I can't get NO....satisfaction....

[kyburg]

Let's see.

You don't need to take Jim's word for it anymore. Even down to the names...which he was a good boy about and didn't tell anyone about either.

Hooray! (And so much for Tiajuana Taxi Fertility Hookups.) Note the words 'there is no law against...' - this is a evaluation by peers, and I hope we find out what they decide. But keep in mind - there is no law, and this won't create one. (Consider what the enforcement of one might look like, BTW. Just think about it for a moment, it'll come to you.)

Let me get this straight. When the McCaughey septuplets were born in 1997, President Clinton called to congratulate the parents, who were given a free 12-passenger van, Pampers for life, furniture, food, and a custom built house. Last spring, when Michelle and Jim Bob Duggar got pregnant with their 18th child, they announced it on the Today Show and their reality TV show launched that fall. When Nadya Suleman, 33, gave birth to octuplets on January 26th, she got revulsion, ridicule and death threats. A talk radio host who called her a freak said his listeners were prepared to boycott any company that helped out mother or babies. Jimmy Kimmel declared that "Golden retrievers do not have that many kids."

Uh, yawp. Single, POC and oh mi ghad IRAQI. SPICY.

(You know, I'd almost expect some people to have a little empathy for people who have somewhat toxic parents....but noooooo. Guess not.) And before you hit that comment button - keep in mind. The lady had choices. Since we see more of the grandfather doing childcare publically than the grandmother, you figure it out. Watch the grandkids leave that house Real Soon. As soon as enough money shows up - and it will show up. (Just keep making those death threats on all those sponsored websites, kids!)

Quick quiz.

Who administers 'food stamp' programs?

- Department of the Treasury
- Department of Homeland Security
- The Internal Revenue Service
- Department of Agriculture (*dingdingding*)

Also, the going term is Supplemental Nutrition Assistance Program - not food stamps. Note the key word - there is no intention for this ever to be the sole support for anyone. (I love the fact they've moved it off paper and to electronic ATM card. No, you can't pool the change from buying a candy bar with a coupon until you can buy liquor anymore. Too bad. *snickers*)

Oh yeah, $490 a month is a REAL GOOD incentive to have a kid. (...where do people get this crap...) And of course you top out, regardless of the number of people in the household.

Defend her? Not so much. What I find amazing is the vitriol where in just about every other case I know of, there was nothing but cooes and praise for being 'so absolutely PERFECTLY FEMALE' for being, well - successful at being female. That's it, isn't it? The pastel pinks and blues, the heft of the rewards thrown, the fairy tale twittering. The strokes - oh yes - THE STROKES.

(I'm catching echoes of it adopting right now, and I know it when I see it. It's perceived sainthood and I'm hip. I got much the same when I was the wife of a terminal patient. It's not helpful, except as a signal that they're not going to bitchslap you.)

I'm glad information is getting out. It's making our lives easier not having to keep our mouths shut. (How many times does WE CAN'TALK make sense?)

What I'm watching for? Terminations at the hospital of people who were peeking into health records when they had no reason to. Yeah, it's all electronic, all tagged with who was doing the peeking and we've had plenty of evidence there's a zero tolerance policy for fraud - though I think Kaiser might handle these a bit differently after a whole family died when both parents were fired for it. Remember - same hospital system.

Whatta parade. Can we talk about Sully instead?

Comments

[trillsie.livejournal.com]

I agree. I personally think the doctor needs to loose his license over it. He obviously did not have good judgment in this. One can't help but wonder how many other IVFs he has done to people who simply has no way to support the child(ren) that will be produced.

My husband and I have 4 kids and it's difficult. I cannot imagine having more than that. Any more and my children would not have the individual attention that they need.

[eyelid.livejournal.com]

So it's a doctor's call to decide who should and should not have children? And if the doctor gets it "wrong" (how would that be determined, I wonder?) the doctor's license should be pulled, impoverishing the doctor and the doctor's family?

[trillsie.livejournal.com]

Perhaps pulled is a bit strong, but the case does need to be looked into. The thing is, we're now going to be supporting these children when she couldn't afford to take care of the 6 she already had. There's something terribly wrong with that. What about the lives these 14 children will have with a single unemployed mother (who is really going to have a difficult time finding employment that will pay enough for daycare) who has already admitted to the plan of using student loans to help take care of them. That is her plan. Isn't there some sort of vetting process for IVF? If there is, then I wonder how she was accepted since she already had 6 children.

[eyelid.livejournal.com]

The thing is, we're now going to be supporting these children when she couldn't afford to take care of the 6 she already had.

assuming the children will be on welfare (they haven't been thus far, and I suspect she'll actually get some sort of TV deal, though who knows), the cost of this particular family's support is incredibly small to the individual taxpayer (probably literally less than a penny), and this situation is entirely anomolous. How many single unemployed women can afford one IVF session, let alone seven? If it were common it wouldn't be news.

so really, putting together some kind of legal response to this freak situation is unnecessary. As is getting upset about the cost. You should spend more energy getting upset about the cost of one day of the war in Iraq. That costs considerably more than these kids will for their entire lives.

