd had a chance to check him out, the doctors in Malaga worked out his condition wasn't serious enough to warrant being in HDU.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
Well this is where I got the transfer information from.
But I disagree with a number of assertions orfeo is making.
BBC news reports that the Southhampton reports that the child needs at least two cycles of chemotherapy before he can undertake radiotherapy (proton or otherwise).
I don't think there is, as yet, any evidence as to the hospital misrepresenting the risk given the information they had at the time.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Matt Black:
Whilst it does seem that the PTB overreacted after the removal from the hospital - and possibly before - someone raised the question on page 1 as to why it was apparently necessary for the both parents, plus Ashya, to go to Spain for apparently the sole purpose of selling a property. I can understand them removing him to take him to Prague, but this is the part on the parents' side that makes no sense to me.
One can only speculate as to whether they'd have done the same without the perception that their wishes were being ignored and/or overridden.
Assuming that's genuinely their perception of course. But I do think that if they really believed there was going to be some kind of legal action to enforce the hospital's treatment, they wouldn't leave him in the hospital while making visible steps towards their own preferred treatment.
In their eyes, that might've been a move that could trigger a hospital response just as much as what they actually did.
Part of the problem seems to have been a perception that Southampton wouldn't even talk to Prague. If the Kings had felt that the hospital was letting them find out from Prague whether that was a good option for their son, things might have gone very differently.
It's rather interesting that Prague has now said he is suitable for treatment.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
And Prague are of course totally unbiased ? And have full access to all medical information about the case now ? Because previously they were giving an opinion without that information.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Doublethink:
Well this is where I got the transfer information from.
The impression I get from the relevant paragraph isn't the one that I got from your post.
And why did Southampton only get in touch with Prague on Monday? Why such a delay from 20 August?
Again, I come back to the point I was making earlier: doctors are entirely correct in giving their professional opinion about the best course of treatment. But it is not the role of doctors to control the flow of alternative information. If the clinic in Prague told the family that they would consider treatment but needed documentation first (which appears to be confirmed by the clinic), then it is completely inappropriate for anyone in Southampton to stand in the way of that documentation being provided.
The fact that THEY don't think Prague would offer a better treatment is irrelevant. The family have the right to make that decision themselves, and to be informed by Prague's opinion. It would be a very different situation if Prague said "no, he is not suitable for our treatment", but that hadn't happened.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
It appears the father believed that conventional treatment would either kill his son or turn him into a "vegetable".
This suggests an extremely polarised position between the family and the hospital.
Rationally, why would you give a treatment to prevent lethal relapse if you believed it would kill your patient ? You'd give palative care in such circumstances.
Vincristin can be lethal if given incorrectly, I wonder how much of the dispute is about the radiotherapy and how much is about the chemotherapy.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Doublethink:
And Prague are of course totally unbiased ? And have full access to all medical information about the case now ? Because previously they were giving an opinion without that information.
What opinion did they give before? As far as I can see they said they wanted further information about the boy's condition.
As to totally unbiased: maybe no-one is totally unbiased. There's no evidence to show that Prague is more biased than Southampton. There's nothing wrong with 2 medical establishments both offering a treatment plan for a patient and saying "we think this is the best option". There's only something wrong with one of those establishments saying "if you pick the other plan, we'll get a court order".
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
quote:
Originally posted by orfeo:
quote:
Originally posted by Doublethink:
Well this is where I got the transfer information from.
The impression I get from the relevant paragraph isn't the one that I got from your post.
And why did Southampton only get in touch with Prague on Monday? Why such a delay from 20 August?
Again, I come back to the point I was making earlier: doctors are entirely correct in giving their professional opinion about the best course of treatment. But it is not the role of doctors to control the flow of alternative information. If the clinic in Prague told the family that they would consider treatment but needed documentation first (which appears to be confirmed by the clinic), then it is completely inappropriate for anyone in Southampton to stand in the way of that documentation being provided.
