I can’t say that I really understand “Octuplet Outrage.” Are we outraged at the $300,000 in medical bills? Or the fact that Nadya Suleman is single and lives with her parents? The desire to produce litters of children does not seem to me a widespread phenomena, and I’m not really worried about an epidemic of aspiring Jon-and-Kates bankrupting the country. I’m more concerned about this impulse, courtesy of Time:
Nadya Suleman said that she wanted lots of children because she had grown up an only child in a dysfunctional family.
How could doctors let her bring so many babies to term?
If there is a problem here, I’m pretty sure it is not that doctors are insufficiently judgmental in matters of female reproduction. Fertility specialists are medical service providers, not religious counselors, not ethicists. I would no more ask a GP whether it is ethical to bring 8 babies to term than I would ask her to hold forth on the existence of souls. Language matters in unequal power relationships, which is why it’s best not to talk of doctors “letting” women terminate pregnancies, “letting” women use hormonal birth control, or “letting” women give birth to whatever it is they want to give birth to. Women are paying for these services; they’re customers, not infants begging for another piece of cake.
I haven’t been following the story closely, so I might be off on this, but my impression was that Nadya was not exactly financially independent. So basically, I think the outrage is at the expense associated with births and ongoing needs these children are likely to have which taxpayers are likely to be asked to pick up. If we don’t say that the doctors “let” her get away with something, then I think it actually casts them in a worse light since they actively assisted in the commission of an irresponsible action. We could perhaps more easily excuse doctors in a world where there was less government intervention and the ability to pay for services was a more reliable indicator of financial stability and independence, but in this world the doctors actions strike me as somewhat analogous to helping craft the language to be included in an email promoting a pyramid scheme. They are not exactly innocent bystanders. And Ms. Suleman, if not guilty of a crime, is nonetheless deserving of social opprobrium.
I would no more ask a GP whether it is ethical to bring 8 babies to term than I would ask her to hold forth on the existence of souls.
Would you ask her if it’s ethical to drink large amounts of alcohol while pregnant with those babies? Or is that also a question best left to philosophers?
While I can’t claim to own one myself, my understanding is that it is very difficult to fit eight fetuses in a human uterus without medical complications ensuing. I’ve heard doctors state that premature birth is virtually guaranteed, and that other, more significant complications are made much more likely. While I understand the difficulty inherent in considering the rights of individuals who, at the time of the relevant decision, remain unborn, the consequences of Ms. Suleman’s past decisions are now clearly affecting the infants, and will continue to do so.
I suppose opinions will vary on where a parent’s obligation not to harm her children begins and ends, but to me it seems not at all unreasonable to conclude that Ms. Suleman has crossed that line.
It’s important to remember that with IVF more embryos are implanted than are expected to come to term. In any case, nobody seems to have offered a cutoff of how many babies should the doctors have ‘allowed’ her to have: Would six have been alright? Only two? Or none at all?
There’s also a double standard on display here. The Duggars’ 18 children get them a reality TV show, and we don’t hear psychologists on the morning shows doubting Michelle and Jim Bob’s word that the only reason for their brood is their Christian, pro-life belief.
If Ms. Suleman were married, and would throw in a bit of religion when talking about her desire to have kids, do you really think the media coverage would look the way it does now?
The faux outrage at this astounds me since it goes directly to the issue of choice. The choice to have 8 children is no different than the choice to have none. Each is a personal decision that belongs to the woman and nobody else.
This woman chose to have the babies as is her right. It is not the job of a doctor or “ethicist” to tell her otherwise unless there was a direct threat to her health, and even then, it is her choice. It is most certainly not the job of the cozy media to tell her what she can and can not do with her body.
And the argument that the public will pay is at best duplicitous. This argument leads to a financial qualification system for the number of permitted children. When all is said and done, one can only wish the mother the best and hope that she is up to the task of raising 14 kids.
Any other position threatens to eviscerate the hard fought freedom to choose and replace it with a government/media/doctor based decision model that takes all choice away from women.
I think the concern is that single women with six children don’t usually want to have octuplets. It may be a sign of mental health issues that she does. In that case, it is reasonable to ask if the doctor has some ethical obligation beyond giving the woman what she wants.
Furthermore, this is not just an issue of a woman choosing to raise 14 children. Octuplets rarely survive infancy and those that do are at high risk for a lot of health issues. She is not the only person who will be affected by this. 8 lives came of it. Given this, I have no objection to the professional establishing standards with regards to how many embryos are implanted into young, fertile women.
Lemon: there probably are mental health issues involved – Ms. Suleman all but admitted as much in one of the interviews. But who gets to determine whether or not someone should be allowed IVF – or any other medical procedure, for that matter?
I’m more uncomfortable with doctors having the power to overrule someone’s decision because ‘X don’t usually want Y’ than I am about one woman having too many kids.
Dave: I think most people are more uncomfortable with the idea that a crazy person can ask a doctor to fill them up with as many embryos as possible and see how it turns out.
