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Wednesday, April 25, 2018

Choosing Martyrdom for Someone Else

Everyone is interested in making Alfie Evans the poster boy for their personal cause. The causes range the gamut from decrying the entrenched evil of socialized medicine to decrying the entrenched evil of parents who refuse to accept that their child is dying.

What a lot of people don't realize is that EVERY doctor who has been consulted about Alfie agrees that Alfie cannot be treated. He can only be made comfortable as he dies. CNN reports:
"At that time, it was suggested that Alfie could be transported to Rome's Bambino Gesu Pediatric Hospital, a Vatican hospital and the main pediatric hospital serving southern Italy, for treatment.

However, a subsequent visit to Alfie and consultation with his doctors led the Roman doctors to conclude that the child's condition is irreversible and untreatable, according to a statement from Alder Hey....

Professor Dominic Wilkinson, a consultant neonatologist at the John Radcliffe Hospital and director of Medical Ethics at the Oxford Uehiro Centre for Practical Ethics at the University of Oxford, said, "In Alfie's case, none of the foreign experts have offered any new treatment or any new outlook for Alfie. The Italian specialists have apparently indicated that they believe that his care should be palliative."
A lot of people also fail to realize that Alfie's father agrees with this assessment:
"“Mr Thomas Evans does not seek treatment. He seeks palliative care in line with his Catholic faith principles,” says his barrister Paul Diamond,"

"Alfie’s receiving food, water, oxygen as well as all the standard drugs for his belly."
Also, many of Alfie's supporters in England do not disagree with this assessment:
Pamela Jacuniak who suggested members of Liverpool’s Polish community rally under Alder Hey Hospital, told little Alfie has a right to live.
She said: “As Poles, we believe the little boy has a right to live and it is up to the parents to decide where Alfie needs to be treated.
“If we believe there is a chance he can live on then it must be used to 100 percent.
“Each and every one of our hearts are breaking because the judges have ruled in a barely humane way to end Alfie’s life.
“There are patients similar to Alfie in Poland whoa re palliative patients and receive full healthcare until the moment of their death.”
Clearly, at this point, Alfie is receiving the palliative care his father and all the doctors agree is appropriate. Would that have happened without all the publicity? I don't know. Certainly no one expected Alfie to survive without a ventilator. Remember, his parents were originally fighting any attempt to remove it. Since it has been taken away, they have had to resort to mouth-to-mouth a couple of times in order to keep their boy breathing. No one... let me repeat that... NO ONE intimately familiar with his case thinks Alfie can be treated. He can only be made comfortable as he dies. As long as the hospital is supplying hydration, nutrition and oxygen, there is no reason to fly the boy to Italy. Again, it is possible the hospital wouldn't be doing this except for the publicity.  Or it is possible that they would have done. I honestly don't know. But it is not the case that Alfie's situation demonstrates the entrenched evils of socialized medicine, nor is it the case that Alfie's situation demonstrates the parents are evil for wanting palliative care.

Whatever led up to the current situation, it is clearly true that Alfie is currently being cared for as well as can be expected given his horrific medical condition. Food, water and oxygen are ordinary care, not medicine, not extraordinary. The Catholic Church is quite, quite clear on this.

But keep in mind that Catholic teaching denies the necessity to undertake extraordinary care. And, yes, there does come a point in every dying process where those extraordinary measures might actually have turned into torture. The courts have a very legitimate Catholic right to be concerned about that. As the brilliant Dominican theologian Fr. Robert Barry once told me, "You can choose martyrdom for yourself. But you cannot choose martyrdom for someone else." Alfie's parents do not have the right to choose martyrdom for him, and they appear to understand that they do not have that right. Unfortunately, it isn't clear that all of Alfie's supporters understand that.

Now, how do we know Alfie is getting palliative care? The news sources do not agree in all details. Yes, there are contradictory sources out there concerning the exact details of how Alfie is being treated. But I notice the "sources" that say Alfie is not getting palliative care have no direct quotes from the parents, while the sources who say he is getting palliative care are directly quoting the parents, who say that he is.

Whenever you read about cases like this, or news about something the Pope is supposed to have said, or really any case that seems designed to get you angry, remember, there are people who make money off of you when you are angry. There are a lot of news sources interested in stirring up a feeding frenzy so they can gorge on the clicks generated by their click-bait. Don't feed the trolls (I'm looking at YOU, LifesiteNews).

The charge has been laid that this essay does not deal with the question of parental authority. Alright, let's deal with it. Certainly a parent has authority over his or her own child except when the parent is abusing or neglecting that child, at which point other authorities have a duty to step in. But that's precisely the problem. 
What constitutes "abuse" or "neglect"?

This is where it gets hard. Let's say there is a parent who believes his/her child is possessed, and further believes that severe beatings will relieve the child of the demonic possession. Should "parental authority" permit the parent to "treat" the demonic possession by severely beating the child?

What if the parent hired someone else to beat the child? Is that ok? What if we substitute "illness" for "demonic possession" and the people hired were doctors?  It is a prudential decision to figure out what constitutes appropriate exercise of parental authority. What if the doctors hired to beat the child, examined the child and said, "No, not only are we not going to beat this child, we are going to make sure you don't get anyone else to do it either." Are those doctors violating parental authority?

When Jehovah Witness' parents refuse blood transfusions for their children, should the state force the blood transfusion anyway? What about vaccinations? What about restricting movement during mass outbreaks of illness? Is it reasonable to move a child a thousand miles just so the child can receive exactly the same food, water and oxygen? We all assume that none of the medical professionals are thinking clearly, but what if it is the parents who are not thinking clearly?

This is a serious problem. Munchausen's Syndrome by proxy is a psychological disorder in which a caregiver, usually a parent, seeks attention by acting as if his or her healthy child has a long-term or otherwise debilitating illness. The caregiver's self-image is bound up in being a caregiver, and s/he can't afford for the child to be healthy, because that threatens the caregiver's self-image. But what if the caregiver also can't afford to let an ill child die, because that same psychological disorder also threatens the caregiver's self-image? If the child is dead, the caregiver loses the self-image of caregiver just as surely as if the child were to recover.

What if the parents are suffering from a form of Munchausen's Syndrome by proxy, and dying Alfie is the focus of their pathology? Isn't that a possibility as well? And what happens to parental authority if that is the case?

These are hard questions. A lot of prudence and care have to be taken to make sure the child is not being victimized by anyone - not the doctors, not the parents, not the media, nor any of the people speaking out about the case. I don't know any more details than what I read in the news. Neither do you. Doctors who have personally examined Alfie have all reached the same conclusion: he's dying.

Clearly, there was an argument about palliative care. It is quite possible the hospital has only provided food, water and an oxygen tube because of public pressure. But we are simply ignoring the facts if we think (a) anyone knows how to treat Alfie or (b) he is not being given food, water and oxygen.

The fact is, no one who has personally examined Alfie is offering anything but palliative care. His own father is quoted as saying he expects only palliative care. He is getting palliative care. So, it looks like parental authority is being honored. Perhaps it is only being honored after public outcry, but it is being honored.

Some argue that the UK should just hand the child over to Italy and be done with it. Since Alfie is a British citizen, the British courts have an interest in overseeing care. They can relinquish that interest to Italy, but apparently they don't want to. Similarly, Alfie's parents could just relinquish their interests to the state, but Alfie's parents don't want to. I don't blame Alfie's parents for not wanting to do that, so I can't very well blame the UK courts for displaying the same sentiment.

Update II
Find the court case testimony on Alfie here

And Alfie's parents admit the charges that the hospital staff were evil was mostly a hoax.

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