Posted by: bridget | 6 November 2007

The Boys Who Lived

When a pregnant woman found out that one of her twin boys was smaller than the other and had an enlarged heart, she agreed to selective reduction abortion.  Initially, the doctors tried to cut his umbilical cord (the procedure is outlined here); when that was unsuccessful, the doctors cut her placenta in half, so that if the smaller brother died, his twin would not be harmed.  Once doctors severed the placenta, however, both boys thrived.  They were delivered about ten weeks prematurely, weighing 3 lb. 8 oz and 1 lb. 15 oz.  Both are now healthy seven-month old boys. (Story here. Hat tip: PatHMV.)

In May, a Mesa, Arizona man and his wife got into a car accident; allegedly, they had been fighting when the wife (who was in the passenger’s seat) grabbed the steering wheel.  Rebecca sustained minor injuries and recovered quickly.  Jesse, however, had a fractured skull and became comatose.  He had a feeding tube, although he did not need life support.  After a week of treatment, Rebecca removed him from the hospital, transferred him to a hospice, and ordered his feeding tube removed removed so as to end his life.  Doctors had predicted that he would remain minimally conscious (in a similar state to that of Terri Schiavo) for the rest of his life and would never recover. 

Jesse Ramirez’s parents were having none of this.  They brought an action to have his feeding tube restored.  Under Arizona law, only a court-appointed guardian or a person with medical power of attorney may order the removal of feeding tubes; Rebecca Ramirez did not fulfill either qualification.  Judge Paul Katz appointed a surrogate immediately, although he refused to order the hospice to reinsert Jesse’s feeding tubes.  (The hospice did so of its own accord the next day; Judge Katz ultimately required that he receive nutrition pending the outcome of the case.)  During the investigation, Jesse recovered; he was able to communicate with those around him, responded to oral commands, and was conscious.  On 19 October, he walked out of the hospital, alive and recovering from his accident.  (Story here, here, and here.  Hat tip: Pachyderm friend at ADF.)

In the case of baby Gabriel, it is strange that doctors proposed death as the first and more humane solution.  Part of their rationale was that he would die anyway, and, in so doing, could kill his brother.  Okay, we all understand that two dead babies is worse than one dead baby.  Nevertheless, the technology exists – and was later used! – to preserve the lives of both children.  What rationale can possibly exist for attempting first to sever the umbilical cord and starve Gabriel to death, and, failing that, to cut the placenta so that his death would not harm his brother?  Why not just sever the placenta and remove the Sophie’s choice, thus giving both brothers a chance to live (as these doctors did)?

Likewise, with Mr. Ramirez, it seems as if the proper order of things would be complete a neurological evaluation before withholding food and water.  70% of comatose persons who suffered from a traumatic head injury (as opposed to oxygen deprivation) will recover some level of consciousness (here). While medical technology may make these issues moot, doctors and surrogates should not default to killing someone who cannot be cured.  The human mortality rate is holding steady at 100%; death ought not be a universal equiliser which serves to degrade us all. 

Final thought: the Alliance Defense Fund correctly noted that the Ramirez case was successful because Arizona law requires that a health care surrogate (court-appointed or appointed by the patient in a prior instrument) act in the best interests of the patient when deciding to remove life support.  Obviously, Florida’s laws are not so pro-life; Texas reconfigured its futile-care law, which is now only moderately problematic for patients and their families (here).

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Responses

  1. I am sitting here shaking my head.
    How do you explain to your child that you tried to kill him before he was born. I guess you tell him you had bad advice, which is apparently true.

    As for the married couple, I have to wonder how that marriage is going to work out.

    It appears to be a lack of both faith and hope.

  2. The tenacity with which people will try to kill the unwanted is amazing. One woman I know of tried the morning after pill and it didn’t work, so she was determined to have an abortion. The unborn human being already survived one attempt on his/her life. Hopefully the mom will reconsider.

    I had the same thoughts as SST about that marriage!

  3. Hmmm … as parents we will be held accountable for attempting to kill our children. No excuses. What kind of a mother listens to that insane advice?

    As for the marriage, I imagine the wife wanted the feeding tube removed for financial reasons, don’t you? I mean normally there is some type of insurance settlement that provides enough money to take care of a brain injured person for the rest of their life. Well, more money for her if the feeding tube is removed. Time is money people!

  4. Sunday School Teacher,

    Yeah, I wonder about that, too. Especially in the age of the internet, that kid will google himself someday and find out that his mom tried to have him killed. Then again, we’ve seen people who wanted abortions sue when they don’t work.

    As for that marriage: I do think that a divorce would not be unwarranted. As a random rant, there is a problem with no-fault divorce: the evidence that she tried to have him offed is not admissible. (This is similar to Prof. Wilson’s experience: http://www.nytimes.com/2006/10/01/opinion/01LIwilson.html)

    Neil,

    Yeah, you gotta wonder. It really upsets me that they first tried to off the baby, and then to just let it live an existence that would not harm its twin. Really, people, why not do things the other way around?

