Wednesday, November 15, 2006

no answers, only questions

Last night at dinner Brian threw this spiky ball into play: The Church of England has stated that in some circumstances it may be morally acceptable (in their view) to for doctors to withhold treatment from babies born before 22 weeks with severe disabilities.

The fuses of my heart and brain immediately overloaded, then promptly short-circuited. Brian’s favorite news pundit, Glenn Beck, spent a good portion of his show on the statement and on the potential consequences for our own health-care system. To be honest, I don’t see a half an hour as nearly enough time to devote to the subject. But it’s a start.

The heart gets involved automatically when you’re talking about babies, doesn’t it? If we can keep them alive, shouldn’t we? Or would it be better to allow a baby’s soul to pass on to another incarnation? Is the Church the best arbiter of that decision? (I say no, but that’s not what the story is about anyway. The story is about leaving the decision to the doctors.)

I tracked back to an earlier article about this from the Observer. It’s long, but absolutely worth reading if you’re at all interested in pursuing this issue.

In these extreme cases, it would come down to a conflict between the doctors managing the case (and there are usually more than one, even in a socialized health care environment such as England’s) and the parents, who might be dead set on making sure their child is given every opportunity to survive, regardless of potential disability.

After all, that’s a choice moms can now make during pregnancy at around 20 weeks or so. We can have a test done (don’t ask me the name of it, but I remember being asked if I wanted it during my pregnancy) that will indicate a chance of Down’s Syndrome in the developing fetus.

I didn’t take the test. Looking back on it now, was I morally lazy? Should I have had the test taken just so that I would have had to make the decision not to terminate given a positive result for Down’s? Or was it just that I had accepted Duckie’s presence and I was already willing to deal with any consequences of it?

Damned if I know now.

If she had been born so early that she would not have survived outside of an incubator, would I have allowed her to suffer the pain of treatment in order to have a chance at life, even if it wasn’t a kind of life I knew? For a while, I’m sure I would have. Is that selfish?

The furor also has to do with the baby’s right to life, as opposed to an older child’s or an adult’s right to life. Babies seem to be given short shrift in terms of choices – because they can’t make their own, can they?

One of the issues that the Church of England raises is compassion. Do you make the decision to let a child die to reduce its suffering (or yours, if you’re a parent and simply cannot cope)? How much does that have to do with other children who also need the care and bed space? Here's a snippet from Gaby Hinsliff's article that I found particularly helpful in understanding this issue:

"The issue is, however, more complicated than it seems. At St George's, consultant neonatologist Sandy Calvert argues that the pressing problem is babies of all ages 'blocking' intensive care beds because of staff shortages in the lower dependency units they should graduate to as they recover.

There are three levels of neonatal care: intensive care for seriously ill babies who cannot breathe unaided; high dependency for less severe problems; and special care for babies who are simply underweight or need a little extra help. The worst shortages, according to Calvert, are in special care - which means babies get stuck in incubators they no longer need. Her own ward currently houses twins who are well enough to return to their local hospital, but its special care unit is full, so they are blocking two intensive care beds.

This problem is primarily not about age, but staffing. Last year, according to Bliss, three-quarters of neonatal units closed at least once to new admissions. Even those with theoretically empty beds sometimes simply lacked the nurses needed to use them."

Moving right along.

The parallels to the conflicts between pro-choice and pro-life arguments is impossible to miss, doncha think? My thought is that these decisions can’t be left to anyone but the parents. I can’t even imagine parents who would willingly or lightly cast aside any hopes of their child’s future. I don’t think this decision would ever be made simply due to the economics of health care.

The debate continues in my own head. If I truly believe in reincarnation, it means that the souls of those babies are going to come back around; they’ll be born into new bodies when the time is right. So even if the decision is made with perfect love, awareness and compassion, what does it do to the souls of the parents and the doctors? Is there really any way for us to know?

I have no answers. But I will say that it’s about time we started asking the questions, and framing the discussion in ways that allow for measured and tolerant debate.

The only thing that is crystal-clear to me (and has been for a while) is that our developments in technology, medical and otherwise, have far outpaced our culture’s spiritual development.

Maybe that’s a given – maybe we can’t answer the questions until they’re forced on us. But to say that these issues didn’t exist 100 years ago seems a little na├»ve to me. They existed in one form or another – but most people didn’t know about them or even want to know about them.

So now we look at these heartbreaking conflicts as a culture, finally. How we discuss and debate is as important as the decisions we make. Casual conversation about this is hard for me – hard to discuss without information, hard to discuss at all, really, without getting so emotional that the brain shuts down. What's heartening is that there are conferences and colleges and considered statements about this - where people are taking into account both scientific knowledge and emotional wisdom. That's more than we had before.

Comment freely.


SB Gypsy said...

You are so right, this can only be a decision for the parents, they are the only ones who know the limits of their resources, both economically and spiritually.

James said...

I read "Glen Beck" and I had to stop reading and breath deeply for a few minutes before reading further.

I agree with you and gypsy whole-heartedly on this issue.