Wednesday, July 8, 2009

I know we CAN, but does that mean we SHOULD?

I have thought about this a number of times in the last couple of years, and am finally writing it out. Please note that while I give a couple of examples in here, I am not generally trying to pass judgment on the people involved, nor trying to suggest that they should have done something different from what they did. I'm just saying that these things give me pause and make me think.

I must begin by saying that I am grateful for many of the astounding advances which science has made in the last century or two. We have broken the sound barrier. We have been to the moon. We have split the atom and begun to unravel DNA. We have cloned sheep. We are able to save the lives of babies who insist on being born scarcely halfway through their gestation. We are often able to stop the pre-term labor that leads to such premature babies. We have machines which can help people breathe or keep their hearts beating when they are unable to do so on their own. We can bring people back from the brink of death.
And yet, in spite of all the things that we CAN do, sometimes I have to wonder, SHOULD we do all these things?

I think of my first two miscarriages, one which occured spontaneously, and the other of which was medically managed (with a D&C). Can medical intervention save lives? Of course--my first miscarriage necessitated a trip to the emergency room in fact, and I'm ever so thankful for the medications they used to stop my bleeding. But with the second miscarriage the intervention was not necessary, it was a choice... and based on the emotional differences between the two situations, when the third miscarriage was immenent I chose to let nature take its course. I suppose that is when I started thinking about what we can do verses what we should do.

I think one of the biggest cases of "but should we" is the atomic bomb. Yes, we can make it...but should we? And if we make it, should we use (or should we have used) it?
We can clone sheep, and dogs, and who knows what all else...but should we? Is it our place to play gods? Is it moral to create a being in this unnatural way? Or is it natural?

I'll admit that I have mixed feelings about the money that is spent on space exploration: I'm just not sure what the practical benefit is, and whether that benefit warrants the cost. My questioning increases with the cost in human life of each Challenger or Columbia.

What of the many people who have the request "do not recussitate" on their medical records? Sure, we can use electricity and oxygen to bring them back from the brink of death--sometimes even from the far side of that brink--but should we? It seems that many people think we should not.

I think about Terri Shiavo, the woman who was in a coma for 15 years before they finally decided to 'pull the plug' and remove her from life support. Her husband was ready to do it after 8 years when tests indicated that she had sufficient brain damage that she would probably never wake up, and would not likely be functional even if she did. Her parents fought his decision though, feeling that pulling the plug would constitute murder since Terri had never left a living will indicating her wishes on the subject. And so it became an ugly legal battle...and the machines kept beeping away for another 7 years while lawyers tried to decide whether pulling the plug was legal or moral or who knows what all else. In 2005 her feeding tube was removed and she died within a couple of days. So the question remains--at what point does it cease to be "life support" and become "keeping a dead person's vital signs going"? Obviously we could keep her alive (to whatever degree) for 15 years, but should we have done so?
(Incidentally, situations like this one are a good reminder of the need to have a living will, not just a will in the event of your death...but that's a different topic.)

My sister-in-law was nearing the end of her first trimester of pregnancy when she began to have signs of miscarriage. She went to the hospital, and they were able to stop the labor and save the baby. She spent quite a while on bedrest to prevent it from happening again. When she did deliver her son at 37 weeks, they discovered that he had Downs Syndrome. He's had heart and breathing problems, several surgeries, hospitalizations, a feeding tube, and so on. SIL explained to me one day "well, my body knew that something was wrong with him, and that's why it tried to miscarry." She is very afraid of having any other children because she feels that they would probably have Downs too. She spends hours every day attending to his special needs. He is a sweet, loving, and lovable child, but he definitely has changed their family.
Now I have been through several miscarriages--would I have stopped them if I could? Yes, probably...but sometimes I wonder how life might have been different for my SIL and her family if science had not been able to save her baby...

As I said, I'm not trying to pass judgment in these cases, nor do I know per se what I would choose if it were me in the situation. All I'm saying is that sometimes I can't help but wonder if we get a little too caught up in what we can do, and forget to ask whether we should.
I think it's a point worth pondering.


