The Terri Schiavo case has drawn a lot of attention to euthanasia lately. There is an aspect of euthanasia/hospice that I bet most folks are unaware of; let me begin by describing my introduction to this dilemma:
As some of you know, my wife recently gave birth to our third child; she was born 11 weeks premature and luckily, is doing very well. When my wife’s water broke at 25 weeks our odds of bringing home a healthy child were dismal. For the month that my wife was in the hospital, I studied extreme prematurely extensively.
Babies that are born extremely premature have a very poor chance of survival. Before 22 weeks gestation, babies pretty much never survive. If born during the 22nd week the chance of survival is about 10%. Mother’s race, age and other factors can increase or decrease the odds. Quality of hospital and prenatal care also make a big difference. Birth weight and sex of the baby can make a big difference. Mostly it just comes down to luck; some kids are born with serious brain bleeds and don’t stand a chance while others are born with a realistic chance of survival. Each week (or day really) that the baby stays in its mother, the survival odds significantly improve.
What constitutes “survival” is the tricky part of this dilemma. A lot of these babies die in the first hours or days. Some last a few weeks or months. Even the babies that survive their initial hospital stay of a several months have a very high mortality rate during their first few years of life.
The vast majority of extremely premature survivors have serious lifelong health and quality of life problems. Cerebral Palsy, mental retardation, respiratory disease blindness, deafness, etc. are common if not likely. Many extremely premature survivors will not be able to live independently as adults.
Kids who are fortunate enough to avoid the most significant disabilities can be expected to have a host of problems such as: lower IQ, ADD, mild hearing or vision problems, poor coordination, may need special education in school, etc.
The likelihood of an extremely premature baby acquiring any of these problems also relates to exactly how premature it was born. A child born very early stands a very slight chance (at best) of going home healthy and “normal”.
So, If you have not yet figured out how this relates to euthanasia: in the US parents of 22 and 23 weekers are usually asked if they want their babies to be resuscitated or if the want to provide “Comfort Care”/”Hospice” to their babies. Most US doctors recommend not resuscitating. In Holland the national policy is to not resuscitate babies born before 25 weeks, regardless of the parents’ wishes.
If you have spent any time pondering the one in a million Terri Schiavo case, ponder this dilemma. It occurs everywhere at a surprising frequency.
eskimo
