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» Ship of Fools   » Ship's Locker   » Limbo   » Purgatory: Who knows best - the state or the parents? (Page 3)

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Source: (consider it) Thread: Purgatory: Who knows best - the state or the parents?
Justinian
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# 5357

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quote:
Originally posted by orfeo:
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!

If the parents did not explicitly tell the hospital to send the medical records to Prague then the hospital was not legally able to do so. Incoming requests for medical records without such authorisation get a polite response - or sometimes just moved to the round file. If the patients had specifically told the hospital "Please send copies of the medical records to Prague" (or more likely "We want a copy of the notes so far" and the parents to then send it on) then and only then was the hospital legally authorised to do so - and with the working relationship the parents didn't have with the hospital I doubt that happened.

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Eirenist
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# 13343

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One thing we can be reasonably sure of about this case: if Ashya is treated by the Prague hospital, and the treatment proves ineffective, it is the hospital in Southampton that will get the blame.

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3M Matt
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# 1675

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The state are swallowing us all up. Particularly in regards to child care.

They want to lower the age that children start school. They want to make the school day longer and longer.

Why? Because they want the children in the hands of the state MORE and in the hands of their parents LESS, because then they can exert more control over the kind of people they turn out to be.

Paranoid? Possibly, but it's a hypothesis that fits the facts.

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3M Matt.

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Justinian
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# 5357

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quote:
Originally posted by 3M Matt:
The state are swallowing us all up. Particularly in regards to child care.

They want to lower the age that children start school. They want to make the school day longer and longer.

Why? Because they want the children in the hands of the state MORE and in the hands of their parents LESS, because then they can exert more control over the kind of people they turn out to be.

Paranoid? Possibly, but it's a hypothesis that fits the facts.

Because Tories are such a fan of teachers.

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My real name consists of just four letters, but in billions of combinations.

Eudaimonaic Laughter - my blog.

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chive

Ship's nude
# 208

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I think the hospital and police response was absolutely reasonable and proportionate. A seriously ill child was removed from the hospital. The hospital had made arrangements for the child to be away for a short period. Instead the family disappeared to another country with the child. At this point the hospital and the police did not know where the child was, whether the child had appropriate care and even if the child was dead or alive.

I'm not saying the parents acted maliciously. I have nothing but compassion for a family which is going through one of the most distressing things possible. I think they did not act entirely rationally and the fact they went to Spain rather than straight to the Czech Republic suggests this.

The hospital and the police had no other options. What would have happened if they did nothing and the child died? They had responsibility for the medical care of the child and they couldn't exercise it if the child wasn't there. There is definitely no question that they acted maliciously. They did what they felt, no doubt on legal and medical advice, was the best interests of the child.

This is one of these situations where there is no right answer only a tragedy. I think all parties acted in what they believed was the best interests of the child as they saw it. That is what they should be doing.

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'Edward was the kind of man who thought there was no such thing as a lesbian, just a woman who hadn't done one-to-one Bible study with him.' Catherine Fox, Love to the Lost

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Belle Ringer
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# 13379

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Once the parents were located, they could have been talked to instead of hauled into jail, hear their concerns. Even if arrested they could have been allowed at their son's bed under guard instead of preventing him from seeing them.

And if they were at his bed constantly in the UK hospital they were well aware of what treatments - or none but feeding - the child was receiving.

One article I read (I admit only one mentioned it) said the parents had been told by the doctors their son has only 4 months to live. If that's true I am totally on their side, nothing to lose possibly everything to gain in changing treatments, with or without permission.

I have had doctors "forbid" me to reject their tests and treatments. I walk out of their office, I tell them order any tests they want I'm not paying for them. I've had doctors follow me to the door telling me have to obey them. Some doctors even today really do use threats (that they know are not enforceable but the patients don't know) to get compliance.

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Gracie
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# 3870

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quote:
Originally posted by Doublethink:
quote:
Originally posted by Gracie:
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]

The texts you quote do not talk about the comparative side effects at all.

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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

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Byron
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# 15532

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quote:
Originally posted by Belle Ringer:
Once the parents were located, they could have been talked to instead of hauled into jail, hear their concerns. Even if arrested they could have been allowed at their son's bed under guard instead of preventing him from seeing them. [...]

Problem with that is, the Spanish authorities would have very little to go on, as they were dependent on England for the facts of the case. All they knew was that the Kings were accused of neglect, and were an obvious flight risk.

Looks like it was all dropped before more info could be brought before a Spanish court.

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JoannaP
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At the moment, the more I read of what Mr King has been saying, the less sympathy I feel for him. This BBC piece suggests that is is a case of choosing whom to believe, as the two versions are just not compatible.
quote:
Speaking about the family's relationship with doctors in Southampton, Mr King said: "They threatened me previously. When I asked about his cancer... they said if I ask anymore questions the right for me to make a decision will be taken away from me because they get immediate courts paper to say that they have right over my child.

"I had so much fear to mention anything to them because they could have stopped my son getting any treatment and just forcing this very strong treatment on him.