Tim said...

Holding on is easier than letting go. I think it takes strength to move on in situations like Shiavo's. It takes strength to accept reality, and realize that she's dead, and pull the plug.
Until that happens, it's hard for the survivors to really move on.
Life is precious, but a condition like Shiavo's is not life.

Destiny said...

It's situations like these that make me so glad I have the ability to receive personal revelation to know for myself whether or not just because something can be done if it should. I do think there are many things that should not be done just because we can. I often wonder if more people had the knowledge members of the Church had what the difference would be. Great post.

Mallory said...

I understand what you mean. These things make me think a lot, too. I'm not sure which is right and which is wrong. I can see good and bad in most of these controversial situations. I just hope that, if I ever have to make a decision concerning life or death, the Spirit will guide me to make the correct choice!

natalie said...
This comment has been removed by the author.
Christa said...

I have something I would like to say about this, but I'm afraid that it will be taken the wrong way, as it has happened in the past.
I will say this, very carefully. I believe in survival of the fittest. There are reasons that some people can do things and others can't. We may not know the reason, we may be able to fix the reason. But I don't think it means that we should. But I don't think people who do those things are wrong or bad, I think they made a decision that I hope I never have to make.
I do worry that people think I'm a hypocrite, because my twins were in the NICU. Doctors would say they took "life saving measures" with my children. I don't see it that way, all they did was feed them and keep them warm for a month and a half. They never had oxygen, or meds. But I don't know how it would have turned out had I not had them at a hospital...if I hadn't been I have to be "thankful" for the care that was provided.

So I agree with you, MANY things in this world we can do, but I don't think we should.

Carrie said...

This post has made me very thoughtful. I think it is interesting that we so quickly jump into making war, which kills so many lives, and yet, are so invested in saving the life of one person who is dead already.

Although I definitely understand the value of the individual, just because we don't know someone personally doesn't make their life less valuable.

Emily said...

I couldn't agree more. There are lots of things to say about it that could be very controversial in today's world, but I will leave it at exactly what you said: just because we CAN doesn't always mean we SHOULD. We can never know the future, or the reason for some things, and interfering with the course of those events could bring something to pass we would rather not have.

Lisa said...

In general, I agree, though I think it has to be taken on a case-by-case basis as individual personal revelation is so unique.

I have seen this happen in my family with regards to death. My dh's family had a certain person in it who simply could not let go when it was time for his parents to pass on, and because of that, dh's parents suffered far beyond what either of them needed to before their deaths. With one parent, it was really only for a few days of life support, but for the other parent, it meant months and months of suffering because one daughter could not let go the first time the opportunity for a peaceful death came along.

This was a complete contrast to my own father's death at home with hospice. My father had endured years of health challenges from juvenile diabetes, and we had definitely sought to prolong his life as long as there seemed to be good reason to do so...but when it was time for him to go, we let him do so.

I know that one area that is often heavily criticized that relates to this is fertility treatment, especially assisted reproductive technologies. I personally have chosen not to go very far down that route, however, I don't think there is anything inherently wrong with other people doing so; many people have been blessed with children through IVF and such. I think it's a very personal decision, and I do see that technology in general as a blessing.

Janeen said...

Christa, I think about that too especially for those who just are never going to be able to contribute to society at all, have to be fed and taken care of for life and I wonder what may have been done to get them here in the first place and I do wonder if too much is done. Sometimes we focus so much on life that we fail to look at the quality of life.

I agree though, I do wonder how far we should go with technology. There was an article recently about a hospital that's really working on ways to basically bring people back from the dead, especially from cardiac arrest. And I guess, it's really helping them learn more about the state of death. But what would that mean?

Then there's the story of the baby who doesn't age. She's been an infant/toddler for 16 years now. Scientists are studying her to see how they can use what she's going through as a way to prevent or slow down aging. Kind of creepy. There's such a find line with these things and hard to figure out what is going too far.

