Tuesday, May 19, 2009

Who will make decisions for this baby?

Over the weekend, I found myself in an uncommon and uncomfortable situation. A baby seemed to be dying despite our maximal efforts and it seemed that we may be reaching a point where it would be reasonable to limit or withdraw life support. This decision is almost never straight forward and only comes after lengthy and careful discussion with those making medical decisions for the patient (in almost every case, the parents). In this particular case, it seemed we had a problem.
This baby's mother was completely incapacitated, unable to make decisions about her own care much less her baby's. So what about the baby's father? Well, unfortunately these parents were not married. So sadly, the baby's father could not make decisions regarding the baby's care either. This leaves us in an ethical/medico legal gray zone. To complicate the situation further, the father didn't speak English. Somehow, these delicate matters don't seem to hold up well to translation.
I'll conclude by saying that the baby survived. The process of identifying the appropriate person to make medical decisions for the baby is a challenging one. Several days later, we still don't have a definitive answer.

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