[...] Is It Sometimes Wrong to Keep Preemies Alive? [...]

First of all, the choice is death or *potential* disability. You took pains to point out that 24weekers aren’t surviving at higher rates, but didn’t quote how many of those who do survive have severe disabilities, which would’ve been quite relevant.

Many many many micropreemies live without disability. I have a 14-year-old sister who was born 1lb, 14oz and she’s frighteningly normal. She’s healthy and bright and you know what? The three months in which my mother did live in the NICU were pretty hard on me and my brothers, but totally worth it. I don’t think, if she had decided that she just couldn’t handle that, that we would suffer to much, that I would be able trust her to be there if I needed something as intense. And honestly, wouldn’t you practically live in the hospital if your 5-or-6-or-17-year-old child, or any child who wasn’t a newborn, was hurt in a car wreck or some other trauma? Is the trauma of preterm labor or preeclampsia somehow different from cancer or car accidents? Or is it just easier to make such a decision about someone whom you’ve just met, rather than someone who has a favorite color and a voice and a name?

Everywhere, these decisions are made with costs in mind, and in fact the UK has a policy about how long an infant must’ve gestated before he or she is even entitled to care of any kind. In the US, if the parents consent to care, the doctors must provide it, regardless of cost as it is emergency, lifesaving care. Parents and insurers are billed later, and charities, Medicaid and Medicare (if the child is disabled) often come up with much of it.

Human beings are our most valuable resource. Check out the work of not-particularly-religious economist Julian Simon for support of this. And remember that so many things that people live through routinely were once thought to be hopeless.

Also, I am a funeral director, and recognize wholeheartedly that death is a part of life, often a beautiful, peaceful, welcome part. But to not even try to save the smallest, most helpless people, because life may be hard for them, is cowardly and diabolical.

Rant over—not calling anyone else diabolical, just the culture that holds death to be preferable to a life with special needs. Probably don’t mean to sound as ranty as I do, and I don’t take issue with your post, ChiLaura.

I couldn’t imagine letting my baby die, no matter the cost or the possible future problems. I would rather my family and I lived in poverty with a live baby than lived to have an exceedingly easy and wealthy life having let my child die.

jenny, thanks for your post. Maybe what I should say, which is much more my point is that this is the sort of situation on which I have no real strong opinion. If a family chose not to hook at 24-wk baby up to machines and let him die instead, I really don’t think that I would judge that family. In my mind, I compare it with a terminl disease the symptoms of which can only be treated by some horrible therapy: I wouldn’t judge an individual who would rather die sooner and not go thru the therapy. It’s much more the degree of invasiveness that I have in mind than anything else, and I’m certainly not saying that a child shouldn’t be saved just because they might have special needs. (FWIW, I’m someone who thinks that terminally sick fetuses — e.g. Trisomy 18– should be carried to term rather than aborted.) Sometimes it seems that medical interventions take place “just because” we have the technology without thought to the larger context.

The caveats are: 1) that it may very well be that my religious faith allows me a greater peace about letting a child die than some others (though, lordy, that sounds sick even as I write it, doesn’t it? I jus mean that I believe in the afterlife and that even a child who dies so soon is still meaningful and blessed); and 2) that I really don’t know that I could watch my 24 weeks’ baby die. At that point in my pregnancy, I’ve suffered for that baby, named that baby, and started imagining that baby, and I don’t know how well I’d be able to let go of that, whatever I may say now. Again, I hope to God that I never, ever have to deal with this.