My thoughts continue to be with C+C and all of Charlie's family, but also with other bereaved parents who have found Charlie's fate so distressing, particularly how it was played out in the public eye. The 'fighting' narrative has a lot to answer for
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I have also been wondering in what situation a treating doctor would make the decision to NOT intubate and ventilate a 2 month old baby?
Decisions to not ventilate people with, say, progressive respiratory problems ARE made from time to time, when the risk of never getting them off ventilation again is considered too great and the distress of having to 'switch off' a ventilator is greater than allowing a natural death to occur. Typically those patients are much older, have had longstanding health problems and their diagnosis is known.
Imagine being presented with a seemingly healthy 2 month old baby who is not thriving and then obviously must have had breathing difficulties, significant enough for him to need mechanical ventilation. Nobody knew what was wrong with him at that point. His condition is vanishingly rare. Of course he (or any child unexpectedly so grievously ill) must be treated with everything that modern medicine has to offer until it is clear what their illness might be, no matter how awful subsequent decisions to withdraw active treatment might be.
Re judgements about quality of life: these judgement calls are made all the time, of course they are. They need to be made, they are often the most important decisions about treatment plans taken. IME they are never taken lightly or without discussion, ideally with the patient, people struggle and agonise over them and of course there can be a difference of opinion, between HCP, between HCP and patients, between HCP and families, between different family members etc etc.
Good, open, fearless, repeated communication is the only thing that helps to keep everybody on the same page and has the potential to avoid such awful breakdown of relationships as the Gards and their son's treating team experienced.