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» Ship of Fools   » Community discussion   » Purgatory   » Medical treatment--who gets what, who decides, who pays? (Page 6)

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Source: (consider it) Thread: Medical treatment--who gets what, who decides, who pays?
M.
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My iPad won't link, but you can read the hospital's press release and statement prepared for court on its website.

M.

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Rocinante
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According to Unicef, 29,000 children die every day, mostly from malnutrition or diseases with well-established treatments that don't cost millions. What is so special about this one? I'm afraid I am genuinely mystified.

His parents have quite a talent for publicity, that's for sure.

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Baptist Trainfan
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quote:
Originally posted by Penny S:
The money will go to a Charlie Gard Foundation.

And how will that be administered? Couldn't it just been given as a lump sum to GOSH?
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Marvin the Martian

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quote:
Originally posted by Doublethink.:
It is reported the doctor had a financial interest in the treatment he was touting¹ - FFS

I am not even the least little bit surprised. As I said a few days ago, there's good money to be made from giving grieving parents false hope [Disappointed] .

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Hail Gallaxhar

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mr cheesy
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quote:
Originally posted by Rocinante:

His parents have quite a talent for publicity, that's for sure.

That's harsh. Their child was dying and they had a platform to try to prolong his life and they fought tooth-and-nail to do whatever they could.

I don't think anyone can be criticised for doing that in their situation. Yes, they were fortunate to be in a system which gave them more than a mother in poverty with a child dying of measles and with no access to healthcare. But I bet any mother in that situation would have done more if she could.

[ 25. July 2017, 08:42: Message edited by: mr cheesy ]

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mark_in_manchester

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Good money to be made from giving _rich_ grieving parents false hope. But no money to be made from giving _poor_ grieving parents (29,000 x 2 of them, every day), real hope.

What is it about comment on the internet which makes me want to state the obvious and view it as profound. Sorry, that's getting at me, not at anyone else.

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(so good, I wanted to see it after my posts and not only after those of shipmate JBohn from whom I stole it)

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mark_in_manchester

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quote:
But I bet any mother in that situation would have done more if she could.

Call me a throw-back to an age of deference, but if a doctor were to tell me 'we can't do more than manage his pain as he dies' I would think 'thank fuck you can do that, and I'm not in the back end of nowhere having to decide when I ought to hit him with a spade and end the agony'.

Well, that's the kind of lines I was thinking along during the difficult births of my two kids.

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"We are punished by our sins, not for them" - Elbert Hubbard
(so good, I wanted to see it after my posts and not only after those of shipmate JBohn from whom I stole it)

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chris stiles
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quote:
Originally posted by Rocinante:

His parents have quite a talent for publicity, that's for sure.

I suspect that the most they contributed was being young and relatively photogenic. They were probably caught up in a process they were not fully in control of - especially once public figures abroad started to get involved.
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wild haggis
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Wonder what the Charlie Gard Foundation is, what is it for and who will manage it?

It's all too easy to think of setting up a charity but the managing of it within the law is not so easy.

What is this foundation aiming to do with the money?

Wouldn't it be better for it to go to GOSH where we know it will be used to improve children's health in a world class setting.

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wild haggis

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mr cheesy
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OK, not that anyone else cares but I'm going to stop looking. I don't think this intensive view of a family in crisis is helping anyone.

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Golden Key
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Re the Sky News article:

I'm not terribly worried about the doc's financial interest, because he helped develop the treatment. I don't know how that's usually handled, but I don't think it's *necessarily* greedy or nefarious.

I'm more concerned that he didn't brush up on the case before appearing in a UK court. The article lists all the stuff he hadn't familiarized himself with--and THAT is shocking.

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Martin60
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Perception is power.

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Marvin the Martian

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quote:
Originally posted by Golden Key:
I'm not terribly worried about the doc's financial interest, because he helped develop the treatment. I don't know how that's usually handled, but I don't think it's *necessarily* greedy or nefarious.

I think it's inherently undesirable for doctors to have a financial interest in the treatments/medicines they're prescribing. If I'm told I need a treatment/medicine then I want to be able to be confident that the doctor has prescribed it because it's the best treatment/medicine for me and my condition, rather than because it's the one that makes the doctor the most money.

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Hail Gallaxhar

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Amanda B. Reckondwythe

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quote:
Originally posted by Marvin the Martian:
If I'm told I need a treatment/medicine then I want to be able to be confident that the doctor has prescribed it because it's the best treatment/medicine for me and my condition, rather than because it's the one that makes the doctor the most money.

