Doctor charged over baby's death

Doctor charged over baby's death

Published: 1 Feb 10 14:15 CET
Online: http://www.thelocal.se/24724/20100201/

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The paediatrician suspected of the alleged mercy killing of a baby at Astrid Lindgren's Children's Hospital in Stockholm in September 2008 has been charged with manslaughter.

The doctor is suspected of having deliberately administered a high dose of the anaesthetic Pentothal in combination with morphine in order to speed up the baby's death.

The prosecutor, Peter Claeson, explained in a press release on Monday that he expects to secure a conviction in court and that the prosecution's case is based on forensic reports and witness testimony from those present at the time of the baby's death on September 20th 2008.

"The evidence is strong," Claeson said to news agency TT, arguing that the doctor and no one else is responsible for the baby's death.

The three-month-old baby was terminally ill with serious brain damage after having been born 15 weeks premature. The birth was complicated and the baby was born unconscious due to a lack of oxygen.

The baby girl's condition worsened when a nurse administered an overdose of saline solution at birth.

A subsequent ultrasound revealed that the newborn had suffered from cerebral haemorrhaging on both sides of her brain.

The case has generated a heated debate in Sweden.

Medical colleagues and the unions have roundly criticized the police and prosecutors for their handling of the case following the public arrest of the doctor at her place of work in March 2009.

The doctor was subsequently released from custody after a successful appeal from her lawyer, Björn Hurtig, and denies any wrongdoing. She has been suspended from her position at the hospital throughout the course of the investigation.

A report from Sweden’s National Board of Health and Welfare (Socialstyrelsen) published in October 2009 cleared the doctor of any wrongdoing in connection with the baby's death.

"We've reviewed all available documentation and spoken with healthcare workers and the information we’ve collected is in order. We can’t see that there were any shortcomings in the care and handling of the little girl," Staffan Blom, head regional supervisor at the board, said at the time.

The board did however confirm the findings from an autopsy conducted on the baby which found abnormally high levels of both Pentothal and morphine in the child's blood.

Staffan Blom confirmed that the board could not explain the existence of the anaesthetic as its use was not mentioned anywhere in the medical records.

Manslaughter carries a penalty of between six and ten years in prison in Sweden.

TT/The Local (news@thelocal.se/08 656 6518)

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#1
15:41 February 1, 2010 by livinginsweden
Thanks to doctors who dare do the right thing ....... that is if the pediatrician had done what is alleged ....

our society kill thousands of fetuses every year ... healthy fetuses ... why? becos the girl or women decided that the fetuses will be messing up their life plan ....

Then another group of parents go to other countries to adopt babies becos their economic situation if bad.

Here is a 'damaged' baby whose future life quality is one of long suffering and pain,, a quality of life that is worse than the thousands of fetuses who were killed... a quality of life we wouldn't wish upon our worse enemy.

A doctor show real courage and empathy and do what is right for the poor baby ..... something more courage and morally right than those doctors who conducted abortions .. and this pediatrician should be admired for her or his courage...

instead we are charging him or her for man slaughter?

Look around us and you can see the real manslaughter and murders in war zones around the world .. and we helped by exporting weapons, etc.

Our sense of the value of life is .... politically correct but morally bankrupt.

ha ha ... human beings ....
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#2
15:57 February 1, 2010 by here for the summer
@living in Sweden .. you have hit many good points ..
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#3
16:37 February 1, 2010 by calebian22
You are correct livinginSweden.

Moreover, 6 to 10 years in Sweden for a mercy killing but 3 years in a psychiatric hospital for premeditated murder by 16 year olds in a love triangle. Talk about arse backwards.
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#4
16:57 February 1, 2010 by Octover
From what I've heard it wasn't a mercy killing, she was just administering pain killers enough to ease the suffering. After some time the body develops resistance to pain killers and in order to alleviate the pain it takes more and more. This decision is having harrowing effects among doctors from what I have heard. I know a pediatrician who can think of many times he has administered more pain killer than is regulated, but how much it takes to actually ease the suffering of a child (none of his patients have died from the pain killers, but there have been terminally ill patients that were at least comfortable when they died)

Also the arrest was poorly handled by a politician trying to further their career. Probably the only reason the case is continuing is that the prosecutor thinks they can't back down now. The police interrupted and delayed treatment in the hospital for current patients. There was no reason to do it in her workplace during her shift, they could've arrested her at any time since no one was in immediate danger.
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#5
18:07 February 1, 2010 by Puffin
I wonder how you establish manslaughter with a dying patient?

