Is it a “fetus,” or is “it” a Person?
I have been progressing through the 33 day preparation for Total Consecration to Jesus Through Mary.
I am well over half way through it, and it has tested my faith every step of the way. I do not mean that it has made me question my belief in God. It has not put my belief in Jesus or the teachings of the Church to the test. Far from it.
What it has tested is the limits of my willingness to live my life based on that belief. Just how far will I go in following Jesus? A book I reviewed today, Fight, also tested those limits.
That seems to be the season I am in. On the one hand, the prayers and meditations of Total Consecration have pushed me to consider just what I will yield to another person, even the person of the Mother of God. How much can I trust anyone, even her? Specifically, how much of my relationship to God, to Jesus, will I yield to her rather than doing it all myself?
Fight challenged me with the question of how far I would follow Him, how completely would I do what He asks, even when I really don’t want to.
It’s really all one question and Jesus asked it best: Do you love me more than these?
His mother answered that question in the affirmative every time in every way. When the Archangel Gabriel asked her to assent to what was death-dealing anathema for girls of that era — unwed pregnancy — she said yes. When Simeon told her how it would end, she said yes. At the wedding at Cana, when she sent her child forward into His ministry which they both knew would culminate at Calvary, she said yes. When she prayed with the Apostles for the birth of the Church before Pentecost, she said yes.
Mary, like Jesus, had to be resurrected and taken into heaven as part of the divine plan. He gave her to us from the cross, and once again, she said yes.
She had to be lifted up because we need her there. The Immaculate Conception of Mary was the door opening on our salvation. She was then and she is now an outstretched arm, pointing to Him.
“Do whatever He tells you,” she instructed the wine stewards.
She says the same thing to us.
Because, as I am discovering and wrestling with, when she is your guide, there are no limits to following Him.
Shacking up, gay marriage and now wed leases.
Given all this, I’m inclined to say as so many people do these days Why bother?
A reader sent me a copy of the Washington Post opinion piece excerpted below. The author, who is a divorce attorney, suggests that, given today’s revolving door marriages, we just set up marriage as a lease arrangement and forego all that “til death do us part” nonsense at the get-go. He sees it as a simplification of the court-laden bitterness of today’s divorce culture.
My first thought was that the guy deserves a couple of stars for innovative thinking and his willingness to legislate himself out of a job. But then I thought that he’s probably as sick of doing divorces as every other attorney I ever met. Setting up wed leases for his clients (His suggestions would require quite a bit of personalized legal tailoring for each couple.) would probably end up being, if not as lucrative as a high-dollar divorce, still a good living for an attorney, and without the need to Xanax.
So, I guess he’s not being entirely selfless.
However, he has put his finger on the truth of what is happening in our society.
We’ve trashed marriage to the point that it no longer means much of anything. Gay marriage is the end of marriage as a legitimate institution. Now the flood gates on redefining marriage are open and you can bet that a lot of garbage is going to trot through them. Of course, none of this would have happened if heterosexuals hadn’t trashed their marriages (and their kids, homes and finances along with their marriages) for so many years.
Christians who want to follow Jesus instead of the world are going to have to make a decision about their marriages. Are they entering into Holy Matrimony, which is a life-long union on which God rains down sacramental graces? Or, are they entering into an elastic “so long as we both dig it” legal contract endowed by the state with nothing much but a lot of misery and legal gas?
The truth is, marriage, as it is practiced today has nothing — and I mean nothing — to do with the sacrament of Holy Matrimony as Jesus created it and as the Church has provided it for 2,000 years.
Which is it Christians?
Have you and your spouse entered into a Covenant before God Almighty that bonds you together in sickness and health, for richer and poorer until death does you part? Or are you just play-acting with some legally created contract that you can breach or nullify anytime there is sickness or poverty or you just don’t feel like it today?
For centuries, the legal definition of marriage corresponded closely enough to the Christian understanding of Holy Matrimony that the two could function almost as the same thing.
In today’s brave new world, “marriage” is a legal construct. At best, it is a contract. At worst, it is a sham. Many times it is both — a sham contract.
Holy Matrimony, at least as the Catholic Church and some other denominations do it, remains unchanged. Outside of those churches that still treat marriage as the life-long Covenantal relationship between a man and a woman that God intended, there is no Holy Matrimony in our society today.
Christians who want to follow Jesus are going to have to learn to make this distinction, first in their own lives, and second as they regard the “marriages” in the wider world. There are things that redefining the law cannot change, and this is one of them.
True marriage, which, to distinguish it from the legal contracts of the wider society, I have decided to call Holy Matrimony, is a sacrament instituted by Our Lord Jesus Christ.
It is up to you, my Christian brothers and sisters, if you want to be married in the eyes of God in Holy Matrimony, or you want a legal contract for sex and shared finances. If you want Holy Matrimony, then you must begin with the Church as the cornerstone of your marriage. By that I mean you must be married in the Church and you must make Christ the head of your home.
I do not think it will be possible for Christians to be the light the world so badly needs if we continue down this path of half Christian/half worldly.
More and more the world itself is demanding that we, as Joshua demanded thousands of years ago, choose this day whom we will serve.
Choosing to follow Christ begins in the individual heart, and it is first acted out in the home. The creator of home is Holy Matrimony.
Everything else is dead legalism.
From the Washington Post:
We all know that far too many marriages end in divorce, yet this institution does not adapt. Indeed, most Americans today want to expand conventional marriage to include same-sex couples.
So why is there no effort to improve the legal structure of marriage, when it shows itself to be deficient?
Marriage is a legal partnership that lasts a lifetime — one lifetime to be exact, that of the first of the spouses to die. Generally speaking, that is a long time for any partnership. People, circumstances and all sorts of other things change. The compatibility of any two people over decades may decline with these changes to the point of extinction.
In real estate, one may own a life estate in a piece of property. This is comparable to the term of a marriage — a lifetime. And in real estate, one may hold possession of property for shorter terms through a lease.
Why don’t we borrow from real estate and create a marital lease? Instead of wedlock, a “wedlease.”
Here’s how a marital lease could work: Two people commit themselves to marriage for a period of years — one year, five years, 10 years, whatever term suits them. The marital lease could be renewed at the end of the term however many times a couple likes. It could end up lasting a lifetime if the relationship is good and worth continuing. But if the relationship is bad, the couple could go their separate ways at the end of the term. The messiness of divorce is avoided and the end can be as simple as vacating a rental unit.
You can not control what other people do. That includes your adult children.
However, if you are lucky, and you’ve done a good enough job raising them, chances are that the things your adult children end up doing will be consistent, at least in an overall fashion, with the values you hold yourself. That does not mean that your adult children will always make the choices that you would make in the same situation. It also does not mean that they are going avoid all the mistakes you wish you’d never made.
