Archie Battersbee - Thread 3

[BongoJim]

Follow on from previous full thread

www.mumsnet.com/talk/in_the_news/4596573-archie-battersebee-case-thread-2?page=1

Just to pick up on this, yes, ITU resources are extremely limited.

I don't know if this is true for kids (I assume it is, but don't know for sure) but plenty of major adult surgery requires that the patient go to ITU for a night or two afterwards, until they're stable enough to go to a ward. If there's no bed, their sugery is cancelled. As you can imagine, this is invariably the big stuff, so not the type of procedures you want cancelled.

If a patient comes in needing an emergency ITU admission and there's no bed, then they're shipped to the nearest hospital who has space. That may be hundreds of miles away. This isn't good for the patient (travelling long distances in an ambulance when you're critically ill is always a risk) or the vamily, who find it hard to visit. It's also expensive.

So, yes, there are wider implications beyond Archie's individual care.

"I would have thought the police would investigate to see if the lad had been involved in an online challenge and say something about it or warn parents to watch out for this. They have not done so, so why has she not said something about that?

They will be doing so. As pp have said, there will be a coroner's inquest, which will go into all the circumstances. It would be inappropriate for the police to say anything before that."

But surely the police would get involved at the time of the incident?
If there is a Tick-Tock challenge leaving kids with very serious life threatening injuries surely the police would investigate and warn parents? I can't imagine the police only get involved if it causes a death

When my Nan was in her last weeks, she got pneumonia. I went in the ambulance with her (I'd been caring for her) and my Mum followed. We had a lovely compassionate chat with a Doctor in A & E who told us that the prognosis was incredibly poor (Nan had heart failure) and that they felt it was kindest to keep her warm, comfortable and pain free. Mum and I both shed a few tears, but agreed a care plan. Then my aunt and uncle arrived, screaming and shouting about murder, getting solicitors involved and our wishes were completely ignored. Nan ended up on a ward for nearly 3 weeks due to their involvement and those weeks were sheer hell for her and us. I've never forgiven them for prolonging her death like they did.

Sometimes you just have to let go because it's the right thing to do.

sorry for your loss badger and the stress your family caused

I’ve just seen on another forum, the court was adjourned at 12.30 & the 2pm withdrawal won’t go ahead.

I just wish it could be different and that they had better advice

I imagine we all do, Hinchcliffe, but I'm not comfortable with the suggestion from some - at least until Tirednurse1's excellent post - that the medics should have explained things better

The NHS gets things tragically wrong at times, but in a case like this with the law involved at every stage there's simply no way they wouldn't have tried repeatedly

Trouble is, you can't explain things adequately if someone simply doesn't want to engage, and in the end the family will damage mainly themselves - all of which adds to my view that this would be better brought to a close so whatever healing's possible can hopefully begin

“Charlie’s Army” and “Alfie’s Army” both petered out quite quickly after brief protests outside the hospitals. They’re basically cheap sentimental social media bandwagons for most participants. Most of the “soldiers” go back to daytime telly and their ice bucket challenges without too much fuss. It’s horribly cynical.

Sorry I’ve read that wrong. There will be no change to treatment until the court has ruled.

It’s interesting re the “rights” of parents - when I was reading the Jahi McGrath case I was struck by how some American states simply wouldn’t have allowed Archie’s ventilation to have continued for so long.

There are a few obvious exceptions, New Jersey being one of them, where a strong religious belief can enable someone to stay on a ventilator until the heart stops.

From the article:

California law requires that hospitals permit “a reasonably brief period of accommodation” before disconnecting a ventilator—long enough to allow family to gather, but not so long that hospitals neglect the “needs of other patients and prospective patients in urgent need of care.”

Jahi McMath

I imagine we all do, Hinchcliffe, but I'm not comfortable with the suggestion from some - at least until Tirednurse1's excellent post - that the medics should have explained things better

No me neither. No amount or quality of communication will land on closed ears.

I have wondered whether an extra fortnight before seeking a court order might have been enough for acceptance to set in, but maybe not in this case.

