Do you think there’s ever a case where doctors should end life support for a child against the parents’ wishes?

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Johnny - posted on 07/16/2012

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This has occured here. A family of quintuplets who were Jehovah's Witnesses were refusing to allow their children to have the necessary blood transfusions to keep them alive. Ironic considering that the quintuplets had been conceived through IVF with donor sperm. But anyway, there were a number of doctors who recommended the procedure, but the parents refused. The courts took away their custody and the Children's Ministry gave permission for them to receive the transfusions. The parents only applied to resume custody of the two kids who hadn't received transfusions, they abandoned the others to the province. Unsurprisingly, they didn't get the other two kids back either.

Personally, I support the idea of removing parental rights if a parent is not acting in the best interests of the child and this is supported by multiple practitioners who are knowledgeable in the area and it can be proven in a court of law. Just because you can create a kid doesn't mean that you are completely sane and rational, and thus able to put their best interests first. Forcing a child to continue to live in a state of agony is just another form of abuse. We don't allow parents to physically abuse a child in any way, I'm not sure why this should be special?

I do think multiple independent opinions supporting the same conclusion should be required though. Along with a court of law overseeing the proceedings. Here, a child advocate is generally appointed, who is an independent person specifically charged with ensuring the child's best interests. They are responsible for ensuring all medical opinions are received, verified, that the courts are given all the information and that the family's interests are also considered. Some parents just can't be depended on to put their own needs aside to benefit their children.

Cherish - posted on 07/04/2012

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I think most parents want what is best for their children and unfortunately parents have to make such decisions every day(thank God I have not been in that situation)
The thing about a vegetative state is some people do respond in ways,(opening their eyes,blinking,making noise..etc) and that gives their families hope of recovery.
And people do sometimes "recover" from vegetative states(tho they are not the "same" as they were before.

I suppose it depends on percent of recovery,the amount of "damage" done,but more importantly quality of life after they recover.

http://www.merckmanuals.com/professional...

@Lacye
Who decides there is no chance of recovery?
Dr's are "practicing medicine" they have not mastered it yet,and they make many many mistakes..Tho I do see what you are saying,that no parent would want to make that choice.And if the parents were considering it,but could not go thru with it,and it was court ordered,then the parents could place the blame and anger on the Dr and the court...

Jodi - posted on 07/15/2012

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"he parents would have to be investigated, taken to court, tried as unfit, and had their rights taken away by judge and the child put in the care of a guardian and the guardian could choose to take child off life support or whatever. "

That's actually exactly what happens. The judge determines that the parents are mentally unfit to make this particular decision. Doctors don't make the decision, the courts do.

Merry - posted on 07/15/2012

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If someone is brain dead there's all likelihood they will never wake up. But there have been miraculous cases where they do and so if a parent doesn't ain't to live with regrets of what if, they just might need to let their child sit on life support for X amount of time so they're confident that there'sno getting them back.
They're our children, and until the parent is proven unfit, it's their choice.

Sal - posted on 07/12/2012

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I was listening to a dr and ethiacist today (it was about end of life plans.... Whole other thread there) and he said one small phrase which summed up this thread perfectly which was a dr must have the best interests of the patient as their concern not the interests of the family parents or friends.... That is Where a patient is dying and prolonging life is purely for the living it is the duty of care to act in the interest of the patient not the family, ideally there will be a reasonable Conversation between the careers and the family where the interests of the patient are Put first but in cases where parents can't face the reality then yes I feel the dr should be able to make the big decisions..... This is a bit of a back flip for me, only a little one, but this guy was so sincere and so reasonable that I fully agree with this now....

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Sally - posted on 08/11/2012

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Yes I do. I think sometimes its to hard for parents to face this choice. I also feel in someways it could be easier for parents, they don't have a lifetime of wondering if what they chose was right or wrong..

**Jackie** - posted on 08/04/2012

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Little Miss, just read your comment from like a month ago about your mom's uncle! That gave me chills! I love love love stories like that. :)

**Jackie** - posted on 08/04/2012

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The title of this made my stomach upset. I just pictured the doctor coming and telling me that they are going to end my child's life and me just screaming "No no!" and not wanting to.



I'd have to say, IF this ever happened to me? (and God forbid it doesn't) that doctor better get some Nike's on because I'd be coming for him.





