Nadya Suleman’s Gift to Society: A Cautionary Tale
After my post last week about why I don’t hate Nadya Suleman, quite a few people insisted on the importance of personal responsibility in the blame-game about who bears the responsibility for the octuplet debacle. (Because while I’m as glad as anyone that the babies are all alive and relatively well, “debacle” it is, for so many reasons…)
I’m sticking to my guns and insisting right back that a woman as compromised in decision-making as Nadya Suleman obviously is (for whatever reason or reasons) deserves the help of society in making decisions as major as whether or not to have a high risk pregnancy (which the transfer of 6 embryos invites), let alone whether or not to bring multiple children of fragile health into the world with few resources at her disposal for their care.
Now I am passionately pro-choice. And as a lesbian whose right to be a parent who is constantly volleyed about rhetorically by the forces of the Right and the Left, whose identity as a “real” parent is challenged by people who don’t understand adoption, let alone transracial adoption, I am loathe to suggest we drag decisions about who can and can’t be a parent into the realm of regulation.
But I do think regulating the creation of high-risk pregnancies and high-needs premature babies is more than reasonable: it’s a moral imperative. I am not talking about disallowing assisted reproductive technologies, to which dear friends of mine owe their own beloved children. I am talking about applying reasonable standards of care that still allow for individual variations of risk and health.
In Wednesday’s edition of The Week, Tish Durkin discusses this very idea by comparing the situation of Suleman’s fertility specialist to the situation of similar doctors in a European context:
“Come on, guys. In Belgium, a doctor who [transfers] more than one embryo in a woman of Suleman’s age and fertility-treatment track record is breaking the law. In Britain, any doctor who transfers more than three embryos into any woman for any reason is very likely to lose his license. In the U.S., Dr. Michael Kamrava [transfered six embryos into Suleman]
Sheri said:
Many women who get pregnant with fertility procedures have high risk pregnancies–whether it be via IUI or IVF, and whether they have one embryo transfered or 6 or just need help with timing. Do you think society needs to get into their business??
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I think people have a right to decide to start a family, and I understand that some women have problems with high risk pregnancies. I just do not understand why you would want to go thru these procedures to get pregnant if you know problems exist. there are alot of children to adopt. When the actions of a woman like this lady we are discussing causes a burden of welfare support then, yes, I think those paying the bill should have an input in to it. More than likely she will get more governmental help whether it be foodstamps and WIC, and even disability payments because of this situation. there are far reaching questions here but the fact remains that she cannot fully take care of the children she already had , now there are more in the mix. In the end the real travesty here will be the future of these children, all brought about by the actions of one woman.
As for the doctors, I’m not sure what should been done in that situation, but there should be some kind of regulations. I respect what docotrs do and thier dedication , but they are not God and should not have the ability act as so. Docotrs as well as the rest of us in society should be held to a higher level of personal and ethical responsibility.
This is just the tip of the iceberg when it comes to medical care and the lack of enforcement of any kind of “standard of care” whatsoever. In reality, medical doctors are indeed above the law. They can, essentially, only police eachother, by law. It is an unacceptable situation.
We can’t even execute people without a doctor in CA, and in this case the doctors are holding hostage the people of the state of California.
Without the ability to construct legislation, with which we have NOT, we are completely at the mercy of the stupidity of the individual. This same lesson applies en mass to our society which is highly, individual rights oriented. Ou government’s inability to react to these situations simply shows what a sitting duck the USA really is.
She did do something wrong. She brought children into this world without the ability to support them, or even nurture them. It isn’t like a family that has many over time she has more to care for than any single person can reasonably expect to. She already had much to take care of which she obviously was not handling so well. So then she became pregnant again. What about the welfare of the 6 children she already had.
There’s a lot of room between “legislating away someone’s chance at pregnancy” and zero real regulation. It seems to me that intelligent, thoughtful people could find that middle ground.
But Suleman doesn’t have normal fertility. She did ivf for each of her pregnancies, transferring a similar number of embryos each time. I can’t say I think it was a particularly good idea to transfer 6, but if you’ve done it five times in the past and never gotten more than twins, it doesn’t seem that unreasonable that she wouldn’t expect to have high order multiples this time either.
And I think you’re missing the point about other high risk pregnancies. There are women whose previous pregnancy history or medical conditions mean they will automatically have a high risk pregnancy every time they get pregnant. If the stated goal is to prevent prematurity, do we also deny fertility treatment to women with a history of severe preeclampsia or an incompetent cervix? Where does the line lie?
