This disturbed me

Started by DemonessOfDeathValley, January 08, 2014, 02:57:43 PM

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Hades

It's good to see the judge in this case made the right decision, though it's terrible that it ever got to the point of needing a judge to step into the situation in the first place.

Sabby

Honestly, I'd be taking the Hospital to court for this, if it weren't for the fact that the patients would be the ones paying for it in the long run.

Iniquitous

I'm not surprised the judge ruled this way. Dead woman, deformed and non viable fetus... it was the only sensible way to rule.
Bow to the Queen; I'm the Alpha, the Omega, everything in between.


Pumpkin Seeds

I'm sure there will be a law sued filed against the hospital at some point in the near future which is unfortunate.

Sabby

Someone needs to be held responsible in the end for this absolute circus.

Pumpkin Seeds

Why?  The hospital was following the law as far as they were able to interpret the law.  The article even points out that there is little clarification on the books regarding this law.  A judge has made a ruling on the law which will now be used as case law for any future disputes. 

If the hospital had withdrawn life support and the family returned to sue them under this law, the hospital would have had a far more difficult time with that battle.

Sabby

Quote from: Pumpkin Seeds on January 24, 2014, 07:55:41 PM
If the hospital had withdrawn life support and the family returned to sue them under this law, the hospital would have had a far more difficult time with that battle.

You mean the thing both the family and the deceased wanted from the beginning?

Pumpkin Seeds

This wouldn't be the first time a family member changed their mind after something was done and sued a hospital.  With a law in place that could be interpreted as life support is required, the hospital was basically protecting itself.

Sabby

You could be right. Actually, I'm just going to go ahead and agree that your more then likely correct. But my gut, who is a pessimist and so doesn't get much say at the end of the day, says that with the place this happened and the subject matter involved, the hospital used a blurriness in the law to get their way. Like I said though, that's just my gut feeling, I really have nothing tangible to base that on, so I might as well rescind it.

Pumpkin Seeds

The hospital has nothing to gain by keeping her on life support.  As I pointed out, this is a level 1 trauma center and she was being kept in the ICU.  These sorts of hospitals are always having to post overflow or refuse patients due to lack of beds.  Believe me there was a lot more money to be made for this hospital by pulling the plug and filling the room.  Case in point, the hospital that attempted to remove life support from the girl whose family did want her on life support.  Whatever money was made off the initial treatment of this woman was lost due to the extended stay and complications.

Valthazar

Nothing new for the hospital though, they'll be ready with lawyers.  Most of these major hospitals have entire risk management teams (with costs already factored in their budgets) dedicated for these types of lawsuits.

Pumpkin Seeds

Yep, but if that law had been interpreted another way after life support was removed then the medical staff involved could be facing criminal charges and the hospital would be paying more damages.  The family now would sue for mental anguish and their out of court settlement won't be as high.

vtboy

#312
I can understand the hospital's initial reluctance to take the risk of removing life support, given the existence of some ambiguity in the Texas statute. What I do not understand, however, is why the hospital is apparently considering an appeal. http://www.nytimes.com/2014/01/25/us/judge-orders-hospital-to-remove-life-support-from-pregnant-woman.html?nl=todaysheadlines&emc=edit_th_20140125&_r=0. Since it is extraordinarily unlikely the hospital could ever face liability for complying with the order rather than appealing it, there seems to be more behind the hospital's actions than mere risk aversion. 

Iniquitous

Again, I am not surprised by the hospital considering an appeal. Even with medical records to show the fetus is non-viable and distinctly deformed the push to "preserve the life of a child" will outweigh common sense. What irritates me is they are doing this at the expense of a family who has suffered a tragedy. They do not care that this family wishes to see the natural and normal conclusion to death. It is akin to psychological torture. It seems to me that the hospital is now just trying to save face. They know the fetus has hydrocephalus, they know it is so deformed below the waist as to be impossible to tell the sex. They know the fetus stopped forming normally back in November. They know there is a possibility of a heart defect. And yet they are considering appeal. It is disgusting. I can only hope that common sense wins out and they let this whole macabre tragedy end Monday.

As for the bill, I have friends in Texas who I have talked to that have more information on this than we get through the newspapers and news websites, they have said that the hospital will bill the family for this laboratory experiment. And if that is the case it is adding insult to injury.
Bow to the Queen; I'm the Alpha, the Omega, everything in between.


TheGlyphstone

Quote from: Iniquitous Opheliac on January 25, 2014, 12:42:54 PM

As for the bill, I have friends in Texas who I have talked to that have more information on this than we get through the newspapers and news websites, they have said that the hospital will bill the family for this laboratory experiment. And if that is the case it is adding insult to injury.

