Compassion or Opportunism?

I am the parent of a disabled ex-premature child and unwilling to go through the preemie experience again. When I recently became pregnant, we approached the doctors to ask about our options if I went into very early labor. ”Doctors would feel bad,“ we were told, ”if they didn’t do everything possible to save a 24–25 weeker.“ What kind of twisted version of compassion is that? How about the awful feelings of parents required to care for a disabled child for a lifetime?”

“I’ve put in 16 years of caregiving—there is no letup in sight, and I’m damn sick of ”them“ telling the world that what I’m doing is not a representation of what is really happening to preemies and their families.”—2 parents.*

When I was a pediatric house officer in the 1940s, obstetricians ruled imperiously in delivery rooms. I was told: “We don’t attempt to save newborns weighing <1 kg because they are previable.” In academic institutions on both coasts of the United States, I saw this dictum conducted in actual practice. A neonate weighing <1 kg was unwrapped and placed in a cold corner of the delivery room and ignored until the infant stopped breathing. The agonal gasping seemed endless, much to the discomfort of everyone in the room, but no one made a move to interfere or even question the rule. Parental consent was not solicited; the marginally viable newborn was baptized by the nurse, and the outcome was recorded as “stillborn.” There was much head-shaking, but, as delivery …

Address correspondence to William A. Silverman, MD, 501 Via Casitas, Apt 421, Greenbrae, CA 94904-1947. E-mail: fumer{at}aol.com