"So from that moment on I had to keep everything quiet."

Dr Pete Wilson, chief paediatrician at Southampton General Hospital, said doctors had told the family they believed proton beam therapy had "no benefit" but had still agreed to refer him for the treatment to be paid by the family and were in the process of helping them down this route.

He also denied any threats were made, adding: "When they [doctors] were asked directly by the family what would happen if they refused treatment, any treatment, they were told that in exceptional circumstances, as doctors, we would need to act in Ashya's best interests and that may need going to the court.



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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

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itsarumdo
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# 18174

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The worth of current medical wisdom and evidence should also considered whilst carrying a small salt shaker. Especially for Cancer. There has been a fashion ("evidence", "best practice") in medicine for some years now that some women receive double mastectomies based on genetic profiling to prevent inevitable breast cancer. The latest evidence is that this has absolutelty no measurable effect on survival or lifespan. If I were Angelina Jolie, I would have a rather wry expression on my face the next time a specialist told me that he was very certain that X would happen and that Y is the best treatment in my particular situation.

The mistake is to think that science NOW is at some peak of wisdom that means it must be so correct that it can't possibly be that wrong. In fact, particularly for medical science, there are very few absolutes that are known with 100% certainty. Other than we are born and some time later we die. One major problem with medical best practice is that it is measured relative to placebo. If you investigate placebo, you will find it is so ill defined that the unit of measurement being applied is more variable in size than a poets monthly income.

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Doublethink.
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# 1984

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quote:
Originally posted by Gracie:
quote:
Originally posted by Doublethink:
quote:
Originally posted by Gracie:
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]

The texts you quote do not talk about the comparative side effects at all.
A "serious adverse event" would be a serious side effect. Plus you need to read the whole article.

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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

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Doublethink.
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# 1984

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quote:
Originally posted by Belle Ringer:
One article I read (I admit only one mentioned it) said the parents had been told by the doctors their son has only 4 months to live. If that's true I am totally on their side, nothing to lose possibly everything to gain in changing treatments, with or without permission.

The telegraph article I cited some posts ago gives a life expectancy of three months - without further treatment.

--------------------
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

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JoannaP
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# 4493

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quote:
Originally posted by Doublethink:
quote:
Originally posted by Belle Ringer:
One article I read (I admit only one mentioned it) said the parents had been told by the doctors their son has only 4 months to live. If that's true I am totally on their side, nothing to lose possibly everything to gain in changing treatments, with or without permission.

The telegraph article I cited some posts ago gives a life expectancy of three months - without further treatment.
According to Dr Pete Wilson, chief paediatrician at Southampton General Hospital, Ashya King is:
quote:
a young lad who has a very, very good chance of survival if he receives rapid treatment. (source)
Which, to me, is not compatible with his father's claim that he has only four months to live.

--------------------
"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

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Doublethink.
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# 1984

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Makes sense of why the hospital were so intensely worried - question "what if we refuse all treatment" action "leave hospital with child leaving no information" does not necessarily = obvious conclusion is they are looking for another hospital.

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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

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justlooking
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# 12079

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This struck me as significant:
quote:
Ashya is required to undergo two cycles of chemotherapy before he could be treated in Prague.

That is expected to take several weeks but afterwards Ashya would be able to travel to the Czech Republic.

So there was nothing to gain in removing Aysha before his chemotherapy was completed.

Also this:

quote:
"When [the doctors] were asked directly by the family what would happen if we refused any treatment they were told that in exceptional circumstances, as doctors, we would need to act in Ashya's best interests and that may need going to the court.

"[A threat] wasn't made. A question was asked what would happen if we refused treatment.

That looks like the parents making a threat, not the other way round. When they then disappeared with Aysha doctors may have suspected they were planning to keep him away from any medical help.

The arrest warrant has been withdrawn but Aysha remains a ward of court and any decision will now have to have the court's approval. .

[ 03. September 2014, 21:15: Message edited by: justlooking ]

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Gracie
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# 3870

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quote:
Originally posted by Doublethink:
A "serious adverse event" would be a serious side effect. Plus you need to read the whole article.

A "serious adverse event" would be one kind of serious side effect, but would not cover all serious side effects as I understand it. I don't get the impression from listening to Mr King that he got his information from Wikipedia.

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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

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North East Quine

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# 13049

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While he was still missing, friends of the family said that they understood that his illness was terminal, and that the family refused to believe that no more could be done.

There seems to a big discrepancy between what the Kings claimed they believed the situation to be, and what the hospital are saying the situation was.

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JoannaP
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# 4493

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quote:
Originally posted by Gracie:
I don't get the impression from listening to Mr King that he got his information from Wikipedia.

Well no. If he had, he would know that Proton Beam Therapy is a form of radiotherapy for starters.

--------------------
"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

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Justinian
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This recent update leads to an obvious question:

If the kid has months to live without treatment, and will probably survive with treatment, and the parents refuse to let the kid receive treatment, should the parents have the right to let their kid die?

My answer is "Fuck, no. That's murder by neglect."