Isn't there some sort of vetting process for IVF?

should there be? ...there isn't for normal parenting. Why should infertile people be held to a higher standard than anyone else?

Compare and Contrast

[betnoir.livejournal.com]

You wanna talk vetting?

Back in '95, when I got fixed (no kids, BTW), I got as my door prizes:

1. A grilling by the OB who would perform the procedure as to why. "Dude, genetic material that is not suitable to wash out latrines in Iraq. What more do you need?"

2. A 30-day wait period, followed by a SECOND grilling. Which elicited the same response. Because, you know, in the span of a month, the rotten DNA I've had all my life might just magickally fix itself.

3. A stack of paperwork recusing the hospital from any legal responsibility should I change my mind AFTER the procedure.

I likely underwent MORE vetting for my decision not to reproduce than this woman did for her decision TO do so.

Because deciding not to further on a genetically defective line (instead of explaining to your kid WHY you decided to have them, knowing what you would pass along) makes you just as OMG Bad and Wrong as chosing to carry eight kids to term.

Re: Compare and Contrast

[kyburg.livejournal.com]

I remember going in to see my OB/GYN, plopping myself down and saying 'Okay, now!'

He yawned in my face, told me I had less than a %2 chance and wouldn't even consider doing anything unless I saw a fertility specialist first.

This was after me talking with him four years prior about going it alone and having the kids now or going to graduate school. He'd suggested school - no worry, etc.

Well, the school didn't happen - and then the kids didn't either. Thankfully, I didn't stay there long and spend all my dough on it. I just wanted a family - how, I didn't care. The idea of going to find my kids instead has always felt better somehow, too. I'm never going to get anything the same way other people do anyhow - I've resigned myself to that.

Yup. Be a good girl. Don't make waves and don't question your purpose. Riiiiight.

(Wish I'd been around then. Those asses needed kicking, and HARD.)

[betnoir.livejournal.com]

With proof that the doctor *knowingly* performed outside the standard of care?

Damn skippy, yes.

[eyelid.livejournal.com]

so, if this is determined to be within the "standard of care", then that's ok?

also, say the standard of care outlawed abortion. Should a physician's group be able to make that kind of personal reproductive decision and enforce it amongst its members?

[betnoir.livejournal.com]

1. *with proof that the doctor performed OUTSIDE the standard of care*.

2. Abortion is regulated by federal law. If Roe v. Wade goes off the books, it then reverts to a states' rights issue. At least here in California, that still makes it legal. It's been *mumblerumph* years since I worked for ACOG, but the last time I checked, abortion was not outside the standard of care.

Why should sanctions against a doctor (if the charges can be proven) be any different for OB/GYN than for any other doctor?

If a psychologist does not breach confidentiality in a case where a patient has made specific harm threats against an identifiable individual, that's failure of duty to warn. And that could potentially mean suspension of license.

As it should be.

I'm really failing to understand why it should be any different for IVF doctors if there is sufficient evidence to prove that they performed outside standards of care.

[eyelid.livejournal.com]

I'm really failing to understand why it should be any different for IVF doctors if there is sufficient evidence to prove that they performed outside standards of care.

Because you're not talking about professional, technical errors. You're talking about barring a doctor from practice because he followed his patient's wishes and helped her have a child.

He didn't stim her wrong. He didn't perform negligently. He allowed his patient to make her own medical decisions.

This is a misuse of the standard of care. The standard of care is there to define malpractice - to say what the appropriate medical treatment is in any given situation, where medicine is of course partly an art and practitioners disagree. It's not there to enforce society's judgment about how many kids a person should be allowed to have!

It is a lot like when a doctor's license could be pulled for performing an abortion.



but the last time I checked, abortion was not outside the standard of care.

But if it were, you would support having the doctor's license pulled for performing it?

[(Anonymous)]

Patients make stupid-ass and uninformed decisions all the time.

Patients walk into their doctors' offices and demand drugs by brand name because they saw the commercial that says that the Purple Pill will cure what ails them. Or that the Happy Egg pill will cure their depression.

Because no drug company throughout the annals of history has ever buried negative findings six feet under. Nope. Never happens.

Should the doctor just roll over and prescribe Happy Egg pill because that was the patient's choice? Even if the doctor knows that Happy Egg is not the right call (and you wanna talk medicine as an art, let's talk about finding the right brain drugs).

As for your question regarding abortion -- the day Roe V Wade goes off the books is the day that question becomes relevant.

[betnoir.livejournal.com]

Whup -- that was me above.

[eyelid.livejournal.com]

Should the doctor just roll over and prescribe Happy Egg pill because that was the patient's choice?

Again, that's a different situation - it's one where the patient has a condition they think the Happy Pill will cure, but the doctor knows that's not true.

Here, we're talking about a person making a decision regarding how many kids she wants to have. You're saying the doctor should decide, as a "medical" opinion, whether it's appropriate for her to have more children.