Especially if he knows diddly squat about your chart.

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Marvin the Martian

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That goes for any prescribing doctor, of course.

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Hail Gallaxhar

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Jane R
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Marvin:
quote:
I think it's inherently undesirable for doctors to have a financial interest in the treatments/medicines they're prescribing. If I'm told I need a treatment/medicine then I want to be able to be confident that the doctor has prescribed it because it's the best treatment/medicine for me and my condition, rather than because it's the one that makes the doctor the most money.
I agree, but I gather it's common practice in the US for Big Pharma to offer 'incentives' to doctors?
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Leorning Cniht
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quote:
Originally posted by Marvin the Martian:
I think it's inherently undesirable for doctors to have a financial interest in the treatments/medicines they're prescribing.

Presumably this doctor holds a patent on the technique that he developed, which is how the financial interest arises.

But all doctors in a US-style system have a financial interest in the treatment: each procedure earns the doctor some sum of money (usually off a tariff set by the insurance company if it's a "normal" procedure). Some procedures earn the doctor more than other procedures, and of course an unnecessary procedure always earns more money than nothing.

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Marvin the Martian

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quote:
Originally posted by Jane R:
I agree, but I gather it's common practice in the US for Big Pharma to offer 'incentives' to doctors?

Just one more reason why healthcare in the US is screwed up.

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Hail Gallaxhar

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L'organist
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posted by chris stiles
quote:
Originally posted by Rocinante:
quote:
His parents have quite a talent for publicity, that's for sure.
I suspect that the most they contributed was being young and relatively photogenic. They were probably caught up in a process they were not fully in control of - especially once public figures abroad started to get involved.

Sorry, but that is not a valid excuse for the poisonous "Charlie's army" that has gathered around the Gard's, nor for the more inflamatory statements issued by spokespeople on their behalf.

For reasons I won't bore you with, I have some first-hand experience of this type of media attention: if the family concerned take reasonable steps it is possible to limit what is made available to the press, and even if so-called "professionals" approach with offers of "help" you don't have to take them.

The judge only gave leave for reporting restrictions to be lifted in the case because the Gard parents had already broken the injunction on speaking to the media: that is contempt of court and in less fraught circumstances may have resulted in a hefty fine or a short prison sentence.

All through this case the Gard's have courted the press at every opportunity and have shown themselves unmoved at the distress and disruption caused to the parents of other sick children in GOSH by the actions of "Charlie's Army" crods outside the building. Having had reason to be up in Lamb's Conduit Street a week ago I have experienced the antics of these people and the noise they make - it was very threatening and impossible to ignore.

As for what the Gard's decide to do with the donations given: there is the Lily Foundation, named for a little girl with the same condition as Charlie, which funds research in MDDS in the UK.

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Bishops Finger
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Well, the Lily Foundation and GOSH are both deserving causes, so to speak, so perhaps the Gards could split the £££ between the two?

Apart from anything else, it might go some way to redress the wrongs suffered by GOSH, and its staff, from the media 'circus', and its creatures.

http://www.thelilyfoundation.org.uk/

IJ

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orfeo

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Anyone remember the case where a hospital claimed that parents "kidnapped" their own child and took him to Spain... where the parents got arrested on the basis of the warrant for the "kidnapping"?

Because that's the last similar high-profile case I can recall along these lines. And as the story developed the hospital got more and more egg on its face as it turned out the "kidnappers" had every lawful authority to take their own son out of the hospital.

There is something about the UK health system which appears to have doctors believing that they are the ultimate decision-makers over and above parents. Perhaps it's that so much of the treatment is government-funded. And yes, they have responsibilities when it comes to the use of those funds.

But I simply cannot understand the mindset that actively tries to prevent parents from taking their children overseas to try treatments. Certainly you can ADVISE against it, and say why you don't think it'll do any good, but I don't see where doctors think they get the authority to go further than that. To me there's a confusion of roles.

[ 25. July 2017, 16:22: Message edited by: orfeo ]

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orfeo

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quote:
Originally posted by Doublethink.:
It's so sad.

I do hope that US doctor thinks twice about promising the earth to desperate people in the future.

How is a 10% chance of improvement "promising the earth"?

And how is saying that the window of opportunity for treatment has now closed consistent with this picture of a doctor out to grab money?