Cynthia said...

It's an interesting question to ponder and I think how you feel about it depends on whose shoes you've walked in.

I gave birth to my twins (twins conceived via fertility treatments which I'm sure are also on your list) at 29 weeks gestation after 3 weeks of being hospitalized for pre-term labor. If your hypothesis holds up, my kids would be dead.

At birth, my 1 lb. 15 oz. daughter would not breathe. They continued to work on her instead of writing her off and at minute 12, they finally succeeded in recusitating her. After 24 scary hours, she was tiny but miraculously breathing on her own.

She's 9 now. Perfectly healthy in every way. No mental problems- she's actually at the top of her class. No physical problems- other than asthma. And even if she had either type of issue, she is still valueable to US. We promised the Lord we would take her in any form he saw fit to give her to us. HE chose perfect and whole. No medical intervention would have saved her if HE intended for her to return.

So I don't think it's valuable to make general statements. It's all a case-by-case thing as far as I'm concerned. I have a beautiful, productive child who has every right to be here.

Emily said...

One comment about reproductive technology: I know it is a touchy subject, so please don't take this the wrong way...

I notice that a lot of people who become pg on fertility treatments end up having some amount of complication in their pg or labor, and I have to wonder if they were meant to get pg in the first place. I mean, if you are not designed to have a baby naturally, maybe there's a good reason for it?

Also, I can't help but think that there are literally MILLIONS of children in the world right now who need good, loving homes. I have a hard time supporting all the time and money that goes into fertility treatment when that time and money could be spent on giving children who are already here a home.

Again, no disrespect intended for those who use or have used fertility treatments. Just things I think about.

natalie said...

Definitely something to think about.

I do feel that there is a big difference between an infant or child and an elderly person, full of years and probably (hopefully) ready to meet their Maker.

(Sorry for my previous comment! I had two comment windows open, and didn't realize I'd put the comment for the other post on yours until later when I got an email about the new comments!)

Cynthia said...

Wow! Emily your comment is potentially the most offensive I've ever read on a blog. Congrats.

Old people don't have many years to live so we shouldn't treat their cancer or other medical issues. What's the point?

If someone is prone to repeat miscarriages that must mean they can't make quality humans (using your 'logic') so they should probably just not reproduce.

Why don't you go out and adopt some of the 'millions' of children you claim are available? Obviously you've never looked into adoption or you'd know how impossible it can be. My friends ALREADY ADOPTED child died in an African Orphanage- they've been trying to get her out of there for 2 years and the politics won't enable it to happen and she finally died waiting.

My obligation to 'save' these children is no greater than your own. Why haven't YOU done anything?

Emily said...

Cynthia - as I said, I meant no disrespect. I think you misunderstood my intention.

I did not say that some people can't make "quality humans." I simply restated what Mommy Bee was trying to say: that we cannot know why some things are the way they are, and by trying to change that, we might invite worse problems instead, as in her SIL who ended up with a baby with severe medical problems. And that isn't to say that her child's life is worth any less - it is just to say that had they not tried to change the natural course of things in the first place, they might have avoided the heartache they now face.

It may be that some women are unable to conceive because of some hormonal or genetic defect, and if they artificially become pregnant, that same defect could manifest itself in other ways, such as a genetic defect in the child, or problems sustaining a normal pregnancy, which itself could result in birth defects.

Obviously it is not up to me what choices each woman has to make for herself, but it is certainly true that every action has a consequence, and I believe that is what Mommy Bee is saying: that in some cases (which we cannot say which ones those are), the consequence of the action may be greater than choosing to do nothing and letting nature take its normal course.

As far as what am I doing for children without homes, I worked for a CPS agency working directly with children and families in placement situations, and helped facilitate placements where possible. From that same job, I know exactly how hard adoption can be, and it doesn't seem to be much harder or more expensive than some fertility treatments. I also plan to foster children when my own are a little older.

