A 9-month-old in Texas was about to be removed from life support. A judge stepped in.

  
Via:  perrie-halpern  •  3 weeks ago  •  28 comments

By:   Minyvonne Burke

A 9-month-old in Texas was about to be removed from life support. A judge stepped in.
"Our care team has done everything they can" to keep Tinslee Lewis alive, Cook Children's Medical Center said. But she "shows no signs of improvement."

S E E D E D   C O N T E N T


A Texas judge has temporarily blocked a children's hospital from taking a   9-month-old off life support   in a court battle that has drawn in the state's attorney general and Texas Right to Life.

Tinslee Lewis has been critically ill her entire life and has spent every day at Cook Children's Medical Center in Fort Worth, the hospital said in a   Nov. 15 press release . Born prematurely in February with a rare heart defect, she underwent her first surgery that same month.


In July she suffered further deterioration due to severe chronic lung disease, resulting in respiratory arrest, the hospital release said. She has since been on a machine that replaces the function of her heart and lungs in addition to being on a ventilator. Doctors also believe she is in pain, and she "requires significant sedation."

"In Tinslee’s time at Cook Children’s, our care team has done everything they can to keep her alive. She’s undergone multiple complex surgeries and despite our best efforts, shows no signs of improvement," the release said.

The hospital said that last month it began reaching out to more than 20 other medical facilities across the country to see if they would take Tinslee as a patient, but they "all agreed further care was futile," the release said.

Under   Texas law , doctors, with the approval of an ethics committee, can end a patient's life-saving treatment even if the patient or the family member responsible for making decisions on behalf of the patient objects.

191123-tinslee-lewis-al-1612_69e8fb3f5c8 Tinslee Lewis. Courtesy of Texas Right to Life via AP

The patient's family must be given at least 10 days to try to find another hospital to transfer the person to before care is suspended, the   Texas Tribune   reports.

Tinslee's family wants her medical care to continue and is   represented by the Texas Right to Life   organization, The Associated Press reported. A district judge agreed and has issued orders that require the hospital to continue treatment until at least Dec. 10.

The child's mother, Trinity Lewis, said at a Nov. 9 press conference that she had thought they were “going to pull the plug on my baby. I didn’t think that she was going to still be here today. And that’s what I’m grateful for.”

The battle has caught the attention of Texas Attorney General Ken Paxton, who filed a brief with the District Court of Tarrant County. In a   statement   Friday, he said the hospital's decision to remove Tinslee from life support "directly violates the mother's request and her daughter's right to life." He slammed the state law as "unconstitutional."

"Patients must be heard and justly represented when determining their own medical treatment, especially when the decision to end treatment could end their life," he said.

Cook Children's said it has been in contact with Lewis and other family members over the past several months about the best course of action for Tinslee. In September, they began talking to the family about instituting a do not resuscitate order and withdrawing lifesaving treatment.

"As medical professionals, our responsibility – our highest duty – is to save lives. We are still working with Ms. Lewis and Texas Right to Life to find alternative care, however, it is our sincere belief that further medical intervention is not in Tinslee’s best interest."

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Gordy327
1  Gordy327    3 weeks ago

As sad and tragic as this situation is, if all options and interventions have been attempted and there's still no chance of improvement or recovery, then it's time to call it quits. Medical professionals who deal with cases like this are in the best position to objectively determine the best course of action, including withdrawal and cessation of all interventions. Of course the family wants what's best too, but they are in an emotionally fragile and vulnerable state and are probably not looking at the situation rationally.

 
 
 
r.t..b...
1.1  r.t..b...  replied to  Gordy327 @1    3 weeks ago
Medical professionals who deal with cases like this are in the best position to objectively determine the best course of action, including withdrawal and cessation of all interventions.

As our ability to extend life increases, the ethics of doing so need to be addressed. As I signed the DNR order for my mother dying of Alzheimers, I did so gladly, if for no other reason than to honor the memory of a vibrant women whose life had long since been taken away by the ravages of the disease.

We need to codify 'death with dignity' legislation and empower primary caregivers to make the most heart wrenching of decisions alongside the council of qualified medical personnel involved in each case and spiritual counseling as the family desires...leaving the courts and those with other agendas out of it. 

