(I sometimes tell this (true) story when talking to medical students or public groups about the ethics of reproductive technology. MPS)
"A couple presented to my office requesting care for infertility and recurrent miscarriages. Within a few visits, it was clear to me and the office staff what the problem was - they were both drug addicts. Their particular addiction was known to increase the risks of infertility and miscarriage, and was associated with a variety of other pregnancy complications. They were in their early 30's and successful in their professions and daily lives. We offered help and strongly recommended that they stop their drug use, but they just wouldn't (or couldn't) do it. How should one proceed in a case such as this?"
Audiences are uniformly unsympathetic towards this couple - no one wants to offer them fertility treatment. Often someone will comment that the situation is appropriate, as drug addicts shouldn't be reproducing anyway. I ask if it matters which drug they are taking, and the answer is "no". Then I reveal that the drug being abused is nicotine - the patients are heavy smokers. At this point some members of the audience become very quiet, as they have packs of cigarettes in their pockets. The rest of the audience usually become less vigorous in their condemnations. No one tries to dispute the harmful effects of smoking on reproduction, but it seems that this addiction is much more socially acceptable than the cocaine or heroine use the audience had in mind.
What ultimately happened with the patients? I finally told them not to come back until they stopped smoking. They never returned.
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5 comments:
My husband and I were faced with a similar situation. We were by no means heavy smokers, but none the less we smoked. We were told that we had to quit so we just asked ourselves one question. Would we rather smoke cigarettes or have a baby? We have been smoke free for about two weeks now. Thanks to Dr. S and his staff for all of their support.
My husband and I were faced with a similar situation. We were by no means heavy smokers, but none the less we smoked. We were told that we had to quit so we just asked ourselves one question. Would we rather smoke or have a baby? Answering the question was easy and we are now smoke free. Thanks to Dr. Steinkampf and his staff for all of their support.
I'm sure you could've heard a pin drop! You are sly...
Dr. Steinkampf, What is your opinion on successful IVF after having had tubal pregnancies for a 42 year old with 1 tube? A nurse has told me the chances are high for another tubal even with IVF. That just doesn't sound right to me. Your thoughts?
Thanks!!
Melinda, you know things are getting weird when your fertility clinic advises you not to do IVF because your tubes are damaged and and ectopic pregnancy is possible - hey, I thought IVF was DEVELOPED for women with damaged (or absent) fallopian tubes.
Last time I looked, about 1% of embryo transfers result in a tubal pregnancy, and the risk is probably higher in women with damaged tubes. If you are truly paranoid about another tubal pregnancy, you can have the remaining tube removed before the IVF cycle. MPS
Do you find that there is an ethical dilemma when a women comes to you with several children and wants more? I have 5 and my last one died of SIDS at 7nweeks old. I want more children and my last fertity doctor made the comment don't you think 4 is enough? I thought that was my decision to make. I also house 1-2 neightbor kids during the week and weekends to get them to church on Wed and Sundays and he comment on they were not my kids and it was not my job to raise someone elses kids. I am glad Jesus did not have these views. How do you feel on the topic?
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