The fact that THEY don't think Prague would offer a better treatment is irrelevant. The family have the right to make that decision themselves, and to be informed by Prague's opinion. It would be a very different situation if Prague said "no, he is not suitable for our treatment", but that hadn't happened.
Well firstly he had a second surgery on the 22nd of August, so I am guessing the medical team might have been wanting to see him stabilise post-operatively before being able to assess accurately what to do next, or for that matter to be able to provide current medical information to Prague.
Press reports suggest that Prague have been sent his MRI scans. But if he had brain surgery on the 22nd of August, there would little point in sending such scans until there was a enough post-op recovery to show clearly what they would be working with.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Matt Black
Shipmate
# 2210
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Posted
quote:
Originally posted by orfeo:
quote:
Originally posted by Matt Black:
Whilst it does seem that the PTB overreacted after the removal from the hospital - and possibly before - someone raised the question on page 1 as to why it was apparently necessary for the both parents, plus Ashya, to go to Spain for apparently the sole purpose of selling a property. I can understand them removing him to take him to Prague, but this is the part on the parents' side that makes no sense to me.
One can only speculate as to whether they'd have done the same without the perception that their wishes were being ignored and/or overridden.
Assuming that's genuinely their perception of course. But I do think that if they really believed there was going to be some kind of legal action to enforce the hospital's treatment, they wouldn't leave him in the hospital while making visible steps towards their own preferred treatment.
In their eyes, that might've been a move that could trigger a hospital response just as much as what they actually did.
Why/ how would the hospital have found out that one of them had gone to Spain? Hordes of Brits go to Spain each summer.
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"Protestant and Reformed, according to the Tradition of the ancient Catholic Church" - + John Cosin (1594-1672)
Posts: 14304 | From: Hampshire, UK | Registered: Jan 2002
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
quote:
Originally posted by orfeo:
quote:
Originally posted by Doublethink:
And Prague are of course totally unbiased ? And have full access to all medical information about the case now ? Because previously they were giving an opinion without that information.
What opinion did they give before? As far as I can see they said they wanted further information about the boy's condition.
As to totally unbiased: maybe no-one is totally unbiased. There's no evidence to show that Prague is more biased than Southampton. There's nothing wrong with 2 medical establishments both offering a treatment plan for a patient and saying "we think this is the best option". There's only something wrong with one of those establishments saying "if you pick the other plan, we'll get a court order".
The court order doesn't mean the hospital get to choose the treatment, it means the case goes to legal arbitration basically. With an independent legal guardian for the child.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Doublethink:
The court order doesn't mean the hospital get to choose the treatment, it means the case goes to legal arbitration basically. With an independent legal guardian for the child.
Yes. What I meant was that the decision-making would be taken away from the parents. That is "if you don't choose our treatment plan, we'll take away your choice".
That doesn't automatically mean that the legal arbitration would go with Southampton's plan. But that approach still involves a piece of leverage against the parents (assuming that anyone did in fact convey anything along these lines). It still means that there are adverse consequences to picking a different treatment option.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Matt Black:
Why/ how would the hospital have found out that one of them had gone to Spain? Hordes of Brits go to Spain each summer.
The reports are that both parents were constantly at the hospital. They wouldn't have necessarily known where one parent had gone, but after a few days it wouldn't have been difficult to notice that one parent was gone.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Matt Black
Shipmate
# 2210
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Posted
I don't think that kind of reasoning would have stood up to scrutiny by a Family Court judge.
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"Protestant and Reformed, according to the Tradition of the ancient Catholic Church" - + John Cosin (1594-1672)
Posts: 14304 | From: Hampshire, UK | Registered: Jan 2002
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Doublethink:
quote:
Originally posted by orfeo:
quote:
Originally posted by Doublethink:
Well this is where I got the transfer information from.
The impression I get from the relevant paragraph isn't the one that I got from your post.
And why did Southampton only get in touch with Prague on Monday? Why such a delay from 20 August?