It's almost like they want to get sued.

IStateYourName

The bill should go to the right-to-lifers.

greenknight

Quote from: vtboy on January 25, 2014, 12:24:48 PM
I can understand the hospital's initial reluctance to take the risk of removing life support, given the existence of some ambiguity in the Texas statute. What I do not understand, however, is why the hospital is apparently considering an appeal. http://www.nytimes.com/2014/01/25/us/judge-orders-hospital-to-remove-life-support-from-pregnant-woman.html?nl=todaysheadlines&emc=edit_th_20140125&_r=0. Since it is extraordinarily unlikely the hospital could ever face liability for complying with the order rather than appealing it, there seems to be more behind the hospital's actions than mere risk aversion.
Of course the hospital is appealing. The news report says the judge ruled the hospital "erred in its interpretation," which means the court's opinion is that the hospital screwed up and that gives the family ammunition in a subsequent lawsuit. No one in their right mind would accept that ruling if they know a future lawsuit is coming. Why do you think so many settlements do not include acceptance of wrongdoing. It's not a matter of liability from complying with the order, it's that the order establishes liability.

Quote from: Iniquitous Opheliac on January 25, 2014, 12:42:54 PM
As for the bill, I have friends in Texas who I have talked to that have more information on this than we get through the newspapers and news websites, they have said that the hospital will bill the family for this laboratory experiment. And if that is the case it is adding insult to injury.
Of course there will be a bill. The staff has to be paid. The expendable supplies must be accounted for. The use of durable equipment must also be accounted for, especially why it wasn't used on another patient. Whether all or part of the bill is forgiven or discharged in bankruptcy or negotiated by an insurer is beside the point. The bill establishes what was done and issuing it is step one.
When you bang your head against the wall, you don't get the answer, you get a headache.

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Iniquitous

Quote from: greenknight on January 26, 2014, 12:46:52 AM
Of course the hospital is appealing. The news report says the judge ruled the hospital "erred in its interpretation," which means the court's opinion is that the hospital screwed up and that gives the family ammunition in a subsequent lawsuit. No one in their right mind would accept that ruling if they know a future lawsuit is coming. Why do you think so many settlements do not include acceptance of wrongdoing. It's not a matter of liability from complying with the order, it's that the order establishes liability.

What is so irritating is the fact that the hospital appealing means that the body of Mrs. Munoz, and by extension the non viable fetus, will be kept in the limbo both have been in since November. This needs to end now, not months from now when the hospital has exhausted every avenue they can find. It is pathetic that they would even consider appealing since they were the ones saying that going to a court of law to get clarification of the law was something they agreed with. They have clarification now - they misinterpreted the letter of the law. Does it open them up to a lawsuit - you betcha. But, like everyone knows, there are consequences for everything. They should not be allowed to keep the cadaver, and by extension the non viable fetus, hostage just to escape the consequences for their decision and actions.

QuoteOf course there will be a bill. The staff has to be paid. The expendable supplies must be accounted for. The use of durable equipment must also be accounted for, especially why it wasn't used on another patient. Whether all or part of the bill is forgiven or discharged in bankruptcy or negotiated by an insurer is beside the point. The bill establishes what was done and issuing it is step one.

Yes, staff needs to be paid. Yes, supplies have to be accounted for. However, it was their decision to ignore the wishes of the next of kin. Whether it was to cover their own ass or for other reasons that will never be made known doesn't matter at this point. They made the decision, against the wishes of the next of kin, to keep a cadaver on machines to try and force the continuance of gestation even after having medical proof that the fetus was not going to be viable. They should eat the cost.

Again, consequences for their decision, their actions. To bill the family and the family's insurance company is salt in the wound. Though, honestly, I suspect the insurance company would laugh at them and deny the claims. I mean, again, how do you claim a dead person is a patient and warrant the astronomical costs that came from keeping a cadaver on machines and IV's since November?
Bow to the Queen; I'm the Alpha, the Omega, everything in between.


Pumpkin Seeds

#318
Well, first of all there will be a law suit.  That is quite simple at this point as there is not a lawyer out there which would not press for the family to file such a thing.  This is especially true if the judge’s ruling places blame at the feet of the hospital administration.  Currently the hospital is probably trying to figure out which would be cheaper, fighting for an appeal or simply eating the cost of a law suit.  To be honest I would think the law suit, but the Texas Supreme Court might give them a favorable ruling as well.  The judge made a cop out decision by not challenging the law, but instead saying the law doesn’t apply in this case so the hospital erred.  Possibly the hospital would be appealing the decision in the hopes that a higher court might find error in the law and so not with their decision.  Keep in mind though neither one of these options on the table would even compare to a wrongful death suit which could've happened if the hospital had removed life support.  Those law suits are in the millions, especially in regard to a fetus.  That a doctor might have gone to prison if an interpretation of the law had gone another way could also be a mighty big deterrent.

