Anyone see this week's ER episode, Nobody's Baby?

The surrogate pregnant woman refuses a life-saving (or rather brain saving) c-section in lieu of a "natural delivery" of a breech fetus...that belongs to another couple.

Any thoughts?

Should a woman be allowed to "sacrifice" her term fetus to avoid surgery; or is the fetus' wellbeing always second to maternal desires...even if they seem unreasonable?

And what about Sam, the nurse, and her "input" regarding informed consent...thoughts?

Come on! The fetus' life comes WELL ahead of the mom's wishes. I can understand if it was mom's life vs. baby's life, but in this case, it's the mom's desire to avoid surgery vs the baby's LIFE! The individual for whom it's a life-and-death matter, comes first - even if it's an individual that cannot defend itself.

Also, gotta add: Women (I mean 99% of them, atleast) are aware that c-sections could sometimes result during during labor. Seems to me that this woman put her own desires ahead of the baby's life because it isn't her kid (biologically speaking) and she's just doing it for the money!

Informed consent.... well, informed consent can just kiss my @ss if it means jeopardizing a life - even a tiny little life, still inside a womb (owned or rented).

Um, abortion is legal in our country. Seems to me this issue has already been decided, from a legal perspective and also in terms of popular opinion. There is some debate about the morality of late-term abortions, of course, but a majority of Americans do want abortion to remain legal, generally speaking. Given that context, I think, legally, if a mom can decide to end the life of a fetus, she also should be able to make a decision that may result in brain damage for the fetus. It gives me the willies, I admit, but anything else would be pure hypocrisy.

I think the parents to be of the baby should have made this woman sign some sort of legal document before she carried the baby agreeing to do everything possible to result in a healthy delivery. It is awful to think that because of her decision, a person would have unnecessary brain damage.
I really think that all possible scenarios should have been decided way before labor, and it should been stipulated that she would have a c-section if the doctors suggested it was in the best interest of the baby.

In "typical" cases (i.e. when the baby 'belongs' to the birth mother) I can see this being totally applicable. But, in this case, the embryo was the DNA of two other people (the biological parents). The surrogate agreed, for money, to "rent" her uterus to *their* embryo. Does this situation change the debate at all?

According to the father in the episode...the woman (surrogate) agreed to "all necessary procedures as related to the pregnancy." The surrogate said "I never agreed to surgery."

It seems to me, that if this "clause" was in the contract...the contract should be easily produced by the biological parents...and the doctors should be legally protected if they had to perform a c-section for the baby's wellbeing. At that point...the surrogate shouldn't be allowed to refuse the procedure. The risks should have been explained before she signed the contract...and the contract should be binding.

Sure, Mya, that changes the debate. But it *does* frame the debate as a property disagreement between adults, doesn't it? On the one hand, that's just ... yuk. But on ther other hand, I think it's a realistic and logical extension of abortion laws in our country. The simple fact is that American fetuses don't have a right to anything. The question of whether the birth mom's rights are more important than the DNA mom's (because, so far as I can tell, DNA dads have no rights where fetuses are concerned) rights is an interesting one. I wonder what case law says in situations like this? Certainly there's a rhetorical tradition from the past several decades that I think would favor the birth mom's rights in this case ("keep your laws off my body" etc.).

Given that context, I think, legally, if a mom can decide to end the life of a fetus, she also should be able to make a decision that may result in brain damage for the fetus.
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If you want to talk of laws, let's get to brasstacks.

IF a woman wants to "rent" her womb out, as a means of making some quick bucks, then she should be prepared to deal with all possible outcomes, INCLUDING but not limited to major abdominal surgery. Most women, including illterates and semi-literates, are very aware these days of the possibility of a cesarean delivery. The woman wasn't living in Mars, was she, to whine that she didn't "expect" surgery?

Secondly, most surrogates are paid based on pregnancy outcomes, and they are usually paid the contracted amount ONLY if their pregnancy results in a live birth. Should the pregnancy end in a miscarriage, they are paid a smaller amount + medical costs. IF the baby is lost due to the surrogate's fault, SHE owes the biological parents money!

I know this happened in one case. A woman was pregnant with triplets, and lost two of them following a car accident (she was in a car, driven by a drunk). She had to have an emergency cesarean and only delivered one baby alive - the other two perished. The bio-parents successfully sued her and won compensation, because she lost the babies due to her own fault.

I am pretty sure that IF this were to be the case in this particular surro pregnancy, the bio-parents can sue her for their baby's brain damange, and no court of law would rule in the surro's favor. When you go into "business", you deliver what you're paid for. If you don't, you become subject to an expensive lawsuit.

If I remember correctly, in the show the contract said the surro had to undergo anything "medically necessary", and she only wanted to have a c-section as "an absolute last resort," citing that "my friend's baby was breech, and she delivered naturally just fine."

This brings up a debate about what's "medically necessary" in a legal sense. If a doctor thinks procedure A is safer, but procedure B has a chance of being just fine, is procedure A legally necessary, even though it comes with its own risks?

I agree that the surro should have had the c-section, but if she did so unwillingly, would she have a case against the doctors for subjecting her to major abdominal surgury that maybe wasn't absolutely necessary?

Hmmmm...

Also, aren't 3rd trimester abortions illegal except when the mother's life is at risk?

I hadn't ween ER in years (back when I had time to watch!). I happened to catch this episode b/c I was in a hotel at a conference, and was kid-free for a few days.

COME ON. That was the most unrealistic scenario I've ever seen.

First...The vast majority of breeches will be identified well before birth (even in multips - usually the kid goes head-down prior to labor). The discussion of what labor method to use happens ahead of time.

Second...I believe "footling breech" was mentioned. That is an unsdeliverable position. You CANNOT get that kid out vaginally.

Third...that doofus YELLING at the Mom was ridiculous, and would never happen.

Fourth...the attending OB would never have allowed the resident to be such a jerk.

Fifth...oh, I could just go on and on (like they let a breech labor in the ER - yeah right)...

ahem. I'll stop now.

As to the question...no, you can't do surgery on someone without their consent, unless they are not able to give consent (demented, unconsious, or whatever). So yeah, she could have refused. Her informed consent (informed refusal) at that point would have included stats about the likelihood of a successful vaginal delivery without neonatal brain injury. That being said, an OB is under no obligation to agree with her plan (most OB's I know will not care for a woman who refuses a C/S for breech, as most are not trained in vaginal breech births). The OB probably couldn't have refused care in the middle of labor, however. And...yes...third trimester abortion is illegal in this country.

But jeez...screaming at this woman all the way through her labor that she was killing her baby. Telling the adoptive parents that they had a brain-damaged baby well before the reality of the situation was known? A sudden realization that C-sections were "out of the question" not realized until labor.

I'm very disappointed in what used to be a compelling, fairly realistic, show.

Sorry for the rant.