The painkillers were given in conjuction with the baby being removed from life support to die.

What I also find interesting is that the prosecutor's falir for the dramatic has actually obscurred the REAL crime in this case by focussing the attention on the last hours before death thus obscuring what CAUSED the death! The baby was very premature and born 4 months early and irreversably brain damaged as the result of a drug overdose administered at another hospital (Karolinska) - by the time the baby arrived at Astrid Lindgrens the chances of survival were zero:

- the overdose that caused the brain damage in the first place - resulted in a 'warning' for the nurse

- the doctor who possibly eased the pain of the dying baby gets charged with manslaughter

Is this logical?
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#6
19:31 February 1, 2010 by krrodman
@livinginsweden.

Hmmmm.........You bring up some interesting points, but there is a huge ethical and legal dilemma here.

The parents are the legal guardians of the baby. Did they consent to the euthanasia? Or, did the doctor take it upon himself to terminate the life of the child?

Is there anyone on this blog that believes that a doctor should be able to perform a procedure on a patient - any kind of procedure - without proper informed consent??? No less euthanasia???

There are standards to determine when a patient is brain dead, or in a persistent vegetative state. The determination must then be confirmed by a second doctor. Only then can a doctor and responsible guardian(parent/husband/wife) make a proper decision about end of life.

I have no doubt that this doctor(assuming guilt) acted altruistically. Nonetheless, if this baby was euthanized without following proper procedures, it meets the legal standard for manslaughter.
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#7
20:25 February 1, 2010 by here for the summer
@krrodman

I agree that the doctors should be trusted to make judgements and to prosecute them for their decisions is wrong. Especially here where the outcome was the same. Is this a ploy for money on the part of the parents or just a government official out for glory?
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#8
20:28 February 1, 2010 by G Kin
krrodman, you are right.

Irrespective of how bad the child's situation was, the doctor is required to follow proper precidure and HAS TO BE CLEAR about what she is doing- You just can't take things into your hands no matter how right you believe you are. She crossed the line. She probably presumed too many powers in her hands than she really has.

The child may have been bound/destined to die. Yes, but let her die the right way and with dignity. Do not hasten her death. DO NOT PUSH HER OFF THE CLIFF.

For some people like myself, euthanasia dehumanizes the human person. For example, I just can't think of memorial ceremonies for a euthanised person.
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#9
20:57 February 1, 2010 by krrodman
Just to be clear, I am not passing judgment on the subject of euthanasia. I will leave that for the philosophers and moralists. Rather, I do not believe there is any moral justification for a doctor to make this sort of decision on his/her own, no matter how desperate the situation. And, of course, the question must be asked, has she done this before?
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#10
21:27 February 1, 2010 by livinginsweden
@ krrodman...

Doctors always prescribe stronger medicine to provide patients with terminal problems and severe chronic pain to ease the agony and comfort them ...... and give patients peace and relief from pain .... dignity for their last days ... often without need to seek consent from anyone...... often the best medical judgement of the doctor.... which included a painless last few days or weeks of life...........

Personally if i am in severe pain in my last days i wish a doctor will pump me with barbiturates and opiates and make my last days a pain free euphoric state....

If i am the parent , i would be thanking the doctor for going out on a limb to end the suffering of the baby I love..... love is dignity, a life that is productive and happy, a life without pain and sadness..... a life full of potential..... not a life bedridden with a severely damaged brain, tubes, nappies, bed sores, smell, etc............

@ G kin ...... if euthanasia dehumanize the human person ..... would a life totally spend in bed, unaware of everything around you, fed through tubes, body that is bones and skin and little or no muscles, without any communication skills (this is a baby) with all bodily functions aided by a group of nurses and personal aids, etc.... where everyone have feelings of sadness and pity only, ....... will the memorial service or burial at the end of a sad and miserable life be a real memorial ceremony or a real relief for those who are living and left behind ? ... and what would the memory of the baby be?

So you do not want to hasten her death ... and let her suffer a long and lingering definite death ...... I would rather be pushed off my suffering and pain and be in a less painful state.....

It would have been easier for all doctors to do nothing ... to do nothing to relieve the pain and suffering ...... but it is a doctor's obligation to relieve pain and suffering..... especially knowing that the baby will suffer severe pain and suffer ....

It is not just the qualify of life for the victim (baby) but also for all the living persons whose lives will also be affected.