In any case, if our government spent as much money on adoption and placement programs as they do on reproductive technology, then it would be much more affordable and less cumbersome to the average family, which was the point I was trying to make. I don't think fertility treatments should be done away with altogether, I just think equal attention should be given to the children who already need homes.

kimberlee said...

Having lost several babies, I think about stuff like this too. Would I try to save a 23 or 24 weeker knowing the odds and possibilities? If I could have saved any of my babies lost, what would the decision have been. I fought very hard to keep Zoe growing in my belly and she is snuggling on my lap right now. But if it weren't for progesterone injections, hcg injections, and a lot of prayer she would have been another of my miscarried babies. And instead she is my Zoe princess full of life and wonderment.
If it weren't for medical care neither Zoe nor Lily would be here. I would have lost Zoe as a Newborn to RSV and Lily as a one year old to RSV. Lily still has lasting effects from her bout with RSV but I am sure happy she is napping on the rocking chair and spends most of her days in the sling.
And we all have stories similar to these. But I saw my grandpa fight Prostate Cancer and know when he went, it was time. And I see W's grandma old, so very old. And know she is prolonging her life past what one 'should'.
Lots of things to think about and ponder.

Lisa said...

I wasn't going to post again on this thread, but I got a call the other day asking me to participate in a study, and ironically, the goal of this study is to determine if fertility treatments have any impact on live birth, pre-term birth, low birth weight, and birth defects. I don't think I will have anything to contribute since I've never conceived, but I thought it was kind of funny after reading this discussion.

I would be interested to see statistics on this. A big part of me tends to think that the incidence of problems after fertility treatments isn't going to be dramatically higher than in "normal" pregnancies. It may be a bit higher, but not hugely higher. I believe this is one of those cases where you hear stories, and the bad stories stick in your memory longer and make it seem like those bad thing happen more often than they really do.

However, I used to know a naturopath who was a world-reknowned expert on infertility, and he definitely felt that conventional fertility treatments failed to really heal the issues, but only tried to circumvent them, leaving women vulnerable to the same hormonal problems they had initially, which could continue to cause future problems with pregnancies, breastfeeding, etc.

I do agree with his assessment, but the more important question for me, and the one less easily answered, is whether or not those risks and potential problems are SO great that it is not worth it to try to get pregnant. I tend to believe that they are not THAT great. Here is where I think it just has to boil down to personal prayer and guidance from the spirit in making those decisions, because only the Lord knows what will happen in the future. I'm willing to surmise that for most infertile women, the emotional risks of not being pregnant or never being a mom are higher than the physical risks of having a pre-term baby or having breastfeeding issues (assuming those risks could be proven).

As far as the adoption issue, adoption heals childlessness, but it does not heal infertility, either physically or emotionally. People really have to be in the right place before they should choose adoption, because not being in the right place will affect not only the parents' lives but the adopted child's life forever more. It's really simplistic to say that people who are infertile should just adopt, and it can be a really bad idea to move to adoption before a couple is ready, in other words "risky" since we're talking about various risks. Those emotional factors of infertility have to be worked through as completely as possible, and for most women, that means having as much closure on not being able to get pregnant as possible, which often means going as far to the end of that road as one can.

We chose adoption early in our infertility journey. Not early in years but early in terms of what kinds of treatment we did (which was not much at all). We had absolute assurance from the spirit that this was the right path, and have continued to have that assurance through the years. But there were ramifications from not going to the end of the treatment road, which I still live with, some of the "what if's" and such. I still grieve all of the experiences associated with normal fertility, from never being able to experience pregnancy or give birth to not being able to provide breastmilk for my children to simply not being like every other woman on earth. My faith in the choices we have made and my knowledge that they've been directed from heaven is what helps me to move forward and be happy with what I've been given.

Just saying that there are no easy answers, and there are more factors to consider than just physical. It's hard for people to foresee risks that may or may not happen, that are not yet "real".

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