Life support

MANDEL: SickKids doc says baby on life support won’t recover

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With the help of a ventilator in the pediatric intensive care unit, doctors at SickKids could likely keep Kaiomi Hall-Kemp alive for years to come.


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But should they?

It’s hard to imagine a more difficult or heartbreaking decision: Kaiomi is only one year old, a beautiful baby girl beloved by her parents, Brittany Hall and Daniel Kemp.

But the 11 attending physicians in pediatric intensive care believe the drowning victim will never come out of his “deeply unresponsive coma” and told the Consent and Capacity Board (CCB) that after nearly two months, he was in her best interest to withdraw the life support and let her die in peace.

Her parents are fighting to prevent this from happening. Represented by four lawyers, the family argued that the SickKids team had given up too soon.

The three-person panel learned that Kaiomi was not clinically brain dead, but after she was found drowned in the family tub and suffered cardiac arrest on July 8, her brain was deprived of oxygen for so long that she suffered irreversible damage.


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His pupils are fixed and dilated; his electroencephalogram – EEG – shows that brain activity is “almost flat”, the board heard. She has taken a few shallow breaths on her own but remains fully dependent on mechanical ventilation, shows no signs of consciousness or responsiveness, cannot regulate her core temperature, and is destined to have repeated episodes of ventilation associated pneumonia. (VAP).

But her parents pray for a miracle.

Even before the medical team recommended removing life support, Dr Elaine Gilfoyle described her relationship with Kaiomi’s parents as “very, very unusual.” She told the board that Kaiomi’s mother accused SickKids of racism, said doctors were trying to “kill” her child and refused to speak with doctors about anything “negative” about her condition. her daughter.


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It got so bad that the mother was taken out of the hospital with a police escort on August 2 after a “disrespectful and hostile” exchange with a staff nurse, we learned at the CCB.

Gilfoyle, the division chief of the pediatric intensive care unit, said the team had done “their best” to support Kaiomi’s family, “including setting up a meeting with the director of equity, the diversity and inclusion of SickKids who did not fear “our behavior shows no racism.”

The team also attempted to accommodate the parents’ wishes to transfer Kaiomi to McMaster, but Gilfoyle said Hamilton Hospital refused, saying they would recommend the removal of resuscitation as well.

She doesn’t believe there is a doctor in Canada who would disagree with their standard of care, she said.


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The audience heard that the mother, who is deeply religious, thinks Kaiomi might wake up. While the father also has faith, he told one of the doctors that “his rational side tells him it’s not a life if she stays like this”.

On August 9, an assessment by SickKids bioethicist James Anderson concluded that the family’s mistrust of the medical team appeared to compromise the mother’s ability to “meaningfully participate in Kaiomi’s care” and it remains “uncertain whether they will. are able to make decisions in Kaiomi’s best interest.

For the first time since 2015, the SickKids team decided to approach the CCB, arguing that Kaiomi “suffers only damage, and no benefit, from continuous mechanical ventilation.”


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When asked by CCB president Mark Handelman if the coma baby was in pain, Gifloyle replied that she didn’t believe him.

“Is she in pain? Handelman continued.

“It depends on your definition of suffering,” replied the doctor. Kaiomi’s body suffers from complications but she is not in pain.

“Well, doctor, why not just give his parents what they want?” ” He asked. “This child is not in pain. What is wrong with keeping her alive as long as she is able to stay alive and satisfy her parents? “

With the capabilities of medical technology, Gilfoyle explained, there would be “no end date” in sight.

“We believe that she will not benefit from it and that she will not recover with more time. We believe it is in his best interest to discontinue these therapies.

The hearing is expected to end on Monday with a ruling issued shortly thereafter.

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