One of the hardest lessons any parent has to learn is that you can’t always save your kids from the hard knocks you gave yourself when you were their age. You can’t — and this is hard to accept — impart the wisdom you gained from getting your nose bloodied to keep them from getting their noses bloodied.
Sometimes all you can do is sit back and watch and be there later with a cold wash cloth and an abundance of love. A lot of times what you will see when you do this is that your children are more like you than you would wish.
The best you can do as a parent is to give your children the tools to manage their own lives productively when they grow up and love them passionately, no matter what, after they do grow up.
My husband and I decided when I was pregnant with our first baby that the tools we could give that mattered the most were, (1) a stable and solid marriage between their mom and dad, (2) a strong grounding in faith in Jesus Christ, (3) a good education, (3) the security of knowing that we would always love them, no matter what mistakes they made in life.
My greatest fear as a parent was that I would lose one of these precious little ones that God gave me to the larger culture. I can’t imagine how anything else in life could matter if you mess up your own kids, and for me, messing them up would mean that they lose their immortal souls.
The trick to child rearing is to do such a good job giving them the right tools that they can manage their own lives and make the right decisions for themselves. This should begin long before they fly the nest. In terms of my Christian faith, that means I wanted to teach them to love Jesus and to give them some basic tools for discernment in matters of faith. The rest, I knew, was between them and the Holy Spirit.
I think it’s important for parents to raise their children. I don’t mean that it’s important for parents to send their kids off to daycare or school and let the people there raise their children. I think parents should do it.
That means a lot more than being your kids best chauffeur and activities manager. When my kids were growing up, they each had one organized activity. At some times, it was chess club. At others, it was swim team or Boy Scouts or Little League. They picked and my husband and I came up with the scratch for the uniforms, lessons or whatever. We also went to tournaments and swim meets and games, etc.
But that was it. I did not want to spend all my precious years with my kids driving them from one activity to another. I saw parents who did this and in my opinion, they weren’t raising their kids. They were scheduling and chauffeuring them.
Kids need time with you. They need time in their own homes where it is safe and they can just play. They need unscheduled down time in which you are just with them and they are free to be.
Families need this, too.
So, the first thing I would advise is don’t-overschedule your kids. Let them be kids. And be there with them.
This business of being there with them leads to the single best way that I know of to raise your children in your faith. Do it as a natural part of interacting with them on a daily basis.
Read Bible stories to them, say prayers with them, take them to church. But don’t think that those are the ways you teach them the faith. Those things model faith in action, but teaching faith is something else.
You teach them the faith by being there when they have questions and giving them faith-filled answers. For instance, I have never been troubled by questions of evolution vs the Bible. I know people who have actually lost their faith in God over this quibbling nonsense.
The reason it never troubled me was that when I first had a question about it when I was little, I asked my mother. She explained to me that God’s days were not simple 24-hour solar days. God’s days were infinite. Later on, I realized that if God created time, that meant that God was outside of time. It all just fell into place from there. The result: No religious crisis over evolution.
The same thing happened with the story of Abraham being called to sacrifice Isaac. My mother told me that God asked Abraham to do this to make it absolutely clear to him and his descendants that God did not want human sacrifice. I learned later that there were other meanings to this story, but I’ve always thought my mother was basically right about this.
The point here isn’t that my mother is a great theologian. The point is that she was there to answer my questions and she did answer them in simple ways that insulated me for life from a certain set of attacks against the faith. All this took place as part of the casual give and take of daily life and living. It was not scheduled.
That’s the way it is with kids. The best and most important moments; the ones that determine who they are going to be, are not scheduled. They just happen, and when they happen, mom or dad need to be there. If you don’t want the larger culture or the mixed up kid from down the block raising your kids, then you’re going to have to step in and be there so you can do it yourself.
I made the decision to homeschool my kids. I think that was one of the best things I ever did for them. All the things people claim will happen to homeschooled kids — bad education, unable to associate with others, etc — did not happen to my kids. You have to work at it a bit, but the payback for protecting your children from the evil that’s out there until they are old enough and their personalities are formed well enough for them to handle it themselves are on-going and enormous.
My husband and I have somehow managed to raise a couple of fine young men who are good people and who have never caused problems for us or for themselves with their behavior or attitude, not even during the dreaded teen years.
How do you pass on your faith in Christ to your children? As nearly as I can tell, you do it by being there in their lives to answer the questions they have when they ask them. You do it by protecting them from being drafted into the sicko values of our larger culture when they are too young to fight back on their own. You do it by reading the Scriptures aloud with them, beginning with Bible story picture books when they are little and working up to the real thing when they are a few years older. You do this with a readiness to put down the book and chat about what it means at any time.
Pray for your children. If you’re like me, you’ll find yourself praying for them and for wisdom to be their mom or dad in the way that God wants you to be their mom or dad several times a day. Pray with your children. Take them to church. Protect them from the world. Put them in places where they will have the opportunity to make friends with kids from families with values similar to yours.
Most importantly, enjoy them. Have fun with them. And love them with all your heart.
Then trust God with the rest. After all, they are His children, too.
“Remember the ladies.”
Abigail Adams to her husband John
Abigail Adams spoke up for women at America’s founding. “Remember the ladies,” she wrote her husband, John Adams. “Be more generous to them than your ancestors. Do not put such unlimited power in the hands of your husbands.”
Unfortunately, John didn’t listen to his wife, such notions being “too radical” for a nation founded on the equality of all men. About a hundred years later, the men of that time didn’t listen to the women who had fought gallantly in the abolitionist cause, either. “It is the black man’s time,” they said, when the fourteenth and fifteenth amendments were drafted. In essence they advised the women who had sacrificed so much to end slavery to, as women are often told, “wait your turn.” Subsequent Supreme Court rulings specifically said that the amendment did not include women.
Adams’ plea to her husband notwithstanding, it took 170 years of marches, speeches, arrests, forced feedings, mob attacks and an entire, separate, Constitutional Amendment to give half the people in this country the simple right to vote.
My grandmother, who was born on the Kansas prairie in 1886, was 34 years old before she had the legal right to vote.
Even today, women are bought and sold like chattel. They are sexualized, degraded and trivialized in our media and even by some “civil rights” commenters. Women are raped, beaten, tortured and murdered at high rates all over the world, including right here in the land of the free and the home of the brave.
We accept this as natural and the way things are. Half the people in this country are told to be careful what they drink when they go to parties because it might be drugged and they could end up being gang raped for fun by the men at the party. Half the people of this country are told to go out in pairs at night for their own protection.
We make the sadistic rape and torture of women into our entertainment. How many millions of men support an on-line porn industry that pumps these hideous images of women being used, abused, beaten, raped and reduced to things into their homes so they can be titillated by it?
The press buried the Holy Father’s statements about women. After all, gay is soooo much more important.
I’m not going to quote the Holy Father’s comments except to say that he didn’t open any new theological ground. You can hear what he said without any filters from me here.