Again, I come back to the point I was making earlier: doctors are entirely correct in giving their professional opinion about the best course of treatment. But it is not the role of doctors to control the flow of alternative information. If the clinic in Prague told the family that they would consider treatment but needed documentation first (which appears to be confirmed by the clinic), then it is completely inappropriate for anyone in Southampton to stand in the way of that documentation being provided.
The fact that THEY don't think Prague would offer a better treatment is irrelevant. The family have the right to make that decision themselves, and to be informed by Prague's opinion. It would be a very different situation if Prague said "no, he is not suitable for our treatment", but that hadn't happened.
Well firstly he had a second surgery on the 22nd of August, so I am guessing the medical team might have been wanting to see him stabilise post-operatively before being able to assess accurately what to do next, or for that matter to be able to provide current medical information to Prague.
Press reports suggest that Prague have been sent his MRI scans. But if he had brain surgery on the 22nd of August, there would little point in sending such scans until there was a enough post-op recovery to show clearly what they would be working with.
Fair enough. And it may well be that there was some miscommunication with the parents over the willingness of Southampton to talk to Prague.
I would note, though, that the Telegraph article you linked to describes the Southampton hospital as executing a U-turn, from "he's getting the best possible care and proton beam therapy won't help" one day, to "we're talking to Prague" the next day. The earlier statements don't really seem to convey an idea that the issue was needing to wait before sending information, they seem more along the lines of having decided there was no need to send information.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Matt Black:
I don't think that kind of reasoning would have stood up to scrutiny by a Family Court judge.
I think you're probably right. But if you were in the parent's shoes, would you wait to find that out?
I'm not saying I think their actions are perfectly rational and the best possible option, but I do think they're understandable actions if they are giving a truthful description of how they perceived the hospital's attitude.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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JoannaP
Shipmate
# 4493
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Posted
quote:
Originally posted by orfeo:
Obviously we don't know exactly what was said, but currently the Kings are saying that the perception they got was that the doctors would take legal action to enforce their treatment plan.
No-one should have ever suggested such a thing. The law is only supposed to be there to step in when parents are acting entirely outside reasonable bounds, not when they are making a choice which is within the bounds of reasonableness. Opting for another medical treatment might not be what the doctors in Southampton recommended, but that's not the right question.
The doctors do not have the authority to take legal action to enforce their treatment plan. The various protection orders can only be granted by a judge at the request of a local authority or the NSPCC so, to deny the Kings access to their son, the hospital authorities would have to persuade at least two other people that it was necessary. It took me less than 10 minutes to find that out so, why the Kings could not spare the time from researching Proton Beam Therapy to do that, I do not know. It is possible that being JW's has affected their perceptions on this matter.
quote:
Originally posted by orfeo:
As for 'secrecy': Where's the obligation to give the hospital information? Given all the things that the hospital seems to have successfully worked out (he's gone, his parents have him, they have a feeding system, they want to take him to another clinic), what exactly were the parents supposed to tell the hospital?
The scenario as currently presented doesn't really have the hospital in the dark about much. The main thing missing is an opportunity for the hospital to act to prevent the child's removal. That's not a piece of information.
At the time the hospital called the police, all they knew was that a seriously ill child was missing and his parents could not be contacted. They did not know that Ashya was still with his parents until they were found. I assume that, before they could take him off the ward, there was some informal agreement as to where they would take him and for how long; at the very least a commitment to return him. So they did give the hospital misinformation; even if there was no obligation on them to provide any information.
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"Freedom for the pike is death for the minnow." R. H. Tawney (quoted by Isaiah Berlin)
"Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety." Benjamin Franklin
Posts: 1877 | From: England | Registered: May 2003
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Moo
Ship's tough old bird
# 107
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Posted
quote:
Originally posted by justlooking
But UK law treats children as having rights and interests independent of their parents or of state authorities. When it comes to a dispute or when a child is seen to be in danger the court and legal system ensure the child's rights and interests take priority.
