Doctors Made the Right Call in Performing Tracheotomy on Baby Joseph

Dr. Manny
I’d like to commend the doctors at Cardinal Glennon Children’s Medical Center in St. Louis, who recently performed a tracheotomy on little Joseph Maraachli.Joseph, a 13-month-old boy, was born with a progressive neurological disease called Leigh Syndrome and has sparked intense debate worldwide on the ‘right-to-life’ issue.

When doctors at the Canadian hospital where Joseph was being treated determined that he was in a permanent vegetative state, they began preparing to remove his breathing tube against his parents’ wishes.  After a Canadian court upheld the doctors’ orders, Rev. Frank Palone and the Priests for Life organization stepped in to help the Maraachli family by placing Joseph in the care of the doctors at Cardinal Glennon Children’s Medical Center.

There, the St. Louis doctors performed a tracheotomy that will allow Joseph to return to his family home in Windsor, Ontario, after some time spent recovering in intensive care.

I’ve heard many comments on this story, and I’d like to clear up some misconceptions. I know that some people are upset – they believe that by performing a tracheotomy, Joseph’s parents and doctors are prolonging his suffering.

First off, let’s get something straight: A tracheotomy does not necessarily prolong the life of terminally ill patients. The main purpose of the surgery is to provide comfort to the patient.

This falls in line with the standards that many institutions have regarding palliative care for children with terminal diseases.

Palliative care, as defined by the American Academy of Pediatrics, is meant to promote the welfare of infants and children living with life-threatening or terminal conditions and their families.  Some of the principal guidelines of palliative care include respecting the child’s and family’s wishes, alleviating the child’s pain and providing access to therapies that will improve the child’s quality of life.

As far as I’m concerned, that’s exactly what Joseph’s new doctors did in this case.

Before the tracheotomy was performed, Joseph had a breathing tube running through his nose and down his throat, which can cause painful sores to develop along the inside of the mouth and throat.  But a tracheotomy inserts a tube directly into the throat through an incision in the neck, and therefore eliminates some of the pain and discomfort associated with intubation.

In this case, it will also allow Joseph to live out his remaining days with his family in his home instead of a hospital.

So, looking back over the guidelines of palliative care – it appears to me that the St. Louis doctors acted exactly as they should have acted. They respected the wishes of Joseph’s parents, who wanted their son to come home, and they alleviated some of his suffering.

I applaud them for both their efforts and their compassion.