Playing God With Birth Defects in the Nursery

NY Times ^ | June 14, 2005 | BARRON H. LERNER, M.D.

[neverdem]

What is best for babies born with a severe neurological condition? Two doctors thought they knew. At a series of medical meetings in the 1970's, Dr. John Lorber argued that they should be left to die. Dr. John M. Freeman said they should be saved.

The neurological defect in question, meningomyelocele, has since declined in incidence. But the issues that the doctors debated remain highly relevant in modern neonatal intensive-care units.

Meningomyelocele referred to a protrusion of the spinal cord through the protective vertebrae of the back. Infants with this condition suffered from a series of problems, including permanent paralysis of the legs, swelling of the head, urinary incontinence and meningitis, an infection of the tissues surrounding the spinal cord.

Meningomyelocele was the most severe form of spina bifida, a spectrum of conditions in which the vertebrae do not close properly. All doctors agreed that in mild cases, with minimal neurological damage, the defect should be closed. But more advanced cases raised genuine questions about whether severely handicapped infants should be saved.

Dr. Lorber was a renowned pediatrician at Sheffield Hospital in England, which had pioneered many of the advances in treating meningomyelocele. These included inserting a shunt to drain fluid from the head into the abdomen, possibly preventing brain damage.

But in a 1971 article, Dr. Lorber argued that to spare children and their families prolonged suffering, the most severe cases should not undergo treatment. In a study of 524 patients, he had found that half the children died despite maximum treatment. Most who lived had severe mental or physical defects, or both. Only 7 percent had a life consistent with "self-respect, earning capacity, happiness, and even marriage."

In advocating "nontreatment," Dr. Lorber anticipated medicine's future concerns about quality of life: just because surgeons could fix things did not...

[neverdem]

Ask them in another 20 years. Thank God and the researchers endowed by their Creator for the discovery of folic acid's properties.

[Stonedog]

It seems so simple to me...You do what you can to save each and every life. Who knows what "miracle" will be discovered tomorrow that might save someone from a life of pain and suffering?

[neverdem]

Today, the use of folic acid in pregnancy and the availability of abortions have made meningomyelocele rare, affecting fewer than 1 out of 1,000 live children.

I would like to know how much is from folic acid supplementation and how much is from selective abortion.

[neverdem]

FReepmail me if you want on or off my health and science ping list.

[beyond the sea]

Playing God

There's a lot of that going around these days.

[moog]

Playing God
There's a lot of that going around these days.

Sigh..... I guess we're polytheistic after all.

[Earthdweller]

Death culture ping.

[Marauder]

Hippocratic Oath: "First, do no harm ..."

[muawiyah]

A much more robust, but harder society, would hold the biological parents to be at least partially responsible.

In that case, they, too, would be terminated as a sort of rough prophylaxis.

[Mr. Silverback]

ProLife Ping!

If anyone wants on or off my ProLife Ping List, please notify me here or by freepmail.

[Coleus]

March of Dimes and Abortion

[Doctor Stochastic]

You do what you can to save each and every life.

How do you ration finite medical resources? Or should the government step in an pay for everything? It's not a simple question.

The question arises with other genetic conditions, Tay Sachs, Huntington's, Caravan, etc.

[balrog666]

How do you ration finite medical resources? Or should the government step in an pay for everything? It's not a simple question. The question arises with other genetic conditions, Tay Sachs, Huntington's, Caravan, etc.

My money, my decision.

[fatima]

Here's a bump Coleus.

[blurb]

Dr. Freeman was also not spared the revenge of hindsight. Even though his policy of aggressive surgery had become standard by the 1990's, he received a surprise when he interviewed two of his "favorite" patients, women in their 20's who were college graduates with steady jobs. Reflecting on their lives spent in wheelchairs with limited social contacts and no hope of marriage, they told Dr. Freeman, as he recalled, "We wish we'd never been born."

Plenty of teenagers without noticeable birth defects say the same thing. Should they all have been left to die?

[RedBeaconNY]

THANK YOU for your tagline. I've been looking for that reference for a week- debating my Swedish (religious) friend on Sweden's neutrality.

[Coleus]

You're welcome

Scandinavia is a moral cesspool.