Quebec court allows breathing tube to be removed from comatose child

A judge from the Superior Court of Quebec has ruled that a children’s hospital in Montreal can permanently remove a breathing tube from a 5-year-old child who has been in a coma since June.

Sainte-Justine Hospital went to court because the child’s parents refused to agree to the procedure unless doctors considered re-intubating the child if things didn’t go as planned.

The hospital said doctors believed the child was able to breathe on his own and that the risks associated with intubation outweighed the expected benefits.

The boy has been in a coma since June 12 after being found at the bottom of the family’s swimming pool – authorities said he had suffered prolonged cardiac arrest.

Days after he was admitted to Sainte-Justine hospital, the boy faced a myriad of problems, including acute respiratory distress syndrome, cardiac dysfunction and seizures.

The decision of the Superior Court of Quebec indicated that on June 16, the medical team discussed for the first time with the parents the possibility of removing the breathing tube. Medical experts have repeatedly argued that “this method of mechanical ventilation is contraindicated for his condition.” It can cause serious damage or even death to the child.

However, doctors say the child should be in hospice care in case he stops breathing without assistance, the hospital maintained.

“The maneuver was risky as it could result in his death,” the Quebec Superior Court ruling said. The parents objected.

Wheelchairs are lined up at Sainte-Justine Hospital Thursday, January 16, 2020 in Montreal.

Court documents say the mother’s reaction was particularly strong. “Her faith in God makes her hope that her baby will come out of the trance he is in,” he said. Parents, on the other hand, were skeptical of the hospital’s motives and believed that the treatment was from a “cost-saving” point of view.

A 20-minute dip in the child’s pool caused “hypoxic ischemic encephalopathy, leaving him in a deep coma and causing massive and permanent brain damage from prolonged hypoxia.” Two MRI scans performed in June and July confirmed “the extent and permanence of the damage”.

Today, the five-year-old can breathe and move his eyelids. The document says his Glasgow Recovery Score is between 0 and 2, the lowest score, and reflects his vegetative state.

The hospital will not remove the breathing tube until the parent has had an opportunity to appeal the decision.

An attorney for the parents said they are reviewing the decision and have yet to decide whether to appeal.

A parent or guardian of a child may agree or deny care, and must “act only in the best interest of the child, respecting as much as possible any wishes the child may have. may have expressed.” Unlike a person 18 years of age or older, “a parent cannot unreasonably refuse, based on the child’s medical condition.”

– This report was first published by the Canadian Press in French on November 4, 2022

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