The Wright Stuff - right to life at 23 weeks?

[jazz412]

Debate on whether money should be spent elsewhere or on premature babies.

I'm unsure at the moment so debate away and I will listen.

according to the stats on that show, 9 out of 10 babies who are resuscitated die before they leave hospital... what other treatments cost so much with such a low success rate? (even disregarding the fact that three quarters will have disabilities).
they make tough choices with cancer drugs, i think this is one of those ones, and leaving it in the hands of the parents is just a cop out.

No but if the doctors KNOW it's not looking good and they tell the parents it's best to stop now or not even try, there are parents that will say fight on, no matter how much pain and distress will be caused to the baby. The doctors should be able to say no enough is enough surely?

Then in other cases they might think a baby is doing better than expected at 23weeks and suggest trying to save that life?

I'm NOT bashing smokers I was just trying to use that as a way to get my point across

changing so at what point in a childs life, when there is a need for medical intervention, should it become
the parents choice. One? Three? Five?

That lovely 21 year old girl hit the nail on the head in last nights documentary. Dont spend money letting 23 week babies live if you are not prepared to support their lifelong needs.

And it was written all over her mothers face - she wished she had known the difficculties that lay ahead back when it was her decision.

i don't really understand what you mean, funsize.

Aitch, is that all resuscitated babies, or premature births?

Hairy - these babies are medically on the verge of "viable" they are not one, two and three year old children born at term with a fighting chance. The odds are stacked against them physically. The parents are not equipped to deal with the enormity of the difficculties the children are facing due to their obvious emotional detachment.

If you had watched the documentary last night, you would of seen the way they operate in Holland, this was a much better way than how British babies are treated.

detachment - attachment sorry!

There's no right answer, I just don't think you can impose a blanket decision. Surely this is one of those issues where you need to consider each individual case.

Catch - before I became pregnant I smoked, I see the argument for saving innocent lives against those whose illness is self inflicted. smokers can give up at any point - I did (not to say I won't ever smoke again as I REALLY miss it!!) BUT as I said before smokers and drinkers to bring in huge amounts of taxes which if we're being realistic the babies won't (see previous comment)

If we're going to put babies lives ahead of self inflicted illness lives, how about putting them, the future, ahead of the very elderly and infirm (they've had their life right?) btw this is NOT my view! I don't think one persons life is worth more than anothers I'm just putting it out there... or how about not treating those with terminal illness in prison?

I don't think it can just be looked at from a money perspective though. I really think it should be case by case.

Aitch - I was meaning in reply to leaving it in the hands of the parents, I don't always agree it should be. Getting distracted by small child climbing all over me

This smoking and drinking element leaves a bad taste - totally irrelevant to the issue.

The fact is, the NHS Commissioners are attracted to the idea of saving early babies at any cost - cost to the physical health of those babies and the emotional cost to the families. The money could be better spent in early labour prevention which is entirely more prevalent in areas where poverty is high and antenatal health is low.

But tbh it can't be case by case.

That is very nice and cosy and all that but it's bollocks.

If the stats are stacking up telling us that viability at 23 is so precarious, so unlikely to end well, so difficult for both the parents and the child, then we should listen to that.

What 'case', what circumstances, makes spending tens of thousands of pound extending a Childs life to 10 days, and only ceasing intervention when the pain vs outcome becomes too much for everyone to cope with.

The case by case scenario will just make parents feel like they didn't fight hard enough. It is harder, surely.

The situation in Sweden where everyone knows that baby is cuddled and loved and given to his parents to hold while (in that dreadful phrase) nature takes it's course is bizarrely and unexpectedly kinder.

It is so difficult.

But the consultant was right - the public will spend millions to ' save babues' -it feels right. But we don't give a shit about giving an eight year old extra physio.

pagwatch - you make a good argument. I like the idea of what sweden do BUT what if that child was one of the 1% that would have no disability or struggle in life?

I am 27 weeks pregnant and at risk of cervical incompetence - my baby could come at any time. Luckily though, I am being monitored closely (weekly scans and cervical examinations) to ensure my consultant is aware of anything before it happens and can act accordingly.

If my baby were to come now, I would want and need a doctor to help me make a decision about how to proceed with his care. I would not want my baby to suffer either now, or in the long term, but I am too attached to him (and have been through so much to get and stay pregnant) for me to possibly make a rational decision.

I knew I shouldn't have watched this programme last night. My DH was away and I couldn't help myself. I was awake most of the night worrying about my little boy and pleading with him to abandon any plans he might have for imminent escape!

Storm - I hope everything goes well for you.

jazz412, you make a good point when you say "BUT what if that child was one of the 1% that would have no disability or struggle in life?" - unfortunately we cannot allow the fact that 1% of children may survive without long term disabilities cloud our judgement entirely.

I have been arguing for years for the smear age to be lowered as I was diagnosed with cervical cancer at 25 - it might have been picked up had I been having earlier checks. The government argues though that the cost of administering smears for all women from the age of 20 would not be cost effective i.e. it would detect cancer in a small percentage of cases, but would be an expensive programme to implement for the NHS. I'm not saying this is right, but it is basically the same thing.

The decision on providing care and medication for a range of illnesses and conditions is made on a similar basis.

Sorry, meant to add

...its basically a cost/benefit analysis.

Thanks Jazz. Sat with my feet up MNetting now, so taking the idea of keeping well rested very seriously! Sure MN will be fed up of me by the time the baby arrives.

I watched the documentary about it last night and really don't know what I think.
On one hand I think if it had been my child I would want everything possible to be done if there was a chance it could live but I also think this would be selfish if the child was in pain and would have no quality of life.
I'm not sure I agree with resucitating the babies either.
A big part of the argument was the cost to the NHS and I agree that the NHS is not a bottomless pit of money and certain cases need to be prioritised. However the elderly probably cost more to the NHS than any other group and nobody would dare suggest cutting back on their care and letting them die so why should it be the case with premature babies?
I really don't know what to think and hope i am never in a situation where I would have to make that kind of decision.
What also upset me about this programme was looking at the babies and knowing that legally they can still be aborted at that stage. I'm sure that argument will be on another thread though.

It's sad but true that everything basically boils down to money (or lack of it) in this life

The only thing I could think of last night whilst watching, was to offer the opportunity to parents of babies born at that age the choice to pay privately for their treatment if they wanted it.

The same as with some cancer drugs etc if you have the money you can have the treatment.

Might not seem fair but might be some kind of halfway line rather than a straight out no for everyone??

I wish I knew what the answer was.

Storm good luck with everything, hope little fighter stays put a bit longer

If someone is alive, then I think of course you save, stabilise then assess.

Some of these babies might be in normal(ish) health, if the prematurity is caused by a maternal factor (like the example above of incompetent cervix). But many others will be premature because of a condition within the baby. These are heart-wrenching decisions, as would be the turning off of life-support for anyone. But is something that, IMHO, should be considered when you have a chance to make them on the basis of informed prognosis.

I watched last nights programme and can see both sides my DD2 now 17 was 3 months early and luckily is absolutely fine( out having a driving lesson as I type) However I am a paediatric nurse and have worked on a NNU and now work in a childrens hospice and see the struggle the children and thier families go thro daily when things have turned out differently. The young adult that was prem hit the nail on the head about what little services there are disappearring when your 18