If you look at the actual statistics on IVF, the average number of embryos transferred is 2.3, and triplets or higher are less than two percent of the resulting births (out of the thirty percent of procedures that result in a pregnancy). More importantly, that number is down from seven percent ten years ago. That says to me that the profession is already doing a good job of moving itself in the right direction, and while I would support stiffer penalties for reckless doctors, I’m not sure it’s a good idea to base laws on a few outliers.
There are always going to be women who need to go beyond the normal recommendations to be successful because bodies are different and what works for most people doesn’t work for everyone. I would hate to legislate away their chance at pregnancy.
Sheri, what I’m saying is that purposefuly creating a high-risk pregnancy–and the strong likelihood of severely disabled children–by creating a high order multiple pregnancy is unconscionable behavior from a medical professional. Six embryos transferred into a healthy woman with a record of normal fertility and successful past pregnancies is unconscionable.
This is quite different from managing a pregnancy that happens to be high-risk already. This has nothing to do with anyone’s right to have a large family and as many IVF procedures as they need to do that.
I do absolutely think society, law and larger ethical bodies within medical practice have every right to draw lines where women’s and children’s lives are placed in unnecessary and known, serious danger.
I am surprised that the people who know ART inside-out–those who’ve used it–would suddenly jump to assume that in a post like this I am suggesting no one have a right to use it. You understand the risks and ethics involved better than most. I don’t think anyone has the absolute right to any medical procedure they want without any consideration of the risks involved–especially when those risks are to the well being of others–namely the babies created through the procedure.
I had 3 high-risk pregnancies. Are you really saying I needed society’s help with that???
Many women who get pregnant with fertility procedures have high risk pregnancies–whether it be via IUI or IVF, and whether they have one embryo transfered or 6 or just need help with timing. Do you think society needs to get into their business??
And what if you want a big family?? And want to have 8 or 10 procedures done in order to have the 8-10 kids??
Thanks Shannon, I appreciate your kind words. I also hope the economy gets better or things could get very rough.
For Lulu:
I have members of family who receive disability payments each month, not because of a catastropic illness, but because they were injured due to thier lifestyle. My wifes oldest brother, who is 43, receives disability payments each month because while driving drunk(4 times the legal limit in SC, and he paseed out at the wheel) had a wreck. he in jured his neck and upper back in the accident. he receives disability and state medicaid because of this. No, I do not think he deserves to receive 1 cent of disability for this. he contines to be a drunk and in the past 10-12 years has become a very bad drug addict. If you can drink and walk the streets hunting drugs, you can work to support yourself. People know that smoking causes many health problems and so does improper diet, yet they never seem to do anything about it, Why? they know that disability and governmental help will be there for them no matter what, therefore why should they change. My sister-in-law receives disability for being bi-poloar, of all things, thats crazy. she comes and goes as she pleases and receives state sponsered medical assistance, why? she’s bi-polar, thats absurd. she has no problem partying and drinking on the weekends but she cannot work because she is bi-polar, again thats absurd. these things are happening in my family and betcha they are happening all over the country. the welfare system should be governed much more closely than it is and then maybe, some of these dead beats would not be sucking the system dry.
For Brittany:
I’m glad that you made the best in your stiuation, but just because a girl becomes pregnant does not mean she should get governmental help. she should not have gotten pregnant to start with, and if she does it is not right for the tax payers to foot the bill for her or her childs care. I my eyes , you cannot justify that. It falls back to personal responsibility, and a girl getting pregnant at such a young age does not show any responsibility whatsoever, therefore it should not be up to that federal or state to provide for her…
Yes, I was just going to say what Phoenix Rising said. The problem here is the way fertility clinics are run in this country. To the best of my knowledge, in other single payer health care countries, such as the UK, there is a limited amount of help for infertile patients. For example, they may be entitled to the first 2 IVF cycles for free or reduced cost. Fertility is treated like what it is, an illness that deserves treatment like any other.
In the U.S., fertility clinics are almost always profit-based and services are paid out of pocket by patients. What this means is that they are market driven and they do whatever they can do to build up an impressive success statistic, which is one of the main things patients look at when shopping around for a clinic.
This puts pressure (and a conflict of interest) on the clinics to stretch what might be in the best interest of the patient in order to drum up better statistics for their clinic. It turns fertility into an industry rather than regular health services whose focus (should be) on the health of the patients.
So, two things would help here. First regulation of treatments that include best practices but also include an independent review panel for what might be exceptions to the usual standard. And second, fertility treatments should be treated as other medical conditions are and paid for or partially paid for by medical insurance. If Medicaid can pay for Viagra, there is no reason why fertility treatments should be seen as “elective” and unnecessary.
