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“Children with trisomy 13/18 are a challenge to the medical system both
medically and ethically. When the medical system or a particular hospital
fails to provide appropriate medical care according to hospital policies,
professional codes of ethics and basic human rights, something is very
wrong. Alarm bells must ring.” FULL Article |
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WHEN WHAT SEEMS BROKEN IS
PERFECT
by Barbara (Annie's Mom)
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Annie's Story: an Ethical Tragedy
The life and death of a much loved baby...
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The graph is still taped to the
inside of my kitchen cupboard, pencil on a string dangling down beside it.
It depicts the progression of my newborn daughter’s weight, most days
showing a moderate increase and thus reflects a thriving child. It ends
abruptly at 80 days.
How can the value and purpose of a life be determined? Can these be measured
by longevity, intelligence or the productive contribution of an individual
to the economic base of society? Even more important, who has the right or
ability to make this judgment?
My husband and I were recently faced with a very difficult situation. We are
in our 40’s, educated and financially stable. We have 5 children at home and
we love sports and travel. The kids do well at school, are athletic, and all
are healthy as horses. Life was good to us. We were pleasantly surprised
when we discovered that we were expecting a new life to love and nurture.
We first heard of our unborn daughter’s genetic condition long before she
was diagnosed. It was considered a lethal condition, an extra 13th
chromosome. Most babies don’t make it to birth and those that do live a few
years and are severely disabled. I thought, “Well, what is the point of that
life?”
When the geneticist uttered the dreaded words, “your daughter has trisomy
13” and it was a diagnosis about my baby and not someone else’s, the
reality was entirely different. With the ferocity of a lioness, I wanted to
love and protect this little girl, and do all that I could for her. If her
existence was only to be a few more months of kicks and flutters in utero,
then I wanted her to have that life for the sake of both of us. We named her
Annie.
After the diagnosis, the research began. It was frantic, and went long into
the night for months. We researched medical details and personal stories. We
communicated with parents all over the world who had a child with this very
rare condition. We discovered that the babies can live longer, but they may
need a lot of medical treatment. The most amazing discovery was that the
parents continually stated that they treasured and delighted in every day of
their child’s life. They knew with certainty, that the gift of that life was
not theirs to keep. The children, called “survivors” were blissfully happy
and progressed developmentally, albeit slowly. It became increasing clear to
us, that unless the medical intervention to provide life was excessive,
Annie was better off alive than dead.
We were not sure how we could do it. I was the kind of mom who usually
forgot to pack a diaper bag. I would often be impatient when one of my
children couldn’t master the math skills in their homework. Could I ever
develop the patience for a child who may not be able to sit on her own for a
year? How could we fit Annie’s care and needs into our busy schedule? We had
5 soccer teams in the summer! We were more frightened than we had ever had
been in our lives. Love for Annie compelled us forward.
Annie was born full term, crying. She was mildly afflicted, as the syndrome
goes. She needed a very small amount of oxygen and had hypoglycemia. Annie
could not take all of her nutrition orally and so she had an NG tube (nasal
gastric tube), which was a tube that went in through her nose down into her
stomach. I became skilled at its reinsertion, every 3 days. We fed her
expressed breast milk. Somehow, we dealt with all of the issues. We knew
that with time, Annie would take more feedings orally and her need for
oxygen would lessen, and likely be eliminated completely.
We were aware that the first year would be rough. Everyone pitched in. Our
12 year old son took over the lawn maintenance and his older sisters took on
Annie’s developmental progress and bought “mind stimulating” music and
ordered her a “Bumbo seat” to help develop strength.
The whole family came together in ways that I never dreamed possible. We
discovered how true our friends and family were by their support and
encouragement. Somehow, the homework got done and the gang made it to their
soccer games.
At age 75 days, Annie smiled at us for the first time. Even now, a year
later, the memory of that first and only smile causes me to cry.
Annie experienced respiratory distress at age 80 days and was transferred by
ambulance to the Children’s hospital. The physicians told us she had
pneumonia. Our beloved baby died less than 24 hours later.
