Saturday, November 20, 2004
Hindu vs. Sikh
Here's a scientific article regarding abortions and female babies that actually shows Sikhs in a good light. The Sikh couple in Case 2 let their religious beliefs determine what actions to take. They proved the doctors wrong. Yay for Mr. and Mrs. K!!!!!
CASE 1:
Mrs. S is a married 35-year-old Hindu woman expecting her fourth child. She has 3 daughters and on several occasions has expressed her desire to have a son. Because of her age she is referred for amniocentesis to rule out genetic anomalies. A healthy female fetus is reported, whereupon Mrs. S requests a termination of pregnancy. The pregnancy is now at 20 weeks. Mr. and Mrs. S are referred for counselling.
CASE 2:
Mr. and Mrs. K, an orthodox Sikh couple, are happily anticipating the birth of their first child. The pregnancy is uneventful until 32 weeks, when gestational hypertension is diagnosed. Over the next 2 weeks Mrs. K's condition continues to deteriorate despite bed rest, hospital care and intensive medical management. Mr. and Mrs. K consent to cesarean section to save the lives of mother and child. At 34 weeks a female infant is delivered by cesarean section under general anesthetic. The baby is grossly edematous, looks dysmorphic and has an Apgar score of 1 at 1 minute. Her birth weight is 1000 g, and the placenta is small and calcified. Mrs. K is still under general anesthetic, and Mr. K is not in the operating room. The physicians need to decide on the degree of intervention. Fortunately, the infant responds to basic stimulation from towelling and drying under a prewarmed radiant heater and to resuscitation with oxygen by face mask. Her Apgar score is 6 at 5 minutes and 8 at 10 minutes. The baby is transferred to the neonatal intensive care unit, and a buccal smear is sent for karyotyping to rule out chromosomal abnormality. Following the surgery, the physicians meet with Mr. K to discuss the baby's condition. The neonatal specialist, considering the baby's condition to be grave and irremediable, advises against intensive intervention.
THE RESULTS...
CASE 1:
Contrary to the physician's expectation, Mr. and Mrs. S do not wait for the counselling appointment but travel to the United States to have the pregnancy terminated.
For Hindus and Sikhs the single most important ethical consideration surrounding the start of life is their belief in karma: that the fetus is not developing into a person but, rather, is already a person from the moment of conception. Abortion at any stage of fetal development is thus judged to be murder. However, abortion is accepted by Hindus and Sikhs if essential to preserve the life of the mother.8 Furthermore, the religious prohibition of abortion is sometimes at odds with the cultural preference for sons. For Mr. and Mrs. S, the desire for a son outweighs the stance of their religion against abortion.
CASE 2:
Mr. K affirms his religious belief in the sanctity of life and insists on maximum medical intervention. Baby K's edema resolves by 50% over the next 24 hours and resolves completely by 72 hours. She requires minimal medical intervention and leaves the hospital at age 10 days. Karyotyping results are normal.
In this example, it might have been easy to allow the cultural bias against female babies to prevail. However, unlike in the first case, the parents' religious beliefs overruled their cultural biases — and the clinical and ethical judgement of the physician involved.
CASE 1:
Mrs. S is a married 35-year-old Hindu woman expecting her fourth child. She has 3 daughters and on several occasions has expressed her desire to have a son. Because of her age she is referred for amniocentesis to rule out genetic anomalies. A healthy female fetus is reported, whereupon Mrs. S requests a termination of pregnancy. The pregnancy is now at 20 weeks. Mr. and Mrs. S are referred for counselling.
CASE 2:
Mr. and Mrs. K, an orthodox Sikh couple, are happily anticipating the birth of their first child. The pregnancy is uneventful until 32 weeks, when gestational hypertension is diagnosed. Over the next 2 weeks Mrs. K's condition continues to deteriorate despite bed rest, hospital care and intensive medical management. Mr. and Mrs. K consent to cesarean section to save the lives of mother and child. At 34 weeks a female infant is delivered by cesarean section under general anesthetic. The baby is grossly edematous, looks dysmorphic and has an Apgar score of 1 at 1 minute. Her birth weight is 1000 g, and the placenta is small and calcified. Mrs. K is still under general anesthetic, and Mr. K is not in the operating room. The physicians need to decide on the degree of intervention. Fortunately, the infant responds to basic stimulation from towelling and drying under a prewarmed radiant heater and to resuscitation with oxygen by face mask. Her Apgar score is 6 at 5 minutes and 8 at 10 minutes. The baby is transferred to the neonatal intensive care unit, and a buccal smear is sent for karyotyping to rule out chromosomal abnormality. Following the surgery, the physicians meet with Mr. K to discuss the baby's condition. The neonatal specialist, considering the baby's condition to be grave and irremediable, advises against intensive intervention.
THE RESULTS...
CASE 1:
Contrary to the physician's expectation, Mr. and Mrs. S do not wait for the counselling appointment but travel to the United States to have the pregnancy terminated.
For Hindus and Sikhs the single most important ethical consideration surrounding the start of life is their belief in karma: that the fetus is not developing into a person but, rather, is already a person from the moment of conception. Abortion at any stage of fetal development is thus judged to be murder. However, abortion is accepted by Hindus and Sikhs if essential to preserve the life of the mother.8 Furthermore, the religious prohibition of abortion is sometimes at odds with the cultural preference for sons. For Mr. and Mrs. S, the desire for a son outweighs the stance of their religion against abortion.
CASE 2:
Mr. K affirms his religious belief in the sanctity of life and insists on maximum medical intervention. Baby K's edema resolves by 50% over the next 24 hours and resolves completely by 72 hours. She requires minimal medical intervention and leaves the hospital at age 10 days. Karyotyping results are normal.
In this example, it might have been easy to allow the cultural bias against female babies to prevail. However, unlike in the first case, the parents' religious beliefs overruled their cultural biases — and the clinical and ethical judgement of the physician involved.