ETA: Just scrolled down and read a few comments and I wanted to add that I also agree with that if the parents were unfit or mentally handicapped then the children should, if not already, be handed over to a family member or another guardian...in which case they should be making that call. Still, never the doctor.

Jurnee - posted on 07/16/2012

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I think it should be left up to the parents, unless they have been proven unfit parents beforehand, ir if they are the ones who cause the child to be brain dead. I read an actual story where a man beat his infant daughter near death, she was brain dead, the mom wanted to take her off life support, and the dad from jail, where hes was for child abuse got a lawyer to uphold his parental rights to keep his daughter on life support, and to incidentally to keephim from a murder charge. Thanfully the courts didnt buy it.

Julie - posted on 07/16/2012

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This is a legal question. I am not to familiar with the law of medicine. Not to mention it depends on where you live, what the child's age is, what papers of consent were signed or not. Who the conservator is. What medical coverage the child has. The medical condition and probably out come of the child. Are they a donor? The list goes on and on.

Merry - posted on 07/16/2012

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Oh! Ok then I agree with that. it shouldn't be the drs call, if the parents really are mentally unfit then a court appointed guardian should be put in charge. But I'd imagine it's pretty hard to prove a parent unfit without relying heavily on the drs opinion. And what if the dr is biased or just really believes opposite the parents. I'd think there should be options for them to find other liscenced practitioners who back them up, and not risk one single dr with an agenda convincing the judge they're wackos.
Because of course we all know this, all drs aren't a match for all patients. I'm sure there's some drs who would say I'm unfit for my decision to birth at home...so I would want the process to he really fool proofed so only the truly incompetent get their rights stripped.

Stifler's - posted on 07/15/2012

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I think that's all well and good... if the parents can afford to have the child on life support at their house sans government funding.

Merry - posted on 07/15/2012

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No I don't think the dr should ever be in charge of choosing life or death of one of their patients.
The parents would have to be investigated, taken to court, tried as unfit, and had their rights taken away by judge and the child put in the care of a guardian and the guardian could choose to take child off life support or whatever.
the dr has NO rights to decide when a patient lives or dies I think. Drs do a service for the patients. They're paid to help us. Not to decide what's best for us.

Jenn - posted on 07/12/2012

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In extreme instances such as clinically brain dead for X number of days or weeks, then I do think after counseling the parents that perhaps a doctor can push for the end of life support. I can only imagine that there are some parents who just cannot bring themselves to end their child's life, no matter if it is machines doing the work or not. In a hospital setting though. If a family has the child at home and can afford to keep going indefinitely with the child on life support, they should have that right. It will be neither here nor there for the child, especially if the parents never plan to donate organs.

On the other hand...it is a slippery slope when doctors give their opinion on when to pull the plug. My grandmother fell on a Thursday, smacked her head and fell into a coma like state. That Sunday, the doctors all said it appeared to be the end for her. My aunt stopped all feedings and hydration for a more natural death. They sent her home on Hospice on Tuesday morning. Within two hours, my grandmother woke up...sat up and asked for a cup of coffee! She is still recovering from the damage done from the lack of nutrition and hydration but her mind is sharp and she is doing remarkably well.

Doctors Do not understand the brain and the intricacies of how it functions. So to give the doctor such power to end a life seems a little scary to me. They are not emotionally invested in the patient. They see the patient as a case first, person second.

Katherine - posted on 07/12/2012

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Sal, you make a really great point there. And sorry I haven't been back to this thread. I have been experiencing major issues with CoM.

I completely agree, as hard as it would be, who am I thinking of, myself or my child? And what would be the point if that child was brain dead? I have had 2 people now die in my life that were brain dead, and their parents both made the decision to take them off of life support and donate their organs. I'm sure it was horrid for them. I can't quite honestly say what I would or wouldn't do....but in those cases that person is not coming back.

Elizabeth - posted on 07/11/2012

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You know, I bet this very thing happens more often than we think. Get an insurance company involved and well there you go. For me, I tried to think...what if it were my child? Would I want a total stranger making that decision for me. The answer is no. My daughter was a big time preemie. She was born at 26 weeks. If she hadn't thrived and died like the little boy in the next isolete would I want the doctors to have kept on in an impossible situation? Losing a child is heartbreaking in the extreme. No one can understand it until it has happened to THEM.My daughters heart stopped 5 minutes after I came to the NICU to see her for the first time, lucky for me...preemies just forget to breathe sometimes..they smacked her on her feet and up she popped. I freaked naturally. But OMG I love that precious bit of heaven named Charlotte. If she were hurt beyond repair, I think I would have to let her go home to her Creator. to keep her alive with a machine would make a mockery of her fight to live when she came in this world and of the funny, beautiful, spunky girl she is. given the time to grieve and come to terms, I would have to make the right decision for her..for any of my children when faced with that. I would deal with me...later.