There are two ironies to this story.
The first is that we thought we had a choice of life for Annie but the
reality is that we did not. The medical records, which we instinctively felt
compelled to obtain and have had reviewed, reveal no signs of pneumonia. An
effective “Do not resuscitate” was ordered without our knowledge or consent.
The final computerized medication report from the intensive care of an
excellent hospital is inexplicably missing.
The hospital issued a letter of apology stating that sometimes
“communication does not occur in as clear and consistent a fashion as we
would wish. For that, we are very sorry.” Recent developments in medical
science can be used to diagnose and terminate certain lives but the choice
to use medicine to prolong these lives doesn’t seem to be an option.
During her 80 days, our little Annie taught us our greatest lessons in life.
Through her life, we experience the deepest sorrow and the most intense
love. She taught us the true meaning and purpose of life and we are forever
changed as a family. Our children have learned that if they are ever in
need, their family will love them, protect them and do anything to support
them just like we did for Annie. They developed an incredible empathy for
the disabled and the vulnerable.
The ultimate irony is that this little girl who seemed so broken, flawed and
seemingly without purpose or value, was in fact, perfect after all.
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| Physician's Home
Not Compatible with
Life, a diary of keeping Daniel
By Kylie Sheffield
Prenatal
Diagnosis Information Package -
Compiled by Kylie Sheffield (mum of Daniel, full
Trisomy 13) in consultation with families on this web site |
| LINKS FOR PROFESSIONALS FROM
MEDICAL AUTHORITIES |
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Lethal Language Lethal Decisions
By Tracy K. Koogler, Benjamin S. Wilfond, and Lainie Friedman Ross
©
The Hastings Center. Reprinted with
permission. This article originally appeared in the Hastings Center Report,
vol. 33, no. 2 (2003),” Editorial email:
editorial@thehastingscenter.org.
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Intensive cardiac management in patients with trisomy 13 or trisomy 18
Am J Med Genet Part A.
*Intensive cardiac management consisting of pharmacological intervention for
ductal patency and cardiac surgery was demonstrated to improve survival in
patients with trisomy 13 or trisomy 18 in this series. Therefore, we suggest
that this approach is a treatment option for cardiac lesions associated with
these trisomies. These data are helpful for clinicians and families to
consider in the optimal treatment of patients with these trisomies.
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Show Me the Money: Financial Considerations in Responding to Parental
Wishes.
Benjamin S. Wilfond, MD,
head of Ethics of Seattle Children's Hospital
Watch the Webcast

View presentation (PDF 425KB)
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Noninitiation or Withdrawal of Intensive Care for High-Risk
Newborns
From the American Academy of Pediatrics Committee on Fetus and Newborn
Organizational Principles to Guide and Define the Child Health Care System
and/or
Improve the Health of All Children
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Amniocentesis: The Struggle to Choose
 By Wendy Hogarth, Mother to Jared diagnosed with trisomy 13 at birth.
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Post-Viability Abortions
 Patricia Lee June, M.D, Pediatrician and PPL board member
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WHAT TESTS SHOULD BE DONE
ONCE MY CHILD IS DIAGNOSED
WITH TRISOMY 13? By Christine Nelson MD, Pediatric Hospitalist
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The parents' journey: continuing a pregnancy after a diagnosis of Patau's
syndrome By Louise Locock,
senior qualitative researcher,
Jane & Jon Crawford,
parents of Benjamin
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Values in End-of-Life Decision-Making: Some Implications for People with
Disability By Jennifer Fitzgerald , Barrister of the Supreme Court of NSW.
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Giving Terminally Ill Babies and Their Families an Alternative to
Abortion
 By Liz Townsend
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PRENATAL
DIAGNOSIS: FEARS & EXPECTATIONS
 by Agneta Sutton, Head of Research The Centre for Bioethics and Public Policy
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Post-viability abortions
 by Pediatrician Patricia Lee June, M.D.