Personally, I want to see the Church begin to preach and teach that violence against women is a sin with the same vigor that it preaches and teaches that abortion is a sin, and for the same reasons. Whenever any group of people is singled out for violence, abuse and murder, that is a deep social sin. We have laws against killing women, while we have laws allowing the murder of the unborn. But in actual practice we live in a world where violence against women is our entertainment.
I once helped organize a meeting of the various heads of Oklahoma’s denominations in an attempt to get them to acknowledge the seriousness and the evil of violence against women. The response was heartwarming, but, the fire went out after the meeting was over. My personal reason for doing this was simply because I had been sitting in pews for decades and I had never once heard a single sermon or homily in which anyone said that rape is a sin.
All I know is that I’ve worked decades of my life on this one issue, both as a lawmaker and as a private citizen, and it seems that violence against women is worse now than ever.
We’ve had talks on this blog about papal encyclicals we’d like to see. I’ll add my hope to the list. It would mean more than anything to me if the Holy Father would write an encyclical condemning the endemic, worldwide and historic violence against women for the great evil that it is.
My kids adore their grandmother.
The word “dote” wouldn’t be too strong to describe their attitude toward her. It’s a mutual doting. She tells me constantly how “brilliant, sweet, generous and good” they are. They, in turn, seem to not mind one bit doing the yeoman labors of making sure she takes her medicine, gets her meals and is constantly looked after.
Caring for an elderly parent is not all that difficult when the grandkids stop their rounds of work, dates and classwork to take on far more than their fair share of the tending. It amuses me no end that the first person they introduce their girls to is my mother. She always knows all about their date lives, while I am usually far behind on the information curve.
They feel so strongly about their grandmother, that when I tried to take on more of her care — in the mistaken idea that I was lifting a burden off them — they protested loud and long.
I felt much the same about my own grandmother. Grandparents are a healthy relief from the intensity of the parent-child relationship. They give a safe place for kids to spread their wings in the relatively low-key and tolerant atmosphere of adoring grandparents. I remember once my mother told me “we don’t do homework at my house,” when I asked her to make sure the boys did some sort of schoolwork that needed doing at the time. I don’t remember if my lower jaw hit the floor or not, but I do remember the amusement I felt when she said that.
I had the urge to tap her on the forehead and ask, “Mama, are you in there?”
This clearly was not the same woman who had raised me.
And, of course, that was true. She wasn’t the same woman who had raised me. At that point, I was the one on the hot seat. I was the parent with the task of shaping these babies of mine into responsible, productive adults who could earn their living and found families of their own one day.
My mother had done her time in the parental labor yard, and now she was deep into that other role of Grandparent. It was not her job to make sure they did their homework, and she wasn’t going to do it. Her job was to adore them and give them the unalloyed love and adoration that only a grandparent can.
Judging by their attitude today, when she’s a little bit dotty and a whole lot in need of unalloyed love and adoration herself, she did well.
Pope Francis spoke of this beautiful and unique contribution that grandparents make to the welfare of their grandchildren yesterday, on the feast of Joachim and Anna, who were Jesus’ grandparents. We often think of Joseph, Mary and Jesus as a totally isolated unit. But in truth, they existed within a community of relations and kinsmen, as do people in the Middle East, even today.
Scriptures mention this in the story of Jesus getting separated from Mary and Joseph when He stayed back to teach at the Temple when He was 12. There are oblique mentions of it later in His life when the Scriptures reference His mother’s relations, as well as His “brothers,” which is to say His kinsmen. Again, even today in the Middle East, people call their kinsmen, including cousins and more distant relations, “brothers.”
We don’t have specific information about how Joachim and Anna lived out their grandparent role in Jesus’ life, but since God had chosen to be born to this particular girl who was part of this particular family, I think it’s a good guess that they did it well. After all, these were the people who raised Our Lady. That’s a powerful testament to their child-rearing abilities.
Pope Francis emphasized on the flight from Rome to Rio earlier this week that the elderly are as important to the future of the Church as the young. There is a symmetry to life and this Latin American pope seems well aware of it. Traditional families, based on a mother and a father, and backed up with the loving help and support of the generation before them, are the best, most stable and healthy way to nurture and guide children from birth to adulthood.
People who grow up in this environment have learned the value of all people at various stages of life by seeing that value acted out in their own families. They’ve learned love by being loved. They acquired stability by growing up in stable homes. They’ve been supported, first by their parents and then by their grandparents who could pitch in and broaden their experiences and also fill the gaps in their experience that parents could not reach.
I had many of the most profoundly shaping conversations of my childhood with my grandmother. She had time to just sit and listen to my childish rambles that my mother and father did not. She was removed from the pressures of getting it all done and could give me her undivided attention for hours at a time. I basked and flowered in the soft sunlight of this attention.
My mother did the same thing for my kids. And now, just as I adored my grandmother, they adore her.
My youngest son drives a pick-up that sits high off the ground. When he wants to take his 88-year-old Amah out for a spin, he picks her up like she weighs no more than a potato chip and lifts her onto the seat. Then, off they go on a ramble.
She invariably comes back all aglow, telling me “that boy is the sweetest thing.”
I was setting up some work on my house yesterday. The lady who took my order was here for a while, measuring and writing down the particulars. I got calls from my kids who were at work and my mother who was at adult day care all through my discussion with this lady. I didn’t think anything about it. They call me all the time.
But as we were winding up our discussion the lady taking the order said, “Do you know how blessed you are?”
I said yes. And I do know. But it was lovely to have her remind me.
The generations, young to old, are good. The Holy Father is right: We should cherish the elderly, for they are vital to us and our well-being.
I’ve written before that Dr Gosnell is the monster that pro choice built.
Dr Gosnell is the recently convicted serial killer/abortionist who operated what some people have described as a “chamber of horrors” in Pennsylvania.
I knew I would catch some flak for saying that, and I did. But I had said it advisedly, based on my experience on both sides of the abortion wars. I knew what I was talking about.
We are seeing the dynamic I referred to acted out once again in Texas; pro choice people are going over the top to fight the regulation of abortion clinics in the name of “women’s health.”
About a week ago, Senator Wendy Davis of the Texas State Senate engaged in a 13-hour filibuster that resulted in a legislative train wreck for a good piece of pro life legislation. Her actions, along with some filibustering from the Senate gallery, effectively killed a bill that would have required that:
1. Abortion clinics provide the same kind of patient safety as any other ambulatory outpatient surgical center,
2. Doctors who perform abortions in clinics must have hospital privileges at a hospital that is within 30 miles of the clinic,
3. Abortion clinics provide their patients with a phone number which would be answered 24 hours so that they can call for medical follow-up to their abortions,
4. Abortion clinics give women the name and phone number of the emergency facility nearest to her home where she can go for medical care in the case of an emergency after her abortion,
5. Doctors, and not staff, prescribe drugs for a chemical abortion according to FDA guidelines, and that the drugs for chemical abortions may not be dispensed until after the prescribing physician has examined the patient and determined that she is not carrying an ectopic pregnancy.