    If you click on one of the links, another mom had the procedure done. The news story skims over the fact that one of her twins was killed in the procedure – it was essentially not mentioned and only alluded to by omission.

    Tammi,

    You’re probably right about financial reasons. Even more than that, they were fighting when they got into the accident. Heck, maybe she had something to do with it.

    I carry really good auto insurance, but it only pays $100,000 per person (max $300,000 per accident). I could imagine that she figured she would be best off pulling the plug before she incurred any costs, collecting some life insurance, and going along on her merry way.

    As Neil once said, I want people to root for me to live. Sheesh!

    As for what kind of mother listens to that insane advice… heck if I know. Thing is, if the kid had been born and the doctors said, “Well, we don’t know if he can make it much longer; I think you should just stop feeding him,” most mothers would ceclare WWIII against the doctor. There would be second opinons, third opinions, elevenses – more opinions than hobbits have meals, until someone gave some advice that said, “Okay, here’s how we can help the little guy to live.”

    QueenofSwords and I were saying that it should be a sign that we’ve given up as a civilisation when we don’t care about our children. What kills me is that it’s always the Darwinists (not that I’m not one) who want to off the kiddies.

  5. Interesting post, BUT, the Terri Schiavo case is different in many ways.

    Terri had designated her wishes (many will discount that) and her husband was trying to fulfill those wishes. The state made their decision.

    The people who tried to change things would typically be on the side of the husband (after all, a woman shall leave her mother and father and cleave only to her husband) and would typically be on the side of state’s rights.

    The Terri Schiavo case held exceptions, but it still bothers me that many of my right wing conservative brothers and sisters tried to take away a husband’s rights. Until you’re in that position, you really don’t know what you will do.

    I’m sure many that follow this blog will disagree.

  6. Um, correct me if I’m wrong, but the morning after pill doesn’t kill any unborn fetus Neil.

  7. Err… Randy… who mentioned Terry Schiavo?

    Not trying to be snitty, but I have HUGE issues with the idea that I am required to a) defend every possible, conceivable, remotely related and sometimes unrelated issue on my blog; and b) go into pedantic detail about how the cases are different.

    No one mentioned Terry. I am NOT going to debate that issue here. Again, not trying to be snitty, but I really hate defending UNRELATED issues that I never meant to defend in the first place.

    If other readers want to, rock on. I’m in the camp of ignoring unrelated issues, such as Terry Schiavo, the Bible, how the Bible should force people to die at the hands of their murderous spouses (well, that’s your theory, isn’t it? – screw the whole part about submitting to your husband or loving your wife as Christ loved his church), or explaining that our laws are secular.

    I was commenting on the way that the medical profession and society have a default position of “if you can’t save ’em, kill ’em.” I’m missing the part about where Biblical mandates on marriage fit into all this, and, frankly, I don’t care at all.

  8. Edgar,

    It doesn’t kill the unborn fetus, no. What it can do is to prevent a fertilised egg (zygote/embryo) from implanting. It also works by preventing ovulation. Obviously, she ovulated, conceived, and Plan B did not work as intended by preventing implantation.

  9. What blew my mind about the news item concerning the Boy Who Lived was the “I’ll be durned!” and cheery tone of the article. Absolutely no introspection on the part of the parents, let alone the writer. Just everyone grinning and celebrating the miracle child.
    It’s obscene. As I told the Pachyderm a couple days ago, it’s akin to stabbing someone 6 or 7 times, with every intent to kill them, and then throwing a party for them because they survived your assault. Perverse.

  10. One day, L&L, you’re going to come out of your shell and tell us how you really feel.

    I completely agree. It’s completely strange to be able to look at your child and not think, “Wow, I can’t believe I ever took that advice,” or “I wonder why the doctors first recommended death.”

    L&L, if you really want to get ticked off, read this (second story). From the way it’s written, you wouldn’t even know that someone died.

  11. Here is a choice exerpt of the procedure:

    After considering their options, the family elected to proceed with selective bipolar umbilical cord cauterization. Given the presence of increased amniotic fluid volume within the recipient twin sac (polyhydramnios), the recipient’s umbilical cord was easily identified and approachable using ultrasound guidance alone. The umbilical cord was grasped and cauterized in three different locations across a 5-cm segment of the umbilical cord. The excess amniotic fluid was then removed from the recipient twin sac, and antibiotics were placed into the uterine cavity to decrease the risk of infection.

    It then talks about how she got bedrest and went home with one baby. Nothing at all about the fact that “umbilical cord cauterization” is a euphemism for “abortion.”


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