Good Old German Engineering...

[Joe Guy]

German mother of 13 pregnant with quadruplets at age 65
Updated 9:38 am, Monday, April 13, 2015

BERLIN (AP) — A 65-year-old German mother of 13 is getting ready to give birth again — this time to quadruplets.

Annegret Raunigk, a Berlin schoolteacher who is due soon to retire, is expected to give birth to the four babies within the next two months, Bild newspaper and RTL television reported.

She already has children ranging in age from 9 to 44, from five fathers. Raunigk said she decided to become pregnant again because her 9-year-old daughter wanted a younger sibling.

Her decision was met with widespread criticism by medical professionals as a risk both to her and the unborn babies.

"Any pregnancy of a woman over age 45 has to be considered a high-risk pregnancy; over 60 this is naturally extreme," Dr. Holger Stepan, head of obstetrics at the University of Leipzig, told the dpa news agency.

"The 65-year-old body is definitely not designed to carry a pregnancy, not of one child and certainly not of quadruplets," he said.

Raunigk told Bild that donated eggs were fertilized and implanted at a clinic outside Germany, which was successful only after multiple attempts.

She defended her decision: "How does one have to behave at 65?"

"They can see it how they want to," she said, "and I'll see it the way I think is right."

source

[oldr_n_wsr]

Taking care of a baby, let alone 4, at 65 is not how I would want to spend my retirement.
But to each her own.

[dgs49]

A 65 year old teacher getting ready to retire. In my area they retire in their early 50's

[rubato]

In the US the doctor who did the in-vitro would lose her license.

yrs,
rubato

[Crackpot]

Sexist

[BoSoxGal]

I think that's a cruel thing to do to a child, ensuring that his/her birth mother won't likely be alive to see him/her through high school graduation, much less the difficulties of transition to adulthood.

[Scooter]

In the US the doctor who did the in-vitro would lose her license.

yrs,
rubato

I agree that he/she should. In vitro in this case is beyond anything that could be considered ethical.

[Big RR]

I don't know; I kind of look at this like I do sex change surgery--I really don't understand why someone would choose to have it, but for some people it is definitely indicated (undergoing an abortion would be another similar situation where I might well not understand why someone makes the choice they do, but I think they should be free to make that decision and have access to the medical services). Sure, impregnating a woman this old is dangerous to both her and her unborn child(ren), and certainly in the vast majority of cases this would be a very bad decision and unethical. But I would think that each case has to be taken by itself--yes, she might die earlier than most other parents, but if someone is in reasonably good shape and can physically withstand the pregnancy, it's not likely to be that soon (and other parents in hazardous professions, from law enforcement to any number of others, might well die sooner as well. I think the scope of an ethics inquiry should look at the particular situation and facts, and lean toward carrying out the patient's wishes if they are not contraindicated. No particular physician should be forced to perform any procedure (at least under normal circumstances), but no physician should substitute his or her ethical code for that of the patients'

[Scooter]

I think I am trying to take the whole complex of circumstances into account. This is not someone who was deprived of the chance to be a mother and is only now being afforded her first opportunity to do so. Nor, as it is evident, was there an attempt to prevent the sorts of multiple births that exponentially increase the risk and which have played a large role in giving IVF a bad name. She has a child old enough to be a grandparent to what will be her sisters and brothers. And I think of what the response would be if a 65 year old woman sought to adopt four infants. She would be pretty much at the absolute bottom of the list of those considered to adopt even one. So why should the existence of technology making it possible make it any more acceptable?

[Big RR]

While I understand your concern, let's not forget that giving birth to a child is not adoption and does not invite the scrutiny of the government (nor should it IMHO). Many people who give birth (by normal means or IVF) would never be much above the bottom of any adoption list, and some would be rejected outright. But this doesn't mean they should be barred from reproducing.

I see much the same here; if she was somehow still fertile and had a child at 65 (a remote but real possibility), no one would have anything to say so, to turn your question back to you, why should the existence of technology making it possible make it any more less acceptable? Indeed, if she were a man who impregnated his younger wife (like Tony Randall did in when he was in his 70s) it would barely raise an eyebrow.

Again, I recognize that there are some distinct medical issues that would have to be addressed to determine if she were a good risk for IVF, but the rest comes down to many who just think people this old should not be parents. While I personally agree with that in principle, I am not willing to substitute my judgment for hers, nor do I think anyone else has the right to do so.

[Scooter]

to turn your question back to you, why should the existence of technology making it possible make it any more less acceptable?

There are lots of things that consenting adults might do for themselves that would be unethical for a doctor to assist them to do. An individual is free to amputate his/her own arm even if it is healthy, but it would be unethical for a doctor to involve him/herself in such an action. An individual might choose to get addicted to narcotics, but it would be unethical for a doctor to prescribe them for that purpose. A bulimic might to choose to vomit after every meals, but a doctor shouldn't be supplying him/her with emetics to facilitate that.

[Crackpot]

Actually under certain circumstances it is not unethical for a doctor to amputate a perfectly health limb.

[Scooter]

Perhaps if they are trapped under a boulder, or something, and there is no other way to get free. I think you know that wasn't the sort of thing I was talking about.

[Crackpot]

I won't argue it because my source (wife) cant remember the details.

[Crackpot]

After doing a quick search it is of "body integrity identity disorder" and is still debated in medical ethics.

[Big RR]

I have heard of women having healthy breasts removed because they feared eventually developing breast cancer (after someone else in the family died or they received genetic counseling).

However, in each of the examples you provide, we are looking at something that is clearly physically damaging to the patient. In the instant case, I would agree that it would be unethical for a physician to impregnate a woman by IVF if it is likely to be physically damaging to her; but if it were not, (s)he has no reason to substitute his/her opinion and ethics for the woman's.

But, e.g., if someone chose to have plastic surgery to alter their appearance to something the physician thought hideous, I do not think the physician would be violating an ethical obligation to the person to grant their request.

[Sue U]

But, e.g., if someone chose to have plastic surgery to alter their appearance to something the physician thought hideous, I do not think the physician would be violating an ethical obligation to the person to grant their request.

Ethical obligation, no. But the risks of a malpractice suit would certainly militate against it -- at least if the physician had any insurance coverage or personal assets.

[Joe Guy]

I have heard of women having healthy breasts removed because they feared eventually developing breast cancer (after someone else in the family died or they received genetic counseling).

Angela Jolie comes to mind. She had a double mastectomy based only on family history of breast cancer and then had her ovaries removed in order to prevent cancer (In that case there was a possibility there was early stages of cancer in her ovaries).

[Sue U]

Angelina Jolie's surgery was not based "only on a a family history of breast cancer." She had genetic testing done that showed a near certainty (87% chance) that she would develop cancer herself.

[Big RR]

But, e.g., if someone chose to have plastic surgery to alter their appearance to something the physician thought hideous, I do not think the physician would be violating an ethical obligation to the person to grant their request.

Ethical obligation, no. But the risks of a malpractice suit would certainly militate against it -- at least if the physician had any insurance coverage or personal assets.

Perhaps, but a good release could mitigate that.

FWIW, I've seen people (on TV) who had devil's horns implanted in their foreheads, or split their tongues to look like a lizard's tongue, and I think it would be very hard for a jury to award them damages for getting the results they asked for.