Octuplets raise ethical questions

ysabel

/ˈɪzəˌbɛl/ pink 5
#1
If you haven't read this thread yet, a woman recently gave birth to octuplets making her the second person in the world to achieve such a feat.

Ethicists have started debating moral issues involved. Main questions are:

1. Should there be a limit to the number of embyros allowed to be implanted in fertility clinics?

2. Is selective reduction (reducing the number of fetuses in a multifetal pregnancy to save other fetuses or lower risk to mom's health) the same as abortion?

3. Should doctors be able to override a patient's request for the sake of saving lives (ex: if patient is emotionally distraught, some decide poorly)?


See article for background:

(CNN) -- As more details of the mother who gave birth to octuplets come to light, ethicists are debating the moral quandaries involved. The woman had six other children before the set of eight, which were only the second set of octuplets recorded in the U.S. The babies' grandfather said Friday that his daughter wanted one more child and didn't expect this to happen.

Kaiser Permanente's Bellflower Medical Center reports that all is well with the mother and children. Seven babies are breathing unassisted, and one is receiving assisted oxygen through a tube in the nose. Seven are being tube-fed donated breast milk.

It is unclear how this woman ended up with eight embryos in the first place. Her mother told the Los Angeles Times on Thursday that the woman had received fertility treatment and that she had embryos implanted last year.

"If she went to a fertility clinic, there's wide consensus from every single ethicist and fertility specialist that this was irresponsible and unethical to implant that many embryos," said M. Sara Rosenthal, bioethicist at the University of Kentucky's College of Medicine. "This is an outrageous situation that should not happen."

Doctors say that giving birth to extreme multiples comes with tremendous risks for both the mother and the babies. Risks for the children include bleeding in the brain, intestinal problems, developmental delays and lifelong learning disabilities.

In certain European countries, particularly Italy and Germany, the limit on the number of embryos allowed to be implanted at once is three, said Robert George, professor at Princeton University and member of the U.S. President's Council on Bioethics. George advocated following those countries' examples so that similar situations don't arise and put the lives of mother and fetuses at risk.

"What you need are professional norms and legal regulations that restrict practices that are inherently very dangerous," he said.

The woman's mother told the Los Angeles Times that doctors gave the woman the option of selectively reducing the number of embryos, and she refused.

As to a "correct" decision at this stage, experts are split.

George said that, based on the information available, his personal ethical decision would probably support the woman's choice to carry all the babies to term. But he said that selective reduction is not the same as traditional abortion because the goal is the healthiest possible birth rather than the termination of a pregnancy.

"The babies didn't put themselves there; it's not their fault," George said.

"There does seem to be a serious ethical question about killing one or more of them, even for the sake of maternal health."

Rosenthal, on the other hand, questions the woman's capacity to make a good decision under the circumstances. Some neonatologists believe that when pregnant women are told about dangers of prematurity or have great expectations about giving birth, their judgment can be impaired, she said.

The situation raises the issue of whether a doctor ought to override a patient's wishes for the sake of saving lives, she said. Although the health care system in America gives patients autonomy in making decisions about their own bodies, when emotionally distraught, some people decide poorly, she said.

A doctor counseling a woman with octuplets may strongly recommend partial or full termination because of the risks to the mother and children. Even with triplets, a doctor would be "remiss if [he] didn't tell a woman with triplets about selective fetal reduction," said Dr. Scott Slayden of Reproductive Biology Associates in Atlanta, Georgia.

Dr. R. Dale McClure, president of the American Society for Reproductive Medicine, said in a statement Friday that the organization has been working to reduce the number of high-order multiple births resulting from in vitro fertilization treatments.

"If this resulted from an IVF treatment, we can say that transferring eight embryos in an IVF cycle is well beyond our guidelines," he said.

The guidelines state that patients under the age of 35 would not have more than two embryos implanted "in the absence of extraordinary circumstances." In fact, a woman in this age group with a favorable prognosis should have only one embryo transferred, the guidelines say.
The mother of the octuplets is believed to be 33 years old, according to the Los Angeles Times.

"It would be extremely unusual, very strange and hard to believe that somebody who is a professional would put that many embryos into a woman who is 33 years old who has children," Slayden said.

