Medical Ethics and the Stewardship of Life
Are medical students different today?
In talking on rounds to medical students who have never known medicine when abortion was illegal, I find that they have an entirely different concept of the worth of human life—it' cheap.
What do you tell these medical students?
I tell them that when I was in their place the very word abortionist was a loathsome thing; now the abortionist is likely to be the professor of obstetrics in the medical school. There was a time when everybody believed that it was wrong to destroy an unborn baby. Now a great many people feel that it is right to do that. Many people believe that what is legal is right. There are thousands of women who would never have an abortion, I am sure, if the law said it's wrong.
What would you consider extreme measures to save an infant's life?
Let's say that a newborn has a situation where so much of his intestine is destroyed that there is not enough left to support life. It would be possible to put that child on total intravenous nutrition and keep him alive for many months but with the ultimate understanding that eventually one would run out of veins and the child would eventually die because you could no longer provide nutrition. To use that type of nutrition would be to me in that circumstance extraordinary care that I would elect not to use. Knowing that the situation was hopeless anyway, I would provide just the usual (not extraordinary) care and the youngster would therefore not live as long. However, no active step would be taken to shorten the child's life and he would be treated with all the love and care and compassion that we had.
Do you differentiate between certain extraordinary means and others, then?
I'm best known for a series of operations on newborn babies, children born without a rectum, with intestinal obstruction, with no connection between throat and stomach, with their abdominal organs in the umbilical cord. It would not be possible for me to have achieved the survival statistics I have if I didn't use extraordinary care. But even in that category there are patients that I know are not going to make it and in them I would taper the extraordinary care. There are three things that I must know to make a decision. I must know the patient, his disease, and how the patient responds to the disease. I've never killed anyone, but I have frequently been relieved when a child under my care has died. I have told the family that this is a blessing in disguise. But that doesn't entitle me to distribute showers of blessings to other people by destroying their children, even though they have big hardships ahead of them.