Keep people like this away from the NICU

After my novel-length post earlier, a quick rant.

In the few weeks since the NICHD ‘before 24’ paper came out there have been a number of newspaper articles reporting the results, and responses to them. A report in the National Post included some comments made by an “ethicist” by the name of Arthur Schafer who for a long time apparently was an advisor to the Winnipeg neonatal group** UPDATE** see the comment from Molly Seshia after the post**. I can only say I feel sorry for them. His comments show a lack of understanding of the issues and a deep misunderstanding/mistrust of modern medicine, not a good combination for a bioethicist:

“Relying on gestational age to judge the viability of a preemie may be inexact and arbitrary – like setting a speed limit or legal drinking age – but it does provide some useful guidance”, argues Arthur Schafer, head of the University of Manitoba’s Centre for Professional Applied Ethics.

What a ridiculous analogy. Keeping to the speed limit won’t kill you, waiting until you reach legal drinking age won’t kill you either. And you can tell pretty accurately how fast you are going, most of us know how old we are.

“Some of the time I had to struggle to suppress the thought ‘How unlucky for these families that their child was born with access to an NICU,'” he says.

“Wouldn’t they have been more fortunate if they had been living in a remote area … where the baby would have died instead of being put through days and weeks of intensive, high-tech medicine, with virtually no chance of surviving, or surviving without overwhelming impairments.”

What a disgusting thing to say. Would he dare say that to parents of a child with leukemia? Or a child who has just been badly burned or hit by a bus? I wonder if he might be more fortunate to be living in a remote area when he gets his stroke.

How unlucky for the babies in Winnipeg that they were born with access to a bioethicist like this.

He clearly has no idea what the actual results of NICU care are. “virtually no chance of surviving, or surviving without overwhelming impairments”? What on earth is he talking about?

Even more unfortunate, we sometimes hear neonatologists say similar things, and they have said them again since that article was published. Seriously, if you think your patients would be better off being born without access to an NICU, you should get a new career. We need neonatologists who will advocate FOR their patients, and not against them.

About Keith Barrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
This entry was posted in The CPS antenatal counselling statement and tagged , , . Bookmark the permalink.

4 Responses to Keep people like this away from the NICU

  1. katharinastaub says:

    Indeed, this is a very appropriate rant. He doesn’t have the slightest idea of what goes on in the NICU. Last time I checked, most babies survived and not only that, they actually go home where they grow up and bring a lot of joy to their families. Thank you to all who care for our children and make it possible for us to be families!

  2. Annie Janvier says:

    When it comes to preterm infants, “experts” and just about anybody think they can say just about anything.
    A speeding limit is a public health policy created to constrain the limits of EVERYBODY who drives for the safety of the population. The limit of 18 applies to ALL human beings (who will at some point be 18) at some point in their lifes.
    Gestational age guidelines for life-and-death decisions apply to one group of patients, the smallest of the vulnerable patients; based on uncertain and incomplete data.

    As for the living in a remote area….
    Imagine if an ethicist said similar things about trauma patients or cardiac patients?

    Leave our patients alone!

  3. Molly Seshia says:

    To clarify..”Arthur Schafer who for a long time apparently was an advisor to the Winnipeg neonatal group…”…He was involved sporadically in the 80s (as I recall).

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