America's Other Litter Problem

America's Other Litter Problem

America's Other Litter Problem

The conventional wisdom debunked.
July 20 2001 8:30 PM

America's Other Litter Problem

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Last week in Washington, D.C., a Saudi woman gave birth to septuplets, only the third set ever to have survived labor. The Washington Post fronted the story under the headline "SEPTUPLET JOY" and reported without analysis the family's two-bedroom apartment, the father's job as a high-school teacher, and his wish for a large family of "ideally, 12 children." The story was peppered with supportive statements from the doctor in charge.

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Forgive me for not celebrating with a cigar (or seven). Yes, the babies are innocents, and of course it's sad that the couple had previously lost one child at 6 months and another at age 3, and, yes, it's unfortunate that the mother had trouble getting pregnant again. But it was indulgent of the parents to use a fertility treatment that tends to produce a high-multiple pregnancy, and it was socially irresponsible of their doctors to make it available to them.

Multiple births and fertility technology don't trouble me, per se. If a couple finds out that they are going to have triplets, that's a blessing, albeit a rather taxing one. And if an otherwise infertile woman makes use of in vitro or in utero technologies to have a baby or two, I'm with her and her doctors. But they lose me when they opt for fertility technologies associated with mega-births, which are essentially the only way to produce quads, quints, and more.

The immense amount of medical care (prompted by premature deliveries and low birth weights) and logistical support mega-babies require for years is a staggering diversion of public resources from the many to the few. An ordinary birth is usually presided over by one doctor and no more than a few nurses, but the delivery of the D.C. septuplets took a team of 50. At most hospitals, a single birth costs about $10,000. The medical costs incurred by the Washington septuplets before they get released from the hospital—they'll be there for months—will be about $2 million. That would pay for essential medical services for many, many non-mega-kids. And the same argument applies to all the subsequent non-medical costs.

It's fine if Bill Gates wants to pursue this nuttiness and write a check for the whole thing, but don't you think it's just a tad reckless for a high-school teacher? He claims that the Saudi royal family will pay for everything, but if true, that's luck, not a plan. The same can be said for the McCaughey family, who had their drug-induced septuplets in Iowa in 1997. The state and various local businesses built them a 6,400-square-foot house and bought them a 15-seat van. You can't expect society to keep rewarding wanton ovulation this way, especially if, thanks to the current boosterish atmosphere, it were to become more common.

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Would-be mega-parents and their co-conspirator doctors seem to rely on two key assumptions: 1) A family's wish to have children is morally decisive, justifying the use of all available relevant technologies; and 2) foreseeable but avoidable complications from fertility treatments (i.e., seven kids with lots of problems) are on the same moral footing as unforeseen and/or unavoidable ones.

These assumptions are obviously false. Regarding 1): A wish may be a mere wish, not supported by the required underlying physical or financial capacity, which therefore has no moral force. I wish to be richer and have a bigger house. This by itself has no more weight than my wish to win the Nobel Prize in Physics. (It's only in the Bible that it says ask, and it will be given to you, an explanation perhaps of why mega-parents tend to be deeply religious.) In many non-obstetrical areas medical procedures are often denied to people who want but don't need them. Years ago, when a knee injury interfered with my running, my doctor did not offer me the perfected but expensive ligament repair then only being performed on professional athletes.

It is not wonderful, but selfish in the extreme, to pursue the mega-wish: It's unfair to other children, including those the parents in question already have, and it's even unfair to the mega-children themselves, whose lives will be dogged by the physical problems and psychological deficits that inevitably come with broods.

Regarding 2): It's glorious that doctors can wield their technologies to save a premature infant, but there is clearly a difference between their doing so when they just happen to be confronted with struggling life and their doing so when they have knowingly created that struggle with fertility treatments. We should encourage suitably trained people to run into burning buildings to save occupants, but we should not encourage suitably trained people to set fire to buildings and then run into them to save occupants.

Mega-parents live in a world where wished-for-children are on a par with (or are even more important than) wished-for-and-sustainable children and with actual children. But actually in that hierarchy, wished-for-children should finish last.