The ethics of eight (babies that is)

January 30, 2009 at 6:13 pm (Ethics, Health care, Medicine, Regulation, Uncategorized)
Tags: Children, Ethics, fertility, Health care, Medicine, octuplets, Taxes

All over the blogosphere people are discussing the California woman who gave birth to 8 babies.  The media was quick to call it a miracle, but it seems it only took a few hours before bloggers, journalists, and doctors began to seriously question the mother’s intentions.  It seems crazy enough to want 8 kids at once, but now rumor has it that the mom is single, living with her parents in a 2 bedroom house, and already has six kids (all under the age of 7 nonetheless).

If you want to be entertained (or appalled), I recommend reading the comments section on articles discussing this woman.  You’ll see a variety of viewpoints expressed, from those who think we should just leave this woman alone, to those who think the government should mandate how many kids a person can have and restrict who can receive fertility treatments.

I guess I fall somewhere in the middle.  I don’t think we should leave this woman alone – that doesn’t mean I think we should all go and teepee her house, but I do think what she did was irresponsible and the situation deserves attention and discussion.  Coming from the medical perspective, each of those 8 babies are really tiny and will face a plethora of medical problems immediately and in the long-term (google “very low birth weight” to get an idea).  Already it has been mentioned that several of the babies are not tolerating feeding tubes.  Think about how serious that is – we’re not talking about a baby not yet ready for taking a bottle because it doesn’t have good motor control to suck, but rather one whose digestive system is so underdeveloped it cannot even have formula placed in it’s stomach without the risk of necrotizing enterocolitis.  These feeding tubes are only part of the picture – these babies must stay in incubators because their skin is so thin and cannot maintain their temperature, and they are likely to be on ventilators to help them breathe (which they will be on for many weeks to come), and monitors to notify a nurse when they stop breathing so she can give them a good pat and get them to start again (and they likely will stop breathing on many occasions – it’s called apnea of prematurity and it’s not rare).  Consider all of the physical and intellectual disabilities these babies are at risk for.  It’s difficult for a parent to manage one child with a disability, but this mother could end up with multiple children who have life-long developmental issues.

Then you have the issue of fertility.  It hasn’t been verified (to my knowledge) that this mother received fertility treatment, but I think the odds are that it is practically impossible for her to have conceived 8 naturally.  I would like to know which doctor prescribed her fertility meds.  Did they know she already had 6 little ones at home?  Did they evaluate her ovaries after giving her hormones to see how many follicles would have a potential of being fertilized?  The woman’s neighbor claimed that she “lied to the doctors who impregnated her“, and for the sake of the doctor, I hope this is true.  If it’s not, then I think the medical licensing board should investigate the doc for their role in this situation.  It is simply irresponsible for someone with the medical knowledge of very-low-birth-weight outcomes to allow an already fertile woman to undergo fertility treatments which place her at high risk for multiples.  I’m not saying women shouldn’t be allowed to have multiples, but you have to apply some judgement to the situation – are they married or do they possess a significant support system, are they financially able to support that many kids, are they prepared to care for kids with disabilites?  I hope a doctor takes these things into consideration before taking someone’s money and giving them hormone shots.

As for the people who suggest the government should somehow intervene and mandate how many kids people can have, and who should or should not be allowed to receive fertility treatments, that seems a bit ridiculous.  If we allow the government to start intervening in the fertility choices of people, it is likely to have unintended consequences (should the government have forced her to selectively abort a few of those babies?  no).  IF someone is self-supportive, it shouldn’t matter to a stranger how many kids that person has.  The problem is that it’s likely this mother of 8…no wait, it’s actually 14 total…is benefiting significantly from the support of the government (which means the support of you – the taxpayer).  Whether it’s the millions of dollars (per kid) of care that is currently being provided by the hospital, the many years of public education these kids will use, or perhaps the medicaid, WIC, or welfare which she may collect in the future to support her brood, you can bet that we’re all paying for it somehow and will for at least the next 18 years (or at least the citizens of California will be).

So, what are your thoughts on the matter?  Are the actions of this woman ok?  Does it change your opinion to know that your tax dollars might be paying for it?