(Also suitable as points of discussion for classes in medical humanities, the social sciences, nursing, public health, and healthcare policy.)
The costs to
care for a premature baby, such as Jacob Jenner, in the newborn period alone
may be half a million dollars or more, and lifetime costs can be far
greater. If “rationing” were to be
instituted in the U.S. health care system, do you think it should be applied to
any aspects of NICU care, and if so, how?
States has one of the highest rates of premature birth of any developed country
in the world. Did you find that any of
the stories shed light on why this is so?
Did reading the stories give you any ideas for how premature birth could
to save babies’ lives has improved greatly over time. In the story about Josi, some neonatologists’
opinions that “because we can (save lives), we should (save them all)” was
voiced. Can you think of any situations
in which technology should not be applied to save a baby’s life?
Jaxon and Jacob
are babies who were born prematurely to teenage mothers. After reading their stories, how do you think
teen pregnancies could be better prevented, or how could teen mothers be better
about Samantha and Grace demonstrated how far both medical professionals and
the public have come in their willingness to talk openly about babies born with
birth defects, instead of shunning them as being “abnormal” and not worthy of
care. How do you think that societal
change came about, and does it need to go further? Do you know individuals who went through an
experience where they felt as if they could not talk about their child who had
a birth defect? How did it affect them?
6. The lower age limit for resuscitation of babies has
continually dropped over the years, and now even babies born as early as the
twenty-third or twenty-fourth week out of a normal forty-week gestation (such
as Josi and Devon) may survive. It seems
that current techniques in medicine may have reached their limits, and the next
step to lower the gestational age at which babies can survive might be to go to
creation of an artificial womb, in which embryos or fetuses could be nurtured
in aquatic chemical environments outside the uterus. Already researchers are working to develop
this possibility. Is this a positive and
desirable step? Why?
7. Jésus and Tiffany are two babies who began their
lives under the influence of maternal drugs.
What do you think are reasonable criteria drug-using mothers should meet
to take their babies home with them? Why?
Since a doctor’s
prognosis about an individual baby’s outcome may be wrong, do you think doctors
should share their opinions about a baby’s prognosis with the parents? Under what circumstances should they, and
when should they not? What duty do they
have to inform parents of possible consequences of their choices for ongoing
care of their babies?
work long hours in a high-stress environment, often twenty-four hours or more
at a time, as in the stories about Preston and Devon. Do you think their work hours should be
10. In Charlie’s story, the topic of “informed consent”
was brought up. Do you agree that
doctors should inform patients/parents about all possible complications, no
matter how remote? Or, is their duty
limited to informing patients/parents of major, more common complications? What would you want to be told if you were
undergoing an invasive procedure or operation?
11. Were there any stories in which you thought the
doctors and/or nurses should have responded to a baby’s family differently, and
12. Was there any baby you found you had particular
empathy for? What was it about the baby’s
story that resonated with you?
13. What was the most surprising thing you learned from
reading this book?
14. Grace’s mother held on to hope that her daughter
would live a reasonably normal life even when evidence suggested
otherwise. Oliver Wendell Holmes said to
“beware how you take away hope from another human being.” How should a health care professional best
walk the fine line between hope and reality when a patient is facing difficult
circumstances? Have you ever had an
experience in which holding on to hope made a difference in your life?