Saturday, January 31, 2009

Because we can?


One of the big news stories this week was the California woman who had octuplets through in vitro fertilization. She has six other children, and all were born using in vitro techniques. From what I've read, it looks as though she is not working, and has always had somewhat of an obsession with having children.

A while back, I wrote about the sorry state of our healthcare system and how we need to rethink the way we look at things. The situation with this woman who decided to become her own little baby factory brings up all sorts of ethical and practical issues.

Bioethics is defined as "The study of the ethical and moral implications of new biological discoveries and biomedical advances, as in the fields of genetic engineering and drug research." Ethics has been a part of medicine since medicine's inception as a field (part of the Hippocratic oath is to do no harm), but as medical technology continues to advance, bioethics has moved from a mainly philosophical exercise to an interdisciplinary one that encompasses not only physicians and philosophers, but also other healthcare workers, theologians, and lawyers.

Some of the thorny issues involved range from organ transplants to organ donation; reproductive rights to infertility treatments; euthanasia to population control; gene therapy to gene privacy and discrimination; and stem cell research to the rights of an embryo. We could debate until we're blue in the face about some of these, but the topic at hand is this woman's infertility treatments and multiple births.

My own parents come from large families. There were 9 kids in my Mom's family and 7 in my Dad's, with a couple of stillbirths and early deaths in each family, as well. People had a lot of kids back then because 1) there was no birth control and 2) kids ended up helping on the farm or with taking care of the younger kids. The world has moved on, and there is birth control readily available to everyone and no need to bring that many children into the world, especially when you cannot support them. Even beyond that, the California woman did not have these children naturally, she had them with the aid of infertility treatments.

Several years ago, I remember hearing a comedian talking about a multiple birth through fertility treatments. I believe it was either sextuplets or septuplets. The woman said, "It's God's will." The comedian said, "Bullshit! God's will was that you have ZERO! You screwed it up!" A little extreme, I know, but these are exactly the kinds of situations we need to look at if we're going to address the multitude of problems in our healthcare system.

The hard truth is that these octuplets are going to cost millions from the cradle to the grave. They are very tiny, and although apparently doing well, will need to spend about a month in the hospital. Over 40 physicians and other staff assisted in the birth alone. Let me ask you a rhetorical question: who do you think is going to pay for that? Let me answer my own question: WE are. Whether through increased hospital costs or increased insurance premiums, we will absorb it. This is where bioethics come in. There are no easy answers, but shouldn't we set some sort of limit on the burden that an individual can place upon society and upon our healthcare system? How is having 14 kids reasonable in today's world? Why did the infertility specialist treat this woman instead of sending her for counseling? Is a physician obligated to treat such a patient, or can they refuse?

The argument doesn't stop with multiple births. At what point do we put a limit on procedures, whether the number of surgeries or the age of the patient? I've seen it happen in my own family. An elderly relative was diagnosed with prostate cancer, but they didn't treat him for such a slow-moving cancer...his life expectancy was exceeded by the amount of time in which he'd succumb to cancer. (And indeed, he died of something else.) I know these are not fun things to think about, but at some point, we have to ask the question, "Why should we do this procedure?" If the answer is simply, "Because we can," we need to come up with a better answer.

18 comments:

  1. I think it is wrong to bring more children into the world than what you can provide for and take care of.
    She must be mentally ill to have more when she had 6 at home to love and take care of. And not even having a husband to help.

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  2. Lots of very valid points made here ,but how was she allowed IV treatment if she already had a family ,IV treatment isnt free is it ? whats going on here ? ...love Jan xx

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  3. Not to stir the pot even more, but why the hell are doctors making babys by the "potfull" when there are 1,000's of beautiful, healthy, loving children in our foster care system who need permanent, loving families?

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  4. I can't fathom ANY woman wanting that many kids under the age of 7.....it's insane.

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  5. after being the lead teacher of the 3 year old class for about a year, i see no sane reason why anyone would want to deal with one toddler alone, much less the 12 i got to oversee, on a daily basis.

    just because we can do things doesnt mean we always should.

    xxalainaxx

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  6. The story has hit the news here also, I don't understand her motives and how she obviously slipped under the radar, surely they are screened, i'll be watching this story to what else unfolds.

    Yasmin
    x

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  7. Beth I was reading this story yesterday and I was certainly disturbed over it. Why would they do IV when she has 6 kids alredy? Can they say no? I did read she is living with her mom and now her mom has said that when the kids mother gets home that she will be gone! This mother is not married and now her mom is leaving, poor children. Now who will take care of them. Maybe she was hoping for a jon & Kate plus 8 t.v. and make $$$$
    Take Care Lynne

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  8. There is just SO much wrong with this whole thing! I'm an only child (very happily so!) with an only child of my own (and she loves being "only", too), I'm probably not qualified to comment on the questionable sanity of this woman in her choice to continue to get IV fertilization, but I can certainly comment on the tax dollars I'M going to be spending on HER kids. Boooooo!