Also, once more, the hospital will eat the cost of this situation.  I even pointed out that the hospital might try and bill the family for some costs not covered by insurance, but in the end they will not get their money.  Odds are when the law suit occurs the cost billed to the family will be included as damages, which means the hospital will have to cover the costs billed to the family.  The insurance company has already paid what will be paid in this case, which is initial treatment and then a certain length of time in the ICU.  After that the insurance company will not pay. 

If the hospital is going to be sued for ignoring the wishes of the next of kin, I do wonder if the hospital can sue the family for failing to voice those wishes in a timely fashion.  As has been stated before, if the husband had stated her wishes to be DNR from the start then this entire situation would not have happened.

Seriously, cadaver now?  That is a bit of a stretch.

greenknight

Quote from: Iniquitous Opheliac on January 26, 2014, 01:16:40 AM
What is so irritating is the fact that the hospital appealing means that the body of Mrs. Munoz, and by extension the non viable fetus, will be kept in the limbo both have been in since November. This needs to end now, not months from now when the hospital has exhausted every avenue they can find. It is pathetic that they would even consider appealing since they were the ones saying that going to a court of law to get clarification of the law was something they agreed with. They have clarification now - they misinterpreted the letter of the law. Does it open them up to a lawsuit - you betcha. But, like everyone knows, there are consequences for everything.
If the clarification was something along the lines of, "Notwithstanding any provision of law, the hospital may comply with the family's wishes free of criminal consequence," the matter would be over. But the judge said they were wrong in their interpretation. I don't agree they were and there's no reason they should just accept the liability the judge laid on them.

Quote from: Iniquitous Opheliac on January 26, 2014, 01:16:40 AMYes, staff needs to be paid. Yes, supplies have to be accounted for. However, it was their decision to ignore the wishes of the next of kin. Whether it was to cover their own ass or for other reasons that will never be made known doesn't matter at this point. They made the decision, against the wishes of the next of kin, to keep a cadaver on machines to try and force the continuance of gestation even after having medical proof that the fetus was not going to be viable. They should eat the cost.
You're absolutely right. It was the hospital's decision to comply with the law and not, I don't know, risk committing murder. That's like saying I'm responsible for the damage to the car that rear-ended me when I slammed on the brakes to avoid running down a kid chasing his ball into the street.

As for the next of kin's wishes, unless discussions specifically addressed what happens when if mom is dead but junior inside might be, they really don't matter. The fetus is the patient, not the deceased mother. We are getting into the frontier intersection of could and should. So, some considerations

  • Most states have laws on the books that define killing a pregnant woman as double homicide. So there is precedent to consider a fetus or younger a person.
  • Who may legally terminate a pregnancy?
  • Who may make the decision for an "incompetent" (minor, mentally challenged, etc) or incapacitated mother?
  • Should that proxy decision ever reside with someone who has a financial or other stake in the outcome and what is the threshold? For example, a father (the fetuses and/or the mother's) who doesn't want the child born? What if the incapacitation isn't expected to interfere with the mother's ability to care for the child or affect either's long term health?
  • Does such a decision matter when the mother is dead and the fetus's status is unknown? Can such a decision even be made in this situation?
  • Could this be the basis of extending a father's right to direct an abortion when the mother wants to keep the child? (Not likely, but let's haul the slippery slope fallacy up against the wall and open fire. And follow up with a flamethrower. And then nuke the site from orbit. It's the only way to be sure.)
  • Abuse is obviously easy with too lax guidelines. Where are the lines drawn to allow prosecution of reported incidents. Consider the FBI's recent estimate that >40% of all adult pregnancies could be prosecuted as sex crimes. I'm not exactly comfortable with that level of potential oversight but I can't complain that it doesn't allow survivors the tools they need.
This is far from a simple black and white issue. There is far more at stake than one family. If the current state of medical science can do this, keep a likely very damaged fetus alive to complete gestation, what happens when we can actually fix it? This is the opening stage of a huge discussion of medical ethics and appropriate law in an age when we can gestate a 4 week old fetus in a mechanical womb and each step in between as we go from now to then.
When you bang your head against the wall, you don't get the answer, you get a headache.

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Iniquitous

#320
Cadaver = corpse. Same thing. What do you call a dead body? A corpse aka a cadaver.

