The Tiniest of All

Or, When It Might Be OK to Lie

The news outlets are abuzz about the report that the most premature baby ever is about to go home from the hospital. The report is interesting to me because of all the new babies born around me in the last few months, and the couple expected soon. This Guardian article is the most interesting, in my opinion. The little girl's mother was pregnant for just 5 months before having an emergency c-section- not even into her 3rd trimester. When the doctors asked how far along she was, she exaggerated by over a week, because hospital policy dictated not to resuscitate babies born before 23 weeks. Little Amillia was resuscitated, and has fought to survive until now, with a very bright prognosis for her future.

As the Guardian article points out, this brings up very serious questions regarding policies of when a baby is a baby- when does our current technology allow the new life to be kept alive? And for how long is a fetus "disposable"? Is there a line between "disposable" and "viable"? From the Guardian article (a British publication):

According to the American Association of Pediatrics, babies born at less than 23 weeks are not considered "viable". According to a landmark report published by the Nuffield Council on Bioethics late last year, which provides guidelines that all British neonatologists and paediatricians are asked to consider, babies born before 22 weeks and six days gestation should not generally be resuscitated. Below 22 weeks, no baby should be resuscitated.
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Meanwhile, although it doesn't often happen, the Abortion Act allows terminations to be carried out until 24 weeks in Britain; any time after that there must be incontrovertible medical evidence that it would be dangerous to continue. The law in the US is predictably fraught and unclear, and in any case varies from state to state. Roe v Wade bans it after the foetus is viable, which, as Amillia has shown, is something of a contestable point.

Contestable point, indeed.

One opinion from the article:

"Should one really be trying at all to keep that baby alive?" asks Professor Richard Nicholson, editor of the Bulletin of Medical Ethics. "Chances are it will require an enormous amount to be spent on it for the rest of its life. We have much less experience of death, so we have become much less willing to accept it. In countries where infant mortality is higher it would be seen as absurd. We live in a society where we have become addicted to physical existence. It's totally unsustainable. Our attempts at the moment to keep every human physically alive as long as possible will make it less likely that the human race will survive climate change."

"Is choosing whether a baby lives or dies an economic or evolutionary one, like this professor suggests? That thought bothers me. Another expert quoted in the article, John Wyatt, a professor of neonatal paediatrics at University College London Hospitals NHS Foundation Trust, has a more compassionate view:

Most parents, when given the facts, would accept that the best thing for a baby born below 23 weeks is to allow nature to take its course, and most neonatalogists would agree that they shouldn't be resuscitated. And yet ... we need to decide what is best for each individual baby. A premature baby is as much a member of the human community as anybody else, and deserves the best care that's available. By and large this care has been extremely successful. There are thousands going into adulthood who previously wouldn't have done so."

The article appropriately ends with an essay by a mother of a premature baby.

You worry about their future, of course, and Amillia's mother will be worrying right now. You scan the pictures in the special-care baby unit of children whose lives started here, and you find yourself thinking: are they normal? Will my child be normal? But even though some of the children in the pictures don't look "normal" - they're too thin, they've got a squint, they're in a wheelchair - you don't ultimately care whether that is what is going to happen to your baby. You hope everything will turn out fine, of course you do: but you already know you love this baby anyway, and you know that nothing is going to change that. Not a doctor's grim predictions today; not a teacher's pessimistic evaluation tomorrow; not the fact that your friends' babies can do more, and earlier. You have that one, precious person - I have my Rosie, Sonja Taylor has her Amillia - and the world will be brighter and better because of it.

That's the point, isn't it? That a new precious person is in the world?

To add, another angle on the abortion discussion: the TIME story on the grassroots abortion war: crisis pregnancy centers and their strategy on winning the abortion debate one woman at a time. (I came very close to blogging about this by itself about a week ago, but didn't. Seriously, read it.)