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From: paul@phs.UUCP (Paul C. Dolber)
Newsgroups: net.abortion
Subject: Dividing Line Found
Message-ID: <1015@phs.UUCP>
Date: Sun, 14-Apr-85 16:27:05 EST
Article-I.D.: phs.1015
Posted: Sun Apr 14 16:27:05 1985
Date-Received: Sat, 20-Apr-85 01:12:21 EST
Organization: Dept. Physiol., DUMC
Lines: 90

Well, almost. From the Durham Morning Herald, Thursday, April 11, in
an AP article titled "Ga. Hospital Defends Decision to Bar One-Pound
Baby:"

   "A doctor who refused to treat a premature baby because he
   considered her a `living abortion' when told she weighed just
   one pound said Wednesday he would have accepted her had he known
   her actual weight was closer to two pounds... [He] refused to
   admit the infant Tuesday [to the neonatal unit at the Medical
   Center of Central Georgia] because of his policy against accepting
   infants weighing less than 500 grams, approximately 1.1 pounds. The
   girl [was] born 13 weeks prematurely... he refused to admit the
   infant because doctors at Peach County [the hospital in which she
   was born] had estimated her weight to be about one pound. When she
   was weighed after arriving in [the Medical College of Georgia at]
   Augusta, doctors found her actual weight to be 760 grams, or one
   and two-thirds pounds. `If that's its weight, we would have taken
   it,' [the doctor] said...  doctors [at the Peach County hospital]
   were able to give only an estimate of the child's weight because
   they didn't want to remove the baby's blanket and life-support
   systems to take a more accurate reading."

So, there you have it: the dividing line is not birth, but birth and a
documented weight, without blankets and/or life-support equipment, in
excess of 500 grams. By the way, there was a picture of the "living
abortion" accompanying the article; looks pretty much like a baby to
me, and about the length of the nurse's arm from elbow to fingertips.
Maybe she's a small nurse, though.

I'll let the above speak for itself; now, on to another issue raised in
the article. The doctor said:

   "`If other doctors feel they can keep a child that small alive,
   they can have all the patients... I have no quarrel with doctors
   who try to keep infants that small alive, but it's my experience
   that I don't have anything to offer these children'... [He] said
   Tuesday he would not accept `babies that are living abortions'
   unless they are born at the Medical Center. `The chances for
   survival are remote, less than one in 100,' he said."

Well, there may be real issues here. First, when medical services are
limited -- e.g., when there are only x intensive care incubators but
x + y patients who need one -- doctors must somehow choose who does
and who does not receive medical services. This does not seem to
apply here, though; the "living abortion" would have received
treatment if she'd been born in the Medical Center of Central Georgia.
Second, there is a valid medical question: Is there any instance in
which "heroic measures" should not be applied? (Said question is
usually asked, in pediatric cases, when the baby is born with a severe
malformation.) In general, I think this is a worthwhile question; I
know and very much respect one pediatrician who is distressed when
some doctors try to keep some extremely malformed babies alive
simply because the technology is available. Is there indeed no point
whatsoever at which doctors are justified in withholding treatment?
This question will, of course, become much more pressing as medical
technology advances; I can imagine that one day any fetus or baby
can be kept in a state legally defined as alive no matter what its
condition. I'd be interested in medical opinion here, if any
doctors (especially pediatricians/neonatologists) are reading this.
Nonetheless, I certainly hope I never have cause to enter any hospital
where I might be treated not according to how well efforts to save me
were progressing, but according to a table of probabilities -- say,
"He's lost 8 pints of blood, and our cut-off is 7 pints since the
probability of survival after losing over 7 pints is only 0.8%."
(NB: these figures are totally made up; I've quite forgetten how
many pints of blood I contain, let alone how many I can do without
temporarily.)

Regards, Paul Dolber (...duke!phs!paul).

PS: The infant was born on Tuesday; she was in "critical but stable"
condition Wednesday. The doctor "said he had not received any adverse
reaction to his decision." I don't know what has happened since.

PPS: I really do feel sorry for doctors at times. Not long ago (a few
months ago, I think), a North Carolina doctor was found guilty of,
and I believe I'm recalling the phrase correctly, "wrongful birth."
It seems that the doctor dissuaded a mother-to-be from having
amniocentesis done despite the fact she was over 35, or something,
and the baby was born with Down's syndrome with usual complications;
the mother successfully argued that, if she'd had the test, she would
have aborted the baby and it wouldn't have had to live. The baby -- or,
if memory serves, the child -- was very much alive at the time of the
trial, and one of the arguments used was that its siblings were
traumatized by having a retarded sib. As I recall, the siblings even
testified to that effect. Again: yes, the doctor was found guilty of
"wrongful birth," and yes, a large settlement was awarded good old Mom.

Life's a bitch, and then you're born.