In most hostage situations involving a child, the police surround the building in which the victim is being held and try to convince the kidnapper not to carry out his death threats. In the case of Alfie Evans, a toddler being held captive by Britain’s National Health Service (NHS), the situation is perversely reversed. The police are standing guard outside Alfie’s room so the child’s parents cannot take him to another hospital. Alfie’s captors, the administrators of Alder Hey Children’s Hospital, have obtained a court order allowing them to withdraw life support — though he hasn’t been diagnosed as terminally ill.
That’s the crucial difference between Alfie’s case and the Charlie Gard tragedy. Charlie’s condition was known all too well and it is always fatal. His parents just wanted to try an experimental treatment called nucleoside bypass therapy, but the NHS hospital holding Charlie refused to release him, though it would have cost the public nothing. In Alfie’s case, the Vatican-affiliated Bambino Gesu Pediatric Hospital in Rome has agreed to admit him, again at no cost to the NHS, and try to diagnosis his condition before pronouncing it untreatable. The BBC quotes a hospital spokesman as follows:
Alfie’s clinical condition is truly heart rending but at each stage of the legal process which has to be followed in such cases, the courts have agreed with the treating team and the independent expert advisers instructed by the trust and the family that Alfie’s condition is irreversible and untreatable.… All the experts agree that it will not assist Alfie to subject him to further tests in order to identify a diagnosis.
That “all the experts agree” (on anything) at Alder Hey Children’s Hospital or any other NHS facility is not exactly comforting. The NHS is, for all intents and purposes, a third world health care system. In addition to the outrageous wait times for which all socialized and single-payer health care systems are notorious, the system suffers from a chronic shortage of qualified physicians and nurses. These problems, in combination with a variety of other issues too numerous to list here, result in abominable patient care, substandard outcomes, and unnecessary deaths. The Daily Wire reports:
A study conducted by the London School of Hygiene and Tropical Medicine concluded that around 750 patients a month — one in 28 — pass away due to subpar quality of care, which includes “inattentive monitoring of the patient’s condition, doctors making the wrong diagnosis, or patients being prescribed the wrong medicine.” In other words, patients needlessly die as a result of the incompetence of the NHS.
And children like Alfie Evans and Charlie Gard are by no means the only kids who suffer due to this kind of bureaucratic incompetence. Britain’s ITV reports: “Two year old Bodie McNulty from Milnrow, Rochdale has a brain stem tumour. The growth is just a few millimetres too large to receive NHS funding for Proton Beam Therapy.” Thus, like the parents of Alfie and Charlie, Bodie’s parents are trying to raise money in order to go abroad, in this case Germany, to get treatment for their toddler. That is, of course, if the NHS doesn’t take the toddler captive as it has with Alfie.
All of which brings us to a relatively new system of bioethics that has been increasingly at play in decisions concerning patients like Alfie, Charlie, Bodie, and countless other victims of socialized medicine. These patients aren’t merely the victims of NHS callousness and the cluelessness of the courts. They have also been affected by a concept that Wesley J. Smith has dubbed “futile care theory” (FTP). The general idea is that physicians, hospital administrators, and courts should be able to withdraw care from a patient — without considering the opinions of parents or other family members — if they believe that additional care would be “futile.” Dr. Smith explains:
FCT empowers strangers to make medicine’s most important and intimate health-care decisions. Deciding whether to accept or reject life-sustaining care is one of the most difficult medical choices. Under FCT, a patient’s decision — whether it be the desire of an infant patient’s guardians or written in an adult patient’s advance directive — matters less than institutional and professional opinions.
And this is precisely the reasoning used by the British court system to determine whether Alfie should be taken off life support. As Mr. Justice Hayden, the High Court judge presiding over Alfie’s case, put it when he passed sentence on the 22-month-old: “I am satisfied that continued ventilatory support is no longer in Alfie’s interests,” suggesting that doing so would somehow compromise his “future dignity.” No one will be surprised that our old friend and rationing advocate, Ezekiel Emanuel, is much enamored of this kind of “best interest” approach. In 2003 the good doctor wrote:
[T]he best-interests criterion holds that the surrogate should evaluate treatments by balancing their benefits and risks … physicians rely on family members to make decisions that they feel is best and only object if these decisions seem to demand treatments that the physicians consider non-beneficial. Without a perfect solution to the problems raised by proxy decision making, this approach may be the most reasonable one in difficult circumstances.
Presumably, Dr. Emanuel would agree with the Alder Hey administrators, and would no doubt consider a trip to Bambino Gesu Pediatric Hospital “non-beneficial.” The bad news for you and your family is that “futile care theory” will probably be part of your future if you sit home on November 6 and allow the Democrats to get control of Congress again. They will get right back to work on moving our health care system in the direction of the NHS. And, if you think patients like Alfie will stir more pity in their hearts than in those of the NHS apparatchiks, you’re kidding yourself.
They don’t care about health care anymore than they care about “gun safety” or “reproductive rights.” For them, it’s all about power. You’ll know the game is up when you find the police guarding a hospital room so you can’t see your son, your mother, or some other loved one.
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