A Frank Ob/Gyn's Message

An honest assessment of all things medical and ethical.

Archive for the month “November, 2011”

IVF, why not?

Last time, I laid down some of the background for how misguided is the promotion of IVF (in-vitro fertilization) when compared to paucity of legitimate infertility treatments that seek to actually restore the healthy state of fertility. Now, I’ll detail some of the specific aspects of this process that I believe qualify it for the ignominy of being indeed the sum of all evils within the medical profession.

The attraction of IVF is mixed with both noble and selfish motives. The desire for children for their own sake within marriage is a natural and universal good. However, the desire for a child as a possession or commodity to own is an obvious reflection of fallen human nature. An appeal to the latter attitude was most conspicuous when I first saw a large highway billboard advertisement for an IVF center with a large picture of an infant’s face covered with the following phrase in 5 meter font “Want One?”. This obvious commercialization of conception is only the tip of the sinister iceberg.

Consider the following typical scenario. A couple seeking treatment for infertility undertakes the following process. The woman is taken to the operating room for a “diagnostic” laparoscopy. During the operation, the physician arbitrarily decides that her Fallopian tubes are enlarged. In a move that would rightly shock most observers, he then proceeds to surgically remove both of her tubes! The complete and irreversible form of sterilization has now guaranteed that the woman will only be able to conceive via IVF. As unbelievable as this may sound, I have personally witnessed such an outrage committed under the dubious claim that this would improve her chance of successful IVF―even though she had not yet even consented to either the sterilization or future IVF attempts.

In the later IVF cycle, the woman is given medications that dangerously overstimulate her ovaries (far beyond their natural function) in order to cause the development of 10 or more ova (eggs) at a time. Naturally, a woman only produces one ovum per cycle. She and her husband are given strict instructions to avoid marital intercourse during this process. Ironically, the woman is placed on a birth-control pill. Then, around mid cycle the couple is brought in to the office. The husband is given pornography along with instructions to collect semen in a specimen cup via masturbation in a nearby toilet stall. The same day, the woman is taken to a procedure room where her ova are “harvested,” in a most undignified and miserable process by which a large-bore needle is directed through the vagina into her ovaries. In the same room, the technician designated “embryologist” examines the eggs under microscope and literally mixes them in plastic petri dish with the recently provided semen. If at least 8 human embryo’s are conceived in this manner, it will be considered an optimal first step. These 8 newly conceived human beings are then graded by the embryologist in order to determine which are of the highest quality. About half usually make the cut; the rest are literally disposed of as mere medical waste. In fact, I was appalled to once hear an IVF doctor respond with unusual frankness to a couple asking what would happen to any spare embryos, “we throw them in the trash.” Of the four remaining, 2-4 will be “transferred” (injected via syringe) into the woman’s uterus with the hope that only one will survive. Those “high quality” embryos not already thrown into the waste bin are sometimes frozen indefinitely at great expense with small likelihood of ever surviving any thawing process for later IVF attempt. If by some “misfortune” more than one embryo survives in the mother’s womb, she is then advised to undergo “selective embryo reduction.” This of course is simply another duplicitous euphemism for a procedure intended to destroy all but one of the human lives. The maternal-fetal medicine specialists are now all too ready to use their ultrasound skills to aid in the decision of which child should be spared. Perhaps they want a boy, perhaps they want to be certain the baby spared isn’t the one with a cleft palate.

What if the harvested eggs or harvested sperm are deemed poor quality? There is a thriving and rather lucrative market of human eggs and sperm for sale wherein for the right price, the couple can purchase eggs or sperm from anonymous individuals of whatever age and background they prefer. In addition to material adultery, the injustice to the children conceived using such vendor (dishonestly called “donor”) eggs or sperm is that the children and biologic parents are separated in a most bizarre and unnatural manner from ever seeing or even knowing of one another. Ever wonder how legal disputes are settled over the custody and rights of the frozen embryos? In the U.S., such cases have established a precedent where such children are treated as property. The last time human beings were legally treated as property in Western society was during the time of African slavery.