Excellent point, PhoenixRising. Some commenters discussed that part of it more on the original post, too.
Shannon, I’m stunned that any conversation about our system of selling fertility compares to Belgium or the UK can even begin–let alone continue–without acknowledging the elephant under the rug.
In countries with single payer health care in which limited fertility treatments are a right, not a product, it makes sense to regulate implantation.
Multiples are sometimes, perhaps often, the consequence of families’ decision to have all the kids they want to raise from one expensive procedure.
That’s what’s crazy, especially when you consider Sara’s point that 3+ is not healthy for members of our species, period.
So in calling for universal access to health care, you can ask for sensible regulation of fertility procedures–but for Americans, they are just one more medical purchase that our insurance may cover or not. Discretionary. It’s a feature of treating health care as a product.
I should add to my previous comments that the REAL cautionary tale will only happen when the media starts reporting on total loss of pregnancies, stillbirths or neonatal deaths, serious disabilities, and maternal suffering and even deaths resulting from pregnancies involving higher-order multiples (i.e., those involving three or more embryos), and especially those involving five or more embryos. Stories like this give people the impression that the main reason not to have 8 babies at once is because it’s expensive and inconvenient, not because it involves absolutely horrifying risks to the mother and children alike. I am amazed when I visit infertility support groups or web sites and find women saying that if they get pregnant with quintuplets they’ll welcome the children, as if that really was the issue. The goal of infertility treatment should be live, healthy children and mothers, and the best way to achieve that goal is singleton pregnancies. Have 8 in a row if you want, but have them one at a time.
Having said that, there is an exception to every rule, and I would hate to see any further obstacles to fertility treatment being established. Patients need to be educated, not patronized, and doctors need to prioritize medical ethics over profits.
I don’t want octuplets, but I do want chilren. I wish my insurance plan were as good as hers. Husband and I both have full time jobs and are struggling to figure out how to pay for infertility treatments. I agree with Sara above – things would be so much better if infertility tx was truly covered by insurance.
As to this family: so much about this story makes me sad, but what’s done is done. I hope that she doesn’t have any more babies. I also hope that she and her community find a way to care for the babies she has already had. I hope she gets mental health treatment. I hope these kids all get good medical care, but further, I hope they get good emotional are.
Dave in SC:
I think that 17 year old should receive that aid because it allows her and her child to survive and get on their feet and that way she can become an educated, contributing member of society. And just for fun, I’d like to tell you that I got pregnant at 17, used state medical insurance to cover my baby for a few months, got a degree, and now my husband (also the father of the child) is an officer in the military which you so gladly support. I’m pretty sure we’ve paid back the assistance we got from that safety net in spades.
Dave, how do you feel about disability payments for people who are chronically ill due to some behavior-related illness, like smoking or poor dietary choices? Should no one with emphysema be allowed to receive disability support because they had the choice not to smoke? Should people with cardiovascular disease be denied medical assistance if their diet caused or contributed to their disabling condition?
I’m sorry to hear you got your hours cut at work, Dave. Good luck to you and your family. Hopefully this economy will improve soon.
well shannon, maybe we should pick and choose who gets social support, then it would not be so easy to get welfare, WIC, and food stamps. my brother-in-law has a step daughter who is 17yrs old that is pregnant. she now gets governemntal asistance for medical care and her needs, why. nobody told her to get pregnant and why should the state and federal government provide for her. I would be willing to believe any rational reason you could come up with. I believe there is none and she should fend for herself. thats the problem, no responsibility whatsoever for ones actions, only a social net to support your irresponsibility. Now I believe that thier are people who have fallen on hardtimes, and really need some help, I say help them. To help people who have brought this upon themsleves, thru thier own irresponsibility, is just not right. there is no accountability, none whatsoever. we can debate this all day, but the fact remains that this lady knew what she was doing when she went to this doctor. she was of mental capacity enough to seek this procedure, therefore she is of mental capacity to deal with the consequences of it. the social system should not have to provide for her, imho.
for me valerie, its not a question of mental capacity, of one of discrimination against tradinoal or non-traditional family. BTW, where in the world did that come from,lol. anyway, for your comment on tax money going to war, if we would have taken care of the situation the right way, and not by fighting by the geneva conventions( which, BTW, we are the only ones who adhere to those out of date relic rules from the past)the war would already be over. yes I would rather see my tax dolloar go to our fighting men and women than to an irresponsible 33yr old idiot. more than likely the tax payer will have to pay the bill for the life long issues of health, education and learning problems that these children may have. its not that I want to be selfish but I have to provide for my wife and son as best as I can, and with my hours being cut at work it gets harder and harder to do. now, this woman comes along and gets artificially inseminated with 8 embryos, and has 8 more children to go with the 6 she already has. now I should feel pity to her or remorse for her situation, I don’t think so, thats not being selfish just realistic. I do not think this is a sad case but just a plain pathetic case of personal irresposibility on her part.
