biomedical ethics: March 2006 Archives

prenatal euthanasia, redux

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A Wrongful Birth? - New York Times.
The author of this article seemed to make a heroic effort to present this topic in a balanced manner. However, her biases were revealed halfway through when she admits to having had a second trimester abortion for a potentially severely disabled child.
I think that you all know my views on this topic. However, I think that you need to know that the pressures on those of us who do prenatal care are enormous.
I was recently made aware of a case where a young woman (20-something) gave birth to a baby with Down Syndrome that was not diagnosed prenatally. Her maternal serum screen showed a risk of Down Syndrome that was greater than her age related risk, but not at the cutoff point for recommending genetic counselling or potentially an amniocentesis. This mom was furious that she had not been offered amniocentesis. She states that she probably would have continued the pregnancy, but that she wanted to know what to expect.
The reality is that even with all the testing in the world, we really don't know what to expect. Every baby is a unique individual. Perfection is not only not guaranteed, it is impossible. I have a friend whose baby was born perfectly normal, but was hit by a truck at the age of two. This child is now 26, severely handicapped both physically and mentally - and is in fact fairly similar in physical, mental, and developmental ability much like the child described in this article. Should he have been 'terminated' after his accident? Should the doctors who saved his life been sued for allowing him to continue to live? I don't think so.

And yet, those of us who take care of pregnant ladies, who help them to give birth, who try our hardest to help them to live healthy lives and have good births, are on the line for every single bad outcome - predictable and unpredictable. I'm not saying that true malpractice should go unpunished. I think that the neglectful prenatal care given to that mom was wrong - I can't imagine doing prenatal care without the basics of measuring the baby's growth with my hands! But the reality is that nothing they did or didn't do had any effect on the genetic chaos in that poor child's body.

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About this Archive

This page is a archive of entries in the biomedical ethics category from March 2006.

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