Jodi - posted on 07/06/2012

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Layce, I said from the US AND anti UHC, LOL. I wasn't insulting all US citizens, just the ones who think we're all socialists based on propoganda because we have health care systems paid for by our tax systems :D

Lacye - posted on 07/06/2012

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Jodi! Your words wound me because I am from the US. LOL

Erin, that is the most ridiculous thing I have ever heard in my entire life. Seriously? Is that going to be your argument in this? In all honesty, that makes no sense what so ever! And what exactly is wrong with universal health care? I'm wishing right about now to have some health care.

Rosie - posted on 07/06/2012

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no i don't think there should ever be a case where anyone other than the parents make that decision. sure people may think that the child should be let go peacefully, i'm probably one of them, but for someone else to make that decision is ridiculous to me. i think a lot of people are doing things wrong by their children, but unless it's illegal the government should have no recourse. i hardly think keeping someone alive is illegal. stupid maybe, but not illegal.

Sara - posted on 07/06/2012

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Yeah, not the most helpful comment, Erin. There are women in here from all over the world, many of whom have UHC. If you want to discuss that topic, please start another thread.

Jodi - posted on 07/06/2012

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Are you for real Erin? Obviously you are from the US and are anti UHC and know nothing about it. I love the socialist cry. It cracks me up. Great argument for your debate.....

Erin - posted on 07/06/2012

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Absolutley NOT! NO ONE BUT THE PARENTS HAS THAT RIGHT PERIOD! I'm sure a pack of socialists selling lower medical care costs would advocate murdering children against a parents will though!! AAACK!!! Sick!!

Lacye - posted on 07/05/2012

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Little Miss: I have to admit, I wouldn't like it however, later on when I sit down and think rationally about it, I would understand it better. Nobody wants to have their child die but it's not about the parents' wants. It's about their child having some dignity and if a parent continues to keep the child on life support, to me the child loses that dignity. It's taken away from them.

Jodi - posted on 07/05/2012

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Actually, I agree you have a good point, that intense therapy for the parents could be a first course of action. However, I still stand that if something like this fails, and every test has been done to confirm that someone is brain dead (including second opinions), than there has to be a fall back position such as the courts. I don't think the doctors should make the DECISION, but I do think they should have an avenue through the courts where they can present their evidence (and the parents can present theirs) to have a decision made.

~♥Little Miss - posted on 07/05/2012

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I think it is a pretty relevant senerio. Both are permanent solutions to a complicated situation both ending in death and having someones rights taken away.

If they really feel it is necessary, then maybe mandating therapy for the parents if they are in that great of denial. Sorry, but I am not caving no matter the examples you give.

For instance, my moms uncle got ran over by a train when he was around 11 years old. he fell off the platform when it was coming. He was pronounced dead in the ambulance and again at the hospital. The mom came, and demanding they kept trying. They continued, she would not leave until they did everything possible. They kept telling her he would not recover. Well, he is now in his fifties and does have prosthetic limbs on his left side. If that mother was not pushing the doctors and staff, his life would have ended in that ambulance.

Parents need to hold onto hope like that sometimes, even if it is just for their sanity knowing that EVERYTHING was done. You just never know.

Jodi - posted on 07/05/2012

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LOL, what an awesome way to have a fast moving debate. Thanks CoM. You are all fucking awesome. I don't have time for this, so I am going to have to bow out anyway :)

Jodi - posted on 07/05/2012

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I don't think the two scenarios compare. For one, the abortion scenario is not indefinite, secondly, it would normally be the other parent of the aborted baby who made that decision.



Are you suggesting that resources should be indefinitely taken up because parents are in denial about their child for years on end, even if they can't afford it, and someone else needs those resources who has a greater need and an actual chance of surviving?

~♥Little Miss - posted on 07/05/2012

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I know, I keep just typing a letter or a period or something, then post it. The other posts seem to show up after a post yourself.

~♥Little Miss - posted on 07/05/2012

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I don't think it is ok, but it is not my call. It is not my child. Just like if you got pregnant, and you were in a terrible circumstance and someone took away your rights and forced you to have an abortion. Same lines, taking away someones right to choose.

