Parents don't get a moral pass

The Toronto Star/February 3, 2007
By Rosie DiManno

Vancouver-–Remember when the news about Canada's first sextuplets was all giddy and gurgling?

Such a blessed event, the live birth of six tiny infants, so mini-me they could be held in the palm of an average adult's hand, their hearts the size of grapes.

Effusive commentators gave unsolicited advice on bringing up babies, estimating that the brood would go through 500 diapers a week. It seemed churlish to question the ethics – medical and otherwise – of carrying half a dozen babes in the womb, complicating all their survival chances. Even the discovery that their parents were devout Jehovah's Witnesses – and is there any other kind of Watchtower congregant? – raised only faint alarm bells about the excruciating moral dilemmas that likely lay ahead, even as hospital officials released the most terse updates, that the newborns were in "fair" or "satisfactory" condition.

Then the babies started dying. One ... two ... Could still, tragically, be more because few know what's happening in the neonatal intensive care unit of B.C. Women and Children's Hospital. Except, as revealed this week, that at least two of these fragile infants were sickly enough to require a blood transfusion, done over the objections of the parents.

Three of the babies, according to court documents, were taken into the temporary custody of provincial authorities last weekend. It isn't clear whether the third child has also been transfused but all were formally returned to the custody of their parents – a rather misleading description since the babies remain in hospital under intense medical care – by Wednesday.

The parents, while grieving over the loss of two babies, are livid with authorities for allegedly thrusting their imperatives aside. Their religious beliefs, they argue, forbid blood transfusion and the procedure has caused them immense distress, to the point, as the father said in an affidavit, that they couldn't bear to be at the hospital while doctors were "violating our little girl."

What doctors were doing, in fact, was probably saving that baby's life.

The parents – their names protected by a publication ban – are not grateful. They are dismayed. Clearly, they view their transfused babies as somehow contaminated, unclean, and repugnant in the eyes of their Lord. Their faith calls for the shunning of those who transgress against this central tenet of the Watchtower Society, which bases its religion on a model of 1st century Christianity, although many would place Jehovah's Witnesses outside of Christendom, in the realm of sect.

These parents profess their profound love for the babies. But where is the love, or the parental obligation to nurture and protect, in this?

How daintily have child welfare authorities, religious scholars and ethicists picked their way through the moral minefield of religious rights as enshrined in the Charter versus a government's duty – a society's duty – to protect children. This responsibility has been upheld repeatedly by our courts because minors, and certainly not infants, can't make mature life-and-death decisions for themselves. Parents don't own children to the extent that they can deny them critical medical treatment any more than they can beat the tar out of kids because they happen to believe that sparing the rod spoils the child.

A spokesperson for Jehovah's Witnesses in Canada pleaded, earlier this week, for the public to avoid "stereotypical assumptions" about this family or the religion. But you don't get a moral pass just because you believe in a thing. And Witnesses have been knocking heads with the courts ever since they adopted the proscription against blood "consumption" in 1945.

The Scriptural basis is found in several passages, but mainly arises from Leviticus 17:10-14. It reads, in part: "And any man from the house of Israel, or from the aliens who sojourn among them, who eats any blood, I will set My face against that person who eats blood, and will cut him off from among his people."

The Bible, obviously, says nothing about blood transfusion. It is an interpretation, the blood taboo formulated at a time when the young sect was deeply suspicious – and ignorant – of modern medicine. Yet the Watchtower Society permits organ transplants, vaccinations and fertility treatments, all of these procedures the results of bio-technical advancements.

Though never confirmed, it's widely assumed that these parents availed themselves of some version of reproductive technology or fertility enhancement. The odds of producing natural sextuplets are one in billions.

So it's permissible to make babies by intervening with nature but not save them by providing a natural and life-sustaining element. This is not religious freedom; it's religious tyranny.

Throughout the pregnancy – the four boys and two girls were born Jan. 7, after 25 weeks gestation – the couple made crucial decisions about how it would unfold. They rejected "selective reduction," which would have killed some of the fetuses in utero by lethal injection. It is understandable that some would refuse this abortive procedure.

The parents also authorized resuscitation for the babies after birth, though they had the option to decline. And every step is being taken to promote healthy development of the infants, as nascent organs and muscles develop.

But blood is blood, the most central component in carrying oxygen to tissues. And blood, transfused, the parents won't countenance. It is a mercy, then, that medical and government authorities trumped their professed religious rights with the right of these frail babies to struggle for life.

"Now ... because we choose alternative medical treatments to blood transfusions, we have been stripped of our parental rights and have been labeled unfit," the father states in his affidavit.

"We have consented to all required treatment and have asked the doctors to more actively employ available alternatives to blood transfusions. We will not, however, consent to blood transfusions."

A 1995 Supreme Court decision allows parents to demand a hearing wherein they may present evidence. This father says that never happened. Government authorities have not confirmed it nor, if so, explained why. It may have been a matter of medical urgency. It's known that child welfare officials acted on the advice of doctors and that an ethics team had been monitoring the situation since shortly after the babies were delivered.

This "gross violation" of the parents' constitutional rights – as characterized by their lawyer – will be argued when the matter comes before the B.C. Supreme Court for a hearing Feb. 23.

The parents and other Jehovah's Witness defenders assert there are effective alternatives to blood transfusion that were not sufficiently pursued in this case. A pediatrician from Sault St. Marie will allegedly advance that premise at the hearing. (Calls to the doctor yesterday were not returned.)

But a blood expert told the Star there is no such transfusion alternative yet.

"There's nothing clinically approved that can transport oxygen to tissue, which is the primary job of blood," said Dr. Mark Scott, a senior scientist with Canadian Blood Services, which manages blood supply in all provinces and territories except Quebec. "If you don't have enough red blood cells, there's nothing to do outside of blood transfusions."

Clinical tests on alternate substances have had poor results, with severe side effects, actually increasing mortality rates.

Blood substitutes, Scott added, might some day effectively boost blood oxygen levels, but the usefulness would be very short-term, until a transfusion was available. Such a product would, for example, be used on wounded soldiers in the battlefield, until they could be transported to hospital.

There are, as well, options for pumping up volume when large amounts of blood have been lost, as in an automobile accident. "Volume replacement therapy can be done with a non-blood product, such a saline. It's like filling up a radiator with antifreeze or water."

With acute blood loss, the body – starved for oxygen – could start to replenish itself by generating its own blood cells. But this scenario relates to individuals who had previously been healthy. It would not be of much use to fragile preemies. Without transfusion, their oxygen-depleted organs would fail rapidly. The Vancouver babies must clearly have been starting to fail.

In his affidavit, their father stated: "We want the best medical care for our children and want them to live."

But only, apparently, on their terms.

God save babies from the piety of their parents.