A Quebec Superior Court judge has ruled that a Montreal children's hospital can permanently remove a breathing tube from a five-year-old who has been in a coma since June.
Sainte-Justine Hospital went to court because the child's parents refuse to consent to the procedure unless doctors consider reintubation for the child if things go wrong.
The hospital says doctors believe the child can breathe on his own and that the risks associated with intubation outweigh the expected benefits.
The boy has been in a coma since June 12 after being found at the bottom of the family pool – authorities say he went into prolonged cardiovascular arrest.
A few days after his admission to Sainte-Justine Hospital, the young boy was facing numerous problems, including acute respiratory distress syndrome, cardiac dysfunction and episodes of convulsions.
The Quebec Superior Court ruling indicates that on June 16, the medical team first discussed with the parents the possibility of removing the breathing tube. Health professionals have repeatedly argued that “this mechanical ventilation is contraindicated for his condition.” It could cause serious damage or even death to the child.
However, doctors say the child should receive end-of-life care in case he stops being able to breathe without assistance, the hospital maintains.
“The maneuver is risky since it could lead to his death,' the Quebec Superior Court ruling said. The parents object.
The court document states that the mother's reaction is particularly strong. “Her faith in God leads her to hope that her child will emerge from the coma in which he is immersed,” it says. On the other hand, the parents are skeptical of the hospital's motives and believe that the treatment is coming from a “cost-saving perspective.”
The child's 20-minute immersion in the pool caused “anoxic-ischemic encephalopathy, which put him in a deep coma and caused major and permanent brain damage due to prolonged oxygen deprivation.” The two MRIs performed in June and July confirmed “the extent and permanence of the damage.”
Today, the five-year-old boy can breathe and move his eyelids. His Glasgow Recovery Score ranges from 0 to 2, the lowest score, and reflects his vegetative state," the document said.
The hospital will not remove the breathing tube until the parents have had an opportunity to appeal the decision.
A lawyer for the parents said they are reviewing the decision and have not yet decided whether to appeal.
The parents or guardian of a child can consent or refuse care, and must “act solely in the best interests of the child, respecting as far as possible any wishes the child may have expressed.” Unlike a person 18 years of age or older, "the parent cannot express a refusal that would be unjustified, given the child's state of health.”
-- This report was first published by The Canadian Press in French on Nov. 4, 2022
