Everything possible?

December 15th, 2011 | Posted by Atlee Breland in Pregnancy Issues

Reprinted with minor modifications from Parents Against MS 26

The official position of Personhood USA on pregnancy complications is that

In cases where a mother’s life is at risk, every effort should be made to save the baby’s life as well; leaving the death of an innocent child as an unintended tragedy rather than an intentional killing.

It sounds so nice, simple, and clear-cut, doesn’t it? Try to save both lives as long as you can, then switch over to save the mother? Well, let’s explore how this might play out in a very real context: chorioamnionitis prior to fetal viability.

Let’s call our mother-to-be “Karen”. She has a very much wanted pregnancy, until at 20 weeks, Karen develops an infection of the amniotic sac (“bag of waters”). She develops a high fever and is rushed to the hospital. Doctors encourage her to induce labor and deliver the baby, who will inevitably die, because there is no way to prolong her pregnancy until viability. The longer she goes without delivering the baby, the greater the risk that Karen will die.

Karen, out of strong pro-life beliefs, refuses to induce labor, because she considers that to be an abortion. She asks the doctors to do everything possible to save her baby, and to give her antibiotics to attempt to treat the infection. As she gets sicker and sicker, her body begins to go into labor naturally, and she begs for tocolytic drugs to stop her labor. The doctors comply, but the drugs don’t work, and she continues to have contractions. Eventually she consents to speed up her labor with drugs, because she is so desperately ill and must deliver quickly to save her own life. Karen’s son is born, and dies in her arms shortly thereafter, because he is simply too premature to survive.

As you may have guessed, this isn’t actually a hypothetical situation. It’s the very sad story of Karen Santorum, the wife of current Republican presidential candidate Rick Santorum, who is notable for his uncompromising pro-life position. Karen and Rick Santorum lost their baby son Gabriel to chorioamnionitis in 1996.

What’s notable about this story is just how far Karen and Rick were willing to go to avoid any action which could be considered a deliberate termination of the pregnancy. The pregnancy was doomed from the moment Karen entered the hospital — the odds of successfully treating the infection, and allowing her to remain pregnant, for four more weeks, were slim indeed. Yet the Santorums felt obligated to try anyway, and to demand every possible lifesaving measure, such as antibiotics and tocolytics. For them, nothing less was compatible with their pro-life beliefs.

Every one of these measures put Karen’s life at additional risk. Every minute that she wasn’t delivered was doing something less than “everything possible” to save both lives. Every treatment Karen tried prioritized Gabriel’s life, and threatened her own. By all accounts, Karen is lucky to have survived — women still die of these infections, even with the best care modern medicine has to offer.

In this situation, there is no way to equally treat both patients. You must choose whom you wish to save.

I’m not criticizing Karen and Rick’s choice. They have the right to decide how they want to handle their medical care. My criticism is that personhood could potentially impose Karen and Rick’s choice on those parents who would act differently in such a situation, and on the doctors who would advise their patients differently.

Other parents might wish to make a different choice, knowing that the odds of a good outcome were so small. They might opt to induce labor immediately, before the mother becomes as sick as Karen did. She might choose to prioritize her own life over the baby’s, and ask the doctor to do something less than “everything possible” to save the baby’s life.

It’s not an absolute certainty that the baby is unviable in all such situations. A rare few women may recover with antibiotics, and be able to remain pregnant long enough to deliver an extremely premature but viable baby. You can’t say at the moment the mother walks through the door that the baby is unviable — you can say it’s very low odds, but nothing is guaranteed. Therefore, the same standard of “everything possible” would apply.

If tocolytics and antibiotics might potentially save the life of the baby, they must therefore be employed. However, using them puts the mother at additional risk, so it’s not doing “everything possible” to protect her. What, exactly, is the doctor supposed to do in this situation? What, exactly, meets the standard of “everything possible” to protect both patients’ lives equally?

If you can’t answer this question, maybe you shouldn’t vote for an amendment which requires doctors to answer it, and to hope that their guess turns out to be on the right side of the law.

Please note: I will not tolerate any abuse of Karen and Rick Santorum in comments. For purposes of this post, I consider them grieving parents, not as political figures, and ask that you do the same.

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