Refusal to operate

Press, Volume CXIII, Issue 33254, 18 June 1973, Page 2

Refusal to operate

rx.Z. Press Association) - ' J *3 ROTORUA, June 17.

A Melbourne pediatrician. Dr E. D. Smith, said in Rotorua he reTused to operate on children with severe defects at birth because the quality of life they faced was so poor.

Dr Smith told doctors attending the biennial conference of the Medical Association of New Zealand that surgeons in Britain and elsewhere were increasingly of the belief that it was best to take this course.

Until recently, surgeons held it their duty to make the njaximum effort to save the lives of badly malformed babies. Now they were asking themselves if it was not better to select those patients they could repair, rather than concentrate on survival. SPINA BIFIDA Dr Smith said surgeons might question this, but such, decisions faced all doctors

whose work involved congenital disorders. Citing the defect of spina bifida, he said that in the past surgeons had been browbeaten into accepting the view that they must operate immediately in all cases. However the quality of life which faced the children was so poor that it now seemed morally indefensible to offer maximum effort for their survival. HOSPITALS URGED Dr Smith said he believed New Zealand should establish two self-contained pediatric hospitals, one in Auckland and the other in the South Island. Such units were necessary a experience had shown that no significant advances in pediatrics had ever come from units attached to a general hospital, he said. Several New Zealand doctors have said that there is: no ethical obligation for a surgeon to undertake extraordinary measures in an effort to save a badly malformed baby. Dr G. Fox, a pediatrician

[attached to the Princess Mary I Hospital, Auckland, said ft i was difficult to generalise but it was widely recognised among doctors that some people, including babies, had “a right to die in peace.” “Every case must be looked at in its own light, and the decision on whether to operate can be very difficult for a surgeon,” he said. "None of them make such a decision individually—it is done in consultation.” Dr H. P. Dunn, a visiting specialist in obstetrics and gynaecology at the National Women’s Hospital, said parents invariably were consulted when a decision was being made. “Often their attitude is that the life of a badly malformed baby should not be prolonged unnecessarily by radical measures.” “DANGEROUS”

Dr Dunn said it would be dangerous for the belief to grow that doctors did not try to save malformed babies. “This would be utterly wrong and against everything we stand for,” he said.