The problem lies in determining what the child's interests actually are.
There was a case about thirty years ago which I found extremely disturbing. Back in the days when treatment for childhood leukemia was not very good, a child's parents wanted to withdraw him from a treatment whose side-effects, they said, made him very restless and miserable all the time. Given the fact that his chances of survival were considerably less than fifty-fifty, they wanted his last days to be as pleasant as possible.
The doctor who was treating the child said that the treatment did not have the effect the parents said it did. He saw the child once a week, but he was sure he knew more about how the child felt and behaved at home than the parents did. His arrogance took my breath away.
The matter came to court, and the parents were allowed to discontinue the treatment. The boy's last days were much more pleasant than they would have been if the treatment had been continued.
Moo
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Kerygmania host
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See you later, alligator.
Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
quote:
Originally posted by orfeo:
quote:
Originally posted by Doublethink:
quote:
Originally posted by orfeo:
quote:
Originally posted by Doublethink:
Well this is where I got the transfer information from.
The impression I get from the relevant paragraph isn't the one that I got from your post.
And why did Southampton only get in touch with Prague on Monday? Why such a delay from 20 August?
Again, I come back to the point I was making earlier: doctors are entirely correct in giving their professional opinion about the best course of treatment. But it is not the role of doctors to control the flow of alternative information. If the clinic in Prague told the family that they would consider treatment but needed documentation first (which appears to be confirmed by the clinic), then it is completely inappropriate for anyone in Southampton to stand in the way of that documentation being provided.
The fact that THEY don't think Prague would offer a better treatment is irrelevant. The family have the right to make that decision themselves, and to be informed by Prague's opinion. It would be a very different situation if Prague said "no, he is not suitable for our treatment", but that hadn't happened.
Well firstly he had a second surgery on the 22nd of August, so I am guessing the medical team might have been wanting to see him stabilise post-operatively before being able to assess accurately what to do next, or for that matter to be able to provide current medical information to Prague.
Press reports suggest that Prague have been sent his MRI scans. But if he had brain surgery on the 22nd of August, there would little point in sending such scans until there was a enough post-op recovery to show clearly what they would be working with.
Fair enough. And it may well be that there was some miscommunication with the parents over the willingness of Southampton to talk to Prague.
I would note, though, that the Telegraph article you linked to describes the Southampton hospital as executing a U-turn, from "he's getting the best possible care and proton beam therapy won't help" one day, to "we're talking to Prague" the next day. The earlier statements don't really seem to convey an idea that the issue was needing to wait before sending information, they seem more along the lines of having decided there was no need to send information.
I think that the the headline is misleading given the content of the article.
In particular, the Southhampton doctor doesn't comment on specifically on Aysha's case in that article he gives general informaiton and secondly the issue is th epros and cons of different types of radiotherapy, which is better in terms of side effects - not clinical effect. In effect, what Southhampton have argued is that they have offered appropriate, treatment and that basically they are being asked to offer a more expensive version of that treatment in another country with little evidence that doing so will offer benefit over an above what they are already offering.
[ 03. September 2014, 13:03: Message edited by: Doublethink ]
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Doublethink:
I think that the the headline is misleading given the content of the article.
We shall have to agree to disagree on that.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Beeswax Altar
Shipmate
# 11644
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Posted
Reading some of the comments on this thread, you would think that the King's read about some novel cancer treatment on the internet and then found a mechanic in Prague who would agree to do it. All of the world's doctors don't live in the UK. The ones who don't may not factor in what is most cost effective for the NHS when recommending a course of treatment. Parents in the UK should have every right to take their child to receive treatment under such a doctor without the government taking their child away to assuage the pride of doctors in the NHS.
They were offered a second opinion? You mean the NHS was willing to bring in a second doctor to explain the NHS policy to the Kings? The court will appoint a legal guardian to make decisions in the best interest of the child? What qualifications will the legal guardian have to make medical decisions for the child of another couple? Will the guardian seek expert medical advice? No doubt the guardian will ask doctors from the NHS about what's in the best interest of the child and act accordingly.
