Making ethical decisions is complicated. Nearly every large hospital now has an ethics board to deal with “cases” which are fraught with emotion. For example, a teenage girl, diagnosed with a rare type of blood cancer needs a bone marrow transplant, a total replacement of her faulty blood with that from a perfectly matched donor. Also involved is a long period of isolation, a very long recovery period, but good health for at least a while.
Parents are asked by the physician to come in and discuss some “options.” Jean and Jim go together to the office and are invited into a comfortable living room-like space, with plush over-stuffed sofas, pillows piled in the corners of the room, and several colorful blankets folded over the arms of chairs. Over coffee, the doctor asks whether the parents have considered having another baby, but not just the “baby God sends from heaven.” With the correct modifications, he explains, they can have implanted an embryo which provides the perfect complement to their daughter’s unhealthy hematology. That embryo, implanted, will grow into a baby sister or brother, whose bone marrow might be used to cure the older sister.
Most of us have heard of IVF, may even have used the technique to have a child when conception seemed impossible. There are ethical concerns about whether one or more of the implanted embryos may have to be terminated for the best possible outcome. There are movies which have successfully filled the theaters with viewers. Cases are studied in college classes, in medical schools.
In my experience teaching an introduction to Medical Ethics class, I have found that one voice is silent. No one brings up the possible danger to a mother of having another pregnancy. This is not a matter to be minimized. Every time a woman goes through a pregnancy, she is courting danger. Physically, emotionally, perhaps even spiritually, she is taking on – mostly by herself – more of the responsibility for having a “happy family.” There are no guarantees that the pregnancy will be “uneventful,” that she will be spared high blood pressure, pre-eclampsia, damage to the uterus, stress on the renal system, as well as a “slight” chance of suffering a stroke during labor and delivery.
We talk loudly and firmly about the best interests of our children, but what is in the best interest of the already alive, healthy, but possibly fragile state of the mother? Some religious groups oppose any kind of interference with the conception -to -birth process, but couples have made their own decisions, sometimes in opposition to their church or temple.
Remember this – allowing the ethics committee to decide is like going to court. The decision will be made by strangers – knowledgeable strangers – by still, strangers. The decision is binding.
Finally, there is the matter of “boundaries.” Is a physician over-stepping the bounds of his/her position by suggesting that having another baby can save an already taxed family? Surely, much more discussion, many more scenarios ought to be considered before making such a drastic change in a family.