The Journal of Medical Ethics published on March 17, 2016 a survey compiled from 490 out of 3000 practicing neonatologists
The survey showed 76% of the neonatologists thought it was ethically permissible to issue a ‘Do Not Attempt Resuscitation’, (DNAR), without asking or notifying the parents for an infant when they “felt it impossible” for the child to survive. 61% of the neonatologists said a DNAR without parental consent was permissible when survival was ‘unlikely’. (See: http://www.bioedge.org/bioethics/unilateral-do-not-resuscitate-orders-what-doctors-think/11807)
Lane Hauber (pictured) had a ‘Do Not Resuscitate’ put on his file as a newborn without his parent’s knowledge or consent. The first few days of his life the hospital staff had been optimistic and talked of how Lane would be treated with heart surgery. However, everything changed three days after Lane was born and he was diagnosed with an extra 18th chromosome.
Lane’s father, Alex, arrived in the Neonatal Intensive Care Unit for a visit to find a ‘Do Not Resuscitate’ (DNR) in paperwork attached to his son’s crib. When Lane’s parents asked who had put the DNR on his file, they were ushered into a private room with the doctor and told the hospital “can make the decision to place a ‘Do Not Resuscitate’ on a patient without the parent’s approval.”
“We were devastated,” Lane’s mom Alisha expressed, “…not only did we get the shock of the diagnosis, but now we were being told that we had zero rights in making medical decisions for our son.” Alisha stated, “The hospital sent us home with zero information, zero support, and told us that we might have a week at most with our son.” Now that Lane is 7 years old and lives with unrepaired holes in his heart, his parents question what kind of life their son could have had if he had been given equal treatment and rights as a patient at birth.
“We felt lied to by the hospital, and angry about our child not being treated like a human being. Why is it O.K. to take away parental rights? Aren’t we the ones that have to live with the consequences of our decisions?” For the neonatologist to secretly and lethally neglect a patient based on many unknowable qualities and capacities at birth can neither be called scientific nor compassionate medical care.
The same physicians who would be shocked or angry when a patient would deny the doctor information to do their job are denying their newborn patients standard care and informed consent. Lane’s parents assumed the hospital and doctors were acting in good faith toward their son seven years ago until they stumbled across the ‘Do Not Resuscitate’. This current study displays that the vast majority of doctors would treat Lane the same way today.
This chilling admission by such a great number of practicing neonatologists that it is “ethically permissible” to secretly put DNR’s on medically vulnerable patients shows that by and large these doctors do not see their responsibility as a doctor to be transparent with their most vulnerable patients. It is reminiscent of the class action suit from 1973 that was filed on behalf of hundreds of poor black men, women, and children at Tuskegee. The doctors who carried out a study entitled the “Tuskegee Study of Untreated Syphilis in the Negro Male” never told the men that its purpose was to show the consequences of untreated syphilis in the black male. Even when penicillin became a known standard treatment for the disease during the 40 years of the study, the men were never informed.
There is little doubt that any patient, whether the vulnerable newborn or the poor farmer, who has standard medical care deliberately and secretly withheld are being treated as less than human. Whether this lack of ethical behavior is a reflection of the attitude in society or in the medical professional it should elicit a huge outcry on behalf of those who are vulnerable patients.
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