IMA furious over Litzman's personal intervention in brain-dead baby case

IMA furious over Litzman

By JUDY SIEGEL-ITZKOVICH
The Israel Medical Association has denounced Deputy Health Minister Ya'acov Litzman for ordering doctors at Schneider Children's Medical Center to treat a lower-brain-dead baby girl like an ordinary living patient and give her antibiotics and other treatment, rather than only keeping her connected to a respirator. Litzman visited the Petah Tikva hospital three days in a row to make sure that his orders, issued at the request of the baby's haredi parents late last week - were being followed. A few weeks ago, Litzman said he "does not recognize lower-brain death" as death, but "observes the law." Under the law, the immediate family of a lower-brain-dead patient can insist that he or she not be disconnected from a respirator or have nourishment withheld, but the patient is not treated like a living person who needs treatment. Otherwise, the default procedure is to turn off the respirator after a two-doctor team decides the patient is brain dead. IMA chairman Dr. Leonid Eidelman said in a letter to Litzman on Sunday that his personal views as a Gerrer hassid should not determine medical policy. The team of doctors who did not disconnect the baby from the respirator at the parents' request, but yet objected to treating her as a live patient, said Eidelman, "were acting in an ethical and professional manner, and there was no room for your intervention. In a democratic country, a deputy minister is not above the law. "If he wants to change the law, he can try through accepted procedures. Your demand that the doctors act according to your opinions is very serious," the IMA chairman wrote. "You had no right to intervene in professional medical considerations, whether it emanates from your world view, political considerations or others." The IMA will not agree to a situation in which "foreign considerations influence professional medical procedure. When doctors go to treat patients, they must view the patient alone, his problem and the ways to treat him without any fear of threats. "Your brutal intervention in medical processes constitutes an existential danger to public health and has destructive implications on the health system. We will do all we can to prevent this," Eidelman wrote. A response to Eidelman - who assumed his post only a few months ago - was sent by the Health Ministry spokeswoman, with copies to health reporters last night. It was dictated by Haim Justman, Litzman's chief of staff. Justman charged in the fierce response to Eidelman that the IMA chairman showed "an unprecedented thrill for attacking the deputy minister and sending his comments to everyone possible even before you did the minimum necessary to hear his position and specific comments on this affair." Justman said families who oppose the criteria of lower-brain death can ask that the respirator not be disconnected and palliative care not be halted until the heart stops. However, IMA secretary-general attorney Lea Wapner noted that "palliative care" does not include active treatment. Justman continued that Litzman felt "it would help the whole health system and [increase] the trust of rabbis" for his instructions to be carried out, rather than to take irreversible action relating to the baby. Litzman, said his aide, wants to "prevent mass conflict between one group and another vis a vis the medical establishment and increase trust in it, especially given the recent events in Jerusalem." The reference is to the arrest of the haredi mother who allegedly starved her son nearly to death but was saved by Hadassah University Medical Center doctors. Former health minister Nissim Dahan of Shas, who was described by Litzman just last week in the Knesset plenum as "the best-ever health minister," stated from the outset that he would not interfere in professional medical decisions, and he maintained this approach throughout his relatively short period in office. Wapner said the IMA would wait to hear a reaction from Litzman himself to Eidelman's letter and not comment on Justman's, whose wording was regarded by the IMA as "scandalous, hysterical and insulting." Wapner stressed that "we are the Israel Medical Association, not a government hospital dependent on the Health Ministry. We may go to the High Court of Justice over this. There never has been such a coarse intervention by the political head of the ministry."