Rights, Ethics and Choice

So by now, everyone has heard of the octuplets in California. When I heard about them that first day when there were no details beyond the bare sketch, I made several assumptions about the mother — including “little” things like… she was married… her husband was there… they had no other children, or at most one or two… that one or both of them were gainfully employed… — you know, logical assumptions when dealing with people who can afford fertility treatments. I assumed she was like Bobbie McCaughey, who had septuplets. As the days since the original story have passed, and more and more facts and details have surfaced, I was stuck somewhere between disbelief (“She’s already got six kids, and she has fertility treatments for more?” and “She’s not even married??” and “She’s living with her parents???”) and shock.

Let me insert one little correction of the media reports: they do not implant embryos; they transfer embryos. Believe me, there’s a whole bunch of women who have undergone or who are undergoing fertility treatments that are screaming at their TVs and newspapers every time they hear that the doctor “implanted” however many embryos in the woman’s uterus.

I could go a lot of different ways with this topic, and have avoided it since that first day because I just couldn’t believe what was being said about her, and thought it must be false. Then as it was verified, it just disgusted me. Now, I read that the same doctor transferred seven embryos into another woman who is currently 5 months pregnant with quadruplets, has no insurance, and is going to be staying at a county hospital on the California tax-payer’s dime for the remainder of her pregnancy, which with quads is probably going to be another two to three months.

Obviously, being pro-life, I do not agree with “selective reduction” — an abortion procedure in which they kill one or more embryos or fetuses to allow the remaining ones a better chance of life and health. It makes me think of the Holocaust, and what if the Jews crammed together in cattle cars on the way to death camps had taken to killing each other so that the living ones could have room to sit down and be comfortable. Yet, it is little short of a miracle that these octuplets survived to 30 weeks and (since I haven’t heard of anything negative, anyway), seem to be doing well. It is not their fault that they are here, and that they were conceived as they were, so I wish them the best; but I just have to shake my head in disbelief at their mother, and wonder what sort of life they will be destined for.

Currently, we have no laws governing how many embryos can be transferred during this fertility procedure. I prefer it that way. BUT I have a feeling it will be soon changing, and it will because of this doctor (perhaps him alone; maybe others will be found that also play fast and loose with the fertility industry’s guidelines… and common sense). It’s not best for the children to have four or more babies crammed inside a single uterus; and it’s very difficult to deal with them and raise them, especially in those high-need baby and toddler years. Naturally-occurring quadruplets and quintuplets are quite rare — I doubt that there are any naturally-occurring sextuplets or above, but the famous Dionne quintuplets who were born in the 1930s in Canada were obviously not the result of fertility treatment!

But stories like this highlight the sometimes opposing viewpoints of patient’s rights and doctor’s ethics. There is a line from the movie Jurassic Park that has Jeff Goldblum saying, “Yeah, but your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should.”I think that pretty much sums up this whole problem.

Just because this doctor could transfer so many embryos, it doesn’t mean he should. Just because this mom could have more fertility treatments, after already having six children under the age of seven, and living unmarried with her parents who have filed bankruptcy, doesn’t mean she should.

In my opinion, this doctor was unethical in his transfer of so many embryos — and these babies are paying the price. Even if they grow up without any lifelong disabilities from having been born so early, they really ought to have had another ten weeks or so in their mother’s uterus. While I’m sure they are receiving top-notch care where they are, no technology replaces the womb.

Part of me doesn’t even want to get started on this mother, for fear I’ll be too unkind, or that I won’t be able to stop the harangue. But just because she as the patient had the “right” to have fertility treatment, does that “right” trump the doctor’s ethics in limiting the number of embryos transferred?

Of course, this discussion on patients’ rights vs. doctors’ ethics assumes that there is some sort of conflict between the two. Ideally, there will be no conflict — because both doctor and patient would be guided by some common sense! Unfortunately, it seems that there was no conflict in this case, and that both doctor and patient were blissfully going hand-in-hand off the same cliff.

11 Responses

  1. What has bothered me most about this is that the media uproar has been over “she’s having too many kids.” I believe a woman has a right to have a big family (the fertility ethics are a different story). What bothers me, and what doesn’t seem to bother the media, is that this woman is purposely creating large numbers of babies who have no daddy. She has spent massive amounts of money to create, on-purpose, children who will have no father and an already-dysfunctional home. Just great.

  2. Diana,

    Yes, exactly! It was hard to keep from getting too political or moralistic about this. But what is the media to say? They can’t say that it is immoral for a woman to purposefully become a single mom, can they? I remember the Dan Quayle / Murphy Brown uproar — this woman is just showing the exaggerated end result of the embracing of single motherhood as being essentially no different from two-parent families. If it’s wrong for her to do it, it was wrong for the fictional Murphy Brown, and the not so fictional Camryn Manheim and Jodie Foster who gave birth to their children, as well as Rosie O’Donnell and Angelina Jolie who adopted their children as single moms. Of course, that’s “politically incorrect” and far too conservative for the mainstream media to admit. So they ignore it — just as they’ve ignored the fact that children born to unmarried women have a much higher likelihood of being born premature and/or dying in the first year of life, than those born to married women.