[ 25. July 2017, 16:24: Message edited by: orfeo ]

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mdijon
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It's a very clever promise of the earth. It's a promise of the earth in the sense that it's pretty much impossible to make that promise with anything more than wishful thinking behind it, but there's a caveat if the expensive therapy doesn't work out.

But fraudulent and cruel nonetheless.

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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon

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mdijon
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quote:
Originally posted by orfeo:
To me there's a confusion of roles.

To me the idea that parents own their children to the extent that they have the right to give them harmful treatment, or deny them life-saving treatment, would be a complete confusion of the parental role.

I also think a recollection of a few cases is a bit much to make a statement about the UK health system. I'm sure children have been made wards of court in other countries.

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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon

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orfeo

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quote:
Originally posted by mdijon:
It's a very clever promise of the earth. It's a promise of the earth in the sense that it's pretty much impossible to make that promise with anything more than wishful thinking behind it, but there's a caveat if the expensive therapy doesn't work out.

But fraudulent and cruel nonetheless.

If it turned out to be fraudulent and cruel then the parents could sue.

What bothers me is the notion that your assessment, or the UK doctor's assessment, should prevail over the parent's assessment. Any more than your choice of colour for my bedroom gets to prevail over my own.

More in a moment as I've just been reading the first 2 court decisions and it just amplifies my problem...

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orfeo

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quote:
Originally posted by mdijon:
quote:
Originally posted by orfeo:
To me there's a confusion of roles.

To me the idea that parents own their children to the extent that they have the right to give them harmful treatment, or deny them life-saving treatment, would be a complete confusion of the parental role.
Is there the SLIGHTEST evidence that the treatment would harm the dying child?

There sure as hell isn't any evidence it would prevent him from receiving life-saving treatment. The entire bloody point is that the UK hospital is trying to stop treatment on the grounds that it won't do anything. So thanks for that utter red herring.

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mdijon
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The colour you paint your bedroom is a very poor analogy for a child's well-being.

What if the parents are JWs and refuse blood transfusions? Or faith healers and refuse all medical care? Are we fine with parents enacting death by negligence on their children because who's to say the doctors know best?

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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon

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Jane R
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orfeo:
quote:
Is there the SLIGHTEST evidence that the treatment would harm the dying child?
The treatment itself, no. The Great Ormond Street medical team argued that it was very unlikely to make a significant difference to his quality of life and that prolonging a life of pain with no prospect of significant improvement was not in his best interests.

Yes, I do remember the Ashya King case. In fact, I linked to it several pages ago: here it is again. It is clear that Southampton General Hospital could have done some things better, but in that case the issue was slightly different; there was an effective treatment available and the NHS offered it, but the parents wanted a different treatment.

You talk about 'taking him abroad' as if it was just a question of hopping on a plane. It's not that easy to transport someone on life support, as mdijon explained earlier.

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orfeo

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Right, so here's my big glaring problem with the court case.

I very nearly said previously that it's entirely orthodox principle for the hospital to go to court to say that THAT HOSPITAL doesn't want to do certain things. And in fact that's the nature of most of the declarations the hospital wanted. They asked the court to declare that they could withdraw artificial ventilation and only provide palliative care.

But then we come to what I regard as the great big stinking problem, and we can thank the use of passive voice for it.

Here's the full set of declarations sought:

quote:
By their application dated 24th February 2017, the applicants ask the court to make the following orders:

(1) That Charlie, by reason of his minority, lacks capacity to make decisions regarding his medical treatment;

(2) that it is lawful, and in Charlie's best interests, for artificial ventilation to be withdrawn;

(3) that it is lawful, and in Charlie's best interests, for his treating clinicians to provide him with palliative care only; and

(4) that it is lawful, and in Charlie's best interests, not to undergo nucleoside therapy provided always that the measures and treatments adopted are the most compatible with maintaining Charlie's dignity.

Do you see what happens? Declaration (2) is really about the hospital saying "please tell us WE can withdraw treatment". Declaration (3) is similar, saying "please tell us that WE can provide palliative care only".

I wouldn't have the slightest problem if declaration (4) was couched in terms of "please tell us WE don't have to provide nucleoside therapy". But it isn't. It's been framed in a way that leans towards "please tell us that CHARLIE doesn't have to undergo nucleoside therapy".

And frankly I don't know why the hospital thinks it's any of its damn business if Charlie undergoes nucleoside therapy with somebody else who wants to provide nucleoside therapy.