Those criticising Southampton, what would you do differently if that was the situation you thought you were in? A parent taking their child away from any practical treatment.

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North East Quine

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# 13049

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I'm not criticising Southampton. But there seems to have been a huge breakdown in communication.

If I believed that my child was getting optimal treatment in hospital, then hospital is where my child would be.

If I believed my child was dying in hospital, that if I challenged his doctors in any way, I might be excluded from contact with my child, but that there was an alternative treatment which held out hope, I might well do what the Kings did.

The question for me is - why is there such a discrepancy between what the Kings appear to to have believed the situation to have been, and what the hospital says the situation was?

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orfeo

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# 13878

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quote:
Originally posted by Justinian:
This recent update leads to an obvious question:

If the kid has months to live without treatment, and will probably survive with treatment, and the parents refuse to let the kid receive treatment, should the parents have the right to let their kid die?

My answer is "Fuck, no. That's murder by neglect."

(Emphasis added by me.)

That's my answer as well, as I'd already said in relation to a case that bib raised.

But it is simply wrong to equate wanting a different treatment with 'refusal to let the kid receive treatment'. This is clearly NOT a case of refusing to let a kid be treated. Refusal of a particular treatment is not refusal of treatment. Not unless there is no other treatment is available.

[ 04. September 2014, 02:36: Message edited by: orfeo ]

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orfeo

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# 13878

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ADDENDUM: And I do note your claim about taking a child away from "any practical treatment". This again has the flavour of depicting continental Europe as some kind of wasteland devoid of decent medical care.

I simply don't buy this proposition that this child was doomed if he was anywhere other than a particular hospital in Southampton.

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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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Zacchaeus
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# 14454

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Hindsight is a wonderful thing.

A very sick child disappeared, a week after an operation, without information as to where he was, what was going to happen to him and what provision for his ongoing care were in place. Even Ashya’s grandmother did not know what was happening.

At the time of his disappearance the hospital got flack for waiting 6 hours before reporting him missing.

We now know what happened, but it still remains his parent took him on an arduous journey by boat and car while he was very ill. I have done the journey to Spain by boat and car and it is not easy even for a healthy adult.

And the end destination of that journey was not treatment for Ashya, treatment is still another 1300 miles away across Europe.

Erm I can see why authorities are concerned about him and want to make sure he gets care…

What that care will be has not been specified, but it concerns me about the parents state of mind and understanding of what is being said to them.

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seekingsister
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# 17707

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quote:
Originally posted by Zacchaeus:
Hindsight is a wonderful thing.

A very sick child disappeared, a week after an operation, without information as to where he was, what was going to happen to him and what provision for his ongoing care were in place. Even Ashya’s grandmother did not know what was happening.

At the time of his disappearance the hospital got flack for waiting 6 hours before reporting him missing.

We now know what happened, but it still remains his parent took him on an arduous journey by boat and car while he was very ill. I have done the journey to Spain by boat and car and it is not easy even for a healthy adult.

But the question still remains, given that the Southampton police have said they broke no laws in taking the child out of the hospital in the first place:

1. Why was a European arrest warrant issued instead of a general Europe-wide alert to find the family and ensure the health of the child?

2. Why were the parents arrested, jailed, and separated from the child?

It's one thing to claim that the hospital was only concerned for Ashya's life, but the response was nonetheless excessive.

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orfeo

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# 13878

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quote:
Originally posted by Zacchaeus:
Hindsight is a wonderful thing.

A very sick child disappeared, a week after an operation, without information as to where he was, what was going to happen to him and what provision for his ongoing care were in place. Even Ashya’s grandmother did not know what was happening.

At the time of his disappearance the hospital got flack for waiting 6 hours before reporting him missing.

We now know what happened, but it still remains his parent took him on an arduous journey by boat and car while he was very ill. I have done the journey to Spain by boat and car and it is not easy even for a healthy adult.

And the end destination of that journey was not treatment for Ashya, treatment is still another 1300 miles away across Europe.

Erm I can see why authorities are concerned about him and want to make sure he gets care…

What that care will be has not been specified, but it concerns me about the parents state of mind and understanding of what is being said to them.

He did not simply disappear, though. It was clearly worked out that he was with his parents.

Given that it was clearly lawful for him to be with his parents, the next question is, what obligation was there for his parents to give anyone further information about precisely where he was, or what provision had been made for his care (again, the most crucial piece of information was known - he had a feeding tube)?

I suggest it's far from clear they had any obligation to provide further information. They didn't have an obligation to the hospital any more than they had an obligation to the grandmother. I can well understand why the hospital might want more information, but that's different.

This again comes back to the 'concern' being based on speculation as much as facts, and a system that encourages people to fill in the blanks in the worst way possible. Yes, the hospital staff knew he was ill, but they also knew he was being cared for. Maybe they thought that care was not as good as the care they would have provided, but charges of child neglect should be for demonstrable cases of inadequate care, not for speculative ones.