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  9. The mother does not work, and lives with her parents, who filed bankruptcy, but were denied. They have more than $900,000 in housing debt. A classic example of riding the bubble, and falling when it bursts. As for 14 kids, that would be great over 20 years, but having 8 at once is just plain stupid. She refused to have some of the eggs culled, and here we are, in a tragic situation. Did I mention "stupid".

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  10. When all this settles down, I hope she has the sense to put some of those kids up for adoption. Given her background, I guess that's unlikely.
    I'm betting child welfare services will be watching her closely.
    I could go on forever about this, but I won't. It's too frustrating.
    Thanks for the insights, Beth!

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  11. I haven't followed the story, or read about it, but I do feel a bit confused that an unwed (?) woman who doesn't work and lives with her parents could possibly afford invitro or be accepted into such a fertility treatment. How does something like that slip through the system?
    The answer, "because we can" is widely accepted on so many levels in so many aspects of life, that responsibility and accountability fall to the wayside to make way for gratification and wants. One can observe that mentality in every corner of the nation. The problem is, if you say "No more" or try to regulate things, you quickly swim into the murky waters of denying someone possible civil liberties, equality and some would even call it 'rights'. A fuzzy gray zone filled with potholes, loopholes, and blaring pitfalls.
    I'd like to think people generally know right from wrong, but that almighty thing called 'want' often overrides all sense of rational. So for now, I teach my daughters often the concept of understanding the difference between need, want, and must have. Just because someone can, doesn't mean they should..........

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  12. Stupid is right, Ken. It just makes me so angry, and who's going to do something about it? Nobody!
    There are people who are very adept at using our welfare system as their life career and income, and this is a prime example. It's an injustice that should be righted, but I don't see it happening.

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  13. Hi Beth,
    This is a really serious issue. This woman is an idiot and the doctor(s) who allowed this to happen should be ashamed of themselves. That said, where do we draw the line? If we were to outright deny some people the right to fertility treatments, we go down a very slippery slope. I hope one of her babies grows up to be a Psychiatrist. She needs her head examined.
    Best,
    Marty

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  14. Rebecca said everything that was going through my mind (wipes brow, I had a whole speech lined up here)...I'm still dumbfounded that this was possible. I always thought you had to under go some sort of psych evaluation before under going any kind of fertility procedure. I know it's a perquisite before cosmetic surgery...seems like it would of been considered for this procedure.

    The whole thing just baffles my mind...as you and everyone else has said, just because you can doesn't mean you should. 14 children...Sigh...(Hugs)Indigo

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  15. well, i should keep my mouth shut....because i paid for BOTH births of my kids....in full..and it was hard to do...even with a spouse....we pay ALL our medical bills, in full, and YOU know how hard that has been for me...so i read about some woman who "wants" lots of kids and can not afford them....and ends up with 8 new ones...plus has 6 other ones...and i AM thankful each new child is healthy...but how can her husband afford all those kids? Will THEY pay off the births like most of Americans do? Unless they land a big TV show (like Jon & Kate Plus 8 have), well, gee.....i can remember nights when i had to go out at 3am to get formula and diapers because Megan went thru both at the same time and being a new mom i was not quite as organized as i am now and it was difficult to get both at the same time some times....so how is she going to PROVIDE all that at once and do it easily unless a tax payer is going to foot the bill? Why is that allowed? What about the moms in America who have NO children who work FT and can not afford any fertility treatments and DESPERATELY want their own baby? Those moms deserve a child as much as this mom.

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  16. Just a note letting you know I was here.

    As to the comedian's joke, black comedian's build some of their riff's around things like this. What is the compulsion for some women to participate in something like this, is beyond me.

    It isn't like she is in a cult ... maybe in the thrall of some sort of religious calling? You are right, there are deep and profound ethical and moral questions here.

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  17. You are right, it is WE the taxpayers who will be footing the bill. The physicians should have a moral responsibility to refuse treatment. This woman needs psyciatric care, there is no way she can take care of them, she probably not taking care of the ones she already has. I sy a bumper stick once that said "If you can feed them, don't breed them." And that is exactly what she has done.

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  18. :shakes head:
    I don't understand it. Having been a single mom for much of my childrens' lives, I can't imagine a woman who already had six children to raise alone deciding to have even one more! I can't imagine any motivation other than financial that a doctor would have for allowing this. You know, my sister in law wanted to have her tubes tied last summer and even though she lives in NYC, she had a hard time finding a doctor who would do it because she was under 30. She doesn't want kids, my brother doesn't want kids, she was tired of birth control but she couldn't find a doctor who felt it was ethically appropriate for her to voluntarily give up her fertility. Yet... we have some yahoo out there willingly creating additional tax burdens. Crazy.

    Good entry!
    *hugs*
    heather

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