Columnists debate ethics of octuplets

Last week, in a modern medical marvel, a woman from Whittier gave birth to healthy octuplets. Congratulations to the medical team for pulling off such an unlikely operation, and congratulations to the mom for pulling through and for the eight bundles of joy that just came into her life.

While I hate to point out the negativity in such a life-affirming event, the case of Nadya Suleman, the mother in question, is complicated by two additional facts. One, she was confirmed to have gone through in vitro fertilization to get pregnant, which means that the pregnancy was artificially induced, and two, she already has six children from previous pregnancies.

The problem with in vitro fertilization, in Suleman’s case, is that she and her fertility doctor knowingly put her life and the lives of the children in danger by exposing her to the likelihood of a multiple birth. The problem with having six other children in her home is, quite frankly, obvious: This calls into question her capacity to care for and raise her children ““ all 14 of them.

These two points escalate this seemingly heartwarming occasion into an ethical debate that seems, at least to me, to point to two radical, albeit necessary, courses of action. Stricter measures must be put in place to prevent the irresponsible exercise of fertility procedures, and regulation must be passed to counter the equally negligent exercise of reproductive rights.

Under the guidelines set by the American Society for Reproductive Medicine, “women under 35 should always be given no more than two embryos during a single implantation procedure in the absence of extraordinary circumstances.” Suleman, at 33, falls within this category. The ASRM recommendation was set with the knowledge that numerous complications are associated with multiple births, both for the mother and the babies.

A mother facing multiple births is at risk of high blood pressure, gastrointestinal problems and increased bleeding before and after delivery, among other things. A child sharing a womb with many others is more likely to have problems with brain development if premature delivery occurs. If things get really out of hand, the mother might also miscarry as a result of multiple gestations. Knowing the risk involved in multiple births, both doctor and patient were undoubtedly irresponsible in the placement of that many embryos.

“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,” said Dr. Scott Slayden of Reproductive Biology Associates to CNN.

The risk taken by placing that many embryos was unnecessary. It was not that Suleman was having a hard time conceiving ““ that was clearly not the case. She had already been mother to six children via a sperm donor before the implantation occurred. This makes the pregnancy an abuse of an avenue offered to those who are having trouble conceiving, or those who are seeking an alternate means to have children. The issue is not one of fertility, nor is it one of a woman’s freedom to give birth. This was an attempt to satisfy a woman’s obsession with motherhood at the risk of innocent lives.

“We are scandalized by hearing this, and whoever performed this act should have his license revoked,” said Dr. Milan Fiala, a researcher at the Orthopaedic Hospital Research Center at UCLA.

This is not an unsubstantiated suggestion. Doctors must be able to draw the ethical boundaries of what is medically proper, and the fertility doctor responsible for Suleman’s implantation certainly did not perform this duty.

The addition of eight more children, on top of the already numerous six, offers yet another controversial dimension to this case.

To begin with, the financial burden is tremendous, no matter how one looks at the situation. To add to this, Suleman divorced her husband, Marcos Gutierrez, in January 2008. This is not to say that single parents are incompetent, but raising 14 children is an overwhelming responsibility, even for married couples. Certainly, the financial burden would have been easier with two people footing the bill, and, all talk of money aside, a significant other could help out with tasks such as babysitting.

Who will be left to clean up the mess ““ child services, the government or nonprofit organizations? This is a preposterous notion. If a mother knows well that she will be incapable of, or even insufficient in, providing for the needs of potential children, then she must not have assumed the responsibilities of a parent in the first place.

In the past, as with the case of the Chukwu family, who gave birth to the first-known octuplets in 1998, cash contributions were sent in from across the nation to help care for the children. In another example, Jon and Kate Gosselin, parents of a set of twins and sextuplets, became stars of TLC’s “Jon and Kate Plus 8,” in which they spoke about the incentives they had due to the quirkiness involved in being a large family.

This is ridiculous. Parents must not be glorified as celebrities just because they have large families, nor should they get a free pass at raising children just because they have more kids than most people. People need to grow up, face the realities of parenthood and fully assume the responsibilities.

Suleman is lucky that she and her children survived the pregnancy and the operation, but others might not enjoy the same fortune. The simple fact is that this incident was a medical rarity, and must not be misconstrued as a standard.

To prevent the potential deaths of babies and mothers due to unsafe medical practices, and to ensure that children are brought up in an environment that can properly sustain them, measures must be taken to assure that a parent’s reproductive rights do not supersede a child’s right to a decent life.

E-mail Ong at [email protected]. Send general comments to [email protected].