Of course you terminate. There is no other ethical choice. You owe it to the children. Letting her die would be like shooting her in the head. Her irrational, bullshit religious beliefs have no ethical relevance to the decision. You don’t kill somebody because they tell you Jesus wants you to, and that is basically what this scenario amounts to.
In the described instance? You think that it makes some kind of sense to die (and leave your existing children motherless) rather than abort a “long from viability” fetus?
Besides, who are you to decide which of her professions she means?
ETA that just to be clear, if the instance described involved a *viable *fetus, I’d be all for respecting her wish to not place her own life above that of her *viable *fetus. That is not the hypothetical. In this particular hypothetical, either they both die, or only the fetus dies.
Because it’s NOT VIABLE. Duh. The fetus will die no matter what. And how would you plan to “get it out?” Hmmm?
As I stated above, I’m all for Zoe’s choice, whether I agree with it or not. But in this particular case, there’s no survival, either way.
Ok, for the sake of argument, I accept your premise. I still don’t accept hers. She didn’t tell me that she wanted to die if she was faced with a choice between an inviable fetus and herself. She told me that she’d rather die than commit murder. Fair enough.
In the situation presented to me (or “my” proxy Wash) in the OP, she’s not committing murder. In her own estimation, she would be, but her belief is based on an objectively faulty premise. By my own reasoning, which assumes that my wife is a person — feel free to argue the point if you like — the one who’d be committing murder by letting her die would be me, and I’m not about to do that. Please, tell me again that I don’t love someone because I won’t make a conscious choice to kill them based on false premises.
If she wants to die on her own terms, she’s free to do that, and as strongly as I might disagree, I won’t stop her. The desire she expressed to me was a preference to die rather than live under a particular set of circumstances, and I don’t believe for a second that those circumstances are true. This makes — quite literally in this situation — all the difference in the world.
Her husband. Who, as was made clearer by **Skald **in a later post, believes *she *would not want to abort under these circumstances based on actual conversations with her.
It’s very well for us all to say, “she didn’t mean this circumstance,” but that’s fighting the hypothetical. Yes, she did mean *this *circumstance, as Washington understands it.
Obviously not, as you would know from my post 2 posts above yours. In fact, when the mother’s life is at risk, I’d consider it murder by negligence even if the fetus WAS viable. I just wanted to fight your bad analogy.
Um, her husband?
So we don’t disagree, do we?
If hypothetical husnad did go to court to obtain an abortion, imiage how the perfect strangers in the anti-abortion movement would react. Only 90% of people agree with abortion to save a woman’s life, and the othr 10% is very vocal and can be violent.
I don’t think the husband would have to get a court order, so hopefully the entire issue would never become public. I can’t imagine the family discussing this in any way beyond “Zoe survived, but she lost the baby.” The fetus in this scenario is toast, regardless of the actions of Washington. There is literally nothing he or anyone else can do to save that fetus.
Even if it did somehow become public, even the most radical of the so-called pro-life proponents have to pick their battles; I think this is a non-starter. It’s hard to call it murder when the only possible outcome is death for the fetus, regardless of whether the mother lives or dies.
In Nancy Klein’s situation, it appears that there was the possibility that Klein could have been kept alive, albeit comatose, long enough for the fetus to be viable. That’s not possible in Skald’s scenario. In Klein’s situation, there appears to have been a choice between the life of the mother and the life of the fetus. In Skald’s scenario, no such choice exists. I know there are highly irrational anti-abortion fanatics out there, but while there might be a few lone wingnuts who think Zoe should die, I doubt there are many. I seriously doubt that Zoe herself, if she were conscious, would choose to die for nothing, even though she might choose to die if by doing so she could save her fetus (I say ‘might’ because, again, ideology doesn’t always win when push comes to shove - she might look at her living children and decide that she wasn’t willing to sacrifice their childhood with a mother for her unborn fetus, or she might just chicken out; I imagine it’s not so easy to stare death in the face).
