Wednesday, May 22, 2013

The Gray Area

Today, while I was observing my son at his preschool, I had a conversation with a mom of twin preemies who also attend the school. Born at just 24 weeks, they were given little chance of survival. In fact, the mom told me that the cut-off for intervention at that particular hospital is 24 weeks. Had her babies been born just two days earlier, the staff wouldn't have tried to save them--and they told her that. I was struck by the absurdity of such a policy! I was surprised they didn't offer to transfer her to a nearby hospital that would intervene, because a couple of excellent NICUs in the area do take babies at 22 and 23 weeks. Each hospital has a protocol for deciding when to intervene. At some point the likelihood of a baby surviving is so minimal and the fight for survival is so painful for the baby that doctors and nurses believe it's not in the best interest of the baby to resuscitate, and since babies that tiny cannot breathe on their own, they simply can't survive. I've seen babies struggle in the NICU, so I understand. And the reality is that even with the best medical advances available, there is a point when a baby simply cannot survive outside of the womb. But, then you see 24-weekers who are healthy and strong at age 2, and you wonder if drawing a line in the sand isn't misguided. Shouldn't it be based on the health of the babies? If a baby born at 23 weeks and 6 days is healthy and capable of being stabilized, shouldn't that baby get a chance at life? I know the dividing line between death and viability outside the womb is a gray area somewhere around 22 weeks, but I'd hate to think that a child that could survive wasn't even given the opportunity. And as with so many medical ethics questions, it feels so much like playing God to decide who should live and die.

I don't even know exactly what the right answer is. All I know is that I'm so thankful both my preemies made it past that gray area, and I'm so grateful for their health. I was overwhelmed looking at not one but two healthy toddlers who but for a few hours might not have lived. NICU stories never fail to be miraculous!

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