In most cases of IVF, the women involved have encountered fertility issues in the past. Even then, it is no longer common practice to implant such a large number of embryos, because of the risks involved with such a high number of multiples.
I don’t think that each woman going in for IVF should be subject to psychological tests, but I do think that in this particular instance it is clear that the woman is not behaving rationally, and the doctor involved clearly went outside established norms for IVF treatment. Should he be sent to jail? No. Is it understandable that reasonable people call his behaviour unethical? Yes.
This is an interesting discussion. I’m just wondering if the woman has the right to do what she wishes, why not 25 embryos? No problem I guess, it’s her body. ??
Just asking.
I have not seen, or maybe I missed, anything about who is footing the expense for Nadya’s hosp bill. If she isn’t getting welfare, who paid?
I can’t say I’m outraged, exactly, but I think you’re being a little too dismissive of what appears to have gone wrong here. Multiple births vastly increase the risks of premature delivery, cerebral palsy, stillbirth and other disabilities (http://tinyurl.com/4jrses). Already, the Suleman octuplets are the longest to ever all survive. I cannot at this moment in time present a foolproof argument for why aborting a fetus is OK but intentionally exposing eight fetuses to such huge risks is not, but I do see a meaningful distinction there — and you don’t even address it.
As for the issue of “letting,” I agree it’s a poor word choice. At the same time, even if you reframe the doctor-patient relationship as one of merely a service provider and a customer, providers are under no obligation to give customers whatever they want. Try getting a whopper at McDonald’s. But it’s more than that. Doctors may too often trample upon patients’ autonomy, but they’ve still the right to refuse to provide care that they simply find unconscionable. And in this case, one needn’t have an uncontrollable desire to control women’s fertility to see why doctors would find transferring a number of embryos that could result in a hugely dangerous pregnancy and dead or disabled babies very troubling, to say the least.
And that’s putting aside the merely libertarian point about Suleman’s use, and abuse, of the welfare system — which the latest reports show encompass not just mandatory emergency medical care but disability payments for herself and her children, food stamps and student loans. Is this any worse in principle than the stereotypical teenage mom who decides to have a baby somebody loves her? No, but the numbers involve compound the moral error as well as the social cost.
Where you would be on firmer ground is in objecting to calls for new regulations that would probably make it harder and costlier for infertile people to conceive using IVF while putting social workers in charge of deciding who gets to be a parent.
I really don’t like this idea that choosing to have an indordinate number of offspring is anybody’s right and analogous to controlling one’s bodily functions. When one chooses to become a mother, one becomes responsible for the welfare of her children. The state does not determine that a parent can do whatever they will with their children, i.e. abuse, rape or murder them. An unemployed woman, already I believe hundreds of dollars in debt before she birthed the octuplets, who gives birth to extremely weak children as a result of her irresponsible choice to put their and her lives at risk by implanting so many embryos and not pursuing reduction, is likely condemning many of her children to either outright death, poor health, or lives of material and emotional deprivation. AND, the state is expected to step in to stop this from occurring. This woman is deranged. There is no other explanation.
Oh yeah, forgot to point out that she already has six children. I believe they are under the age of two.
Kerry, read the headline and first paragraph of this article.
This woman is a giant parasite on the public fisc. She makes babies and makes other folk pay for them.
If she were not on the government tit, it would be no one’s business. As it is, I’m ready to support the idea of retroactive abortions for all 14 kids and their mom.
I’m afraid that there’s a substantial amount of social and ethical judgement involved in the practice of medicine, from determining child abuse to weaning life support. While during my clinical practice, I rarely alluded to my (nonexistant) religious beliefs, I dealt with an almost constant barrage of ethical issues. Physicians are not mechanics because we are trained to improve health, which is an admittedly nebuolous concept, but one that is not always open to invidual redefinition.
For example, if you went to a nephrologist and expressed the desire to have both of your kidneys removed and spend the rest of your life on dialysis, you would be turned down by pretty much any office you went to. And if you weren’t turned down, the surgeon would likely lose his or her license.
Intentionally inflicting illness on the healthy, even at their request, is an act of opprobrium within medicine.
“Fertility specialists are medical service providers, not religious counselors, not ethicists.”
While I have nothing wrong with this woman having eight children… I think it’s rather horrific of you to suggest that people should leave ethical judgements aside unless it is their specialty.
Everyone is an acting moral agent and we are all ultimately responsible for the consequences of our actions… it cowardly and irrational to suggest that the moral opinion of the doctor should be irrelevant. It certainly shouldn’t have been to him… he (or she) should be free to pass moral judgement on her based on whatever standards he’s set and act accordingly. He certainly could have refused to provide her with that service for a myriad reasons even if I would not have refused.
I would expect a similar treatment from everyone I deal with on a day to day life… this all-too common idea that unless you are a trained ethicist you should refrain from acting on your moral conclusions. An absurd and terrifying sentiment.
If you ever want to see a reader’s feedback
, I rate this post for 4/5. Decent info, but I have to go to that damn yahoo to find the missed pieces. Thanks, anyway!