Again, a fetus is not a person and, notwithstanding the states that have limited laws to allow prosecution for double murder in the cases of a pregnant woman being murdered, should never be given rights. Why? Because then you get the sticky issue of abortion rights and who's right trumps who's.

SO... with that said, the law in Texas states doctors cannot withhold or remove life sustaining treatment from a pregnant patient. Let's look at the facts again. 1. The moment brain death was determined Marlise Munoz ceased to be a patient. The dead cannot be patients. 2. To imply that the fetus then became the patient is applying personhood to a non person - a thing with no rights.

The hospital misinterpreted the law. As I said before, whether it was to cover their own asses (I do understand that reasoning quite well - better to be safe than sorry after all) or because they are staunch pro-life supporters doesn't matter. They read the law in a way that it wasn't meant, they acted upon their understanding of it despite evidence that supported the wishes of the family (mother dead, fetus not developing the way it should, major deformities with the fetus that exclude it from being able to  live/survive).

I'll say it again. Shit happens. Since the dawn of time when a pregnant woman dies, the fetus goes with the mother. It sucks, it's horrible, but it is how nature intended it. Just because we have the technology to keep a dead body from decomposing doesn't mean we should use that technology to try and gestate a malformed fetus.

I've seen so many people screaming and hollering about the fetus and yet these same people do not give two shits for the torment the family is going through. It is disturbing that so many think that it is perfectly okay to turn women into incubators... dead or alive.
Bow to the Queen; I'm the Alpha, the Omega, everything in between.


Kythia

Quote from: Iniquitous Opheliac on January 26, 2014, 02:18:56 AM
I'll say it again. Shit happens. Since the dawn of time when a pregnant woman dies, the fetus goes with the mother. It sucks, it's horrible, but it is how nature intended it. Just because we have the technology to keep a dead body from decomposing doesn't mean we should use that technology to try and gestate a malformed fetus.

Yes.  And from the dawn of time if you got pregnant then you had the kid, as nature intended.  No abortions.  Of course, you stood an astronomical chance of dying in childbirth, as nature intended.  That's if the cholera which nature intended or one of nature's other intended diseases didn't get you first.  Even if you avoided all of that, you'd still end up squatting in a cave thinking that lightning meant the gods were angry with you, as nature intended.

"As nature intended" arguments rule out all of modern medicine, not to mention basically everything else.
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vtboy

Quote from: greenknight on January 26, 2014, 12:46:52 AM
Of course the hospital is appealing. The news report says the judge ruled the hospital "erred in its interpretation," which means the court's opinion is that the hospital screwed up and that gives the family ammunition in a subsequent lawsuit. No one in their right mind would accept that ruling if they know a future lawsuit is coming. Why do you think so many settlements do not include acceptance of wrongdoing. It's not a matter of liability from complying with the order, it's that the order establishes liability.

How does the order directing the hospital to discontinue life support establish liability on the part of the hospital? A hospital's legal duties of care generally run to the patient, not to the patient's family. The hospital's decision to continue life support inflicted no legally cognizable harm on the decedent or on the fetus. What sort of lawsuit by the family are you envisioning?

The difficulty in this case is that the Texas Advance Directives Law (http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.166.htm), which does not define "patient", provides precious little guidance for hospitals following the brain death of pregnant patients on life support. The legal questions presented -- whether the statute's prohibition against discontinuance of life support to a pregnant patient continues to apply after the pregnant patient's brain death and whether the fetus may be considered a patient to whom independent legal duties are owed after the death of the mother -- appear to be of first impression in Texas. That the court disagreed with the hospital's interpretation of the statute hardly suggests the hospital acted unreasonably or otherwise "screwed up" in continuing life support in the absence of an order to the contrary.

I remain puzzled by the hospital's consideration of an appeal, since it does not appear to be prompted by any realistic appraisal of potential legal liability. Something else is at work here. My own uniformed guess is that it is Lone Star State right-to-life politics.

Mnemaxa

Give them a few hours in the room with the child after it's been born - if it survives - and they will take a much harder look at those laws.

The Well of my Dreams is Poisoned; I draw off the Poison, which becomes the Ink of my Authorship, the Paint upon my Brush.

Kythia

Quote from: vtboy on January 26, 2014, 06:38:32 AM
I remain puzzled by the hospital's consideration of an appeal, since it does not appear to be prompted by any realistic appraisal of potential legal liability. Something else is at work here. My own uniformed guess is that it is Lone Star State right-to-life politics.

I don't know the US court system, but could it be as simple as requiring a higher court to define exactly what should have been done?  From reading the article, it seems the judge just said "Nah, that's not it.  Guess again" Could an appeal to a higher court simply be a way of getting them to say "OK, this is how this law is applied in these cases"
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