 
 
 
Gordy327
1.1.1  Gordy327  replied to  r.t..b... @1.1    3 weeks ago

Hospitals do have ethics and legal committees to deal with situations like this. Unfortunately, the mother disagrees with the medical team and hospital committees, which prompts legal intervention such as this. And it's the child that has to suffer most through it.

 
 
 
Heartland American
2  Heartland American    3 weeks ago

So, a judge steps in because the family is still looking at alternatives.  Better than the UK where they murder the baby over the objections of the parents and other countries.  

 
 
 
MrFrost
2.1  MrFrost  replied to  Heartland American @2    3 weeks ago

So how many doctors have been arrested for murder regarding cases similar to this one?

 
 
 
Gordy327
2.2  Gordy327  replied to  Heartland American @2    3 weeks ago

Did you even bother to read the article? The hospital itself contacted 20 other facilities to take over care of the child. ALL of them said there was no chance of recovery. So the mother is searching for alternatives. Although, I doubt she'll find any. 

Do you seriously think the removal of life support measures or therapies is "murder?" Have you ever heard the term "comfort measures?" 

 
 
 
sandy-2021492
2.2.1  sandy-2021492  replied to  Gordy327 @2.2    3 weeks ago

For those protesting the discontinuation of life support, making a political point is of secondary value to the welfare of a suffering child.

 
 
 
JohnRussell
2.2.2  JohnRussell  replied to  sandy-2021492 @2.2.1    3 weeks ago

I'm not making an argument for or against ending the life support, but I dont believe it is reasonable to say that ending someone's life (removing them from existence) constitutes "doing something for them"  aka contributing to their "welfare".  In order to have done something for someone's welfare, they would have to still exist after the act.  JMO. 

 
 
 
PJ
2.2.3  PJ  replied to  JohnRussell @2.2.2    3 weeks ago

I think you're splitting hairs.  Contributing to someone's welfare could be to give them dignity to die.

 
 
 
sandy-2021492
2.2.4  sandy-2021492  replied to  JohnRussell @2.2.2    3 weeks ago
I dont believe it is reasonable to say that ending someone's life (removing them from existence)

I don't see the discontinuation of life support as ending someone's life.  I see it as no longer prolonging their life, which is different, to my mind.

In the case of those who are suffering and have no chance of recovery, no longer prolonging their life contributes to their welfare by ending their suffering.  Existence is not requisite to welfare, when existence is, on the whole, negative.

 
 
 
JohnRussell
2.2.5  JohnRussell  replied to  PJ @2.2.3    3 weeks ago

Do you really think that baby knows anything about "dignity"?  The dignity part is what the survivors experience. 

 
 
 
Gordy327
2.2.6  Gordy327  replied to  sandy-2021492 @2.2.1    3 weeks ago

They also seem to emphasize quantity of life over quality. A child who's had multiple surgeries, is connected to wires and tubes constantly, needing sedation to control pain, and will likely not recover but probably continue to  deteriorate, has no appreciable quality of life.

 
 
 
PJ
2.2.7  PJ  replied to  JohnRussell @2.2.5    3 weeks ago

I think you're getting caught up on a word rather than the point that was being made.  Don't get fussy with me Mr. Russell.  jrSmiley_82_smiley_image.gif  

 
 
 
sandy-2021492
2.2.8  sandy-2021492  replied to  JohnRussell @2.2.5    3 weeks ago
Do you really think that baby knows anything about "dignity"?  The dignity part is what the survivors experience.

She knows pain, and unfortunately, she's not going to survive.  She shouldn't have to suffer pain to satisfy others' sense of dignity.

 
 
 
Gordy327
2.2.9  Gordy327  replied to  sandy-2021492 @2.2.8    2 weeks ago

She's also going to suffer because some people are too emotionally selfish to let her go. 

 
 
 
MrFrost
3  MrFrost    3 weeks ago

Forcing her to live and suffer is inhumane. 

 
 
 
Kathleen
4  Kathleen    3 weeks ago

Very sad situation here.  I can understand the parents having trouble letting go, but they are prolonging her suffering and she really has no life like this.  I am not in their shoes and it has to be tremendous pain for them, but they have to realize that they have done everything they could do.  So sad...

 
 
 
r.t..b...
4.1  r.t..b...  replied to  Kathleen @4    3 weeks ago
So sad...

