Source: The Guardian >> Read full article and comment

Denis Campbell

Surgeons talk about the heartbreak of having to decide whether to operate on children who have run out of options

Blessing is just 48 hours old. A serious congenital heart defect means that, without surgery, she will die within days or weeks. But the operation could itself prove fatal. “Her father agreed to it without hesitation, which is a reflection of human love,” recalls Victor Tsang, the cardiac surgeon who performed the procedure. “He wanted us to do everything we could to help his daughter, even at the risk of her death.”

The baby’s plight typifies those confronted regularly by staff at Great Ormond Street hospital in central London, the world’s best-knownchildren‘s hospital. Its expertise means it ends up accepting patients few others can. Tonight a candid BBC2 series begins which shows the trauma involved for those who have the unenviable task of deciding when to treat, or not to treat, children who have run out of options.

“I gave Blessing’s father the options of a major operation that involved putting her on a heart and lung bypass machine, or comfort care – palliative care, no surgery, letting nature take its course,” says Tsang. “It was very difficult for him to take in what I was saying. His newborn daughter was very sick in hospital, his wife was recovering from a caesarean section and so he also had to look after his two other children.”

Parents always want to know the percentage risk involved in an operation, adds Tsang. “It’s hard to apply a mathematical risk to an individual. If parents say, ‘Doctor, if there is even a few per cent chance [of success], we are prepared to take it,’ then it’s very difficult for the doctors to say no.”

But that natural human reaction puts doctors in a difficult position. “We want to push the boundaries medically speaking, because that’s how progress has been made in surgical techniques,” says Tsang. “And as human beings we understand the dilemmas and the trauma that thefamily is going through. I try to imagine their position, because I have children myself and I know how precious children are to their parents. But sometimes you know the chances of success are quite low because the child is so sick. … Continue reading