Here’s an idea. Make IVF free for infertile people if they agree to transfer only a single embryo (if under age 35), or a larger number of embryos if medically necessary, after receiving approval from a committee of uninvolved docs. That would take away the incentive for patients to choose transfer more than one embryo at a time. This is estimated to add only about $20/year to insurance premiums, and might even save money by preventing premature births. (see http://www.slate.com/id/2211151/pagenum/2 and http://www.blogher.com/octomom-and-embryo-transfer-debate-0).
Dave in SC, that just doesn’t make sense. I am sure there are plenty of people using public assistance whose decisions I would not agree with. But we don’t pick and choose who we support. Either we have a social safety net or we don’t. And if we do, well, people like Suleman are what it’s there for. People who need help–for whatever reason. I am glad no one has handed us all a list of the personal life details of every person who ever claimed unemployment or WIC or food stamps.
Perhaps you believe we should have NO social safety net, but why should babies and children (and women who often have little to no choice about what happens to their own bodies) suffer?
The fact is, a microscopic amount of “my” (or your) tax money goes to help people like Nadya and her babies. It is irrational in the extreme to get all het up about that unless you are going line-by-line through the federal budget and ready to sign off happily on the other spending we’re doing. Do a little research and lodge the complaints where the big money is, for heaven’s sake. Don’t let Perez Hilton be your guide to where the money goes.
I wonder how our perceptions would be different if any of the following circumstances existed in this sad, sad case:
a) She’s still of questionable mental capacity, still single, but has unlimited funds. Yes, she’s been born to extreme material wealth, and the public would not have to worry about supporting her and her 14 children…
b) All things being equal, but she’s married. IS this partially a case of discrimination against an (albeit extreme) non-traditional family? Would we have more sympathy for her if there were a “daddy” we could see (and use to share some of the blame?)
I keep looking at different scenarios and keep coming up with the same answer. It’s NOT the money (I’d rather have my tax $$$ going to babies than to an unpopular, unending war) and it’s not the conventional or lack of convention family. I am just so sad/angry/who knows what that in this day of medical “advancement,” eight children have been brought into this world who will suffer a lifetime of potential health, learning, and emotional problems. We can do so much today that wasn’t even imaginable one or two generations ago. Why do this, put all these lives at risk, when there are so many other options available. This is a problem without end, and as long as we are selfish and only consider our own immediate needs first, it is apparently just the tip of the iceberg.
This all looks quite bizarre from here (UK). Clearly the doctor behaved in a way that left both a vulnerable woman and her children in peril of their lives. Now it seems she is to be put in the pillory too. What a terrible shame for the whole family.
I don’t hate this woman but I also do not want to support her family with any of my tax money. This is nothing more than this lady wanting a free ride on the welfare system. she has no personal responsibility, if she did she would not have had this procedure. this whole thing of her nad childhood and wanting a big family is a load of garbage. when will people stop using thier misfortues of the past to validate thier stupidity in the now. I personally could care less about this woman or her children, I did not tell her to have any of these children, and I refuse to help her in anyway. she shows no responsibility at all.
I definitely agree that coming up with regulations is a difficult, but very necessary step, since a doctor with screwed up risk assessment skills is a far greater danger to the general public than one mother is. I personally feel wary of any absolute system – the prospect of one where implantation of more than 3 embryos at a time triggers a review makes the most sense. There may very well be medical circumstances where implantation of a greater number of embryos is warranted, since it helps to keep one individual from playing god. (The possibility that Suleman’s doctor encouraged six embryos to try and increase his statistical yield as an RE is dangerous and terrifying.)
Nadya Suleman definitely is a goal-oriented woman, someone who wants a large family. However I would also say she is selfish, because she is doing so by leeching from the rest of society. Just think of how poor the US would be if every woman was like Nadya
I think this is a question of medical ethics not of personal choice. So, I guess I am agreeing with you. Nadya wants kids and found a way to legally obtain them. Maybe she is a few bricks short of a load but she didn’t do anything “wrong”. An educated, trained professional in the medical field should definately know better.