Maybe those who felt guilty for the state of the baby needed to shift the blame to the doctor.... in order to relieve guilty off their own minds....
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#11
21:29 February 1, 2010 by MorbidMiss
There is no such thing as dieing with dignity. We come into this world covered in blood, afterbirth and sometimes fecal matter, and we leave much the same way.
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#12
21:34 February 1, 2010 by livinginsweden
To the doctor:

You probably did what you think was the right thing to do as a doctor for the baby who was suffering ... I salute your compassion because there is nothing personal to be gained for yourself ...by your action.

As a doctor, you can sleep at night knowing that you did the right thing for the baby ... but you might not be able to sleep much now, because of the actions brought on by those who wish to see the baby suffer in pain for whatever short life she might have.

Good Luck and hope that the judges see the selfless act you did.....

Maybe the doctor should have gone to court and seek the judges' direction as to whether society would like to see the baby suffer in pain or whether the doctor or hospital should prescribe a dose of pain killer ... a dose which could both relieve the pain or possibly result in a painless death at the same time.

We must ask ourselves a question:

What is to be gained by the doctor personally for prescribing that dose of pain killer?

If the answer is NOTHING..... then the doctor is not guilty.
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#13
21:48 February 1, 2010 by krrodman
@livinginsweden

You are missing the critical point here. A doctor does not have the right to make this decision, even if his/her motives are pure. In this particular case, the baby had parents who are responsible to direct the medical care of their child.

For the sake of argument, let us assume that the doctor is guilty as charged. To make the argument more interesting, let's assume that the parents would never have given permission for the baby to be euthanized, but wished for everything to be done for the baby. Do you still think the doctor had the right to take this baby's life?

And, let's make it more interesting still. Let's say this doctor feels very strongly about preventing suffering, and a review of the medical records show that 50 other baby's have died suddenly while under the care of this doctor - all 50 deaths without proper consent and without following guidelines. Do you still think this doctor is an angel of mercy?
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#14
22:30 February 1, 2010 by livinginsweden
@Krrodman

I never said that the doctor intentionally ended the baby's life........ admittedly what i wrote may lead you and others to think so.

When the baby is at that precarious stage between life and death, and becos of the baby's fragile physiological state, and this apply to people with serious illnesses as well, it is very difficult to determine the highest dosage that is optimal to relieving pain and the dosage that could be fatal.

The doctor could continue administering a low dosage and let the baby suffer pain and let sleeping dogs lie ....... or make an effort to provide the patient maximum comfort .... which means administering the highest dose possible.... and that does could be fatal.

The doctor never take a decision to give a fatal dose..... but to provide the highest dose possible......

If the doctor ask the parents which is the maximum dose they will allow to give to babies ... then we dont need the doctor ... who is supposed to use his judgement.

The bodily functions are near a stand still and any dosage could be fatal.

Again I emphasize, the doctor did not intentionally give a fatal dose to commit euthanasia .... but the high dose to relieve pain ... may or may not have caused the death. That is just a fact.

A doctor stationed at a terminal ward where most of the patients are near death are likely to have a lot of deaths occurring under his watch... that doesnt mean he killed them all. He is neither an angel or mercy nor an angel of death.

If more people who commented here have spend time with people like that baby .... and with the dilemma facing the medical team caring for such patients ... maybe more will accept the fact taht medical care at end stage of life is ... like walking a thin line...

maybe care should be by committee at this stage.......to protect doctors from such charges.....
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#15
22:43 February 1, 2010 by Octover
Let's talk about the facts of this case though. The doctor to my knowledge was acting according to the wishes of the parents. Not to euthanize the baby, but to provide it with the necessary amount pain killer to ease the child's suffering. Due to the long exposure to pain killers the baby had built up a tolerance. Thus in order to provide any relief required to go outside of regulated dosing. This is common and just about any doctor who deals in pain killers does it, if their patient is obviously still in pain in suffering due to a tolerance then they prescribe more. Usually children in these cases die of what they were terminally ill with, and it could have been the case this time, but the autopsy did show the higher than regulated dosage of pain killer still in the blood.

The prosecutor in the case somehow got wind of this and wanted to come in with the press as the savior of the babies from the doctor of death. Rather than serve the arrest warrant at the doctor's home, or do anything to make it non-disruptive, the prosecutor led a team of police into the middle of the hospital ward, while the doctor was on shift, ironically potentially putting other patients lives in danger. I know a pediatrician who feels quite threatened by this case that he has to choose between jeopardizing his freedom and career in order to actually treat his patients.

The prosecutor still believes this to be a career making case into politics and the public eye. They won't or can't back down now, especially since they originally got the media focused on them about how wonderful they were to catch this case.