Recognizing that he is not an expert in such matters (and being too lazy to do the research just for a message board discussion), the OP did that on purpose.
This debate would have been much more interesting if Zoe had been at a point in her pregnancy where the fetus was viable.
Zoe said that. But people are known to make promises like that when there’s no actual threat to their health and then back out when the threat becomes real.
If she’s conscious, leave the decision up to her. She’s the one that has the most to lose in this scenario, so they should abide by her opinion, even if Washington disagrees. If she’s not conscious, terminate; perhaps she’ll come to understand that the pre-fetus had little chance of surviving even if Washington did choose to sacrifice her.
I’m prolife, but even I would have Wash have the baby aborted because as people have pointed out, it is not going to survive either way - I can’t see how it would be going against Zoe’s wishes because when a mother says she’d die for her baby, it almost always means “so the baby can live” and that’s simply not going to happen here; I know a lot of women who are prolife who say they’d die for their unborn child to save it, but none that say they’d want to die with their doomed child. It’s sad that such a choice is necessary, but the reality is Wash is either going to lose his unborn child and his wife, or just the child, and no matter what he choses the child is already beyond saving.
The issue becomes much thornier if it’s like lisalan says, and the baby is borderline viable, and the choice then becomes do you preform surgery (c-section) on someone who is gravely injured to abid by her wishes, or do you abort to possibly help her recover. That’s a harder choice because you might end up with a live baby and dead mother, a live mother and dead baby, or if everything goes well a live baby and live mother. In this case I’d make a different call than the case presented in the OP.
You know, there is a possibility, however slight, that she might survive, even while comatose, possibly even while brain dead, long enough to produce a viable fetus for a C-section. I wonder if it would be possible to keep her on a ventilator and an IV drip going and use her body as an incubator.
There is also a possibility that she might come out of her coma long enough to make her own call – thought I’m sure the physicians wouldn’t wait around long enough for that unless Washington went ahead and made a call to try saving the baby at any cost.
It depends on why the doctors are recommending that the pregnancy be ended. The most logical reason I can think of for that is if she’s had a placental abruption and they can’t get the bleeding to stop - in worse case senario the cure for that is a hysterectomy, which of course would kill a non-viable fetus even if the abruption itself didn’t.
Right. And, again, in reality, they’re going to perform lifesaving measures to stop the bleeding, probably without even consulting the husband about it. It would fall under the “presumed consent” of emergency medicine. They’ll take her into the OR, do what needs to be done and come tell him later that they were unable to save her “baby”.
I’m afraid that the hypothetical as written just doesn’t make a lot of sense, the more I think about it. I know you’re not an OB expert, Skaldy, but it’s almost as if you had proposed a hypothetical in which a car started filling with water sitting in the middle of the street. Cars just don’t make enough water while combusting fuel for that to be possible.
I’m really trying to figure out a way to save the hypothetical…
Hmmm…how early can preeclampsia hit? I know it usually happens after 20 weeks, but could we cheat it to 18 weeks and still be realistic? That’s previable for sure, but if they can’t get her blood pressure down with Mag Sulfate and she starts to seize, the next step is to deliver the fetus ASAP. And there’d be enough observation time for them to have a conversation with Washington about it.
OK, checked my books. Yes, I believe eclampsia is the way to go. Here’s how we can massage the hypothetical a bit and preserve what I believe is the essential challenge:
Wash and Zoe live in some little backwater of [del]space[/del] the country where the nearest big hospital is an hour away by ambulance. Their local hospital has a Level IIA NICU, which can handle moderately sick infants, but nothing really serious or premature.
Last night, the chief of the ER had his arm lobbed off by a helicopter on the roof, and the whole area is closed to MediVac flights while Sheriff Andy completes his investigation. (Okay, that’s obviously fiction. Pretend there’s a big snowstorm with white out conditions if you prefer. Lots of gusty winds preventing a safe helicopter landing or take off.)