It would have been perfectly possible for the hospital to express its desire for further information, to make sure that he was alright, by finding ways to ask the parents to provide that reassurance. They could have left phone messages, sent emails, left messages with relatives such as the grandmother, all saying "can you please get in touch and let us know that he's okay".

Instead, they turned "we don't know whether he's okay" into more positive assertions that he wasn't okay. That's the problem. The legal system was used to convey that this child was in danger. I can well understand why the lack of information led to speculation, but someone along the bureaucratic chain should have hit the pause button and asked what was actually known and what was speculation.

The impression that he was in imminent danger because his feeding device battery was going to run out is perhaps the most dramatic example of speculation. Some of the reporting certainly seems to indicate that the hospital gave this impression to some people. But any statement that "he will starve because the battery will drain" was a speculative one.

A truer, and less urgent-sounding, statement would be "it's possible he might starve because we're not sure whether they have a charger for the battery, but at the same time if that happens we recognise there's a fair chance they'll seek help at a hospital because they know he needs the tube and they want what's best for him".

None of that paragraph requires hindsight. All that it requires is a series of reasoned inferences from information already known to the hospital.

[ 04. September 2014, 09:16: 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.

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orfeo

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# 13878

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It's not unlike what happens with terrorism. I can't remember the name of the documentary, but there's a show examining 9/11 and the response where one person involved in the United States intelligence agencies observed how, after 9/11, there was this sense that every possible risk had to be neutralised.

The result was a system that encouraged people to imagine the worst possible scenario, with no mechanism in place to assess how likely this doomsday actually was, and whether addressing this doomsday was the best use of available resources.

In my own country, a raft of new anti-terrorism laws were passed. I think at one point the average rate was one a week. The intelligence agencies basically had to say "we might need this" and they would get it.

Some of those laws eventually resulted in an innocent doctor being detained for 25 days as a suspected terrorist. Subsequent investigations showed how those who tried to point out there wasn't actually much in the way of solid evidence linking him to terrorism were overridden by those determined to create a speculative scenario that showed he was a terrorist.

Western countries agitated for Indonesia to create new terrorism laws to deal with the Bali bombers. The conviction of these people was placed in jeopardy after the Indonesian consitutional court ruled that the laws could not be applied retrospectively. No-one seemed to say for a long time "hang on, why don't we just charge them with 200 counts of murder?"

We seem to have a cycle whereby public/media outrage that something wasn't done in a particular case leads to a determination to be seen to be doing something in every case. The fear of being seen to be inactive is far greater than the fear of doing the wrong thing. That's precisely why you get heavy-handed responses - because being seen to do something becomes more important than working out the best thing to do.

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itsarumdo
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quote:
Originally posted by orfeo:
...

We seem to have a cycle whereby public/media outrage that something wasn't done in a particular case leads to a determination to be seen to be doing something in every case. The fear of being seen to be inactive is far greater than the fear of doing the wrong thing. That's precisely why you get heavy-handed responses - because being seen to do something becomes more important than working out the best thing to do.

Nail on the head

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orfeo

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^ Thanks.

"You must do something" is one of the most unhelpful sentences in the English language. Even when it's correct, it's rarely useful information.

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justlooking
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quote:
Originally posted by seekingsister:

But the question still remains, given that the Southampton police have said they broke no laws in taking the child out of the hospital in the first place:

1. Why was a European arrest warrant issued instead of a general Europe-wide alert to find the family and ensure the health of the child?

2. Why were the parents arrested, jailed, and separated from the child?

It's one thing to claim that the hospital was only concerned for Ashya's life, but the response was nonetheless excessive.

They broke no laws in taking the child out of hospital but their actions gave rise to justifiable fear for the child and the hospital would have been in breach of its legal obligations if it had taken no action. Once the child was made a ward of court then the parents had to comply with the court's orders.

An arrest warrant was issued because the child appeared to be in danger and in need of speedy intervention to ensure his safety.

The parents' arrest and the subsequent actions of the Spanish police were in accordance with the legal processes following the issuing of an arrest warrant.

Every decision now is subject the court's approval. The court's duty is to act in the child's best interests and with regard to the child's wishes, as far as his wishes can be determined.

I see nothing excessive in the actions taken by the hospital, the court or the police in order to safeguard this child.

[ 04. September 2014, 10:03: Message edited by: justlooking ]

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Zacchaeus
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When a child’s health is at stake they cannot afford to make ‘reasoned inferences’ they have to be certain. The hospital have the obligation to be certain the child is being looked after.

Yes the hospital knew his was with his parents and knew that they cared for him, as in loved him very much. They had no way of knowing for sure that they were caring for his medical needs, they are not allowed to assume or infer.

The hospital tried phoning the family but the calls were ignored and in the absence of information they have to seek to make sure the child is ok.

The hospital had no way of knowing that the family had rigged up a way of charging the food pump using their car battery or had to hand what ever other medical care that we are not allowed to be told about because of patient confidentiality. But there is bound to be medication or other things that Ashya needed.

There will be a lot we don’t know, the family can say what they want now they have been found, but the hospital can’t because of patient confidentiality.

