Are Duomoms as Bad as Octomoms?
A debate on the New York Times website examines the question of regulating twins. Just as many people called for restrictions on in vitro fertilization after Nadya Suleman gave birth to octuplets, some medical experts are outraged by the far more commonplace occurrence of twin births — and they’d like the government to intervene.
The first panelist, Mark I. Evans, correctly points out that twin births have a larger effect on the health care system than do newsworthy events like the birth of octuplets. Twins are more likely to be born prematurely and to experience other complications. Although Evans stops short of recommending policy changes, some of the other panelists suggest regulation to prevent twin births.
I don’t think public opinion sides with the experts who consider any case of twin gestation to involve unacceptable risk. Nor do most casual observers decry Suleman’s actions based on a comparison of the cost of the octuplets’ birth with other burdens on the health care system. Instead, the objection to Suleman seems to arise from rule utilitarianism — the idea that bearing octuplets is morally wrong because it would be disastrous if everyone did so.
Proponents of regulation admit that bans on twins won’t be enacted any time soon. Robert Stillman, another panelist, blames America’s respect for freedom, which he sees as an oddity. I’m amused by the attitude that there’s single-payer health care, and then there’s everything else (emphasis mine):
In our non-single payer health care system and in our national cultural context (with its paramount legacy of individual rights over those of the state), patient autonomy will almost always prevail.
Higher deductibles for multiple births? The market would say yes, but health care isn’t really that free of a market, and the public would have a field day over it, like the dropping of the insurance of the statistically more likely to be expensive ‘chubby boy’.
My experience with octo-mom was that the outrage was over how could a single mom raise eight kids on her own, even if she did have some parental help? They would become wards of the state in one way or another.
As a friend of mine said, Million Dollar Baby isn’t just a movie.
Comment by Papillon — October 28, 2009 @ 5:15 p.m.
What would happen if a couple conceived twins naturally after a ban on twins had been enacted? Would the state mandate an abortion of one of the fetuses?
Comment by Christine Harbin — October 28, 2009 @ 5:24 p.m.
Christine–as far as I can tell the panelists are focused on fertility treatments, but here’s what Evans says:
“Although difficult for many to accept, if one defines success as a healthy mother and healthy family, there is no question that it is safer for a woman with twins to opt for reduction and give birth to only one child.”
He does not advocate turning that into policy, though, at least not in the essay on the Times website.
Comment by Sarah Brodsky — October 28, 2009 @ 7:58 p.m.
“opt for reduction”
woah. euphemism of the year.
Comment by vroman — October 30, 2009 @ 12:25 a.m.
There are women who do have elective single embryo transfer (eSET) and still end up with twins (identical, of course). What then?
I’m all for single embryo transfers, but as a woman who has undergone IVF I know how expensive it is. There needs to be a way to encourage women to undergo eSET, such as reducing the costs for embryo freezing and the cost for a frozen cycle.
Comment by Beth — October 30, 2009 @ 5:19 a.m.
vroman–I agree.
Comment by Sarah Brodsky — October 30, 2009 @ 9:32 a.m.