And as far as I can see, the courts have quite unconsciously wandered down that path of reasoning without questioning it. There's quite clear discussion about what it's okay for the hospital to do (withdraw certain treatment), but then it blurs and slips into discussion that isn't at all about what the hospital would do. It's about what some entirely different medical practitioner who isn't a party in the courtroom would do. And I think that's just very wrong in principle. The hospital is perfectly entitled to make applications relating to its own conduct, but to me it's extremely worrying and dangerous for that to morph into an application relating to the conduct of any medical professional, anywhere.

I think part of the reason for this slippage is that courts do indeed have a role in making decisions about certain radical kinds of treatment such as sterilisation of children or treatment for gender dysphoria. One key reason being the treatment can't be undone. But those applications are made by the parents. What we have here is the court making a declaration asked for by a hospital, framed in terms that don't just apply to the hospital.

Forget the particular radical treatment for a moment. It would be wrong to say that if the next hospital down the road wanted to keep Charlie on an artificial ventilator, they couldn't do it because Ormond St didn't want to do it. And declaration (2) was couched in terms that said "it's okay to withdraw ventilation" rather than "no-one can provide ventilation".

But you get to declaration (4) and it morphs from "it's okay for Ormond St to not provide this therapy" to "Ormond St got to ask the court to say that no-one was to provide this therapy".

The hospital has no business making such an application and the court should have fixed it. If the roles had been reversed - if the parents had wanted a declaration that they could say no to treatment the hospital wanted to give - that would have been orthodox and appropriate. But giving the hospital the right to dictate treatment that would occur outside the hospital, that's a fundamental rewrite of the court's supervision of parental jurisdiction and no-one seems to have realised just because the declarations weren't written in active voice.

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orfeo

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quote:
Originally posted by mdijon:
What if the parents are JWs and refuse blood transfusions? Or faith healers and refuse all medical care? Are we fine with parents enacting death by negligence on their children because who's to say the doctors know best?

As you will see in my long post, trying to treat "parent wants to refuse treatment" and "hospital wants to refuse treatment" as interchangeable is in my view completely contrary to established legal principle.

This is exactly why active voice - identifying WHO is doing the refusing - is so important. No judge should ever be making a declaration that "treatment can be refused" without identifying who it is that is allowed to refuse treatment.

[ 25. July 2017, 17:03: Message edited by: orfeo ]

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orfeo

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quote:
Originally posted by orfeo:
This is exactly why active voice - identifying WHO is doing the refusing - is so important. No judge should ever be making a declaration that "treatment can be refused" without identifying who it is that is allowed to refuse treatment.

Sorry, now I'm going to include an addendum and it's sufficiently important to requote myself:

Because when a hospital "refuses treatment", they are refusing to supply it.

When a patient, or a parent on behalf of a patient, "refuses treatment", they are refusing to receive it.

And that's where this has gone so horribly wrong. Because it's all just been couched as "refusing treatment is okay", you've ended up with a supplier of treatment going to court and getting a declaration that is about receipt of treatment.

Which is fundamentally inappropriate. It makes no more sense than a company who can't/won't provide me with a particular service being able to prevent me from going to any of their rivals to see if the rival can provide the service.

Certainly there are situations where the court has a role in making decisions about receipt of treatment. But that's a supervisory jurisdiction of parents. The hospital, a treatment supplier, does not have a parental role and doesn't belong on that side of the transaction.

[ 25. July 2017, 17:14: Message edited by: orfeo ]

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Jane R
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I see what you mean, orfeo.

In cases like this the court appoints an independent guardian for Charlie with the job of representing his interests. That's why there are three plaintiffs (if I've got the terminology right), not just two (Charlie's parents).

However, we do take a dim view of unnecessary medical procedures over here: in fact someone has just been struck off for carrying out a number of unnecessary operations.

[ 25. July 2017, 17:20: Message edited by: Jane R ]

Posts: 3866 | From: Jorvik | Registered: May 2001  |  IP: Logged
orfeo

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quote:
Originally posted by Jane R:
In cases like this the court appoints an independent guardian for Charlie with the job of representing his interests. That's why there are three plaintiffs (if I've got the terminology right), not just two (Charlie's parents)

Again, I'm not sure that's normally true in "cases like this". It's true in cases where parents go to court to seek an order about treatment.

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orfeo

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This kind of confusion of roles is pretty common. Another example that I think was discussed here at the time was the so-called ban of a Christian ad in cinemas.