Jodi - posted on 07/05/2012

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So a parent who remains in denial for 2 years, 3 years, you think that's okay?

~♥Little Miss - posted on 07/05/2012

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If I was in that position, I still would not want a total stranger deciding for me such a major decision.

~♥Little Miss - posted on 07/05/2012

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Then it is their decision. It is their child. Not the doctors, or the judges child.

Jodi - posted on 07/05/2012

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But, Little Miss, what if the parents can't or refuse to make the decision (because they are in denial) and they have had the best specialists (more than one) do tests to confirm the child can never recover and is brain dead. What then? Shouldn't the doctors be able to petition the court, provide their expert evidence and have the courts decide?

~♥Little Miss - posted on 07/05/2012

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Lacye, I am sorry to hear that about your FIL. But you as family were granted the opportunity to make that decision over his life. Not a stranger.

Lacye - posted on 07/05/2012

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I think Stifler's Mom and Jodi said it better than I did. LOL

If a child has been in a horrific car accident and is brain dead, then a doctor should be able to make that decision if the parents are unable to. To me, it's no way for a person to live. I know this is kinda different but my husband's father had lung cancer and was eventually had a trach put in his throat to assist him to breath. The hospital put him in a nursing home to help him rehabilitate off of the trach and the nursing home was not paying attention and the trach fell out (it sounds weird but very true). In the end, my husband's father had lost so much oxygen that he was brain dead. When hubby and I went to see him in the ICU for the last time, he didn't even know we were in there. He was pretty much gone but his body was still going thanks to life support. We made the decision to take him off life support. It was no way for him to live. The same with a child, they can't live that way.

Jodi - posted on 07/05/2012

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"No, it is not their child. Parents need to retain the rights to their children no mater what. No exception. If they want to continue paying medical bills for the rest of time and have their child in a bed on machines then that is up to them and not anyone else. " If the child is actually braindead, I disagree with this. That bed and those machines could be used for another child that actually has a chance at survival.

"Tho Katherine said "life support" and people that are on life support are often not in a vegetative state.... " If you're in a vegetative state, you are probably hooked up to IV's for fluid and feeding tubes for nourishment. Those are both forms of life support, since without them, the patient would dehydrate or starve to death. But, I don't think that's exactly what Kathering meant by life support. So, people in vegetative states are nearly always on life support, unless they're being "let go".

But otherwise, if the child has a chance of recovery, then no, it's not the doctors choice. That should be left up to the parents of how far and how long they want to "wait and see" so to speak.

But,

~♥Little Miss - posted on 07/05/2012

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Doctors can make mistakes. But either way, no I don't think someone who doesn't know your child from the kid in the next room should be able to take a child off of life support without parental consent. That mother and father knows and loves their child. Having a stranger say they have the right to take them off of life support is not ok with me. I would not want that for my own family. As hard of a decision it would be to make, it is the parents decision.

[deleted account]

Yep I'm with you Stifler.

Sometimes parents are the last to be able to make the right decision, because they are incapable of facing up to reality. If it costs taxpayers a fortune to keep someone on life support and there's no chance of them ever waking up, I think the doctors need to make a decision as to the best place to allocate scarce funding.

Sounds tough, but if a kid is brain dead, they should turn off the machines, full stop.

Stifler's - posted on 07/05/2012

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If there is a good chance the kid will wake up and be okay a doctor isn't going to suggest taking them off life support and then do it without consent. When my friends 3 year old was brain dead on life support they turned it off after 2 or 3 days.

Stifler's - posted on 07/05/2012

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Yes. A braindead person on life support is a waste of resources and delaying the inevitable. The sooner they turn it off the better especially for the parents. Being on life support for weeks gives false hope they will one day wake up when they will not.

Kelina - posted on 07/04/2012

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Sonetimes, I agree with Jodi, A child can't be kept on life support indefinitely simply because a parent can't let go. That's no way to live. I can understand not wanting to let go but to watch a child physically grow but chained to a bed never moving, no longer full of vitality and spirit-for me that would be more painful than letting them go. Cherish, believe it or not that's not uncommon. When my mother was in palliative care, they were unable to do anything to prolong life. She slipped into a coma and it took her nine days to die. nine days after several weeks with very little food, mostly liquids, and while I was there I was not the only one who watched a parent go through that.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 07/04/2012

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This is a hard one for me. Since, I can totally do my best to understand how hard it would be, as a parent. Which my current comprehension, is probably not great, never having been in this position (and hope to never ever be).