6. Doctors who perform abortions who prescribe drugs for a chemical abortion also provide follow-up care, including a follow-up examination by the physician to determine that the abortion is complete and a 24 hour phone number in case the woman needs questions answered.
7. Doctors who perform abortions must report adverse affects caused by drugs used in chemical abortions to the FDA according to FDA guidelines.
These are the “outrageous” regulations that pro choice people are demonstrating to stop. In my humble opinion, there is not one thing on this list of requirements that even the most pro choice person would not want for their daughter if she was undergoing an abortion.
Doctors who do abortions — which are a surgery — should have hospital privileges?
Abortion clinics — which are outpatient surgical clinics — should comply with the same health and safety regulations that every other outpatient surgical clinic does?
Abortion docs should examine their patients before surgery and follow up with them afterwards? They should report side effects of the drugs they prescribe to the FDA? They should make sure that women they give abortion-causing drugs aren’t carrying an ectopic pregnancy, when giving those drugs to a woman who is carrying an ectopic pregnancy can cause her to bleed to death?
These regulations are exactly what anyone who is interested in “safe, legal” abortions should want. Frankly, I think the pro choice people should thank the pro life legislators who are pushing this bill for cleaning up their dirty little industry.
However, the pro abortionists have pulled out all the stops to kill this bill, including misrepresenting it to their own followers. I doubt very much that the many “pro choice” people in this country who are buying the stuff the abortion industry is putting out about this legislation actually know what the bill contains.
If they did, most of them would favor the legislation. Frankly, anyone who favors “women’s health” should favor this legislation. But they’ve been conditioned for many decades by the constant drum beat of pro abortion extremists to believe any stupid thing those extremists say. There is little actual thinking that goes into the positions they take on abortion.
I would imagine that even most of the legislators who oppose this bill think they are doing it because if they don’t women will be “sent to the back alleys.”
The Texas legislature can not overturn the United States Supreme Court. Roe is not in danger. What is in danger is the lives of the young women who go to clinics that are protected from providing good medical care by abortion zealots who are so caught up in their cause that they don’t have a genuine thought in their heads.
I read this morning that there are plans for celebrities to come to Texas and speak against the bill. The whole thing has turned into a cause celeb, both literally and figuratively. After all, it turns out that many of the clinics in Texas will have to close because they can’t comply with operating like regular outpatient surgical clinics do.
They want, they demand, that they be exempted from providing good medical care to women because if they do have to provide the same level of care that other outpatient surgical clinics provide, it will endanger women’s health.
Does anyone know who’s on first?
What are we making sure of?
That women’s doctors are free to not follow up with them, don’t have to provide the same health and safety for them that they would for any other surgery, don’t need to examine them before doing surgery on them or administering dangerous drugs to them, and … get ready for this now … don’t even have to have hospital privileges at a nearby hospital.
That’s “women’s health,” abortion style.
Remember Dr Gosnell and his chamber of horrors? This kind of folderol is exactly how pro choice built that monster.
They fight against any and all pro life legislation on the grounds that even safety standards “narrow” Roe. They tell poor deluded women that if laws like this one pass, they will be “forced into the back alleys” again.
So what happens to the women?
A lot of them end up suffering harm that would have been prevented by better medical care. I’m not even talking about what happens to the baby here. I am talking solely about women’s health.
I had to have a couple of surgeries last year. I came home the same day after both of them. Neither of them was as risky as poking around in a pregnant uterus.
I can tell you that I wanted a doctor with hospital privileges holding the knife when he went to work on me. I wanted him to examine me beforehand and make sure that he knew what he was doing and that I was a good candidate for the surgery. I wanted health and safety standards dutifully enforced in the place where he did this surgery. I would have been outraged if I had learned that I was on my own after the surgery with no support or follow up if something went wrong.
Nobody anywhere was out demonstrating for the doctor who cut into my foot to be free to practice dirty medicine, not have hospital privileges and dump me after the surgery. Not one person thought it was outrageous or a violation of my rights that my doctor was required to practice competent medicine on me.
But if I had been a woman who was seeking an abortion, they would have been jumping up and down, demonstrating, filibustering, importing celebrities to defend my “right” to incompetent medical practices.
That’s how pro choice built Dr Gosnell and his chamber of horrors. It’s how they endanger women’s lives all over this country.
Look at this carefully and tell me: What’s wrong with this picture?
I think we need to look to ourselves first when we consider the post Christian society we are entering.
The move to create a system of discrimination against Christians in this country is well under way in the Western world, including America. Christian business owners are being penalized and forced out of the public square by laws that do not allow any exemptions for their faith. Universities and colleges increasingly demand that Christian groups leave campus. Public figures are scolded and harassed if they mention the name Jesus.
We are going to have to chose who we will serve, and we’re going to have to do more than talk about it or make it into a political issue. If we want to follow Christ, we are going to have to follow Christ in the way we live and what we do in our own lives and families.
Before we begin to deal with the mess we are facing in the larger culture, we need to consider our own contributions to how we got here. One of those contributions is the way we have treated our own marriages and our own families. I am going to write a post soon talking about the way we have abandoned our children to the public schools and the larger culture and allowed that culture to shape their values, thinking and beliefs.
But for this day of fasting and prayer for marriage and religious freedom, I will just use a old post of mine to revisit the question of why marriage is such a mess and who is responsible. Hint: It isn’t homosexuals.
I support traditional marriage. I have a public track record and the scars to prove it.
I voted to put an amendment to the Oklahoma Constitution on the ballot that defined marriage as between one man and one woman. I also authored and passed a resolution memorializing Congress to begin hearings on an amendment to the United StatesConstitution doing the same thing. That is as much as I can do to support traditional marriage from my elected position.
It’s not a complicated issue to me, and it has almost nothing to do with what marriage is not. It’s about what marriage is. What marriage is begins with the law. Marriage under the law is and should continue to be a union freely entered into by one man and one woman. But legal definitions are just the scaffolding we use to support the social structures of how we order our lives. The actual edifice, the reality of marriage as it is lived, is something much more complex and important than that legal definition can impart.
We focus our national attention on the definition of marriage under the law. We wear out our keyboards writing about it and revile one another over our positions on it. But despite the accusations and counter-accusations that season our debate, we ignore the home truths of marriage in this country today. The truth is, marriage has been a mess for quite some time. And homosexuals weren’t the ones who messed it up.