But I ask questions about any parents who can take their very ill child on a journey of 1000 miles, including on a boat, without any medical help on hand. If something had happened and they needed to consult a doctor/hospital there were no medical notes with the child and treatment would be delayed.

If the family thought it essential to all go to Spain to sell their apartment, there would be ways of doing it that gave their child medical care along the way and in place for when they arrived.

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orfeo

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# 13878

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quote:
Originally posted by Zacchaeus:
When a child’s health is at stake they cannot afford to make ‘reasoned inferences’ they have to be certain. The hospital have the obligation to be certain the child is being looked after.

How so?

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after? Is there some sort of roving duty of care in relation to all children in the area?

I don't think this obligation you are claiming exists. I think a hospital has an obligation to its patients. I don't think it follows that someone who is a patient continues to be a patient. I don't think it follows that termination of the patient/doctor relationship requires the doctor's consent.

[ 04. September 2014, 10:29: Message edited by: orfeo ]

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itsarumdo
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I'm sorry, but as soon as "child" is mentioned, there seems to be this all embracing desperate lavender fragrant panic that says "we must do everything". it's a CHILD!!!!!!!!

A child is not some entity on its own - it is part of a family, and there is a natural order of responsibility and authority. The state, the doctors, should come second to that natural order unless it's really really really awry. The lavender and hysteria make it so that a proportionate sense of what is reasonable and that the parents are the childs first primary guardians - have already flown out of the window and are nesting in a tree down the road.

In psychotherapy there is a principle of "good enough" parents - because very few parents have the continuous day by day wherewithal to hang it together through all stages of pregnancy through to adulthood that gives an optimum family life. There is therefore a generational guilt that passes down which is most visible in new mums that says "whatever I do is never good enough". This is the basis of the hysteria that creates these unbalanced decisions. Good enough.

The doctors - in fact - anyone - only have these rights of guardianship transferred if the parents transfer them for some reason - either they wilfully an unmistakably and *repeatedly* abuse the child, or they pass over responsibility voluntarily because they decide that person/organisation is far better resourced to deal with what is happening - for a defined period of time. And I say "repeatedly", because "good enough" means the right to seriously screw up and not be permanently branded by that action or judged by others. We already judge ourselves far too much.

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seekingsister
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quote:
Originally posted by justlooking:
They broke no laws in taking the child out of hospital but their actions gave rise to justifiable fear for the child and the hospital would have been in breach of its legal obligations if it had taken no action.

I accept this, but it still is a large leap from "justifiable fear for the child" to criminal neglect.

It is now confirmed that when the hospital told the police that Ashya's life was in immediate danger, this was not actually the case.

The hospital overreached, exaggerated, and perhaps outright lied in order to get that family locked up. And I firmly believe that their JW beliefs played into the hospital's fears. There is an article online of one of their neighbors in Spain who says they were extremely public about their faith and handed out pamphlets constantly. So this was likely known to the hostpical staff.

[ 04. September 2014, 10:38: Message edited by: seekingsister ]

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orfeo

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quote:
Originally posted by itsarumdo:
I'm sorry, but as soon as "child" is mentioned, there seems to be this all embracing desperate lavender fragrant panic that says "we must do everything". it's a CHILD!!!!!!!!

A child is not some entity on its own - it is part of a family, and there is a natural order of responsibility and authority. The state, the doctors, should come second to that natural order unless it's really really really awry. The lavender and hysteria make it so that a proportionate sense of what is reasonable and that the parents are the childs first primary guardians - have already flown out of the window and are nesting in a tree down the road.

In psychotherapy there is a principle of "good enough" parents - because very few parents have the continuous day by day wherewithal to hang it together through all stages of pregnancy through to adulthood that gives an optimum family life. There is therefore a generational guilt that passes down which is most visible in new mums that says "whatever I do is never good enough". This is the basis of the hysteria that creates these unbalanced decisions. Good enough.

The doctors - in fact - anyone - only have these rights of guardianship transferred if the parents transfer them for some reason - either they wilfully an unmistakably and *repeatedly* abuse the child, or they pass over responsibility voluntarily because they decide that person/organisation is far better resourced to deal with what is happening - for a defined period of time. And I say "repeatedly", because "good enough" means the right to seriously screw up and not be permanently branded by that action or judged by others. We already judge ourselves far too much.

This is pretty much my reaction to most of the remarks about the wisdom or otherwise of the parent's decisions. I'm not for a second suggesting that what they did was smart or the best possible option.

But we don't require parents to engage in the best possible option - not least because that requires hindsight, the kind of hindsight best obtained 30 years later when the child hires a psychiatrist and identifies all the ways their parents screwed up their life.

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Justinian
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quote:
Originally posted by orfeo:
But it is simply wrong to equate wanting a different treatment with 'refusal to let the kid receive treatment'. This is clearly NOT a case of refusing to let a kid be treated. Refusal of a particular treatment is not refusal of treatment. Not unless there is no other treatment is available.