That she carried eight fetuses does not necessarily mean eight embryos were implanted, Slayden said. Four to 5 percent of the time, an embryo will split. As few as five embryos could have given rise to the eight children, he said.

Although it is "amazing" that the mother and eight children appear to be healthy, the story is somewhat dangerous for would-be mothers seeking fertility treatment, he said. They may see this example as a reason to take chances in attempting to birth extreme multiples, despite the large risks involved in such pregnancies and the rarity of their success. The nanny who works with the octuplets' siblings said Friday that the woman "adores her babies" and is "a perfect mom."
Thoughts?
 

Pugz

Ms. Malone
V.I.P.
#2
She paid for the treatment and she took the risks; what actually bothers me is that she had the 8 babies and her previous 6 through the treatment-her neighbours say she lives with her parents and have never seen her with a man.

Could something be wrong mentally? Why would she want to raise all those children, not on her own, but without a perminant father?
 

Stab-o-Matic5000

Cutting Edge in Murder
#3
As for question one, there should definitely be restrictions. Putting in multiple embryos is just frankly insane and asinine.

For question two, I would say yes, it is the same as abortion, however, just like with abortion, if it is done to save lives it is a necessary evil.

Question three, even with impaired judgment, a person still has the right to decide what is best for their body. As long as the doctor has advised the patient about the risks involved, the patient should be able to make up their own mind.
 

ysabel

/ˈɪzəˌbɛl/ pink 5
#4
She paid for the treatment and she took the risks; what actually bothers me is that she had the 8 babies and her previous 6 through the treatment-her neighbours say she lives with her parents and have never seen her with a man.

Could something be wrong mentally? Why would she want to raise all those children, not on her own, but without a perminant father?

Hmm, now that you mention it, I just noticed there's no reference about the father. The articles only referred to the octuplet's grandfather and the woman's mother. :hmm:

It just adds to the ethical considerations. Should fertility clinics be more selective with who to accept for the implants (these are possible babies), the same way adoption clinics are when choosing suitable guardians for a child? Would it be right to enable someone to have this responsibility (having children) if the situation casts a doubt about a person's capability of handling it? Or should they not be concerned with such considerations (ex: consider everyone has a right to bear kids anyway) as long as the patient paid for it?
 

Merc

Certified Shitlord
V.I.P.
#5
Her body, her decisions. People need to figure this equation out. It's not very difficult. If she wants to attempt an eight child birth, that's her choice.
 

Smelnick

Creeping On You
V.I.P.
#6
If they put restrictions on the number of embryos that can be implanted, that would definitely remove some of the later ethical dilemnas (ie: should some be taken back out, should the doctors override decisions etc)

Why shouldn't there be a limit eh? If women really were intended to have 8 babies at a time, wouldn't that be a little more common? twins is the most common, and triplets is rough I imagine, but also common. But 8 babies is ridiculous. And she has 6 kids already. I worry about what kind of life all these kids will have, and who is paying for all their food and stuff?

Cons, in regards to your comment 'her body, her choice'. Sometimes it's better to restrict the choices a person can make. Her 'choice' just might lead to a bunch of neglected kids running around cause mom can't take care of all of them at once. These rebelling teens will probably run around causing crimes and stuff. Also, a lady successfully having 8 babies, is going to encourage alot of other silly ladies to have large multiple births as well. Imagine school now lol, one third of the grade 4 class is the Smith kids, another third is the johnsons etc. lol. Anyhow, the point I'm trying to make is that , yes, it's true that it's her choice, however, some choices need to be nixxed, and/or controlled, because they don't just affect her.
 

Merc

Certified Shitlord
V.I.P.
#7
Cons, in regards to your comment 'her body, her choice'. Sometimes it's better to restrict the choices a person can make.
Yes, if that person exhibits or has pre-existing reasons supporting a decision to restrict their choices. A person with a history of physical violence should not own a handgun, a man who beats his wife should not be allowed to adopt children, etc.

Her 'choice' just might lead to a bunch of neglected kids running around cause mom can't take care of all of them at once. These rebelling teens will probably run around causing crimes and stuff.
They may also move to England and take the professional rowing circuit by storm, winning countless awards and making their family rich beyond compare due to their unnatural rowing abilities.