I wish this shit didn't happen in the United States but it does. Here, the police, child protective services, and courts got involved when parents tried to move their child from Boston Children's Hospital back to Tufts Medical Center. The parents didn't sufficiently kiss the Ivy League asses of the doctors at Boston Children's Hospital.
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Losing sleep is something you want to avoid, if possible.
-Og: King of Bashan
Posts: 8411 | From: By a large lake | Registered: Jul 2006
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Justinian
Shipmate
# 5357
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Posted
quote:
Originally posted by orfeo:
And why did Southampton only get in touch with Prague on Monday? Why such a delay from 20 August?
The legal situation under the Data Protection Act.
quote:
But it is not the role of doctors to control the flow of alternative information. If the clinic in Prague told the family that they would consider treatment but needed documentation first (which appears to be confirmed by the clinic), then it is completely inappropriate for anyone in Southampton to stand in the way of that documentation being provided.
And if a journalist pretending to be a clinic in Prague phoned up and asked for the infomation? What then? There are little things like the Data Protection Act to prevent just this scenario happening.
quote:
The fact that THEY don't think Prague would offer a better treatment is irrelevant. The family have the right to make that decision themselves, and to be informed by Prague's opinion.
That does not mean that the hospital in Prague can contact Southampton and say "Hi. Can we have random patient's medical notes." Standard process says that the hospital can not give out the notes without consent of the patient - or the patient's guardians where applicable. The patient's guardians were not able to be contacted for obvious reasons. At which point the hospital could not legally send the notes to Prague.
When the patient's guardians reappeared and made explicitly clear what they wanted to do then and only then could the notes be sent to Prague without breaking the Data Protection Act.
Without the patient or the person legally able to speak for the patient (i.e. the parents) saying that the notes should be sent to Prague then it is illegal to send them to Prague. And I see no evidence to say that the patients had asked for the notes to be sent to that specific hospital.
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My real name consists of just four letters, but in billions of combinations.
Eudaimonaic Laughter - my blog.
Posts: 3926 | From: The Sea Coast of Bohemia | Registered: Dec 2003
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Justinian:
And if a journalist pretending to be a clinic in Prague phoned up and asked for the infomation? What then?
Maybe we can wait until that actually happens to find out. I'm not going to speculate on slippery slope bogeymen ideas like this.
[ 03. September 2014, 13:24: Message edited by: orfeo ]
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Justinian
Shipmate
# 5357
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Posted
quote:
Originally posted by orfeo:
quote:
Originally posted by Justinian:
And if a journalist pretending to be a clinic in Prague phoned up and asked for the infomation? What then?
Maybe we can wait until that actually happens to find out. I'm not going to speculate on slippery slope bogeymen ideas like this.
Or maybe we can obey the law that was put in place for a depressingly common thing - and not blame the hospital for not breaking the law.
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My real name consists of just four letters, but in billions of combinations.
Eudaimonaic Laughter - my blog.
Posts: 3926 | From: The Sea Coast of Bohemia | Registered: Dec 2003
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Justinian:
quote:
Originally posted by orfeo:
quote:
Originally posted by Justinian:
And if a journalist pretending to be a clinic in Prague phoned up and asked for the infomation? What then?
Maybe we can wait until that actually happens to find out. I'm not going to speculate on slippery slope bogeymen ideas like this.
Or maybe we can obey the law that was put in place for a depressingly common thing - and not blame the hospital for not breaking the law.
You seem to be missing the fact that the parents were around for at least a week between contacting Prague and leaving the hospital. Your proposition that it wasn't possible to obtain the parent's consent makes no sense. This isn't something that only arose after they left the UK.
Surely you're aware that I, of all people, wouldn't advocate breaking the law!
[ 03. September 2014, 13:32: Message edited by: orfeo ]
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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