Sunday, February 01, 2009

Stupid Medical Ethics Writing

My wife and I have been debating the recent birth of octuplets to a woman in Bellflower, CA, sparked primarily by this post on the New York Times parenting blog. The missus, an ED physician, largely agrees with Ms. Belkin's assessment that the fertility specialist(s) who performed the implantation acted unethically. On the other hand I find Ms. Belkin's reasoning to be completely unpersuasive:

I covered medical ethics for years for this newspaper, and wrote a book on the subject, and while I have not directly heard this mother’s story nor that of any doctors involved, at the moment I cannot think of a scenario that would ethically allow the implantation of eight embryos in a woman who already had six children. Actually I can’t think of scenario that would allow the implementation of eight embryos ever. There is just too much risk here - to the mother, to the newborns, even to the emotional needs of the existing children. And we need not even get started on the expense.

The fact that she already had a large family at home adds more questions. This technology was invented to prevent heartbreak for parents who cannot conceive naturally, and was then expanded to prevent physical devastation, by helping parents who carry genes for serious illness to screen for such before an embryo is implanted.

I don’t see how it could have been created for this.

God, she got paid to write this?

Her indictment starts out with an argument from ignorance; she has no personal knowledge of the situation but can't imagine how it can possibly be ethical. All she can muster is vague, hand-wavey arguments about "too much risk". Please... if you're a professional ethicist surely you can come up with something better than that? Presumably she recognizes that the individuals with the best information, the mother of the octuplets and her doctor(s), evaluated the attendant risks ahead of time. That being the case she's implicitly questioning the judgement of all those people; that takes a lot of chutzpah coming from someone who doesn't know any of the specifics of the case.

And then there's the argument that "[t]his technology was invented to prevent heartbreak for parents who cannot conceive naturally". Bleh... that's just one step away from "They're PLAYING GOD!!1!!!". She asserts that, because the technology was originally intended for one particular purpose, there's something wrong with using it for another, again without anything in the way of support. Jebus... she's worse than Randy Cohen.

My gut is that there's probably a great deal that I'd find objectionable with respect to the mother's choices, but I simply don't have enough information to make a judgement one way or the other. So, unlike writers for the NYT, I think the wisest course of action for the time being is to keep my trap shut.


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