Zoe is in her 20th week of pregnancy, which is considered nonviable, and is definitely nonviable with only a Level IIA NICU available - which means they are not able to provide ventilation assistance to newborns. There is no way to get Zoe or her fetus to another hospital with a Level III NICU (where they *might *intubate, but with no expectation that the fetus would survive for long - basically, they might intubate long enough for Zoe to wake up and let her baby die in her arms).
So Zoe comes in with a bitch of a headache, a swollen face, legs and arms and a high blood pressure. She’s diagnosed with preeclampsia. Preeclampsia is a condition that’s not very well understood, but it causes a woman’s blood pressure to get very very high, and if left untreated, will progress to unconsciousness and seizures. It can kill you. First line treatment for it is a drip of Magnesium Sulfate through an IV line. For most women, this works in several hours to lower their blood pressure and prevent seizures.
As the Midwife is explaining this to Wash and Zoe, she starts the IV for the Mag Sulfate. About two hours into the Mag Sulfate treatment, Zoe loses consciousness. The nursing student - a dashing young woman named Kaywhynot Lee, known as “Kaylee” - takes her BP and finds it to be 268/120. She then notices that the edema is now pitting edema when the blood pressure cuff leaves a line on Zoe’s arm that doesn’t rebound within a few seconds. Checking her deep tendon reflexes, Kaylee finds that they’re 4+. Zoe is in a severe eclamptic state now, and unlikely to regain consciousness. In fact, she’s very likely to experience a seizure within a few minutes (privately, Kaylee is amazed she isn’t seizing already with a BP that high).
So now the midwife explains to Washington that Zoe has not responded as they’d hoped to the Mag Sulfate, and the only way to reduce her blood pressure and save her life is to remove the fetus, now, by an emergency c-section. The fetus will not survive, because this hospital doesn’t have the ability to intubate (place a breathing tube) for it.
That better? It’s not a very far fetched hypothetical at all now. It’s right out of my OB nursing test, where they make the assumption that, of course, the c-section will happen.
A fetus is not viable at 20 weeks even if they had a level 2 NICU. The earliest a fetus has been born and survived is a little less than 22 weeks gestation. Even is they intubated a 20 week old fetus the baby would not survive as the lungs have not developed enough for this to be successful.
Correct me if I’m wrong but I think most pro-life people would go with saving the mother in this situation.
Exactly. Skald specifically wanted a previable fetus in the hypothetical, so I gave him one. Said several times it wasn’t viable. As I said, a Level III NICU might, just might but probably wouldn’t, intubate him for an hour or so until Zoe regains consciousness and then take him off the vent to die in her arms. They would at least have a micropreemie sized ET tube on hand, which a Level II wouldn’t. I made it a Level II specifically so that there would be no option in which the fetus lived.
And I don’t think you’re wrong. I’m just not sure if they’re right. Honestly, it’s probably because I’ve had the “patient’s rights and autonomy” lectures pounded into me for the last 18 months, so I’m thinking like a nursing student, not a husband.
James Elgin Gill, born in 1987 at 21 weeks and 5 days, is the earliest born preemie to survive into childhood (well, adulthood now I guess, as he’s still alive.) Amillia Taylor, the Florida baby who was in all the news reports as being a 21/6 preemie wasn’t really. That number was based on the date of conception, not the date of last menstrual period, putting her at 23 weeks and 6 days of gestation, 2 weeks older than the Gill baby. My own daughter was also born at 23 weeks and 6 days and is a healthy 5 year old now. Because of how the abortion laws are written in my state, I could have aborted her as she was still previable, and the doctors did offer to induce a vaginal birth which would have resulted in her death - “abortion” by any other name. (We chose the c-section instead, obviously.)
^This.
Does this extend to any and all wishes, no matter how harmful they might be to the partner and/or others involved in the relationship?