Monday 17 October at 8.30pm on ABC1
Next Monday on Four Corners, ‘The Price of Life’ – a story that investigates the ethical and medical dilemmas involved in keeping tiny, premature babies alive. Who decides if they live or die and what, ultimately, is the cost of keeping them alive?
Imagine this. A young, healthy woman is 23 weeks pregnant. Then, for a range of reasons, she goes into labour. She is rushed to hospital and gives birth to her child. It cannot breathe unassisted, its skin is so thin it bruises to the touch and there are problems with its heart. Should the doctors apply massive medical intervention and keep the baby alive, or should it simply be made comfortable so that nature can take its course, allowing the newborn to die peacefully? Twenty years ago this would not have been an issue. Modern medicine simply had no way of saving the baby. Now things are very different, and that creates a whole new set of questions that must be addressed.
In this week’s Four Corners, BBC science and medical reporter Adam Wishart goes inside a neonatal clinic to tell the story of 23 week gestation babies and what keeping them alive entails.
In the emotion-charged atmosphere of a hospital emergency ward, it’s hard to see situations dispassionately. How does a doctor tell a parent that although their baby is alive the odds of it surviving without a major disability, including brain damage and severe heart problems, are close to one in a hundred?
In a situation where a child is born prematurely there are no rules about how much treatment is offered to the infant. Instead, there needs to be a delicate negotiation between doctors and the parents. Few doctors would reject a parent’s plea to intervene to keep the baby alive. That means that major decisions about health care priorities are left to the parents caught at the centre of an emotional maelstrom.
The other issue that cannot be ignored is cost. Keeping a premature baby alive is expensive. It’s estimated that the care for each child is something around $3,000 a day. Every case is different but in Britain and Australia it’s estimated that treating a severely premature baby could cost over $200,000 by the time it leaves hospital.
The implications of a decision to use highly sophisticated technologies to help an infant survive do not end at the hospital door. Most children that survive will need life-long medical treatment and support.
It does seem there needs to be a debate about how and when modern medical intervention is used, but for now it’s a debate that most of us, including the medical profession, are reluctant to have.
‘The Price of Life’, presented by Kerry O’Brien, goes to air on Monday 17th October at 8.30pm on ABC1. It is repeated on Tuesday 18th October at 11.35pm. It can also be seen on ABC News 24 at 8.00pm on Saturdays and on iview (abc.net.au/iview).