Which led to all sorts of stuff about rights to freedom of speech and so on, as if the cinema company involved was the government and had forbidden the ad. In that case, there was nothing to prevent a different company providing the service of screening the ad if they liked the ad. There was no "ban".

With Charlie, on the other hand, we seemingly ended up with one hospital succeeding in banning anyone else from doing the treatment, even if some other medical practitioner genuinely believed the treatment was worthwhile.

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Doublethink.
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# 1984

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Best interest law in the UK doesn't work the way you suggest. I'm more familiar with adults lacking capacity, but in any case, best interest decisions are not reserved to the family and/or parents.

Essentially, the hospital were arguing that what the parents wanted to do was harmful to the child. As medics already treating, they had a duty of care to the child.

The treatment suggested hadn't even been tested in mice for the condition the baby has, if some random doctor had said amputating his leg would help - would you expect the hospital to facilitate that ?

[ 25. July 2017, 18:34: Message edited by: Doublethink. ]

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Doublethink.
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# 1984

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You may find the British Medical Association guidance¹ relevant.

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¹ BMA

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ThunderBunk

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Legally there are two different processes. Guardians ad litem (or whatever they are currently called - my information is about 10 years old) are appointed to represent the interests of children in adoption and other legal proceedings, where the parents are not present or otherwise being held to be able do so.

The Court of Protection appoints deputies to manage the properties and affairs, or the health and welfare, of adults who lack the mental capacity to do so.

Then there are orders under the Mental Health Act 1983, with which I am less familiar, but that is the act, which among other things people are detained against their wills because they are a danger to themselves or others. From scrutiny of the legislation, I can't see who is appointed to deal with their affairs - Doublethink???

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Eirenist
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# 13343

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What I fail to understand is how 'Charlie's Army' and their supporters could believe that picketing GOSH and the RCJ, screaming abuse at doctors, nurses, lawyers and the judge, sending death threats, etc. could ever be the slightest assistance to the parents' case. Can anyone explain?

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Jane R
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orfeo:
quote:
I'm not sure that's normally true in "cases like this". It's true in cases where parents go to court to seek an order about treatment.
That is in fact what I meant when I said 'cases like this'. I apologise if I was unclear. Court-appointed guardians are not necessary in cases where the parents are willing to listen to medical advice. They are not even necessary when the parents ask for a second (medical) opinion, as is their right.

As Doublethink has pointed out, the hospital have a duty of care towards Charlie. Do you really think they would have wasted all this money on lawyers and gone through all this circus if they hadn't, or didn't care what happened to him?

Are children considered to be the property of their parents in Australia as well?

[ 25. July 2017, 18:52: Message edited by: Jane R ]

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Doublethink.
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# 1984

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MHA detention of adults only overrides capacity with regard to decisions about care and treatment of the mental disorder, not - for example - accommodation.

If you need to make a decision whilst, say, acutely psychotic, the person requiring the decision to be made will need to assess your capacity - if you are found to lack capacity then a best interest decision must be made (if the decision can't be delayed until you're better) and this may require an application to the court of protection depending both on the nature of the decision and whether it is disputed.

Best interest decision should involve those involved in your care and family/carers - but if you are considered to be 'unbefriended' you would be assigned an independent advocate.

All this has to be properly documented, and can be disputed by interested parties in the courts.

Child is different, cos the default assumption is that the parents can make the key decisions, this only gets complicated if those around them come to believe they are not making decisions in the child's best interest or that they lack the capacity to do so for some reason. Then it becomes either a court or social services issue.

These high profile cases are rare because everyone involved desperately wants to avoid going down that route, no one wants to try to displace next of kin decision makers. It's a protracted legal nightmare and massively damages therapeutic relationships etc. Clinical teams will bend over backwards to avoid it.

I notice GOSH, had commissioned independent second opinions and invited that US doctor over in January - the case didn't come to court until all those various attempts at reaching a shared decision had failed.

[ 25. July 2017, 18:57: 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

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Doublethink.
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# 1984

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I think we also need to add the treating team's duty to the child is separate from what a hospital may be able or willing to supply.

So if a doctor sees a child with cleft lip and palate in a local hospital but the cleft centre is in a regional centre at a different hospital - they have a duty to refer to the regional service for appropriate treatment. If the parent wants send their child to be treated privately, the NHS doctor would be expected to make the referral sending the relevant information onto the private provider.

If the parent is trying to get the child referred for a completely inappropriate treatment, like say trepanning, even if is being done under medical control in a proper operating theatre - that will cause serious concern, the doctor will refuse to refer and it'll become a legal issue.

