When man de­cides who should live and who should die

Sunday Times (Sri Lanka) - - COMMENT - By Dr. Ni­lal Rat­nayake

Life is a gift we have re­ceived. We are thank­ful to our par­ents that we are given a chance to live this life. It is not what we chose, our par­ents con­sid­ered every child a wanted child.

And now with the devel­op­ment of med­i­cal tech­nol­ogy, we can de­tect anom­alies when the baby is in the mother’s womb.

As a re­sult if there is a fe­tal im­pair­ment called “In­com­pat­i­ble with life” one of the op­tions is to kill the child while in the uterus also called ter­mi­na­tion of preg­nancy.

The sad part is that rather than us­ing med­i­cal tech­nol­ogy to heal the dis­ease we doc­tors are killing the child to be born due to the lim­i­ta­tions of med­i­cal sci­ence with­out than tak­ing the chal­lenge to help the child live a qual­ity life.

The dan­ger of this trend com­ing to our coun­try is go­ing to be to the chil­dren to be born in the fu­ture, as there is a high prob­a­bil­ity that they may not get a chance to be born.

This is a se­ri­ous de­ci­sion the doc­tor im­poses on the par­ents where they will de­cide to kill their own child as the doc­tor can not cure the dis­ease. This adds to the men­tal trauma where they suf­fer from the guilt of killing their own fe­tus. This painful silent suf­fer­ing goes on un­til the end of the par­ents lives.

But if we doc­tors re­spect hu­man life from the mo­ment of con­cep­tion un­til nat­u­ral death, we have done our best to pre­serve and re­spect life even if the child dies af­ter birth. The par­ents and the doc­tor can sleep peace­fully say­ing hon­estly to their con­science that they have done their best to pre­serve life.

And the other re­al­ity which we must un­der­stand humbly is the fact that man is born to make mis­takes, wrong judg­ments, di­ag­no­sis and prog­nos­tic out­comes as some fe­tal im­pair­ments, can­not be di­ag­nosed with hun­dred per­cent ac­cu­racy while the baby is grow- ing in­side the mother. Thus a child who will have a chance to live might also be killed by the doc­tor.

I would like to dis­cuss some of the con­di­tions jus­ti­fy­ing killing ( ter­mi­na­tion of preg­nancy) that are rec­om­mended by the med­i­cal pro­fes­sion­als

Os­teo ge­n­e­sis im­per­fecta

Brit­tle bone dis­ease is where the baby is more prone to have many frac­tures. This dis­ease has many types, and some types are com­pat­i­ble with life. eg. type 1, type 4.

Dou­glas Jhon Her­land was a per­son born with os­teo­ge­n­e­sis im­per­fecta. He won the bronze medal in the 1984 sum­mer olympics. He also pro­moted adap­tive row­ing for the dis­abled. Luck­ily for him his par­ents neve r thought of him as in­com­pat­i­ble with life and as go­ing to be a bur­den to so­ci­ety. Dou­glas lived for nearly 40 years.

Pot­ters syn­drome

Is a con­di­tion where the fe­tus has no de­vel­oped kid­neys. And as a re­sult there is less am­ni­otic fluid and the fe­tus gets com­pressed in­side the uterus. Thus the air pas­sage is not formed well. Ac­cord­ing to doc­tors there is a hun­dred per­cent chance the child will die, so they ad­vise the child be killed while the baby is grow­ing in­side the mother.

But this is what Jaime Her­rera Beut­ler, a US Repub­li­can congress woman and her hus­band did when she was told her baby has pot­ters dis­ease and the doc­tors ad­vised her to kill the baby grow­ing in­side her. She re­fused and went to a dif­fer­ent doc­tor at John Hop­kins in Bal­ti­more who was will­ing to try a treat­ment that could po­ten­tially save the fe­tus. The doc­tor in­jected mul­ti­ple doses of nor­mal saline into the congress woman’s ab­domen (uterus) cre­at­ing enough fluid for the baby’s lungs to de­velop. Abi­gail was born, ac­cord­ing to Dr. Steven Alexan­der a pae­di­atric kid­ney spe­cial­ist, while she was on dial­y­sis. And her fa­ther do­nated the kid­ney and Abi­gail is still alive. So who are doc­tors to de­cide who should die?


Is a gen­eral term for dis­or­ders of devel­op­ment of bone and car­ti­lage

Achon­dropla­sia as it is com­monly called is also in­cluded in this and is not a dis­ease in­com­pat­i­ble with life. Thus where the proper bound­aries are, the in­di­ca­tions for killing the fe­tus, is not clear cut: these should be killed and these should be pre­served. Au­thor­i­ties should be more re­spon­si­ble in these grave and se­ri­ous mat­ters as in­no­cent healthy ba­bies will also get killed.

An­other mis­take the Law Com­mis­sion of Sri Lanka has made in this se­ri­ous is­sue is that a post mortem ex­am­i­na­tion of the killed baby is not in­cluded to be sure that the di­ag­no­sis of the doc­tor was ac­cu­rate. If he has made a mis­take of killing a heathy child proper le­gal ac­tion should be taken against the doc­tor.

Lit­tle miss courage

Rashmi Gu­nawar­dena was born with only one leg. She writes with her only foot. she was the only stu­dent to pass the grade five schol­ar­ship exam with 153 marks for the last 10 years from Deloluwa Ju­nior School. If this law was there the chances of Rashmi be­ing born a live would be slim

It is very un­for­tu­nate that doc­tors do not un­der­stand that go­ing against the laws of na­ture will be the down fall of hu­man­ity.

Fi­nally I would like to re­mind the doc­tors of the Hip­po­cratic oath which we stood by which specif­i­cally spells out not to per­form abor­tions and to safe guard hu­man life from the very mo­ment of con­cep­tion.

And the other fact the peo­ple of this coun­try should be aware of is that abor­tion harms the woman’s body in many ways. It is safe to con­tinue the preg­nancy to term and de­liver.

Al­ways re­mem­ber abor­tion is al­ways safe for the doc­tor be­cause it is not his body he is do­ing the pro­ce­dure on. It is the woman who has to live with the short and long term con­se­quences of an abor­tion.

Killing the fe­tus is of course the easy way out, pre­serv­ing life is dif­fi­cult. But what we have to do is the cor­rect thing, not what is con­ve­nient to us.

(The writer prac­ticesPe­di­atric Oph­thal­mol­ogy at the Lady Ridge­way


The sad part is that rather than us­ing med­i­cal tech­nol­ogy to heal the dis­ease we doc­tors are killing the child to be born due to the lim­i­ta­tions of med­i­cal sci­ence.

Rashmi Gu­nawar­dena, a coura­geous stu­dent

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