You might want to re-read Joanna P's comment and follow the link she presented.
quote:
From The Father:
"When they [doctors] were asked directly by the family what would happen if they refused treatment, any treatment, they were told that in exceptional circumstances, as doctors, we would need to act in Ashya's best interests and that may need going to the court."

So the communication pathway with the hospital ran according to the father:
F: What happens if we refuse any treatment [at all]
H: If you refuse all treatment that's murder by neglect
F: *Clams up and stops talking to the hospital*

Sometime later the father takes the child at a point that makes Proton Beam Radiotherapy impossible for now. The last question the father has asked is what happens if he refuses any treatment for his son.

Explain to me please how when the last question the father has asked is what happens if he tries to refuse all treatment, and he takes away the patient at a time that disrupts all plans for Proton Beam Radiotherapy, the obvious inference is not that he is taking the child away for the reason he last asked about and was told wouldn't be allowed? Please further explain how taking the child away just before a necessary stage in the treatment pathway for any radiotherapy makes it likely that he is seeking out a different form of radiotherapy rather than seeking to deny the child treatment?

According to Mr. King's own account, the actions he has let the hospital see are almost entirely in line with the actions of someone trying to ensure that the child does not receive treatment. Asking what happens if he tries denying the kid treatment, then taking them away just before chaemotherapy starts, the chaemo being a necessary precursor to the proton beams the father claims he wants for his son but now can't happen until a new chaemo regime is arranged.

What sort of telepathic powers do you think the hospital should have used to know that the last thing the father asked about was not something he was thinking of? Further what sort of telepathic powers do you think the hospital should have used to realise that the father wanted proton beam radiotherapy rather than more conventional radiotherapy for his son despite the fact that taking the son away when he did meant that a necessary precursor to proton beam radiotherapy was being prevented - and the son is on a clock.

quote:
Originally posted by orfeo:
ADDENDUM: And I do note your claim about taking a child away from "any practical treatment". This again has the flavour of depicting continental Europe as some kind of wasteland devoid of decent medical care.

I simply don't buy this proposition that this child was doomed if he was anywhere other than a particular hospital in Southampton.

And this is a complete misreading.

If the child were in a (non-homeopathic) hospital in Europe, with all the medical notes, I would not have said that. However I do not believe that a hotel with no full time nurses laid on is capable of providing treatment. And he was not actually transferred to a hospital.

The child is on a clock. Four months IIRC. He was just sitting in a hotel room with no medical care arranged - and over 1000 miles away from the hospital his father claims he is to be treated in. Because the father stopped talking to the hospital it is not possible that anywhere he took the kid could have up to date information on the kid's condition. Which means that they would have to start the entire cancer treatment pathway from a relatively early diagnostic phase while the patient is on a clock - and a clock that is ticking while the patient sits in the hotel room.

And even if he had arranged transfer of notes (which he evidently didn't) cancers grow.

[ 04. September 2014, 10:50: Message edited by: Justinian ]

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Enoch
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I'm tending to agree with what Orfeo has been saying on this, even though he's thousands of miles away.

However, I'm also tending to suspect that most of our reactions to this sad story are driven by which side we instinctively come down on in respect of a quite different question.
Do we instinctively trust authority figures, experts etc, believe they know best, and act with public spirited integrity until demonstrated otherwise, or are we instinctively suspicious of them? Do we give them the benefit of the doubt, or don't we?

I know that my deep seated instinctive preference for the latter side of that fence is influencing me when I say that, knowing the UK's box-ticking, back-watching, blame-diverting official culture, I tend to assume that the Southampton Hospital feels affronted by a family that hasn't done what it was told and that both the Hospital and the local Police are driven as much by fear of being held responsible à la Baby P etc and being named and shamed by the gutter press if they didn't go over the top and the poor boy died, as by genuine concern for a sick child.

But as I say, I know my reaction is as much influenced by which side of that other fence I instinctively find myself, as by an objective evaluation of this case. I suspect the same is also true of those who leap to defend the Hospital and the Police.

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quetzalcoatl
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As well as the idea of good enough parents, therapists also sometimes talk about bad enough parents. This is an interesting idea, meaning that perfect parents would really screw you up. A bit like the oyster and the grit, children need a bit of frustration and bad behaviour by parents; something to get their teeth into. And yes, it is a great boon to psychiatrists and therapists in later life.

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Justinian
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quote:
Originally posted by orfeo:
How so?

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after?

Does your nephew have four months to live if they are not treated?

quote:
Is there some sort of roving duty of care in relation to all children in the area?
No. Merely the ones who need medical treatment or they will die.

quote:
I don't think this obligation you are claiming exists. I think a hospital has an obligation to its patients. I don't think it follows that someone who is a patient continues to be a patient. I don't think it follows that termination of the patient/doctor relationship requires the doctor's consent.
It does not.

On the other hand kids are not the property of their parents. Parents do not have the right to kill their children. Had this been an adult recklessly endangering themself rather than a child being recklessly endangered by their parents the response would have been very different.

