Rights of the fetus?

Once again this issue arises from the murk to confront us. I was thinking about a case which happened a while ago, where a woman pestered the surgeons into doing her C-Section at 35 weeks so that she could go to her sister's wedding. I couldn't believe they would do it, and even in retrospect I am still amazed that she could find a surgeon to do this.

To me, it seems unethical in the extreme to risk another person's life for a small social convenience. She could still have gone to wedding pregnant, after all. It was purely her own vanity and convenience that wanted the baby out of her and in the nursery for someone else to care for!

Of course, the baby suffered with respiratory distress and needed to be transferred to another hospital and ended up on a ventilator for a few days to stabilize his breathing. Oh yes, during this time she went to the wedding.

I asked the O&G guys how they could live with themselves (not quite in so many words of course) and was even more amazed and horrified at their answer. Since the baby is fetus, it has no rights. So if a mother requests a C-section early it is not a matter of weighing up the risk to the baby against her convenience. There is no consideration given to the baby's needs, if the mother does not advocate for it. The baby has no rights as an independent person at all!

I probably should not be surprised, since we practically have abortion on demand in this country. Women are still required to show that having the baby would "damage" them in some way, but since the range of damage accepted includes economic and social, this is not very difficult. After all, no-one can argue that having a baby is financially advantageous!

Technically, the baby is not a "person" until the moment the cord is cut. At that moment is becomes legally its own separate person with all the rights and protections from the state that any person can expect.

And yet, a fetus does have some legal existence. One child I have been seeing is receiving compensation from damages sustained from a car accident while in utero. It was obviously enough of a legal entity to receive compensation, yet if the mother had decided to terminate it she probably would have been legally entitled to do so. So a baby's life depends completely on its parents acting as its advocates. If they do not, no one else will, or in fact can. What a strange society we live in!

To Whom do we listen?

I have been listening to CS Lewis's "Narnia Chronicles" on audio-book. One of the good things about working in the country is that I get to listen to lots of music and literature as I drive! One part of "Prince Caspian" struck a spark in my mind:

Aslan is talking to Susan about why she couldn't see him. He says "Daughter, you have listened to your fears. Do so no longer."

I began thinking about this - listening to our fears instead of listening to God. I wonder if part of the reason we struggle with doubt is that we listen to the voices around us instead of standing on God's Word. Most of us can quote lots of reassuring verses and promises about how God is in control, how God works all things together for our good, how God will make all things right in His time. Yes, we know the words all right - but do we really believe them? As soon as we are alone or with friends, the doubts come: am I really doing the right thing? Should I just take things into my own hands? Should I prepare for the worst? I don't want to stretch out in faith because I'm frightened of what might happen. It is all about fear, listening to the voice of the fears over the voice of God.

The worst part is that God won't force us, or make us keep our word to Him. If we choose to trust ourselves and our bank accounts and our own wisdom and worldly advisors, He will let us go our own way. We are the losers when we fail to trust in Love and instead listen to Fear. Where do we place our trust? To whom do we listen? I know I have listened many times to the voice of Fear; I want to do so no longer.

Detachment

I was reading some interesting stories on another medical blog: www.ahyesmedschool.blogspot.com and I started thinking about detachment. One person wrote to the blogger "Do they teach you detachment in medical school?" to which I immediately thought "They should!". The blogger actually replied that no, in med school we learn to be sensitive, communicative, respectful, touchy-feely types. Which, of course, just makes it worse when we become real doctors and have to see more patients than we can handle, deal with death, dying and lawsuits, see outcomes and life events we would rather not and generally get slammed with all that goes with handling issues of life and death.

Some of us overload and drop out, some have breakdowns, some stress out and take it out on their partners and family. The rest of us learn detachment. I think detachment comes with realizing that it is not all your fault, that you can't make it all better, that you can't even make it as good as possible because little things like money get in the way. Detachment is learning to leave it at the hospital door when you leave. I suppose patients think detachment is a bad thing - I keep hearing how doctors don't empathize enough and aren't available enough to patients. I think the reality is that we have to have enough sense of self to have some patient-free time in our lives.

Some patients do follow you home. After running a resus (especially one that fails) it does stay in your mind. Knowing a mother is about to bring a lawsuit against you does pop into the head at odd moments, even if the case it totally unjustified and everyone tells you not to worry about it. Worrying is part of being a doctor.

I think it is the old balance problem. How to be sensitive and empathetic and sympathetic, and yet how to hold yourself far enough away that all their problems don't become your problems. I wonder if this is why there is such a culture of anger in medicine? (I sometimes think it is because of the male dominated nature of medicine as well.) It is acceptable to rant and rave and complain about the patient's family, about the hospital system and the government. It is acceptable to be angry with incompetent referrals from the ED, even to yell at the resident on the phone. It is somehow not acceptable for the doctor to cry, to admit to feeling guilty, or inadequate or even inexperienced in some circumstances.

Doctors are under pressure to be inhumanly perfect, inexhaustible and altruistic. When we fail these expectations we are branded flawed, faulty, greedy, selfish - usually to the tune of several million dollars. Ah yes, medical student, you will be walking a fine line, and the conversion from Fake Doctor to Real Doctor is by walking through the refining fire of responsibility. Don't wish for it too soon.

No reason

The autopsy showed nothing. No reason why a perfectly healthy baby with a normal heart and normal lungs and a normal response to labour should suddenly be born dead. The blood tests showed nothing, the X-rays showed nothing. Why, why, why?

My play

My play has been selected to be a finalist in the Booroondara Playwright Competition 2005! Out of all the plays submitted, mine is in the top three and is going to be staged in December! I can't believe it! My scribblings, my thoughts and feelings, my words are going to be acted out by people on stage - I am apprehensive and excited all at once. It doesn't really matter if I win or not - I've won already by getting this far with my first script!

Funny coincidence - I put in my biography that I was inspired to write a play after seeing Helen perform in the finalist plays last year. Helen put in her bio that she auditioned because I wrote a play! Strangely, she will be starring in my play as one of the leading characters. It will be so weird to hear her saying lines I have written.

I hope no-one is offended or upset, but I would like to make people think. I mean, homosexuality in the church is a pretty "hot" topic, so I suppose anything I say is going to be controversial, but I really hope the actors don't turn my characters into caricatures. Every point of view presented by the seven characters is one I believe in and know people who hold them in all seriousness. The point I really wanted to make is that all POV are valid and there is something to be said for them, and I wanted to say it!