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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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orfeo

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But you are still presenting a situation where it's about the doctor refusing to do something. And I would not have the slightest problem with the doctor asking the court: "please give me a declaration that I don't have to do this".

But that word "I" is crucial.

Similarly, talk of a duty of care... this is what worries me, slipping from a duty of care about what the hospital does or doesn't do into a GENERALISED duty of care where the hospital is a parent and gets to make decisions about what anyone else will do with the child.

And would people stop suggesting I'm talking about children as property. The fact is that UK and Australian law BOTH start from the fact that it's a parent who has general responsibility for a child's welfare. You will prosecute a parent who fails to take the necessary care. If a parent just left a sick child at a hospital and said "well, they're looking after her now", you'd be appalled.

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Brenda Clough
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A summary of the American assholes who made the entire situation much worse. I should emigrate.

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Curiosity killed ...

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Since the Children's Act 1989 the duty of care of children in England and Wales has changed to anyone who works with children. Parents have primacy and should be consulted, but education health and social care all have duties of care. That duty of care has been reinforced by additional legislation.

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orfeo

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# 13878

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That article still gets basic things about the case wrong, making it look like the parents went to court instead of the hospital.

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orfeo

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# 13878

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quote:
Originally posted by Curiosity killed ...:
Since the Children's Act 1989 the duty of care of children in England and Wales has changed to anyone who works with children. Parents have primacy and should be consulted, but education health and social care all have duties of care. That duty of care has been reinforced by additional legislation.

"Duty of care" is not equivalent to "having care of" or having custody, and this is exactly what worries me.

Every time I get in my car I have a duty of care towards other drivers, pedestrians, anyone around me. This is no way empowers me to make decisions for them. That is not what "duty of care" MEANS as a legal concept. It's a duty to take care, to take that person into account, to consider their interests.

[ 25. July 2017, 23:21: Message edited by: orfeo ]

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orfeo

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Having a fairly quick look at the 1989 Act, it is immediately clear that it does not intend to change the law on "parental responsibility" (that term is defined).

And that's fundamental to my problem here. Having a duty of care towards a child is simply not equivalent to having parental responsibility towards a child.

What the Act then does is then impose other duties on various other people. I cannot yet see anything that suggests that the legislation makes parental responsibility shared across the various people that might work with a child.

I'm quite certain that various people who interact with a child have duties towards that child that affect their own interactions with the child. But the fundamental difference with parents is that they have a general responsibility to manage the interactions a child has with other people.

[ 25. July 2017, 23:32: Message edited by: orfeo ]

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Doublethink.
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# 1984

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Case law in the UK is that disputes over medical treatment of a child fall within the inherent jurisdiction of the high court.

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Leorning Cniht
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# 17564

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quote:
Originally posted by orfeo:
The fact is that UK and Australian law BOTH start from the fact that it's a parent who has general responsibility for a child's welfare.

Right. But to take a different example, suppose a child has income (because he's a child actor, say). Everyone agrees that the parents get to manage the child's money in his best interests, with some reasonably wide latitude as to what "best interests" means, but I think in both the UK and Australia, if a parent spent his child's income on expensive whisky and cheap women, he'd find himself in a certain amount of legal trouble.

Is that not so?

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orfeo

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# 13878

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quote:
Originally posted by Doublethink.:
Case law in the UK is that disputes over medical treatment of a child fall within the inherent jurisdiction of the high court.

I know. That's not quite the issue. The issue is how a dispute about the treatment to be undertaken in Ormond St hospital became a right for Ormond St hospital to intervene in relations between the parents and any other medical practitioner.

"Disputes over medical treatment" requires you to identify the parties to the dispute. If the parents and a doctor in Edinburgh had agreed on a course of treatment, there being no disputes between them, what legal basis would there be for someone else to waltz in and say "I don't agree"? Can any old doctor pipe up, or does it have to be one who saw the child previously?

You all seem to think that being someone's treating doctor at present somehow gives a general power to manage all treatment. And I cannot for the life of me understand why. I cannot see why you think that one member of a profession ought to be able to regulate the future relationship between a client and another member of the profession. In most cases that would be labelled a restraint of trade.

There's a fundamental difference between a doctor saying "I don't want to do that" and a doctor saying "I don't want anyone to do that", and until these couple of recent cases the nanny state hadn't extended as far as doctors actively preventing patients/parents from following up on alternative options.

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