True true just depends I guess. If she goes quiet they will or just post amongst themselves. Or if she doesn't go quiet and carries on after...then they'll stay. These groups could be so supportive and a actual help. Maybe to the families they are but to the outside. Just seems bit odd having a profile pic of a child who you've never met and never will.

is there any news on the hearing yet

What needs to change is the people who set up these sort of online groups are traced, held responsible and face the justice system

Good luck with that, Blankets; for all it's many benefits the internet is a Pandora's Box which now can't be closed, and if the authorities tried to go after every maniac online they'd never do anything else

I have wondered whether an extra fortnight before seeking a court order might have been enough for acceptance to set in, but maybe not in this case

Sadly, I'd say almost certainly not; if all these months and every resource being offered haven't made a difference, I can only see matters getting worse as Hollie moves between pointless hope and despair

Mostly though I worry that, except for the HCPs and courts, Archie and his dignity are no longer the focus of attention

FWIW, the hospital's own review committee should have been enough but if there is a desire to have an 'appeal' body, there should be established a national medical review body staffed with medics appropriate to the presenting condition rather than a series of legal reviews involving judges who do not appear to understand medical biology sufficiently. Judges may become focused on incorrect use of 'balance of probability' and scientific rigour in terminology leading to a reluctance to clearly state in lay-persons' terms when a patient is regrettably dead. The language is imperfect when a patient is dead but being kept in a breathing state mechanically as the language used says that patient is still alive though only through heavy medical intervention. It is odd that is often the state from which transplant organs are removed yet the courts do not appear to become hung up about organs being removed from someone who is 'alive'. When someone is ill, they don't take an ambulance to the courts and this instance seems to indicate how little understanding of medicine the courts can have. I doubt they will but I would hope some of the bodies involved should look to their conscience but I suspect their beliefs render them immune to such introspection.

This is the elephant in the room with these cases. In the real world, medical teams know that resources are rationed, whether we like this or not. There are a finite number of doctors, nurses and ITU beds. If resources are spent on people that have no hope of recovery, it means that they are not available for someone who might recover. I really feel for doctors who recognise this and know that they are having to postpone urgent treatment for some people who would otherwise have a good chance of recovery. And that these situations result from campaigns by people who cannot accept the reality of their child's condition. It is heartbreaking but just the truth.

There will be a significant healthcare opportunity cost from the 3-4 months of ITU occupancy and there will be healthcare and financial opportunity cost from the legal challenges. The families of the children who suffer those won't know and the media don't seem to be asking that question.

So other people may have been directly impacted, possibly even died, as a result of limited resources being used to ‘treat’ someone who has already, medically, passed away?

the courts do not appear to become hung up about organs being removed from someone who is 'alive'

It's an interesting point, Zilla, and maybe just one more example of possible unintended consequences of a case like this

Not sure about the "national medical review body" though, since in the UK the basic premise is that the courts must be available to everyone and changing that by statute could be risky. It's fortunate that in the vast majority of cases it never comes to this, but it seems to me a case of good laws not being made on the basis of exceptional events

Sorry, hit post too soon.

should have added, I find that very difficult to reconcile.

I’ve been reading Joshua Rozenburg’s reporting of the case, and it sounds like the court is certainly not going to roll over. The parents submission that the court had no jurisdiction not to accede to the UN’s request was called “adventurous” (ie batshit), and they’ve been asking about timescales for this which the parents aren’t able to give them. The court has pointed out the UK govt has 6 months to reply to the request (which may give an indication of how quickly these things progress). The court has also raised the point that the convention is about helping to ensure people with disabilities can participate in society but Archie has no hope of doing so.

Never wise to second guess a court but I don’t think this will result what the parents want.

Had there been any mention of donating his organs? Is it even possible in his case?

Court will give decision at 3pm. I expect parents will try to appeal to Supreme Court. I don’t think any treatment will be withdrawn today.

Jesus. There are fates worse than death, IMO.

I would comeback and haunt anyone who allowed me to be kept alive in that state. In fact I have an advance directive which states that should I become vegetative and reliant on life support then all treatment is to be ceased. That way my family won’t be left with the decision.

The family made it public knowledge. They obviously wanted it out there and for us to discuss it. This whole situation is all they're doing. Most don't go public and keep they're privacy at such a difficult time. I certainly wouldn't want to be facing the media. I would rather be at my child's bedside while I can.