See? It just doesn't work that way. It's a hassle to have that many kids, but it doesn't mean that they're going to fail as parents and that their children will be delinquents. No offense, but I think a lot of us get these ideas from the media and entertainment venues. It's logical that a big family is harder to maintain, but it doesn't guarantee anything in the way of the "quality" of their children. I've known parents with a single child who fail miserably and families with six who have succeeded in raising all of them to be honor role students with clean criminal records.

Also, a lady successfully having 8 babies, is going to encourage alot of other silly ladies to have large multiple births as well. Imagine school now lol, one third of the grade 4 class is the Smith kids, another third is the johnsons etc. lol. Anyhow, the point I'm trying to make is that , yes, it's true that it's her choice, however, some choices need to be nixxed, and/or controlled, because they don't just affect her.
But you're not dealing in guarantees here. That's like saying, "Well Mrs. Smith, your nephew was a serial killer, so we're suggesting you get your tubes tied to save the rest of us from the wrath of your potential dangerous baby oven". You can't predict what will happen to a person or how their children will turn out based on generalizations. Just because some families with a lot of kids are dysfunctional and out of control doesn't mean they all are. My mother had 4 (total) and people considered her nuts for that many but our family is doing just fine. I understand what you're getting at, that she may have taken on "more than her fill" but it doesn't make anything certain or predictable.

Also, I don't see how having eight kids is going to "encourage" anybody. Most people who don't give birth to eight kids aren't thinking, "Damn if only there was a way to have eight kids, I'd be INVICIBLE!"

Hell no dude!

Most of them do not have that many kids because they simply don't want that many kids. I bet if you could poll the nations, an overwhelming majority would want between 1-3 kids and no more. Just because one lady pulls a nutter and chooses to have 8 doesn't mean any women are going to follow suit. That's a tad bit ridiculous there.
 

Smelnick

Creeping On You
V.I.P.
#8
Yah I guess your right. I think I may have been trying too hard to make a point that wasn't really much of a point =P I still think that women shouldn't be having 8 babies, but its more for the sake of the babies than anything. My mom had a hard enough time with 5 kids. This lady has 14 now. In the old days, families had like 14 kids, but usually by the time the 14th one around, the older kids were old enough to help out and stuff. More than half of this lady's kids are the same age. One mom, (single at that) taking care of 14 babies is gonna be hard, so lets hope she gets smart and gets some help.
 
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ysabel

/ˈɪzəˌbɛl/ pink 5
#9
I'm not against artificial fertilization methods but I agree that there should be restrictions and not just be careless with its use. We cannot control who gets pregnant naturally even if some people want to be able to control it (ex: think that some people shouldn't have kids). But if we had the power to minimise irresponsible breeding without going against the natural scheme of things, I think we should take the opportunity. Otherwise it will just look like a baby factory where you can order x number of babies as you want (for whatever reason). However it would lead to another question: when is it responsible?
 

Bananas

Endangered Species
#10
1. Should there be a limit to the number of embyros allowed to be implanted in fertility clinics?
Yes, definitely. it is unnatural. If the science behind artificial fetilation if it is not enough medeling in natures affairs then doing it multiple times as a fail safe is just foolish. If we are going to recreate nature then we should recreate nature as its norm, 1 cycle = 1 embryo.

2. Is selective reduction (reducing the number of fetuses in a multifetal pregnancy to save other fetuses or lower risk to mom's health) the same as abortion?
Yes it is the same as abortion, regarding the ethical issues of that and to be frank we should not put ourselves in that position to start with (see q1).

3. Should doctors be able to override a patient's request for the sake of saving lives (ex: if patient is emotionally distraught, some decide poorly)?
I assume this is reference to q2; It would all depend on the situation. It is within the Doctors ethics to save a life when possible. If the patientss request is handing out a death sentence then I'd prefer the Doctor to use their better judgement and to face the consequences later.

Regarding the case in question it should of never been allowed to happen. Sure some embryos split, for it to happen repeatedly until there were 8 is unlikely. We should not have the option of embryo reduction as those embryos should not of been there to start with. If that narrows down the probability of the patient getting pregnant then her odds are still higher than with no treatment.

They put the mothers life at risk and also gave very poor odds to 8 more lives who willl most likely suffer many ailments as a result of this greed and mispractice.