Doctors are neither trained nor morally positioned to make another person's reproductive choices.

You're trying to say a doctor should be de-licensed because the doctor allowed a woman to decide whether she wanted to reproduce or not. Not because the doctor fucked up a medical procedure or prescribed the wrong pill or cut off the wrong leg. Totally different from a doctor dictating another person's repro decisions.


As for your question regarding abortion -- the day Roe V Wade goes off the books is the day that question becomes relevant.

you're refusing to answer it because you don't like the answer you'd logically have to give. That's cowardly.

[betnoir.livejournal.com]

Who said anything about morals?

If the standard of care says "Do X" and the doctor does not do X -- regardless of what the patient does or does not want, that's a problem.

This is not about reproductive rights specifically. This is about the standard of care that ANY doctor should be held to.

As for any discussion of cowardly -- you've set up a strawman. You are asking me to posit a situation that is not relevant. A 'what if.' Talk to me the day ACOG changes its position. As an aside, the day that happens is the day I call up my first boss and have a "Dude, WTF???" discussion.

Talk to me the day Roe v Wade goes away (and so that you do not misunderstand my stance on that -- I do NOT want it to go away). Until either of those two things happen, the point is moot.

Not moo as in COWardly.

[kyburg.livejournal.com]

I'm waiting to see what the board says. I sure hope they show some backbone. (And we get some history - some of the reports are saying the prior pregnancies (ending in singletons, mostly) were also 6 eggs implanted. If that's the case? *shrug* I'm not the titled professional and any opinion I have about the whole thing is just hot air, nothing more.)

Who can and can't have kids? Not on the table.

I'm trying to remember what the criteria was for Dr. Whiz-bang. I do recall he wouldn't do additional work for people with three or more children at home - vaugely.

[betnoir.livejournal.com]

Some of those six eggs went down to one due to 'selective reduction.'

Now that, right there, is a euphamism for ya.

[anahata56.livejournal.com]

Did she do a reduction in the first six pregnancies?

When asked about it for this one, she said that she absolutely wouldn't even consider a reduction.

I wonder what happened to make her change her mind between those pregnancies and this one?

[(Anonymous)]

Dunno. Don't need/want to know. Not my bidness.

That's HIPAA at work. And if folk want it to work in their favor, they'd best siddown, shuddup and let it work for her.

(sorry, not schnarky at you, but at people who demand her personal info, yet would howl to the moon if their medical info suddenly became public fodder).

[feyandstrange.livejournal.com]

First, do no harm.

Those eight kids survived by a sheer fucking miracle; they didn't even know how many were in there. Can you honestly say their lives weren't endangered by a reckless implanting of 6 embryos at once? Or the mother's life?

[eyelid.livejournal.com]

First, do no harm.

That's a completely amorphous standard and you're abusing it. you might as well say that if a person dies during surgery, the surgeon obviously "did harm" nad their license should be pulled.


Can you honestly say their lives weren't endangered by a reckless implanting of 6 embryos at once?

First, it wasn't "implanting." I don't think you understand how IVF works. Doctors can't "implant" embryos; the embryo has to do that itself. And often, they don't. Thus, putting back of multiple embryos is standard.

Second, it wasn't necessarily reckless. every one of her previous pregnancies involved the putting back of 6 embryos, apparently. And 5 of those pregnancies were singleton births. A history like that would dictate putting back of several embryos.

This outcome was a fluke, not evidence of malpractice.

This is exactly why laypeople can't be trusted to judge a "standard of care" on these issues. You're looking solely at outcome and judge based on that. Like if a person dies from surgery, OBVIOUSLY there was malpractice! But in fact, outcomes are frequently bad in medicine, not due to physician malpractice at all.

[betnoir.livejournal.com]

I'm sorry.

What makes you think everyone here is, by default, a lay person?

[anahata56.livejournal.com]

Really.

[eyelid.livejournal.com]

What makes you think everyone here is, by default, a lay person?

I never said "everyone here" is a lay person.

But a person who refers to the transfer of embryos as "implanting" embryos is obviously not a reproductive endocrinologist.

And frankly, I seriously doubt you're a fertility specialist either, or you wouldn't be throwing around de-licensing the way you are.

[betnoir.livejournal.com]

Well, hell. You outed me.

Six years editing research papers (including yes, some repro endocrinol ones) for the journal Obstetrics & Gynecology (an official publication of the American College of Obstetricians and Gynecologists) doesn't qualify me to have any opinion whatsoever.

Followed by another six working for the leading tabloid going to psychiatrists.

I guess I don't get to have an opinion on that either.

Good thing we aren't discussing Dalkon Shields. Because, boy howdy, I have an opinion on that as well.

And on that note, do have a day. Once it gets down to dick-sizing over qualifications to have an opinion, it just no longer gets to be fun.

kyburg, I profusely apologize for my part in this donnybrook. Your journal, your rules.

[kyburg.livejournal.com]

Not at all. Between the two of you, this has been one of more intelligent conversations with substance on the matter I've seen in a week.