Homosexuals didn’t set off the epidemic of divorce in this country. Homosexuals didn’t create the millions of feral children who spend most of their time alone, raising themselves on video games, drugs and interactions with their peers. Homosexuals don’t cheat on our spouses. Homosexuals don’t break into our homes and yell and curse at our families. They aren’t the cause of the rising number of unwed births and the global pandemic of abortion. We did these things. Marriage is a mess and it was heterosexuals who messed it up.
We insist that the legal definition of marriage should be a union between one man and one woman. But we behave as if it says that marriage is a union between one man and one woman at a time.
I know that is tender for many people. I know that divorce cuts people in half and leaves them with broken hearts and shattered lives. I know that some marriages are so bitter, destructive and even violent that they have to end. I know that even if you want to hold the marriage together, sometimes your spouse won’t. I know all this, and it gives me pause writing about these things. I don’t want to pick at half-healed wounds and start them bleeding again.
But the truth is that serial monogamy is NOT monogamy. Serial marriage is not marriage between one man and one woman. And heterosexuals, especially Christian heterosexuals, have a responsibility before God to care for and raise their children, cherish their spouses and build enduring stable homes which can nurture a true family. Heterosexuals who have failed to do this are the root cause of most of the social problems we face today. They, not homosexuals, are the ones who have brought marriage to the sorry state it is in now.
I have a public track record of supporting traditional marriage. I’ve got the scars to prove it. But I think that supporting traditional marriage, especially traditional marriage in the Christian sense, means more than being against same-sex marriage. I think that as Christians we are required to look past what we’re against and find what we are for. It isn’t enough for Christians to be against same-sex marriage. It certainly isn’t enough to do as some have done and whip people up into a rage and then cash in on that rage to advance your political career. That is just cheap demagoguery.
Leadership, especially true Christian leadership, mandates that we don’t just get people worked up against something. We have to lead them forward to something. In the case of marriage, we should be for true Christian marriage and we should live that kind of marriage in our own lives. Christians must be FOR marriage as a loving, giving, living institution that cocoons young children in a world of stability, positive discipline and love so that they can grow up and create loving homes of their own.
The bond between husband and wife, as the Bible says, makes them “one flesh.” This doesn’t refer just, or even primarily, to the physical union of marriage. Sex, apart from this bond of love, is a physical act. But true marriage is a spiritual bond. The deep, life bond of trust and mutual dependence that is marriage nurtures everyone within its reach. Marriage creates not just family, but home. I do not mean a building where you sleep. Christian marriage creates home that is a refuge from the coldness of modern life.
This isn’t a hypothetical for me. My home and my husband are the living sanctuaries of my life. I could not endure the pressures of being a Public Catholic and all the controversy and criticism that engenders if I wasn’t able to go to my house, shut the door, and be Home.
Marriage is the progenitor of life, family, emotional safety and abiding peace in this life. It is a sacrament, given by Our Lord, to enable us to walk through life together and not alone.
If we are going to “save marriage” in this country, we certainly do need to resist efforts to alter its legal definition. But we also need to begin living the sacramental love and fidelity of marriage with our spouses and within our homes. We need to do this because it is what God intended for us. Marriage is His blessing on our lives and through it we can become blessings to our whole society.
Frank Weathers has another take on this question here.
Tomorrow is the day that the Supreme Court is scheduled to hand down rulings that will affect how America deals with the definition of marriage for decades to come.
The legislation in question is the Federal Defense of Marriage Act and California’s Proposition 8.
The Court can do anything. It can remand the whole question back to the states. Or, it can issue a ruling of sweeping proportions similar to Roe v Wade. It can even announce that it isn’t going to rule at all.
People on both sides of the question studied the Justices’ every twitch and cough when the cases were presented earlier this year. We all wanted a crystal ball so that we wouldn’t have to endure the suspense of months of waiting before we found out which way and how far the Court was going to jump on this issue.
Tomorrow, the waiting and guessing will be over. The Court will make its ruling.
After that will come the dissecting and rejecting of whatever they rule. I am reasonably certain that no matter what the Court does on this issue, a large segment of the American population is going to be unhappy and angry about it. I am equally certain that no matter what the Court does, the debate about how we will define marriage under the law will continue.
Which leads me to the question of how we should behave tomorrow and on into the months and years ahead. Much of the debate concerning this issue has devolved into slander of people who hold opposing views. I think part of the reason why this happens is that both sides of the argument believe that their position is a moral imperative. Another part of why we behave so terribly when we discuss how to define marriage is that the temper of our times has taught us that bullying, slander, smear tactics and mud-slinging are legitimate tactics.
Instead of dealing with the issues at hand and talking about the arguments being made, we tend to try to discredit the people making the arguments.
My feeling about this is that if you are a Christian, you have a moral responsibility to forgo this kind of behavior. It does not matter what they call you, you may not slander them back. Let the other side have the low road.
We are defending home, family, life. We are defending the core institution on which Western civilization is built. We do not need to attack anyone to do that.
Also, we need to remember that homosexuals are just people. More importantly, they are children of the same God whose teachings we are trying to defend. No matter what they say or do, they are our brothers and sisters in creation. We should try to convert them, not destroy them.
The other side of public debates involving Christian values of any sort always seems to try to base their arguments on Christian bashing and degrading our faith. It can be hard to take; especially when they defame the name of Jesus. But do not reply by degrading or defaming them. Do not do it.
That does not mean that we should back away from saying the truth of things. It just means that we should forgo attacking people. We can talk about issues and even bad behavior all we want. Just don’t attack a person while we do it.
I believe that no matter how the Court rules tomorrow, the fight will go on. I also believe that no matter how the Court rules or what detours or setbacks we suffer, the victory will ultimately be ours. All we have to do is our part, and do it in a way that lets everyone who observes us know that we serve a Risen Lord.
I knew when I posted The New Prostitution: Surrogate Pregnancy that I would get a flurry of indignant responses and lies from people who buy and sell women’s bodies in this new, medical form of prostitution.
I’ve been to this particular rodeo before. What I encountered then and now is what people who stand up for the human rights of women always encounter: Lying attacks from their exploiters, self-destructive defenses of their own dehumanization by self-hating women, and stories of the “benefits” of the prostitution from their purchasers.
Just for the record, I don’t put pimps’ testimony on this blog. That includes pimp husbands who take money from their wives selling their bodies to medical science and doctors who buy and sell women’s bodies. I also don’t put johns’ excuses for their behavior on this blog. You’re wasting your time, trying to comment here.
My experience with this began when I went through infertility treatment to have my first child. I know a lot of about these drugs they give people. I know about their side effects and how they make you feel. I do not have first-hand knowledge of the irresponsible medical practice of egg harvesting.
My doctor was treating me for a diagnosed medical condition. The dangers and miseries I endured were part of a legitimate treatment for a bodily disfunction. She never over-stimulated my ovaries to try to make as many eggs as she could. She also never lied to me about the risks. She told me everything before we ever started, including the fact that the treatment could kill me.
