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ADVANCE Perspective: HIM

Eight Is (More Than) Enough

Published February 6, 2009 12:10 PM by Lynn Jusinski

Editor's note: This blog is a guest blog from our nursing publication, but we thought HIM professionals might like to chime in on this controversial issue, too. You can see the comments left on the blog on the nursing Web site here.

By Adrianne O'Brien, consulting editor at ADVANCE

As most of us know by now, Nadya Suleman, of Whittier, CA, gave birth to octuplets on Jan. 26. I don't think I'm alone, here, in having a moral and ethical problem with this.

Suleman, 33, is already a mother to six children, and is a single parent. The fact that she is a single mother isn't the issue. The issue is that she is now a single mother to 14 children, eight of whom are newborns. Angela Suleman, Nadya's mother, who has been taking care of the other six children while her daughter recovers, has issued a warning. She told her daughter that when she gets home from the hospital, "I'm going to be gone."

How well can one extraordinarily sleep-deprived parent tend to and care for eight newborns, let alone an additional six, all of whom are under the age of 7. Surely Suleman will have volunteers to help her, but still - the mind boggles.

Ethically, this is a dicey issue. Should a healthcare practitioner make a ruling that parents with children, even single parents with multiple children, cannot undergo in vitro fertilization, as Suleman did? No. But in this scenario, it is the physician's duty to understand a patient's emotional and financial - in addition to physical - health before implanting embryos.

Exactly how many embryos were implanted is not known; Suleman's fertility doctor has not been identified. That is, if she actually was implanted. Jacqueline Gutmann, MD, a fertility specialist with  Northern Fertility and Reproductive Associates, Philadelphia, called Suleman's story "thin" in a Feb. 4 radio interview. She noted insurance companies are more likely to pay for fertility injections, which often lead to greater numbers of higher multiple births, than vitro fertilization, and wondered if Suleman had actually used injections.

A good friend of mine, a nurse in the Philadelphia suburbs, underwent in vitro fertilization several years ago. She and her husband were asked very directly about the absolute maximum number of babies my friend would want to carry. (Their answer: four; three survived, and my friend delivered triplets in March 2003).

Any premature baby is at risk for lifelong problems, particularly higher multiple births, including blindness, deafness and cerebral palsy. For a person who has earned a degree in child development, as Suleman has, from Fullerton College, her decisions have been downright reckless.

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