Six Kids, Eight More: Ethicists Speak Out

Mothers Who Can't Say No to More

In the United States, however, there is nothing illegal about adding eight children to the six you already have. And doctors point out that while doctors are free to advise mothers against mega-multiple pregnancies, there is no rule that says mothers must take that advice to heart.

"In general, doctors cannot force a patient to make a decision, though most [doctors] have a lengthy conversation with the patient," said Dr. Geeta Swamy, a maternal-fetal specialist at Duke University Medical Center in Durham, N.C.

Steven M. Donn, director of the Division of Neonatal-Perinatal Medicine at the University of Michigan Health System, said that for many mothers who opt for fertility treatments, the decision to selectively terminate some fetuses is anathema.

"If indeed this woman was an infertility patient and got pregnant, and then the first thing that they asked her to do is to terminate some of the pregnancies, this is probably very incongruent for her," he said. "It's extremely difficult for an infertile woman, once she conceives, finally, to think long-term."

Significant Religious Convictions

Still, if the six kids in question are indeed the woman's biological children, it is clear that she was, at least at some point, fertile. At this point, other factors may come into play.

"You can often tell who is going to flat-out say that they are not going to do it," Swamy said. "These are often people with significant religious convictions. ... For them, it is often all or none."

These convictions might endure, even in the face of the serious risks that mega-multiple pregnancies entail, Georgetown's Subramanian said.

"Even without discussing the issue of fetal reduction, which is controversial in its ethical, moral and religious arenas, any number over two or three fetuses is detrimental to the mother's health during pregnancy and after," he said. "It is also detrimental to the fetuses where they compete for the resources with some failing to get enough nutrients."

When 14 Kids Is Too Many

As it now appears likely that the mother and her eight new babies will share a three-bedroom apartment with six other children, most people could also find themselves grappling with the notion of how a mom with 14 kids could possibly make ends meet.

"Right now multiple births are being treated as a 'lark' on television series and in some news reports," Pennsylvania's Caplan said. "But this 'Brady Bunch' attitude obscures the risks and dangers, especially when many vulnerable babies are added to a family that is already very large."

Massive hospital bills aside, the newly expanded family will also face day-to-day expenses such as food, clothing and proper housing. Medical care could also be a major consideration, as premature babies, on average, require more health care services throughout their childhoods than their full-term counterparts.

Subramanian noted that whether the mother relies on private insurance or Medicaid, "it is still a tremendous resource utilizer, especially if she has had six other kids."

Said Caplan: "It is important that social services check into this story to see that the other children are not being neglected."

Keeping Burgeoning Families at Bay

So what can be done to curb what some call an abuse of medical technology? Caplan said reform is needed to ensure that such an episode is unlikely to happen again.

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