The doctors who perform egg harvesting in Oklahoma lie about the risks. I know they lie because when I introduced a bill to stop them from paying women to undergo egg harvesting, they lied to other legislators and to the press. One of them said that egg harvesting was no more dangerous than riding in a car, among other flat-out lies.
They also claimed that they had not ever had a single complication. Another lie. One of these docs was part of the infertility clinic I went to. He wasn’t my doctor, but I knew him. While I was undergoing treatment, one of his patients lost an ovary. Call me crazy, but I think that qualifies as a complication.
These doctors are misrepresenting the risks and exploiting young women, endangering their lives, future health and fertility. They are reducing women and children to things to be bought and sold on the marketplace. They are also turning medical practice into an exploitative and dangerous profession that people cannot trust.
If doctors can subject people to dangerous treatments that the patients have no medical need of in order to make money, if they can lie about the risks and use their professional associations’ political clout to create an environment that allows them to do this with impunity, then how can anyone ever trust their doctor?
We rely on these medical people to tell us the truth. We rely on them to give us treatments that we need because we are sick and need those treatments to get well. We rely on them not to inflict unnecessary medical treatments on us to make money.
These doctors are preying on women. They are buying and selling babies. All the lies in the world won’t change that.
There is one simple solution. Take the money out of the equation. If a woman wants to undergo a surrogate pregnancy for someone out of the goodness of her heart and she knows the risks and freely undertakes them, ok. But do not allow anyone to pay her to do this. The same should go for egg harvesting.
There is a reason we have laws that do not allow people to sell their bodily organs. The same laws should to apply to egg donation and surrogate pregnancies.
What I want to do is,
OUT OF THE EQUATION.
Give women and children their human dignity under the law.
Otherwise, stop lying and call it what it is: The new prostitution.
The story below comes from a young doctor. She gave me permission to use her testimony when I was working to pass a bill to make it illegal to pay for egg harvesting in Oklahoma. I never used it, even though she gave me permission. She was still a student and afraid of what public use might do to her medical career. I didn’t think she understood how vicious and slandering these people really are, and I did not want to harm her in any way. I left her out of that fight.
However, she is in a different place in her career now. She has offered her story as testimony to the Kansas State Senate and it is published at the Eggsploitation web site.
I reprint it here with permission. From Eggsploitation:
Testimony by Sindy, M.D., Ph.D. to Kansas State Senate on Senate Bill 509, “Women’s Health and Embryo Monitoring Program Act,” March 2010
My name is Sindy. I have an M.D. and a Ph.D. in Biology with specialization in the field of real-time live imaging of the early immune response. With my strong background in basic science research and publications in top scientific journals such as Nature and Science, I have always been an avid supporter of biological research using live subjects and donated tissue, both animal and human. However, my experiences have taught me that at times, even a scrupulous medical scientist may be tempted to make erroneous assumptions, cut corners, or risk safety in order to save time or achieve success. In my medical and research training I have learned the importance of certain principles whenever attempting a procedure or study. These include: 1) ethics, 2) subject safety, 3) informed consent, and 4) patient autonomy. I am testifying today as a former egg donor on the dangers posed to women by the egg harvesting industry. I believe that all four of the above key principles had been violated in my case. Even though I suffered immediate life-threatening complications from the process, it wasn’t until many more years of medical training that I was able to understand the full scope of how I had been taken advantage of, mislead, and abandoned by the egg harvesting industry. As a medical professional it is still difficult to accept that such abuses are allowed to exist in my profession. Meanwhile, players “behind the scenes” such as the egg donation agency and the egg brokers have left the issues of ethics, health, and safety to the doctors, so that they can concentrate on profit. It is my assessment that the egg donation industry cannot be allowed to continue without regulations aimed at preventing unethical recruitment, substandard practices, and inadequate monitoring of women for the purpose of egg harvesting.
The goal of my testimony is to illuminate the importance of placing regulations on the way that the egg harvesting industry is run — from ethical, legal, and medical standpoints. 1) The health and safety of women must be protected first and foremost in any procedure related to ovum production, and should never be superseded by concerns of profit, costs of screening and monitoring the subject, quantity of eggs produced, quantity of eggs retrieved, or completion of the cycle. 2) Furthermore, like any other industry, the egg harvesting industry must be held accountable for reporting adverse effects and for tracking the long-term health of donors. 3) Ethically, informed consent must be properly obtained, with an admission that more research is needed to illuminate the long-term risks to donors. It is also an ethical responsibility for those who profit from egg harvesting to track the health of donors, including conducting large scale research in order to study risks.
I will now relate my experience. In 2001, while still in the combined MD/PhD program, I signed up for egg donation after seeing a university newspaper advertisement for egg donors. The monetary compensation of $6,500 seemed like a lot to me at the time, as I made barely enough to live on. Though I had a desire to help an infertile couple, money was definitely a major driving factor in my decision. Before I started, I searched the medical literature with a fine-tooth comb to verify that this procedure was indeed as harmless as advertised by the egg donation agency. I did not find any hard evidence in the literature of future infertility and cancers, and it seemed that the risks of other complications were extremely low. However, I was not told that the egg donors were rarely followed after the donation, and that doctors were under no obligation to report adverse events.1 Like many other women egg donors, I was bound by legal contracts to remain anonymous and therefore even if late complications occurred, they would be difficult to report.
At this point I had a normal gynecologic history, including normal age at first menses, regular menstrual cycles, and nothing significant on pelvic ultrasounds. It was assumed that I was healthy enough to undergo the egg harvesting protocol. Then I submitted my photographs, passed my genetic screening as a “quality assurance” for the tissue purchaser, and submitted myself to a psychological screen and IQ test administered by a psychiatrist. Based on these results I was chosen as the egg donor, from whom a “designer offspring” would be created.
The legal contract stated that the creation of these eggs were for the purpose of in vitro fertilization. The recipients of my eggs would retain all rights to my eggs and any subsequent embryos created from my eggs, “including but not limited to the ability to make all decisions regarding disposition of embryos.” The literature given by the egg donation agency outlined the possible risks of ovarian hyperstimulation syndrome (OHSS), as well as some other theoretical risks that they assured me were rare. What I did not realize at this time was that there were other hidden players in the egg industry who could potentially make money off my eggs, and that there were no laws in place to discourage hyperstimulation of many more eggs than reasonably needed for the goal of helping the infertile couple. My contract did not guarantee that third parties would not be involved in the trading or selling of these eggs, though it specifically forbade donations to other infertile couples without the donor’s consent. My eggs could have been a high-value commodity for profiteers who had nothing to do with the infertile couple, and I was not made aware of this possibility in a forthcoming and direct manner.
The below was part of the information provided to the public by the egg donation agency:
Q: How many eggs are removed during the retrieval? A: The average is 10-15 eggs aspirated per cycle, but donors can produce 16 or more eggs.
