Would you rather have a child said to be SS or abort? - page 2

This is a question one of my patients had asked me.Very difficult one. She had gone to a genetic counsellor as her doctor ordered but feels she doesn't want to keep the baby because of associated... Read More

  1. by   SmilingBluEyes
    33-weeker: That is a fair question to which I would answer, yes and no. Actually you are correct; the debate exists within this situation, sure. But what I hate to see happen is a flame-fest free-for-all abortion debate come out of what is a very specific ethical question and situation in this particular thread-----A generic abortion debate would tend only to lead us far away from the worthy topic at hand. It's about a lot more than the basic argument of pro-life/pro-choice here, I think.....(or maybe not!) I guess the point is, there is a specific ethical situation/problem that guides the debate of prolife/prochoice within this particular situation.....

    OK I know it's late and I am rambling...

    Does that make sense? Hope so.
    Last edit by SmilingBluEyes on Feb 15, '07
  2. by   Soup Turtle
    It seems a bit extreme to me. I'm guessing she's got the worst case scenario in mind.
  3. by   33-weeker
    I guess it depends on whether abortion is a 'black & white' or 'shades of grey' issue for you.

    I've seen too many mistakes in prenatal Dx.
    Best thing to do... ask around and see if anyone you know who has SS would rather they have been aborted than live with the disease.
  4. by   dawngloves
    ICURN7, what type of pt is this to you? I mean is she a home care, OB, ICU.
    Does she have SCA?
    I think you are doing the right thing by empathizing with her. It is not your job to give her an opinion one way or another.I bite my tounge every time a parent tells me they want their son circumcised. If they ask my opinion, I give them both sides of the fence and let them chose.
    Perhapes she is misinformed or misunderstanding what SCA is? Or maybe she has an underlying circumstance as to why she wishes to terminate her preganancy that you aren't aware of?
  5. by   RNin'08
    To me this patient sounds uninformed/misinformed about this disorder. Does she have SCA? Maybe she has it and doesn't want her child to live with it or perhaps she doesn't and is only going off of the horror stories she's heard.
    Personally, I see no reason to abort (especially so far into the pregnancy) because of SCA. I think this patient needs a second opinion and some good, accurate information about treatment and prevention of crises.
    I have the same question as UKRN. Is this the insurance company trying to persuade her? I can't imagine that she'd be counseled by her OB or specialist to abort at this point.

    RNin'08
    ~my reality check bounced~
  6. by   SmilingBluEyes
    Quote from 33-weeker
    I guess it depends on whether abortion is a 'black & white' or 'shades of grey' issue for you.

    I've seen too many mistakes in prenatal Dx.
    Best thing to do... ask around and see if anyone you know who has SS would rather they have been aborted than live with the disease.
    I would agree and do the same thing. I would want a LOT more information before making such a huge decision/action.

    I know I would not abort a baby that had any real chance at a quality of life. But that is just me and I can't say what others should do.
  7. by   ICURN7
    Thank you all for all your opinions. It's really a hard nut to crack. The uncertainty of living with an SSA child is overwhelming. From her point of view, she would not want anything to happen to this baby, moreso when she had looked several years and could not conceive. On the other hand, she was saying it would be more painful if she keeps this baby and the baby dies unexpectedly like that....more sorrow...In any case, it may sound easier for us but really hard to predict how it might go. The point is that, at this point, we can't really predict whether this type of SSA is the mild one or the more severe one. Personally, I've seen people who live normal lives with this SSA but i have also seen others that live up to their teen years and just gives up the ghost.It's really a tough nut to crack...very painful thing....
  8. by   BouBou
    I hope she realizes that she carries the Sickle Cell trait and that the child's father has the trait as well. As a result, any child that she has will have an at least 50% chance of having Sickle Cell and an even higher risk of carrying the gene. Therefore, terminating this pregnancy may seem like a way of ending the situation. However, she may have to face this situation again in subsequent pregnancies.
  9. by   CHATSDALE
    my dgd was told that tests indicated a down's syn but after a mri the dx was changed to gastro ecetic...she had a difficult pregnancy but child is doing fine
    i don't know how accurate those bkiid tests are but like has been said some can do well with little or no sx and some have a miserable life esp teens
  10. by   cardiacRN2006
    Quote from BouBou
    I hope she realizes that she carries the Sickle Cell trait and that the child's father has the trait as well. As a result, any child that she has will have an at least 50% chance of having Sickle Cell and an even higher risk of carrying the gene. Therefore, terminating this pregnancy may seem like a way of ending the situation. However, she may have to face this situation again in subsequent pregnancies.

    Fabulous point.
  11. by   missapoo
    I agree that it's tough to remain nuetral when people ask for your opinion about ethical issues. Most of you did point out the very true fact that sickle cell anemia is not a death sentence and can be controlled with the sufferer living a pretty normal life. This mom needs a 2nd opinion and then she needs to find peace with her decision....will she be able to live with the fact that she takes a life to prevent some hardship? is it really for the baby or is it for her if she makes that decision? Just food for thought.
  12. by   lupin
    For those of you reading this, I am in no way suggesting a pro-life or pro-choice standpoint. I am just giving opinions and suggestions.
    As far as Sickle cell anemia goes, everyone is correct. It is a farily maintainable illness with variable outcomes. If your pt is not able to care for the child with this or any other illness due to socio-economic, religious, or insurance reasons, then instead of aborting perhaps an open adoption could work for her.
    Everyone is also correct on the accuracy of prenatal testing however there is a reason these tests are done. If there is an indication of a problem with the fetus, then it is still a variable to be considered. I personally feel that telling her or any pt accounts of how these tests are wrong will influence them in refusing these tests and set them up for disaster if a complication that is easily fixable is not identified in future pregnancies.
    As for caring for any child "normal" or otherwise, it will have to be an individual decision and as nurses our job is to present every option, no matter what our personal feelings on the matter is. And sometimes that means offering options we personally may not prefer. The coice is ultimately hers and her partner's. Best of luck.
  13. by   Marie_LPN, RN
    What i personally would rather have is support for whatever i decided was best.

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