However, I've read a few things in the past few days that have really gotten me thinking and, since there isn't anything interesting to report on here in Madrid anyway (with the exception of some sun, at long last), I've decided that venting my frustrations is probably more appropriate in this forum than in the mass of comments at the bottom of these news stories (the letters to the editor of the internet generation and, therefore, populated mainly by crazies who like to hear themselves talk).
I love google. Despite recent signs that they're making the inevitable fall to the dark side, they really know me. And as long as I refrain from thinking about how sinister and creepy that really is, I usually really enjoy the links they provide for me at the top of my gmail. Today it was an article about the high costs of premature births. If you don't feel like reading the whole article, the gist is basically that not only do premature infants, which account for about 13% of babies born in the U.S., eat up an incredible amount of financial resources (this is the emphasis, since it is a Business Week article) but that a huge proportion, especially of severely premature babies, suffer from moderate to severe birth defects for the rest of their lives. The piece tells the story of baby Ryan, who was born at 28 weeks and now suffers from a plethora of physical, neurological and learning disabilities. I was shocked to learn that babies born at 22 weeks are considered viable these days and (crossing our fingers here) doctors may be able to push that to 20 weeks in the next few years.
This may be incredibly insensitive of me, but I think we are finally going too far. At this rate, soon we'll be able to grow babies in incubators from conception. And although this is good news for my figure (haha), it is, at the very least, ethically questionable. Is it really responsible to save every single premature child? It might be hard to accept, but we are the Earth's children and it might serve us well to remember that mother knows best. Certainly there are extenuatiing circumstances sometimes - the mother's health is in danger or there is a terrible accident or some other calamity that prevents the baby from being carried any longer. But, in general, we have to accept that nature knows what it's doing. Miscarriages are natural. Yes, they can be devastating on an individual level, but rationally, they happen for a reason. That fetus was not viable, whether we can keep it alive in an incubator or not.
Even more disturbing was this 1991 article about how parents of premature infants have less and less say over what heroic measures are taken to save their children. I didn't find any more current articles in a quick search, but if this trend has continued, it's absolutely abhorrent. I can see where the rationale would come from in this pro-life society we live in, but that doesn't make it right. In this article, a mother was chastised by doctors after questioning "when do we say enough is enough" when her premature TRIPLETS suffered from serve brain hemmorhages that most often lead to cerebral palsy or severe retardation. From the article:
When...she asked the neurosurgeon if he would consider not reviving the baby if he went into cardiac arrest. She said the doctor replied, "I'm not your executioner."When that article was written, the mother had quit her job to stay at home and care for the three boys, then 4 1/2 years old, all with seizures and cerebral palsy, one blind and another paralyzed on one whole side of his body.
So why do we do this to our children? I'm not talking about a few weeks premature here. I am talking about severe prematurity. Is it really because we value the sanctity of life so dearly? Do we really just want to give these tiny, helpless, dying creatures a shot at the good life?
I hate to be cynical, but I think the answer lies in both of these articles and it comes down to that number one motivator. No, not love. Money.
It turns out that although insurance companies love denying the claims of 9/11 rescue workers, middle aged mothers dying of breast cancer, elderly patients who may have filled a form in incorrectly, and pretty much anyone else seeking medical care in the U.S. they pull out all the stops when it comes to keeping premature infants alive. This may be partially thanks to Federal regulations passed in 1985 with somewhat vague bereaucratic wording about how far doctors have to go to save infants. No doctor wants to be labeled a baby killer. But this is also probably because the insurance companies fear being labeled as "anti-life" by crazy evangelical groups. Also dead babies and grieving young parents are much more sympathetic plaintiffs in lawsuits than old people with lung cancer. The fact of the matter is that insurance companies will approve any and all heroic measures to save preemies, even highly experimental procedures.
Now, 17 years later, we can see in the Business Week article what the result of that is: Neonatal Intensive Care is a big time profit maker for hospitals, unlike the rest of their operations. It turns out that highly specialized, invasive medicine, the kind that insurance companies are guaranteed to approve, is fantastic for the bottom line. Need emergency care? Sorry, not a priority. But we will build new NICUs wherever we can find a few square feet to build a new state-of-the-art facility.
And if NICUs are such good money makers and, in this corporate age, hospitals have to figure out ways to be profitable, it makes me worry that too much is being done to save preemies not only because it is in their interest, but also because it is good business for the hospital. Why would you allow a parent cheat you out of hundreds of thousands of dollars worth of profit by suggesting you not take heroic measures?
It is true that all of this practice and experimentation has had some positive effects. We are now much better at keeping premature babies alive and have taken signiciant steps to reduce the chances of "complications", as they say. But at what cost? How many children and families have suffered from our overzealousness?
I'm not an advocate of genetic cleansing or anything and I'm not suggesting we go back to the days of leaving premature or disabled babies by an open window on a cold night, but I do think we should be able to trust our health care establishment to help us make good choices, not necessarily the most profitable choices. Some babies are surely better candidates for long term incubation and innumerable procedures than others. And if a parent doesn't want their child to suffer, they certainly should have that right.
Our practice of saving all premature babies, no matter what, is certainly not the only thing wrong with our health care system, but I think it does underscore the problem of a self-devouring system: hospitals are forced to emphasize acute care and very high specialization to stay afloat, discouraging healthy people to be interested in staying healthy, which raises health care costs, which the insurance companies pass on to the consumer through higher premiums and the denial of claims, as well as even more questionable meathods. Heaven forbid you don't have adequate insurance. It is not a sustainable system.
Now, in a mostly unrelated topic, let's venture to the other side of life. As you must know, Tim Russert, the well-known right-leaning (ahem) host of Meet the Press died of a massive coronary last Friday. And, of course, when someone dies it is time for everyone they ever disagreed with to posthumously bury the hatchet and praise their former foe, no matter how much they criticized them in life. The New York Daily News, which, by the way, I do not recommend reading, ever, hates it when we don't conform to this silly societal obligation, criticizing Arianna Huffington in this bizarre gossip (?) column.
Apparently his fans are upset that Huffington, an adversary of Russert's, waited several days to make her own posting acknowleging Russert's death and that, when she finally did, "her detached wistfulness didn't even amount to faint praise".
Sorry, people, but death, no matter how untimely or tragic, doth not a hero make. Why are we forced to churn out worthless sentimental bullshit whenever someone dies? Why should we praise someone in death who we wouldn't praise in life? Personally, I think it is an insult to the complex people we are and the nuanced ways we choose to live our lives to gloss over all the relationships, conflicts and, yes, mistakes that make us whole and real. For someone who made a career out of interviewing people of disparate perspectives and encouraging people to argue with each other, I would think Russert would agree.
It is possible to empathize with the family, reflect on the fagility of life and appreciate the days we have without selling out our beliefs. Or it should be anyway.
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