The doctor was not trying to euthanize the child, she was just trying to provide it the necessary amount of drugs to actually make it comfortable despite the tolerance it had developed to pain killers.
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#16
22:57 February 1, 2010 by krrodman
@livinginsweden

I certainly agree with you that the intention of the doctor is critical. If the dose of pentothal and morphine were reasonable, then the doctor should be given the benefit of the doubt. However, if the dose indicates that the doctor intended to end the life of this child, his/her actions are indefensible.

I would like to point out two things:

First, many of the elderly with terminal conditions such as cancer have severe pain that requires aggressive therapy, I do not believe that neonates with severe brain damage have a similar source of pain. So, I am not sure of the role of morphine here except perhaps to help with sedation.

Second, I am not at all clear as to why pentothal was used here. Pentothal would not be used for routine sedation. Perhaps the child was placed in an induced coma with pentothal to reduce brain swelling. If that were the case, then there would be no need for the morphine because the child would already be comatose from the pentothal.

The facts of the case will speak to the intentions of the doctor.
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#17
23:44 February 1, 2010 by livinginsweden
Let us consider it from another perspective:

A normal pregnancy is about 38 weeks.

This baby is 15 weeks premature, i.e. she was 23 weeks old when she was born.

... and she had severe brain damage and so on on top

The upper limit of legal abortion is 24 weeks.

That means that abortion doctors kill babies older than this girl... so legally this doctor is not killing 'anything' ... if the doctor is found guilty of killing this baby of 23 weeks, then all abortions of 24 weeks is murder or man slaughter. Interesting thought.

Interesting thought isnt it?

Lets consider another issue: brain damage.

I think more than half of us taking part in this discussion suffer from some form of brain damage due to alcohol or were born half witted.

Now this baby suffered from hemmorrages to both sides of the brain .... meaning that she will be a few times more stupid than most of us here. If we think that half of us here should be euthanized, ....... what hope is there for this poor girl?

THINK!
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#18
00:11 February 2, 2010 by dizzymoe33
If a animal breaks it leg especially a horse don't you usually shot it to put it out of its misery so it won't suffer a long agonizing death? Granted the doctor should have had permission from the family before acting. She should not have taken it upon herself to end the suffering without consent.
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#19
01:19 February 2, 2010 by DAVID T
a lot of the comments posted here are presuming the dr killed the baby - whatever happened to innocent until proved guilty?
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#20
06:48 February 2, 2010 by Gary O'Mara
It is logical and correct that the doctor be charged with manslaughter. Doctors must uphold their oath: Do no harm. What is more alarming can be seen from the utterances of the health regulator in Sweden. Are they hiding something such as a more widespread pediatric euthanasia? Having had such experiences of craven medico-legal types, for example, the infamous TEO in Finland, I see yet again the silky spin of the bureaucracy at hand. The usual bile is handed out to a credulous Swedish public and the bien pensant, to wit, a putative investigation is made, hand-picked 'experts' used; and while the evidence of serious overdoses of highly toxic drugs are actually admitted: no conclusions as to the likely effect, apropos forensic toxicology ,are made. In other words, to use racing jargon, the authorities back each-way at the tote but get winners odds. The system always prevails and cover-up the order of the day.
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#21
09:56 February 2, 2010 by wifey
We don't know the FULL story, only what the media has chosen to tell us. We were not there. Lets not be too quick to pass judgement.
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#22
13:02 February 2, 2010 by Audrian
One of the most important contributions of modern medicine is in the area of pain supression. In the middle of 20th centuries and before people suffered from all sorts of pain, which today are unthinkable. Royalties and commnen people alike died groaning.

The outcome of the above trial is to spread fear in doctors about the use of pain killers. To be in the safe side doctors would give patients the minimum amount of pain killer, which might not be adequate enough to supress the pain!

There are many major malpractices in the hopital that are often ignored, e.g., not listening to patients' compalaints, careless diagnosis of diseases. This is where the authorities should focus, rather than on a none existing crime.
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#23
14:54 February 2, 2010 by krrodman
@audrian

No doubt that patients in pain require aggressive therapy. But, we are not talking about an adult patient with cancer pain.

Tell me, what is the source of pain in a brain damaged neonate? Why large doses of morphine? Why Pentothal?

Makes me wonder.
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#24
17:55 February 2, 2010 by sissygirl
The family had to deal with watching their baby suffer after being born way too early. Now she is gone and they must deal with that grief. Put on top of everything, their doctor is charged with killing their baby and the media is having a field day with their loss.
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