In summary, let’s itemize the evils incorporated in the IVF process: 1) contraception, 2) sterilization, 3) pornography, 4) masturbation, 5) in-vitro fertilization itself, 6) induced abortion, 7) euthanasia (destruction of the “spare embryos”), 8) freezing of live human beings (“cryo-preservation”), 9) material adultery, 10) the degradation of human beings to mere property in striking likeness to the slave trade of past centuries, 11) the flagrant exploitation of couples seeking medical remedy for their suffering of infertility. Is there any other practice in or outside of medicine that entails so much harm to the good of the human person? If one understand that IVF is indeed the sum of all evils in modern medicine, why not?

–Dr. Frank (Ob/Gyn)

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Is IVF good?

Let us address the issue of infertility and the most common approaches to treatment in contemporary society. Many, I suspect, will be surprised to learn of how disordered the current approach typically is regarding the medical pathologies causing infertility. For example, in a remarkably unusual display of logical consistency (the initial fallacy notwithstanding) the state of infertility is increasingly treated as if it were the healthier or more normative state; this, of course, logically follows the absurd presupposition that fertility is a dangerous condition in urgent need of contraceptive remedy.

No wonder then, in the U.S. (where the provision of health-care is increasingly constrained and manipulated by corrupt corporate and government entities), we have seen the following phenomenon: 1) Large “private” insurance companies and government plans have created a monopoly wherein they alone now decide what will be covered in terms of medical services, 2) Infertility has essentially become the only medical not considered worthy of treatment and therefore not covered/funded, 3) All manner of contraceptive agents and sterilization procedures are the only elective procedures routinely funded despite a lack of any true medical indication or need. Needless to say, such policies create tremendous barriers for couples seeking treatment for infertility.

Even infertility specialists now treat infertility as if it were a normative state that need not be corrected in order to achieve human reproduction! Indeed, this should sound incredible. However, the widespread practices of artificial reproductive technology (ART) including artificial insemination and in-vitro fertilization (IVF) illustrate this point very well. However, because of the high fees charged for such services (especially when IVF is involved), these procedures are increasingly considered a privilege reserved for the most wealthy–not unlike cosmetic plastic surgery. As these procedures have become increasingly common and profitable in their application to those willing and able to pay for them, the skill and competence to actually treat and overcome the pathologies causing infertility is unfortunately in rapid decline. Most conditions causing infertility can actually be successfully treated by physicians willing to do the work required to diagnose and treat the underlying problem. Unfortunately though, the anti-fertility bias of the profession on the one hand and the financial incentives promoting fertility bypass procedures (like IVF) on the other have left most couples with limited access to fertility restoring treatments.

Consider also the fact that these medical procedures such as IVF and artificial insemination completely bypass any semblance of human reproduction resulting from marital intercourse.

With horror, I have witnessed numerous married couples subject themselves to all manner of degradation at the hands of ART focused clinicians. The creation of new life within the naturally intimate and deeply personal nature of marital intercourse is callously replaced with starkly debasing and impersonal medical procedures. Worse, these undignified procedures are usually repeated multiple times before a successful pregnancy is achieved. A more detailed analysis of the ethical and moral problems with IVF and related ART procedures will follow next time. Suffice it to say for now that IVF could easily be considered the sum of all evils perpetuated by the medical profession. However, very few of the patients subjected to this process are aware of this most tragic reality.

–Dr. Frank (OB/GYN)

Is abortion ever necessary?

The next topic was generated in response to a recent article published in a pro-abortion religion magazine wherein the author claims that the conscientious objection, by some American physicians, to participate in abortions is somehow endangering the lives of women.

