February 11, 2009
These are somber and sobering times, but they may offer us the opportunity to reexamine not only the material extravagance that has characterized so much of our recent life, but also some of its emotional excesses.
Take, for example, the grotesque story of Nadya Suleman, the sad and disturbing serial mom whose apparent addiction to childbirth recently resulted in the delivery of octuplets. That brought the 33-year-old, unemployed single mother's "family" to 14 -- including a set of twins -- all conceived through in vitro fertilization, all reportedly at the same Beverly Hills fertility clinic.
As one detail concerning this bizarre sequence piles on another, this strange young woman's odd story seems to be moving out of the freak show that nowadays passes for far too much of our news and into the realm where serious -- rather than merely prurient -- thoughts occur.
The treatments Suleman underwent to bear her children aren't cheap; they typically run from $8,000 to $15,000. Let's assume, for the sake of argument, that her doctor gave her the lower rate (as a volume discount), which would put her expenses, simply for conception, at $48,000. Suleman told a television interviewer that she covered those costs out of a $165,000 disability settlement she obtained after suffering a back injury working at a state mental hospital.
She also said she is not "on welfare," which is a bit of a semantic dodge, because it turns out she's receiving both food stamps and Social Security payments for two of her children who suffer from unspecified disabilities. She also told the interviewer she plans to "support" her family with federally guaranteed student loans while she pursues a master's in counseling. (One tries to imagine receiving therapy from this woman, but the mind refuses to form the requisite image.)
In the meantime, the Kaiser Permanente hospital where the eight newborns remain under care reportedly has applied to the state for assistance with its expenses under the Medi-Cal program. We don't know yet whether any of the octuplets will be disabled in ways requiring public assistance. It appears that, in the case of the Suleman family, raising 14 children takes not simply a village but the combined resources of the county, state and federal governments.
The manifest irresponsibility of this eccentric woman toward her children is one issue. Another is the irresponsibility of the physician who took money to impregnate a jobless, husbandless woman with 14 children. His peers and state medical authorities will have to sort that one out. Hiding out there in the weeds, there's also the issue of the man who reportedly contributed the sperm that helped produce all 14 children. Does he have any responsibility for what happens to them? If not, why not?
Here we confront the complexities that arise when people assume that because something can be done, it should be done. The fact of the matter is that decisions about reproduction and child-rearing quite properly occur in a zone of privacy. It is, however, an abuse of the mutual respect we extend to each other to behave as if decisions made in private have no impact beyond the bedroom door -- or, in this case, the door of the doctor's office.
The Suleman case is a caricature of the issues raised by contemporary fertility medicine, but sometimes a cartoon brings discomforting truths into high relief. One of them is that the novel, perplexing and often unhappy demands that situations such as Suleman's make on our legal, ethical and social consciences aren't really a matter of necessity, but of choice. That choice is an outgrowth of the narcissism that has become our society's background noise.
When the Nadya Sulemans of the world say, as she has in interviews, that they undergo these extreme, invasive, unpleasant, uncertain and expensive medical procedures because they "want children," that isn't really the case. If what people want is children -- and the incomparable experience of parenthood -- there are tens of thousands of children in our country and perhaps millions more abroad waiting for adoption. Thousands of others in our country are waiting for foster care.
The impulse that has made fertility medicine such a large and lucrative specialty in American medicine is about something other than children; it's about the narcissistic assumption that one is "entitled" to "the experience" of childbearing and, more to the point, the notion that, somehow, if your particular strands of DNA don't live on into another generation, the species will be poorer for it.
That sense of entitlement and its enabling delusion are about a lot of things -- but none of them really involve children.
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