Baby Receives Tracheotomy After End-of-Life Dispute

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It looks like Baby Joseph's parents may have finally won the battle to extend their baby's life enough that can die at home.

In February, Canadian doctors told Moe and Nader Maraachli that their baby's degenerative disease was so bad that no treatment would bring him out of a persistent vegetative state. Health care professionals presented Baby Joseph's parents with a consent form that would allow doctors to take him off life support.

But the Maraachlis refused to sign the waiver, and they fought for their son to receive a tracheotomy, which would allow for the Maraachlis to care for their baby in his final days at home.

According to The Associated Press, doctors at Cardinal Glennon Children's Medical Center in St. Louis, Mo. performed the tracheotomy on Monday. He will remain in the pediatric intensive care unit for a week to 10 days.

For months, Baby Joseph's life was literally in negotiations, underscoring the sensitive balance many parents may face between keeping their babies alive as long as possible and pouring money and medical resources into a losing battle for their child's life.

The case was brought to the Consent and Capacity Board, an independent body created by the government of Ontario, and then a supreme court judge. Both entities ruled that Baby Joseph's breathing tube should be removed.

Joseph's parents appealed both decisions, and the debate brought strong emotions on both sides of the issue.

A Heated Debate is Sparked

"From the beginning, the point of view of the family has been, 'If my child is dying, at least let us bring our child home,'" said Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, who has acted as a spokesman for the Maraachli family.

"They weren't asking for extraordinary medical treatment or for the government to pay for a ventilator with an in-home nurse."

The Maraachlis requested that doctors perform a tracheotomy, so that Baby Joseph's family could take him home and take care of him in his final days. While other babies in similar situations have been sent home with a breathing tube and ventilator through the Canadian health care system, Schadenberg said the family was not offered this option, and Joseph's parents did not know to ask.

But a statement given Monday from London Health Sciences Centre where Baby Joseph has been treated since October, 2010, said the contrary: "The LHSC position is consistent with the treatment plan approved by Ontario's Consent and Capacity Board as being in the best interest of Baby Joseph. It involves transferring home, on a breathing machine, and then placing him the arms of his family before withdrawing the machine."

The statement goes on to say: "The transfer would not involve performing a tracheotomy, which is not a palliative procedure. It is an invasive procedure in which a device is installed in a hole cut in the throat. It is frequently indicated for patients who require a long-term breathing machine. This is not, unfortunately, the case with Baby Joseph, because he has a progressive neurodegenerative disease that is fatal."

The controversy has sparked heated debate throughout North America, and the hospital has even reportedly received several threats from people in the United States and Canada. Support for the Maraachlis has swelled in recent days, and people have come together in at least two different Facebook groups to stand behind the family.

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