Couple fight to keep infant on life support as doctors argue she won’t recover
Sick Kids intensive care team has applied for permission to override parents’ objections
A Toronto couple is fighting to keep their infant daughter on life support at the Hospital for Sick Children, despite the fact 11 doctors say she has “no chance of recovery” and will remain in a deep, unresponsive coma, requiring ICU-level care for the rest of her life.
Kaiomi Hall-Kemp arrived at Humber River Hospital on the evening of July 8 after she drowned in a bathtub, where she had been “temporarily left unsupervised” with a two-year-old.
She was pulled from the water and underwent an estimated 45 minutes of cardiopulmonary resuscitation before her pulse returned.
Within an hour of slipping under the water, she was already showing signs of severe brain injury and was transferred to the Pediatric Intensive Care Unit (PICU) at Sick Kids, where she has remained.
Since mid-July, the Sick Kids’ PICU team has been recommending her parents, Daniel Kemp and Brittany Hall, support the withdrawal of life-sustaining therapies, which means pulling the plug on a ventilator. The continuation of invasive medical therapies will not improve her condition, and could make things worse, the doctors advised.
Because of the parental refusal to follow the recommendations from the treatment team, a Sick Kids bioethicist conducted an assessment. He concluded the family’s mistrust in the medical team appears to be compromising the mother’s ability to participate in the care of her daughter and it remains “unclear whether they are in a position to make decisions in the best interests” of the child.
For that reason, Dr. Elaine Gilfoyle, the PICU division head, said she had no choice but to commence an application to the Consent and Capacity Board for permission to implement the recommended plan.
During a virtual hearing this week in front of a three-member CCB panel, Gilfoyle described the acrimonious relations between doctors and the baby’s mother, who accused the medical team of lying and trying to kill her daughter.
“We are really incredibly sorry that this has happened to Kaiomi, and we do feel very sad for her parents and understand how this is an extremely traumatic event,” Gilfoyle testified at the independent provincial tribunal.
“Unfortunately, we deal with other children like this, but have always been able to establish a therapeutic relationship and make best decisions together, (but) it’s been impossible to have a relationship like that. We feel that we’re in an impasse.”
Lawyers representing the parents say one of the treating physicians told Hall that keeping the baby alive would not be worth the cost of medication.
“It may well be the elephant in the room with all of this, and that is the price of keeping Kaiomi alive,” lawyer Michael Kohl said during Friday’s hearing. He added, as doctors have testified about Hall’s “belligerent” conduct, the comment about costs “puts some of those accusations in context.”
Adjudicator Mark Handelman said he didn’t see how this was relevant to the issues the panel has to decide.
“I can assure you sir, we don’t care what it about costs … (or that) there have been disputes between the parents and treatment team. They feel the relationship has broken down. But that’s a collateral issue to what’s in her best interests.
“That’s we care about.”
Under cross-examination, Dr. Christina Marrata testified that if she did use the word “cost,” she meant it as a synonym to the word “toll,” and “not dollars and cents in relation to withdrawal of life-saving therapy.”
“I apologize if I was misunderstood,” she added.
Handelman granted an adjournment until Saturday, over the objection of lawyer Saron Gebresellassi who noted it was the infant’s birthday.
“The best birthday present we can give Kaiomi, all of us, including her parents, is a prompt resolution of what plan of treatment … (is), in her best interests,” Handelman responded.