Hey @jimmykimmel, please explain to us again in your beta male tears why socialized medicine is so great?— Tyler Zed (@TyEducatingLibs) April 28, 2018
Sorry #AlfieEvans. You deserved much better than big brother deciding your fate. #RIPAlfieEvans
The tweeter is referring to Alfie Evans, the 23-month-old British child at the center of a legal battle over withdrawing life support. On one side, Alfie's parents Kate and James, now ages 21 and 20, fought a series of legal battles to keep their son on life support. On the other side, doctors who decided it was past time to remove life support. Ultimately, the doctors prevailed, life support was withdrawn, and Alfie passed.
As the legal battles unfolded, there was no shortage of social media opinion on what should be done for Alfie. Most recently, a Rome hospital offered to take Alfie, but courts in Britain and Europe would not allow Alfie's parents to take him out of the country.
Medically, his doctors considered Alfie beyond all hope. In his first seven months of life, Alfie repeatedly missed developmental milestones. He was hospitalized for seizures at age 7 months. Alfie suffered from a neurodegenerative condition that eventually reduced white brain matter to 30% and the rest of his cranial space filled with cerebrospinal fluid. Sixteen months ago Alfie was put on a ventilator.
The claim that socialized medicine killed Alfie isn't intellectually honest. First, the doctors believed it was long past time to remove Alfie's life support. Whether he was in a public hospital or a private hospital, the legal battle could have occurred. The courts decide based on evidence presented and their first consideration is the interests of the child. The courts decided that the medical evidence warranted removing life support. Children are not property of their parents. Parents have a great deal of latitude in decision-making for their children, but there are limits, and this is a case that ran up against those limits.
The same thing could have happened in the US. Prior to the lifting of lifetime caps under Obamacare, Alfie would have lost insurance coverage. At that point, Medicaid might have paid for his life support if ongoing support was recommended by doctors. At any point in time, private insurance or Medicaid could have ruled that continued support was futile and medical care would no longer be paid. If the doctors decided that it was time to remove life support and the parents resisted, the matter could have landed in the courts. It would be decided through a process similar to the process that led to the removal of Alfie's life support. It isn't about private or publicly paid medical care. There are limits to both. There are also limits to parental rights and there are limits to entitlement to care. Doctors are not required to provide futile treatments even if a patient wants those treatments.
I don't know for sure if the courts made the best decision in Alfie's case, but I trust the doctors and the courts examining the medical evidence more than I trust tweeters.
It's an incredibly sad story, but there are many Alfies out there right now. Their tragic stories don't make headlines because doctors and parents usually come to an agreement in these matters without going to court.
Finally, while I can't speak for Jimmy Kimmel, I think it's reasonable to guarantee care for children who have a chance of benefiting from treatment. At the same time, I don't believe in a blank check to cover care or force care deemed medically useless. Again, in the case of doctors and parents at odds about the course of treatment, it may come down to a court weighing evidence and expert testimony on what is in the best interests of the child and what is or is not medically futile.