...and tragic that their suffering, and her daughters, are now subject to scrutiny from those who care nothing about them but will seize upon it as a chance to further their own agenda. The most despicable of opportunists. 

 
 
 
Kathleen
4.1.1  Kathleen  replied to  r.t..b... @4.1    3 weeks ago

Plus they said that she has to be heavily sedated because she is in pain. That should be enough to let her go. Yes, very tragic.

 
 
 
Paula Bartholomew
5  Paula Bartholomew    3 weeks ago

As much as it hurts, sometimes you just have to let go.  

 
 
 
Jack_TX
6  Jack_TX    3 weeks ago

Who's paying for all this?

 
 
 
PJ
6.1  PJ  replied to  Jack_TX @6    3 weeks ago

I had a discussion with a colleague several years back.  She was an advocate for pulling the plug.  She relayed a story about one of her friends who is an MD.  Her friend's mother who was in her 90's had been on life support for several years and there was no evidence that the mother was going to recover but the woman was unable to pull the plug.  My friend was appalled for a variety of reasons including the cost to those paying into medicaid for someone who was never going to recover and had lived a full life.  She remarked this was one of the reasons insurance is so high.

If private organizations want to foot the bill for situations such as this I applaud them but at the risk of sounding cruel, there has to be a limit when the cost is being passed on to the pool of insured.  We also have to consider the quality of life the person is left with in these circumstances.

 
 
 
MUVA
6.1.1  MUVA  replied to  PJ @6.1    3 weeks ago

Next it will be it is too expensive to take care of a kid with spina bifida or down syndrome.I can agree with a 90 year old that has been on life support for years I have a hard time with a child under 2.

 
 
 
PJ
6.1.2  PJ  replied to  MUVA @6.1.1    3 weeks ago

I don't know many people that want to decide to pull the plug on anyone no matter the age.  It's difficult and isn't made lightly.  As I said, I applaud the organizations that are willing to put their money where their mouth is by supporting those cases that have met the threshold of care.

I try to approach the situation as if it were my family member.  Would I want them alive but not living?  Would I want that burden of care hoisted on a family member essentially creating a lifestyle prison for them?  I think about what will happen when the caregiver is no longer able to care for the person.  I think about the financial burden placed on the caregiver.

It's not as black and white as some like to suggest.

 
 
 
MUVA
6.1.3  MUVA  replied to  PJ @6.1.2    3 weeks ago

I agree I have seen kids my youngest started out in school with that have spina bifida that have lived already longer than they were expected to so you are right it isn't black and white.

 
 
 
Jack_TX
6.1.4  Jack_TX  replied to  MUVA @6.1.1    2 weeks ago
Next it will be it is too expensive to take care of a kid with spina bifida or down syndrome.I can agree with a 90 year old that has been on life support for years I have a hard time with a child under 2.

Cook Children's is one of the best childrens' hospitals in America.  They've also reached out to hundreds of other hospitals to see if anybody else thinks they can help this child.  Every single one has declined.

It's not like this is a capricious decision.

Now....if these parents are wealthy and want to spend their money this way, fine.  But the rest of us should not be forced to pay for a hopeless case.

 
 
 
MUVA
7  MUVA    3 weeks ago

This is a tuff one I have a child with a handicap we were told by experts he would never talk read or write maybe not even walk he did walk till almost 4 years old.Well fast forward 20 years he will graduate from ODU next year with honors as he did from high school. I know the situation is different but just think if they kill this child and some type of life saving discovery is made.   

 
 
 
Enoch
8  Enoch    2 weeks ago

This article's comments section is probably the wrong place to mention this point. 

To understand it one must have a very high degree of expertise in bio-medical ethics.

There is a July 3, 2013 monograph by Emeritus Professor Don Marquis that is on-point in any discussion of when to "pull the plug" ethically, not legally. 

It is entitled, "Why the DCDD Task Force Failed".

It rests on the diagnostic distinction between permanently and irreversibly.

The law is in part a reflection of political weight.

The moral part of such a decision is not subject to political expediency.

Too intricate to get into here. 

In future, as time permits I may write on this topic in the Ethics area of Chaplains Corner, and the front page. 

Sometimes families of the terminally ill seek non-legal counsel from a moral perspective on such difficult and heart wrenching choices, if they have standing to decide.

2020 is the earliest I can get to it.

P&AB to One and All.

Enoch.

 
 
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