Q: Can a donor not produce enough eggs in a stimulated cycle? A: Yes, if the doctor cancels the cycle for poor response the donor will be compensated between $650.00 — $750.00.
According to my agency, failure to produce more than 4 eggs qualifies as “not enough eggs”. Four is typically higher than the target for women who are receiving fertility treatment using oral medications. However, note that there is no upper limit for the number of eggs a donor may safely “produce”, indicating that safety of ovum overproduction is being ignored. This illustrates that the drive to produce a higher number of eggs is extremely high, and failure to produce “adequate” eggs is linked with reduced financial compensation for the donor. Needless to say, this concept of “more is better” brings up ethical questions concerning the use of financial compensation for the recruitment of egg donors. This is especially alarming when no standards are in place to prevent an agency from overproducing eggs. The agency also told me that if I had a successful donation and become a proven donor, I may receive more compensation for future cycles, upwards of $8,000 (on paper) to $20,000 (verbally) – more than I would make in a year of intensive lab work. When “successful” production cycles are linked to increased financial compensation and “failures” are linked to a decrease in financial compensation, women will become more likely to tolerate untoward side effects, including those of OHSS, for fear of losing this compensation. This payment structure poses an obvious ethical conflict.
After signing my legal contract I began to administer all the medications as directed by the egg donation agency. These medications arrived by mail. I already knew how to mix and administer the medications but I don’t recall being instructed by medical personnel. At no point did they adjust my dosage. I remember receiving follow-up early on with a local doctor, and more exams after I travelled by plane to Northern California for the harvesting. Imagine my surprise when they told me that I was producing approximately 60 egg follicles! A mature follicle measures ~2 cm in diameter. The normal ovary measures approximately 4 x 2.5 x 1 cm, and is analogous to the testes. Therefore, you can imagine how 30 mature follicles of 2 cm diameter clustered within each gonad must look like and feel. I was concerned, but the doctors and nurses assured me that this was within the reasonable range for a fertile young woman.
A couple of days before the retrieval the nurse emailed me that my blood estrogen (estradiol) levels came back much higher than they had anticipated (~10,000 pg/ml). A woman in her 20s has an average estrogen level of ~150 pg/ml, with a peak of ~400 pg/ml prior to ovulation. In late pregnancy, the levels may rise 100-fold, but this rise normally occurs over a 6 month period. I asked the fertility specialist to consider altering the timing and course of this process. I was concerned because the drugs I received were probably tested on Caucasian women of average weight. I am a thin non-Caucasian woman. Studies have shown genetic differences in liver drug metabolism for ethnic populations; the examples are too many to reference and are beyond the scope of this topic. Despite my concerns, the doctor told me that even though my hormone levels were extremely high, they would not make any adjustments to the protocol because they did not want to risk failure. I continued to follow all their directions, as it stipulated in my legal contract that I “[understood] it [was] imperative” that I “not deviate from [the protocol] unless instructed to do so by the IVF physician.” Therefore, I proceeded to finish my ovarian stimulation, finishing off with a shot of human chorionic gonadotropin (HCG) to help release the eggs for the harvesting. The next morning, I underwent transvaginal needle retrieval of the eggs.
What was unknown after the surgery was that the doctor had punctured an artery during the harvesting. When I woke from the anesthesia I became weak, nauseous, and dizzy. I was scheduled to catch a plane that afternoon, to return home. They told me that I looked good and was ready to go home, even though I had problems maintaining my blood pressure. At this point I refused to leave, because I could not stand without getting dizzy – orthostatic hypotension after an invasive procedure typically raises the suspicion of blood loss. A few hours later they started giving me intravenous fluids because they thought that the anesthesia was causing my low blood pressure. Then I developed pain and difficulty breathing. An ultrasound showed that everything was fine except for fluid in my pelvis, which they said was normal (later, this was documented as “fluid pocket near the right kidney”. During this entire time the doctor and nurse persisted in trying to get me to leave, which would mean hours of traveling by car and plane. The pain in my belly became unbearable and I became convinced that I was bleeding internally; something was irritating and pushing on my diaphragm. When I asked if I could be bleeding internally, they told me that it was unlikely. My blood pressure was even lower at this time, so they gave me medication to raise it. Unfortunately giving pressors in a bleeding patient increases the bleeding rate. At 6pm, after 8 hours of slowly and painfully bleeding out, they FINALLY admitted me to the hospital. To me it seemed like they had done just about everything to get rid of me up until that point. The fertility doctor ordered me to eat something. As soon as I sat up in bed to eat, I developed sudden distress and difficulty breathing. They took my blood pressure and called out “40/20″. At that moment I feared that I was going to die. In my medical records the blood pressure reported was 61/29. At this point they finally began to realize that something was terribly wrong, that I was going into shock from blood loss, so I was taken into the operating room for an emergency exploratory laparotomy to find the source of bleeding. The surgeons flipped through my bowels three times to ensure that no other organs were punctured.
During the harvesting of ~60 eggs, which I assume required 60 passes of the needle through my ovaries, the fertility doctor had punctured a high pressure artery in my right ovary. This tiny bleeder was easily fixed with a touch of electrocautery. I had an emergency blood transfusion to replace the 1.5 liters of blood lost. There is absolutely no reason why they should have waited so long to properly diagnose me, thus turning this into an emergency surgical situation when they could have done a small laparoscopic procedure to diagnose and fix a small bleeding artery. Had I followed their directions and gone home, I would have died. Unfortunately their disregard of the signs of OHSS, low index of clinical suspicion for post surgical complications, and their extremely slow response resulted in a horrific clinical outcome.
After the surgery, I had to be kept on a breathing machine in the intensive care unit (ICU) and treated for acidosis throughout the next day. After I was stabilized enough to move to the regular medical wards, the fertility doctor came to see me. She told me that the bleeding was probably due to a genetic bleeding disorder (i.e. my own fault) and that this has never happened before. Then she proceeded to check me for rare genetic bleeding disorders – nothing. I found the doctor’s reluctance to accept that a simple, clear-cut complication had occurred to be highly disturbing. A few days after I was admitted, the 9/11 attack occurred and all planes were grounded for a week. Despite not being able to walk or tolerate a 10 hour car ride home, the doctor told me I needed to free up medical resources and go home now. She tried to get me to leave by stating that when she had her C-section it only took her 3 days to start walking again. However, she neglected the fact that I had gone into prolonged shock caused by her own negligence, spent time in the ICU, underwent a massive surgical procedure, and had emergency blood transfusions. There were no apologies from beginning to end. I was shocked by this dismissive attitude from a top doctor of a top fertility treatment center, a medical expert who has published many articles on safety evaluation and recommendations for egg harvesting. At the same time, I was afraid to launch any complaints because I was a student in the same hospital system with plans to pursue the same field – Ob/Gyn; years later I decided on another medical specialty for unrelated reasons.