However, I think if it is an absolute, that the child is already gone and the only thing keeping them alive are machines, then perhaps, yes, the doctors should be able to take it to the courts. I mean, it is not fair to anyone involved, really. It causes extreme heartache for the parents, to see their child this way daily and they are not getting a chance to morn, properly. It is only going to get harder and harder, as the days and weeks go by. It is also taking precious resources, that may be able to be used in saving another child (I know, that sounds callous but I think it would be, if your child would never live without machines and was taking away from those, that could).



So, as hard as it is, my answer is yes but ONLY if it is an absolute and several specialists have given this opinion. Perhaps, after a certain period of time or something. Not sure how long, I won't go there.



It's a sad thought, to think of how there are parents out there, that are going through this very excruciating pain, right now. :(

Sal - posted on 07/04/2012

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I'm torn my gut says no never but when a parent cannot accept reality in a situation and holding onto lost hope is cruel the child and the caregivers who have to deal with the child and the parents and the parents, there are no winners in taking action to pull the plug but I do t know what other options there are. Someone mentioned if the parents can afford To keep paying the bills they sould be able to kept them Alive for ever but what happens when they can't pay anymore I think the guilt of turning off machines because your broke would be worse than the guilt of doing it because you felt it was the right decision in the interests of the child

Jodi - posted on 07/04/2012

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In cases where a child is on life support and showing evidence of brain death, and as long as there have been second and third unbiased opinions on that, then yes, I believe doctors should be able to petition the courts with the evidence and give them permission to turn off life support if the parents refuse.

I do understand why a parent presented with such evidence may still refuse to accept the facts, but a child can't be kept on life support indefinitely because the parents hold out false hopes. There needs to be a way in which someone can make the decision in an unbiased way.

BeeJay - posted on 07/04/2012

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I dont think so. I dont think it should be up to anyone to tell you when to say "goodbye" to your child. I am sure all parents know that at a certian time, they will have to, but they deserve the comfort of holding their child and holding on to "Hope" at least for a while. It shouldnt be up to a dr to be able to walk into a room and say "This is the last time you will see your child alive, say goodbye" and pull the plug. I would be begging for just 5 more minutes. The parent needs to have the peace on their own to be able to say good bye.

Cherish - posted on 07/04/2012

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Lacye...
There are people in vegetative states that can move around(minimally).But how do they KNOW the child can not think?If you can not talk or communicate then how would people know what is really going on?
The only reason I am saying this is because my son is 10 and can not talk but he CAN think and get into everything...lol
But I have friends that have children that have severe physical/developmental impairments and tho they will prob never be like a "typical" person...they do have a good quality of life.
My friends have been told things like their kids will "never" walk,talk,smile,eat...etc,they have been asked to sign a DNR and refused(and some did sign it),but the ones that did not sign a DNR (which they often give to people on life support),have kids that are now happy,some can talk,walk,eat..etc

Tho Katherine said "life support" and people that are on life support are often not in a vegetative state....

I believe that if it was a hopeless situation,most parents would not want their children to suffer..tho again I totally see what Layce is saying,if the court ordered it,then the parents would be able to place the blame and anger on the court and not have to make such a horrible decision.

This discussion reminds me of the Terry Schiavo case...Which I believe was HORRIBLE the way they went about it..she lived 13 days after her feeding tube was removed,so she starved to death,it was AWFUL

http://en.wikipedia.org/wiki/Terri_Schia...

Lacye - posted on 07/04/2012

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I'm talking about severe brain damage to the point the child will never be able to move, talk, or anything ever again. The child won't be able to even think for him/herself.

Lacye - posted on 07/04/2012

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It completely depends on the situation. If the child had no chance in hell for recovery, I think the doctors should be able to make the decision for the parents. Honestly, no parent wants to make that kind of decision because that is their child. They wouldn't want to have to live with that kind of decision. So why not allow the doctor to make the decision for them.

Dove - posted on 07/04/2012

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I don't think so. I do not think I could ever 'pull the plug' on my child any more than I could ever get an abortion. And yes, I'm well aware those are two totally different scenarios and I don't mean to compare them. It's just for ME... they would both be 'killing' MY child and that's not something I could live with doing and I'd probably never 'heal' if a judge made me do it.

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