Tuesday, June 24, 2014

Tried and True Tuesday: "Slow Code"

I have to admit, when it comes to all things hydranencephaly I always focus on the rainbows and butter... Eh, bumblebees. 

Although I've faced the dark, scary horrors that this condition can bring to life; I have chosen to keep things realistic with a heavily positive edge. 

The true stuff is rarely great, in a "woohoo" fashion; but more like in a "cover my eyes, I don't want to see" while peeking through my fingers kind of style. Some of the true stuff is pretty incredible, on both ends of the spectrum, and you can come be witness... But I've now made a commitment to bring it all to our audience in an effort to better portray all things hydranencephaly.

Starting with my most recent appalling discovery.... 

Perhaps this article from Life News features a different diagnosis, Trisomy 18, but the prognosis and the story are entirely the same. You can read the whole story HERE, but I've quoted some important points:

"...2 ½ years old and began to have some serious illnesses that almost took her life several times. The hospital did some basic things to help her get over the illness and we thought that they were giving her the necessary care any other child would receive."

A piece of the Hippocratic Oath, the oath historically taken by physicians who swear to practice medicine honestly and comes to mind so often when reading cases such as this: "I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone." "In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing..." and most importantly when I cannot see how else to view these cases other than as a violation of this oath, "If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all humanity and in all times; but if I swerve from it or violate it, may the reverse be my life."

And back to the gory topic of this particular article:

"...Slow Code is when the medical providers offer the appearance of treatment, but knowingly administer the treatment so slowly that it is useless to the patient. This may sound crazy and like something we might make up. We not only learned the term from their industry journals, but we experienced it.

There are times in a hospital where you might hear CODE BLUE for an emergency, but why is it you never hear CODE SLOW? Hospitals hide this practice in a deceitful way so they can inflict their decision on the patient. This is not care, but lethal neglect or intentional death which I have always termed murder.

In one article of the Journal of Perinatology, a pediatric ethics committee discussed an option of Slow Code as a possible solution in the case of an infant with poor prognosis. CPR had been offered to the parents and was later withheld by way of a DNR placed on the patient by doctors. The committee debated this decision, but only from the perspective that CPR should probably have never been offered in the first place.

So here we have a committee of medical “caregivers” suggesting that forms of care should not even be offered to patients based upon their value(less) judgment. Withholding medical care and suggestions for treatment is now the medically ethical way to handle a patient? In the end, this particular committee decided that it is deceitful to use Slow Code. Ya think? The fact that this suggestion was even considered legitimate enough to be discussed is troubling."

I first read this article the day it was posted, just over a week ago on June 16, 2014. It's not an outdated medical practice, one that died with institutionalizing children with special needs (a practice that has, unfortunately NOT died entirely!), this is true-life and considered common practice today...

Unfortunately, aside from a blip in an online dictionary and a brief mention of the discussion on NPR back in 1998, I have been unable to sit and dig through further research sources to find out how well-practiced this is in care facilities (but sadly, I do not doubt for one second that this is some disgusting underground secret that families are totally unaware of). The NPR topic description includes the following, "..."Show Code," "Hollywood Code" and "Light Blue," a Slow Code happens when a terminally-ill patient goes into cardiopulmonary failure. The medical staff goes through the motions of attempting resuscitation but do not make a sincere attempt to revive the patient. Dr. Gazelle maintains this occurs because the attending physicians has not written a DNR order or the patient's family has requested that "everything be done" to save the patient, but the doctor decides that the patient can not expect a quality of life that warrants sincere efforts at resuscitation." Read the full transcript of the interview HERE

Unsure whether it is a memory that grew from reading this article, but I faintly recall a mention of this code during failed resuscitation efforts in my own home in November 2012. There will be more on this topic, but in the meantime... please be aware and prepared to advocate for your child or anyone else in your life that falls under circumstances which may prompt this code.

1 comment:

  1. This is so disturbing on so many levels. Thank you for posting this, I have never heard of it and now has me thinking back to hospital stays and ER visits and how they were handled. Wow.


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