I am thankful to be alive, but I know that it was not because the doctor caught the post surgical complication. It was because I finally took a stand, and refused to go home when I knew that something was wrong. If I had died I would not be here to tell my story. I fear that cases like mine are buried deep by the fertility centers who do not want to lower their reputation. While I was in the hospital the fertility doctor told me that she would write a case report on the complication I had. When I searched the medical literature for all of her publications some years later, I wasn’t surprised to find that there was no such report. I have no way of knowing if this incident even made it into a statistical analysis somewhere in the medical literature. It makes sense that an industry thriving on profits and reputation has little incentive to report adverse events, for fear of driving away potential IVF clients and egg donors.
The $6,500 I was given has long since evaporated into medical treatments for multiple late complications caused by this incident. I developed an infection inside my incision site and required multiple steroid injections into the scar to stop it from growing out of control. I suffered from post traumatic stress for months because of my near-death incident, and was unable to work for two months due to both physical and mental deterioration. When I came off birth control a few years later I discovered that my previously normal menstrual cycles and hormone levels had become irregular. My previously normal ovaries took on a polycystic appearance, with more than 25 small follicles in each ovary. I developed occasional incontinence and pelvic pain likely as a consequence of the emergency surgery causing adhesions (fibrotic bands, analogous to scarring) around my organs.
The worst part of this is my current struggle with infertility, requiring continued exposure to the very same types of fertility drugs that I had already been overexposed to in the past – exposure whose link to cancer has not been adequately studied and may take decades to emerge.1 I may need more surgeries in the future to determine if the emergency surgery that was done had damaged my reproductive organs. I fear that the procedure may have harmed the quality of my eggs, even if the fertility experts are certain (at least theoretically) that quantity of eggs remains unaffected. Because of the high hormonal exposure during my egg donation cycle and multiple anecdotes from other egg donors, the development of early cancer is always in the back of my mind. Though a large study has found no evidence linking IVF to ovarian cancer, there is a generalized, undeniable causal relationship between transient exposure to female hormones and transient risk of rapid-growth gynecologic cancer.2 I believe that is absolutely necessary for egg donors to be followed and studied, especially if they had experienced hyperstimulation during the process. No follow up has ever been offered to me. Nobody from the egg donation agency, fertility clinics, or hospital has contacted me since, except to obtain my insurance information so that they could pass my hospital bill to my own health insurance company.
Summary and Conclusion:
1) Ethical considerations:
Financial compensation for eggs disproportionately targets college women with financial hardships. These women usually have long academic careers ahead of them and have not considered childbearing yet, so any infertility caused by the procedure would cause more psychological and physical damage to these women. Docked pay for failure to produce a target number of eggs and escalating pay scales for subsequent cycles are factors that may encourage underreporting of adverse side effects by the egg donor.
2) Subject safety:
Subject safety is variable, being highly dependent on the individual clinician’s practice. This is why there needs to be standardized safety practices and mandatory reporting of complications. In the article “Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research: Workshop Report (2007)”, one fertility expert advocated the following:3
By working from such information as a patient’s age, weight, and follicle count… a doctor can begin with an FSH dose based on those factors and then modify it as necessary. We monitor during the course of the stimulation to further decrease the dose if too many follicles are developing or the estradiol levels are too high.
To reduce risk of hyperstimulation, these actions were also recommended:
- •Modify stimulation protocol
- ◦Decrease gonadotropin dosage
- ◦OCP/Lupron/Low dose gonadotropins
- •Reduce the ovulatory dose of hCG
- •Delay administration of hCG: “Coast”
- •Cancellation of cycle eliminates the risk of OHSS
- •Withhold hCG administration
Basically the safety recommendations for egg donors include determining the initial dosing of these powerful drugs on the weight and age of the patient. If there is any evidence of producing more eggs or hormones than expected during routine monitoring, then the drug dosage should be reduced, the administration of stimulating medications delayed, or the cycle cancelled. None of these recommendations were followed in my case. In fact, it was one of my own egg donation doctors who was consulted and quoted in the above article.
Regarding the risk during surgical retrieval of the eggs, the perceived negligible risk of complications is likely due to incomplete data:2
It is difficult to know, however, exactly how often such complications occur . . . Although excellent statistics are kept on such things as how many viable eggs each procedure produces, the statistics are not so complete on the complications that ensue during and after.
As my case illustrates, this perceived near-zero risk is inherently dangerous because it will not raise red flags when complications do occur, resulting in delayed intervention and a poorer-than-expected outcome. When a complication does occur, the denial of medical responsibility based on statistical rarity is a faulty and circular argument. This denial of responsibility would also prevent egg donors from obtaining monetary compensation for treatment of complications and appropriate follow-up. As my case illustrates, poor management of retrieval complications can be a problem even in the hands of the most experienced clinician.
Lastly, I received no follow up after my procedure. It is the ethical duty of the fertility industry to conduct timely follow-up and research studies in order to promote safety. This is true of any other industry especially pharmaceutical – so why make fertility an exception?
3) Informed consent:
Many are improperly informed about the risks of the egg harvesting process. Verbally I was told that risk was virtually non-existent and that studies have not linked the procedure to cancer and infertility. I should have been told that there were not enough studies or long-term follow up to determine risk.
It should be made abundantly clear if embryos or stem cells may potentially be secondarily sold, traded, or gifted. The amount of profit potentially generated from each transaction and the purpose of each transaction should be transparent to everyone involved, especially the donor. Without this information, the egg donor cannot possibly make an informed decision.
4) Patient autonomy:
I was hyperstimulated with approximately 60 eggs retrieved. During the procedure I expressed concerns about not using weight-based dosing of fertility medication, the excessive number of follicles produced, and skyrocketing estradiol levels. Nothing was done to personalize my procedure based on clinical findings, which is clearly incongruent with the standard of care. After the procedure my concerns about internal bleeding were not adequately acknowledged until I went into shock and had to undergo an emergency laparotomy. In my experience, the pressure to complete a successful cycle became stronger as I became more invested in the process, and thus I progressively lost my right to make decisions regarding my own body.
Even the tiniest risk of complication needs to be taken seriously especially when dealing with perfectly healthy young women, who have no need to undergo a potentially life-threatening procedure. Procedures with risk are performed on sick patients with the understanding is that the benefits of the procedure outweigh the risks or the consequences of doing nothing. In egg donation there is no medical benefit, only risk. It represents a conflict of interest when the physician does not perceive the egg donor as a patient for whom they have the responsibility to minimize risk. This aspect must be considered when treating healthy young women with everything to lose.
1. Nature. 2006 Sep 7;443(7107):26. Health effects of egg donation may take decades to emerge.
2. American Journal of Epidemiology Vol. 153, No. 11 : 1079-1084.
3. Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research: Workshop Report (2007).