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Clinical Case - Patau Syndrome and Perinatal Decision Making
 Ethics Journal of the American Medical Association May 2005, Volume 7
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Trisomy 13 Facts
&
A Guide for
Professionals
From the Support Organization for Trisomy 18, 13 and Related Disorders
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A
Different Kind of Crisis Pregnancy: When There is “Bad News” About Baby By Monica Rafie
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Understanding Grief: A Component of Neonatal Palliative Care
By
Tricia L. Romesberg, MSN, CNNP
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Disability
Matters - Blog - Institute for the Study of Disabilities & Bioethics Dr.
Mark Mostert, from Johannesburg, South Africa, is co director of Regent
University’s Institute for the Study of Disability and Bioethics.
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| Articles on Eugenics, Ethics,
Selective Abortion, Selective Induction and the killing of Disabled Children |
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Personal Qualms Don't Count: Hospital Forces Nurses To Participate In Genetic
Terminations by MARNIE KO
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ESSAYS BY TRISOMY 13 PARENTS
Free
literature to share with your patients |
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WHEN WHAT SEEMS BROKEN IS
PERFECT
By Barbara Farlow (Annie's Mom)
The decision to accept
disability:
One family’s perspective
By Barbara Farlow BEngSci MBA
A Letter to: Pediatric
Physicians, OB-Gynecologists, Geneticists & Healthcare Providers, from ThereseAnn - A parent of a
Trisomy 13 child
How Our
Babies have changed our Lives by Maria Demers
A Mother's
letter to newly diagnosed Families
(Printable to have on hand in your office to give to patients) by
Julie Sexton
Message to
All Obstetricians & Perinatologists
Message to All Physicians,
Specialists, and Doctors Alike by Mary Mabeus
Letters to Physicians -Trisomy 13 Survival Tactics -Patients
Plan of Care - Faith in Action -Considerations in Making a
Specified Plan of Care by Janina E. Arritola
How can anyone say that
these children do not contribute to society, therefore what is the point?
by Melissa Roy
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| Website & Articles for Surgical Procedures for those opting for medical intervention for specific abnormalities.
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What is an Omphalocele?
The method of delivery will be discussed with you as the
time gets closer. The method of delivery is dependent on the
size of the omphalocele. If the size is quite large and
especially if the liver is involved, the doctor may prefer
to do a cesarean section (c-section) to avoid the risk of
injury to the liver. Otherwise, the preferred method of
delivery is vaginal."
Decompressive cranioplasty may improve the clinical symptoms
of children with mild trigonocephaly and intracranial pressure:
report of 56 patients - June 5 2004
Mild trigonocephaly with clinical symptoms:
analysis of surgical results in 65 patients
- June 5 2004 |
| Termination, Abortion the only choice?
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(A must read for Physician’s who advise
parents after early testing and prenatal diagnosis) These women share the immense pain a termination has left on their lives.
When counseled by Professionals they were offered no hope. They were not given
the option of carrying to term and holding their child, if even briefly. Nor
offered the compassionate support this diagnosis requires. Instead these women
felt they had to make the heart breaking choice to end their child’s life.
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A Story of Regret - "Maybe if the professionals we had
talked to had given us more information we would have made a different choice.
To this day, I still live with the pain of the choices we made. Trisomy needs to
have a bigger voice and all the professionals need to be more open minded and
not so much on terminating"
~Katie -
Full Story
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"It is a choice I cannot live with to this day. I look at these pictures,
read your stories and my heart aches. Since I had a D&E, I never even got to
see or hold my daughter."
~Laurie-Beth
Full Story
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After experiencing the effects of an abortion with a previous pregnancy,
Elizabeth shares her experiences with carrying to term a child with Patau
Syndrome - Trisomy 13.
~Elisabeth Slotkin
Full Story
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This is a portion of a speech given by Eagle Forum Alaska President,
Debbie Joslin on the capitol steps, January 22, 2008
Full Story |
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