    I totally support large families, as long as they can afford them and don’t rely on government assistance — I don’t see a thing wrong with the Duggars and anyone else who wants a lot of kids and can support themselves. But I do have a problem with the danger these children were put in, by transferring so many embryos at once, as well as the fact that there is no way the mom can possibly afford to feed 14 children, all age eight or younger. I didn’t go into this in the blog post, but I think the doctor had the ethical right to refuse to treat her for infertility if she was not married, or at least, not in a committed relationship. In fact, I think he was morally wrong and possibly ethically wrong to continue to try to get her pregnant, given her life situation. There comes a point when somebody’s gotta stand up and say, “Enough’s enough!”

  3. just a random… actually, the doc she used is one that has an experimental technique that actually does implant directly

    (from http://www.foxnews.com/story/0,2933,489825,00.html and several other sites)

    Dr. Jeffrey Steinberg, a professional acquaintance, said Kamrava worked to develop an embryo transfer device that allows doctors to implant an embryo — or sometimes sperm with an unfertilized egg — directly into the uterine lining using a plastic capsule.

    “Usually we inject the embryos into the uterus and they float around and attach themselves,” said Steinberg.

    It was not immediately known if the technique was used on Suleman. Steinberg said there was no evidence the method improved success rates for pregnancy.

  4. Interesting — I read it on an infertility blog about the transfer / implantation thing. The various women were practically up in arms over the repeated use of the word “implant”. It doesn’t surprise me that they’ve tried actually implanting an embryo into the uterine lining. Ah, well, maybe they did implant.🙂

  5. Here’s our new email! We switched providers:

    From my understanding, even if he is “embedding” an embryo into the uterine lining, “implanting” is an action taken BY the embryo that can’t be done by a doctor – it’s the embryo’s “decision” whether to stay or go. If the doctor truly did “implant” then it would be 100% success rate b/c “implanting” means “successful pregnancy” – right???

  6. Diana,

    Thanks for the email update — apparently it’s not yet changed in the Blogger system.

    As far as “implant” vs “transfer” — I just don’t know — it may be a connotation vs denotation argument. I won’t make a person an offender for a word.🙂

  7. Good converstion. I would fight for the rights of the Duggars however I do believe they are selfish when it pertains to them using more than their share of our earths resources. I also think she is addicted to pregnancy or child birth. A child may be considered a gift however God also gave us a mind that I am certain he intended us to use it. Most of us know when to have sex to prevent conception. Octo-mom has serious mental problems. I have seen her before plastic surgery photos. Having plastic surgery with this many children and no income speaks very loudly to me.

  8. Is it a certain thing that this woman agreed to the Dr. using so many embryos? Was she properly advised of the risks of carrying so many babies, including health problems for the children? Was this Dr. using her? I have a hard time believing that any woman would choose to have so many babies at one time.

    But, if this is the result of a conscious decision, maybe to be Uber mom, to stay on public assistance, or to become famous, then trying and convicting her in the press and on the internet could just lead more serious risky behavior, which could seriously impact her !14! kids.

    I personally don’t care if my tax dollars go to her family. Better her and the kids than some questionable Hawaiian retreat for our public servants.

  9. Evie,

    What I have heard is that this doctor transferred six embryos every time this woman got pregnant — the three sets of twins plus the octuplets. Of course, I could be mistaken. Somehow I doubt that the doctor told her the health risks, or else she just assumed it wouldn’t happen to her. I, too, have a hard time believing that any woman would choose to have so many babies at once… yet I have a hard time believing that any woman with three sets of twins under the age of eight, without a husband, living with her parents who have just filed bankruptcy, would intentionally get pregnant again *naturally*, much less **artificially**!! That fact alone, which is undeniable, makes me seriously wonder about her mental condition.

  10. (Biting Sarcasm) Yep. Well, who cares anyway? Now we’ve got a great new procedure to implant embryos, in which there is a near 100% rate of conception! Now women can go through IVF and plan on just ONE embryo being successfully established. So what if mommy wasn’t advised of the risks, and she wasn’t properly assessed? Embryo implantation works! She and her babies are just another experiment in the name of furthering the birth industry and the point is, now BILLIONS of dollars worldwide can be spent on this new, very successful procedure which is destined to bring the joy of motherhood to so many! Barf.

    This doctor who implanted so many embryos, as the fertilizer and “father” should have to financially support at least 6 of these kids, but not have any legal access or custody, as they would just be an extension of his research, and set an unnatural and immoral precedent.

    I really feel for her as I know how hard it is to raise just one set of natural twins, and people just look at them and say “How cute, that’s what I want too!” without any idea of what they would have to go through. This woman needs an army of helpers, if not for her sake, for her kids’, and the doc. who did it should provide the finances for it.

    Parents and taxpayers should not have to fund the excesses and end products of medical researchers unless there’s no other alternative, as in insolvency, especially if the client had problems, mental or otherwise, which would negate ability to give consent. I believe this also goes for unnecessary and untimely birth interventions, and the resulting medical problems which stem from them, including PTSD and PPD. When providers are truly held accountable for their actions, as they are ethically and legally obligated to be, we’ll see some changes.

  11. Maybe we’ll see her state of residence either impose fines or sue for damages in this case, to recoup tax dollars and pay for long-term expenses for this ill used family.

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