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orfeo

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quote:
Originally posted by Enoch:
I'm tending to agree with what Orfeo has been saying on this, even though he's thousands of miles away.

However, I'm also tending to suspect that most of our reactions to this sad story are driven by which side we instinctively come down on in respect of a quite different question.
Do we instinctively trust authority figures, experts etc, believe they know best, and act with public spirited integrity until demonstrated otherwise, or are we instinctively suspicious of them? Do we give them the benefit of the doubt, or don't we?

I know that my deep seated instinctive preference for the latter side of that fence is influencing me when I say that, knowing the UK's box-ticking, back-watching, blame-diverting official culture, I tend to assume that the Southampton Hospital feels affronted by a family that hasn't done what it was told and that both the Hospital and the local Police are driven as much by fear of being held responsible à la Baby P etc and being named and shamed by the gutter press if they didn't go over the top and the poor boy died, as by genuine concern for a sick child.

But as I say, I know my reaction is as much influenced by which side of that other fence I instinctively find myself, as by an objective evaluation of this case. I suspect the same is also true of those who leap to defend the Hospital and the Police.

While I appreciate the theory and agree with it to a considerable extent, I'm going to expand on a point that I briefly made in response to Justinian yesterday.

Politically, I'm moderately left-wing. I don't believe in small government.

I am a bureaucrat.

I write laws. I believe passionately in the rule of law. I doubt I'd enjoy my job if I didn't see it as vital.

I certainly wouldn't spend as much time as I do in trying to explain to clients why I haven't typed what they asked me to type if I didn't think it mattered what the law said. I wouldn't make the lives of clients so goddamn difficult! I'd just keep them happy and ignore the questions in my mind of how the law is going to work in practice, and say that wasn't my problem.

An examination of my history, whether on the Ship or elsewhere, will show me frequently and passionately defending the right of people given authority by the law to exercise that authority.

I instinctively believe, exactly as you describe, that most people in the public service are trying to do their best (just as I believe most people are trying to do their job as well as they can).
I've also observed more than once then when faced with a choice between a government conspiracy and a government stuff-up, one should always assume the stuff-up. I'm not inherently suspicious of government.

So when I look at my fellow bureaucrats - my own team, as it were - and think "oh dear, you've stuffed up", I'm reasonably confident I'm doing it because I genuinely believe that this time around they've stuffed up.

I might also note that I have no children and so don't have any experiences in relation to the government trying to tell me how to bring up my children.

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orfeo

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quote:
Originally posted by Justinian:
quote:
Originally posted by orfeo:
How so?

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after?

Does your nephew have four months to live if they are not treated?

Who knows? Maybe someone should go around to his house and check.

You still seem to proposing, in the next paragraph of your response, that a hospital automatically has an obligation towards anyone (or at least, anyone under the age of 18?) in the area who is terminally ill. Again I would question that. It would involve a pro-active duty of a hospital to go out and seek the terminally ill, not wait for them to come and ask for help.

Obligations arise from relationships. A hospital has an obligation to its patients. The patient relationship can be terminated.

It seems fairly clear to me that the parents, by their actions, were terminating the patient relationship. I would fully accept that the hospital had obligations towards the boy while they were treating him, but there seems to be this unstated assumption that they were still treating him. I don't think that assumption stands up very well to proper examination.

[ 04. September 2014, 11:11: Message edited by: orfeo ]

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itsarumdo
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quote:
Originally posted by quetzalcoatl:
As well as the idea of good enough parents, therapists also sometimes talk about bad enough parents. This is an interesting idea, meaning that perfect parents would really screw you up. A bit like the oyster and the grit, children need a bit of frustration and bad behaviour by parents; something to get their teeth into. And yes, it is a great boon to psychiatrists and therapists in later life.

I don't get that - it's not a familiar idiom to me, and it's not representative of the vast majority of people or therapists I know. Birth is a great boon to paediatricians, to schools, to career advisors, and eventually to people who run care homes for the elderly and to undertakers.

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North East Quine

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Originally posted by orfeo:

quote:
Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after? Is there some sort of roving duty of care in relation to all children in the area?
Pretty much. The hospital check that, for example, if the parents are taking their newborn baby home by car, they are doing so in a properly fitted car seat. You can't just waltz out of hospital and put a baby in an unsecured carrycot on the back seat. Not here, anyway.

Once you're home, there are follow-up visits by a midwife, and then by a health visitor. Plus you're expected to show up regularly to have your baby weighed at a clinic. I'm not sure at what point alarm bells would start ringing if you kept your baby away from all health professionals, but it would happen at some point.

Also (voice of bitter experience) if your child hasn't been fully vaccinated (because your child had an adverse reaction to the first vaccination and your GP refused to give the second, and this is fully documented on your child's medical records) there are reassessments every few years of your child's not-fully-vaccinated status.

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orfeo

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quote:
Originally posted by Justinian:
On the other hand kids are not the property of their parents. Parents do not have the right to kill their children. Had this been an adult recklessly endangering themself rather than a child being recklessly endangered by their parents the response would have been very different.

