Neonatal Withdrawal of Treatment: A Doctor Writes…

There’s a great little article recently published in the BMJ about what it’s like to be the medic considering withdrawal of feeding from a neonate.

Survival is often much longer than most physicians think; reflecting on my previous patients, the median time from withdrawal of hydration to death was 10 days.

I had no idea it’d be that long.  I had no idea it’d be that long even for healthy adults who stopped drinking, let alone already-ill neonates.  (My scientifically-naïve intuition would have been that an adult body could stand up to more than an infant one.)

The fact is ethically neutral; and we need to be careful about skipping over the fact/ value boundary too easily.  But value claims bounce off, and are informed by, factual claims, and this is the sort of thing that might well be important when considering questions about withholding and withdrawing treatment, and about killing and letting die, and all the rest of it.

And, of course, the infant isn’t the only morally relevant actor in all this:

It is draining to be the most responsible physician. Everyone is looking to me to preside over and support this process. I am honest with the nurse when I say that it is getting more and more difficult to make my legs walk me on to this unit as the days elapse, that examining the baby is an indescribable mixture of compassion, revulsion, and pain.

I can see how that’d be.