These latest attacks against pro-life health professionals seeking to follow their informed conscience are based entirely on false assumptions (premises). The first is the mistaken belief that there exist situations where a direct abortion is required to save a woman’s life or somehow preserve her health. An appendectomy, hysterectomy, or salpingectomy is often necessary to preserve the life or health of a woman. Sometimes an early delivery may be needed to save a pregnant woman’s life. For example, a pregnant woman with sepsis needs IV antibiotics and possibly an early delivery–even if the infant is too young to survive outside the womb. (Unfortunately, this baby would not be able to survive very long either in or outside the uterus.) One thing this woman certainly does not need is a direct abortion. For example, in my experience, I’ve treated several women in the unfortunate situation where she had an intra-uterine infection at a point during the pregnancy where her preborn child was too young to survive outside the womb. In these tragic settings, I’ve never hesitated to recommend induction of labor. Sadly, the child is unable to survive inside the uterus due to the infection, nor outside due to prematurity. Even though the child dies soon after delivery, he or she dies as a foreseen, yet secondary effect resulting from the unavoidable prematurity. He or she does not die as a direct result of my violent dismembering of the child’s body using surgical instruments. Students of ethics will recognize this as the principle of double effect. Another classic example used to illustrate this concept is that of uterine cancer (tubal pregnancy can easily be substituted here also). The pregnant woman with advanced uterine cancer will usually benefit from a complete hysterectomy as soon as possible. If this determination is made before 24 weeks of pregnancy, the baby would of course die as a similar secondary effect and this would be ethically permissible (i.e. it would not be a direct abortion). If on the other hand the child is beyond 24 weeks, the child’s life can be saved by delivery via cesarean immediately prior to the hysterectomy. As an obstetrician, my duty is to do everything in my power to preserve the life of both the mother and the child. Conditions (like advanced cancer) that seriously threaten a woman’s health also threaten her preborn child’s health. Therefore, its misleading to suggest we’d place higher value on one life over the other. Justice demands that we do everything possible to save them both. Imagine a firefighter being told he had to choose to save only the mother or her child from the burning house. I’m sure every firefighter alive today would do everything possible to save them both if at all possible.

I repeat: a direct abortion is never required to preserve the life or health of a woman. On the contrary, a direct abortion always threatens the life of the woman and seriously damages her health. Recall the continued talk by pro-abortionists of the multitudes of women dying from illegal abortions? (A deceptive tactic effectively used to force legalization of abortion in the U.S., and one that is no doubt being used today to try and force the same barbaric practice upon Ireland.) Declaring these procedures legal by judicial fiat does nothing to change the nature of the abortion procedure itself. This newer argument about abortion being necessary for a woman’s health is just another variant on the same illogical theme and ironically, it discredits the first argument.

First, it is argued women’s lives are endangered by abortions simply because they are illegal. Once legalized (as in the U.S. today), the next baseless claim is that women’s lives are endangered because some doctors refuse to perform these now legal abortions. In other words, we are supposed to believe that the mere legalization of abortion immediately transforms this violent procedure from one that kills women to one that women will die without! Furthermore, we are frequently challenged with absurd claims that refraining from direct abortions will result in “a woman bleeding out from a uterine rupture, or going into shock from sepsis following a miscarriage.” Such statements betray not only profound ignorance of obstetric medicine but also a reliance on dishonest fear mongering to push a militant pro-abortion dogma.

The second and more broadly dangerous error frequently made is based on a tragically misguided idea. I am speaking of the flawed logic which suggests evil actions may be done to bring about good. St. Paul rightly condemns such foolishness: “And why not do evil that good may come? — as some people slanderously charge us with saying. Their condemnation is just.”(Romans 3:8). Furthermore, St . Thomas Aquinas is quoted by the Catechism of the Catholic Church on this very principle: “An evil action cannot be justified by reference to a good intention” (par 1759 CCC). More succinctly stated, the end does not justify the means.

Ideas have consequences and bad ideas often have disastrously violent consequences. How soon we forget that the utilitarianism of Nazi ideology was used to justify the killing of innocent humans for the supposed good of the German economy and human race. Recall too how the errant communist ideology similarly justified the direct killing of millions more (under Stalin and Mao Zedong) in the name of an apparent necessity for the life and health of their supposed great society. No doubt, many Nazis shared the current pro-abortionists errors on both points when they claimed that killing Jews was somehow necessary for their life and health. Moreover, they share the same spiteful tone and rhetoric deriding any who would dare suggest that all humans have a human dignity and value that we should respect. Most despised of all were and are the courageous priests who taught the inviolability of all human life in defiance of the Nazis then and those priests who teach this truth in defiance of pro-abortionists today.

–Dr. Frank (Ob/Gyn)

 

 

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