This is relevant to the duties of the parents, not to the duties of a hospital.

It is also relevant some case where the prosecution hasn't said "oh dear, there's absolutely no prospect of a conviction for child endangerment".

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Matt Black

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quote:
Originally posted by orfeo:
quote:
Originally posted by Justinian:
quote:
Originally posted by orfeo:
How so?

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after?

Does your nephew have four months to live if they are not treated?

Who knows? Maybe someone should go around to his house and check.

You still seem to proposing, in the next paragraph of your response, that a hospital automatically has an obligation towards anyone (or at least, anyone under the age of 18?) in the area who is terminally ill. Again I would question that. It would involve a pro-active duty of a hospital to go out and seek the terminally ill, not wait for them to come and ask for help.

Obligations arise from relationships. A hospital has an obligation to its patients. The patient relationship can be terminated.

It seems fairly clear to me that the parents, by their actions, were terminating the patient relationship. I would fully accept that the hospital had obligations towards the boy while they were treating him, but there seems to be this unstated assumption that they were still treating him. I don't think that assumption stands up very well to proper examination.

The healthcare service here has an ongoing responsibility to children and other legally vulnerable individuals, whether or not in hospital, hence the visits given as examples by North East Quine above. That relationship does not automatically terminate on discharge from hospital.

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orfeo

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quote:
Originally posted by North East Quine:
Originally posted by orfeo:

quote:
Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after? Is there some sort of roving duty of care in relation to all children in the area?
Pretty much. The hospital check that, for example, if the parents are taking their newborn baby home by car, they are doing so in a properly fitted car seat. You can't just waltz out of hospital and put a baby in an unsecured carrycot on the back seat. Not here, anyway.

Once you're home, there are follow-up visits by a midwife, and then by a health visitor. Plus you're expected to show up regularly to have your baby weighed at a clinic. I'm not sure at what point alarm bells would start ringing if you kept your baby away from all health professionals, but it would happen at some point.

Also (voice of bitter experience) if your child hasn't been fully vaccinated (because your child had an adverse reaction to the first vaccination and your GP refused to give the second, and this is fully documented on your child's medical records) there are reassessments every few years of your child's not-fully-vaccinated status.

I see. I'm beginning to understand why medical staff think they have a law enforcement role...

I'd note that there are laws here, too, about car seats. Some of the other stuff I wouldn't know about. But while medical staff certainly have a role in advising you that you need a proper car seat, I suspect there'd be a fairly fundamental rule of law problem with preventing you from leaving without a proper car seat. Legal authority to detain people is pretty strictly confined. I can't take action against all the stupid fools who break the speed limit even though I'd dearly love to. About the most I'm empowered to do is report them to the police.

I very much doubt that even laws relating to the welfare of children would alter this. They usually impose duties of reporting, not of enforcement.

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orfeo

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quote:
Originally posted by Matt Black:
The healthcare service here has an ongoing responsibility to children and other legally vulnerable individuals, whether or not in hospital, hence the visits given as examples by North East Quine above. That relationship does not automatically terminate on discharge from hospital.

Because of the nationalised nature of your health service?

I see.

I don't suppose you have any references to legislation handy?

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Justinian
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quote:
Originally posted by orfeo:
It is also relevant some case where the prosecution hasn't said "oh dear, there's absolutely no prospect of a conviction for child endangerment".

And the prosecution was right to do so based on information that was unavailable to the hospital. Remember that by his own admission the last question the father asked was about withdrawl from treatment - which from his phrasing I and the hospital took to mean withdrawl from all treatment.

The father's actions were not in line with the message he communicated to the hospital. But the hospital didn't have that information. It just had the last thing the father talked with them about being taking the child away from treatment - and then he removed the child just as the treatment was about to start.

Had he been doing what he communicated to the hospital he was going to do there would be a clear cut case for child endangerment.

Why do you expect the hospital to be telepathic?

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seekingsister
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quote:
Originally posted by North East Quine:
Pretty much. The hospital check that, for example, if the parents are taking their newborn baby home by car, they are doing so in a properly fitted car seat. You can't just waltz out of hospital and put a baby in an unsecured carrycot on the back seat. Not here, anyway.

Just to say this is not just something that exists in a nationalized health system. I had relatives who had a baby in New York City (where hardly anyone has a car) and you are required to take the newborn home in a car with a properly fitted car seat. So taxis do a good service outside of maternity wards. It's a fairly undue burden given the majority of New Yorkers don't even own cars, so the car seat is rarely used for that purpose afterwards.
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orfeo

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# 13878

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quote:
Originally posted by Justinian:
Why do you expect the hospital to be telepathic?

I don't. I also don't expect them to ignore the fact that the parents had the presence of mind to take a feeding tube with them.

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Justinian
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quote:
Originally posted by orfeo:
quote:
Originally posted by Justinian:
Why do you expect the hospital to be telepathic?

I don't. I also don't expect them to ignore the fact that the parents had the presence of mind to take a feeding tube with them.
Feeding the patient is not a cancer treatment.

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