Fetal Surgeries Provide Evidence of the Humanity of the Unborn

by DAVID CURTIN, National Catholic Register, February 17, 2002

DOUGLASVILLE, Ga. - A raised fist is often used as a symbol of anger or defiance. But in Samuel Armas' case, his raised fist proclaimed to all the world that children in the womb are people too.

Two and a half years ago, a startling photograph of little Samuel's fist, poking out of his mother's womb on an operating table, made headlines around the world. At only 14 weeks gestation, a routine medical exam showed Samuel had a severe form of spina bifida, a condition in which the spine is exposed, possibly leading to brain damage and profound physical handicaps.

His parents, Julie and Alex, from Douglasville, Ga., agreed to have Samuel undergo an experimental operation - at an unprecedented 21 weeks, while he was still in the womb - to help correct the problem.

Today Samuel is a healthy young boy, with only minimal physical handicaps due to spina bifida. But Samuel's condition isn't the only positive outcome of the landmark surgery. His world-famous fist was seen by many as undeniable proof of the humanity of the unborn children.

And medicine continues to provide more evidence.

In fact, medical treatment for children in the womb is not new. The first "open fetal surgery" (such as Samuel's operation, in which the uterus is temporarily removed from the mother while the child is operated on) was performed at the University of California at San Francisco as far back as 1981.

Today, the main centers for fetal surgery in the United States are Vanderbilt University in Nashville, Tenn., Children's Hospital in Philadelphia, and the University of California at San Francisco. But Dr. Lillian Blackmon, chairman of the Committee on the Fetus and Newborn of the American Academy of Pediatrics, said that "to a fair degree" fetal surgery of any kind is still considered experimental.

Blackmon explained that there are five major categories of open fetal surgery currently being practiced. These procedures treat cystadenomatoid malformations of the lung, urinary tract obstructions, congenital diaphragmatic hernias, spina bifida, and sacrococcygeal teratomas (tumors on the tailbone). The last three procedures are among those still considered experimental.

Risks

Because fetal surgery often carries a high risk to both mother and child, some pro-lifers have questioned certain operations, in spite of the value of fetal surgery in the public debate over abortion. The operation to correct spina bifida, for example, is life-threatening, while spina bifida itself is not.

Julie and Alex Armas, who are pro-life, never considered aborting Samuel when told of his condition. They agreed to allow the operation to be photographed and to speak to the media in part because they felt Samuel's story would serve the pro-life cause.

But Julie told Focus on the Family Magazine, "We've been asked several times, 'How can you say you wanted your child to live no matter what, then risk his life for this surgery?'"

Julie's response was simple: "How could it be an ethical dilemma for us to make his life better?"

This reflects a very delicate situation parents like the Armases find themselves in. Although there is no clear requirement for it, there appears to be no ethical principal that would forbid such high-risk surgery. It can even be considered praiseworthy, apart from the possible benefit to the child, inasmuch as it may advance medical science and help others in the future.

Dr. Edward Furton, director of public affairs of the Boston-based National Catholic Bioethics Center, said that while an operation like Samuel's "goes beyond what is morally obligatory," there is no definitive Catholic position against high-risk procedures in such cases.

"Those who make use of [experimental procedures] are advancing the science of medicine on several fronts … not only the cure of spina bifida but also the whole area of intra-uterine surgery. I don't think Catholics should take any different moral stance on this than the rest of the community. We should be as much a part of looking for cures … as anyone else."

While the wisdom of an individual operation may sometimes be subject to legitimate debate, there is little dispute about the impact fetal surgery has in countering pro-abortion arguments. Mo Woltering, assistant director of public policy of the American Life League, said that advances in fetal surgery make it harder to deny the truth about abortion.

Said Woltering, "Everything in science points to the human embryo, fetus, neonate - right from the beginning of conception, everything points to its being a human person…. [Fetal surgery] certainly helps reinforce the fact that we have a human subject living in the womb and that subject deserves every kind of protection as well as medical benefit available."

Powerful Images

The moving photograph of Samuel's fist was used powerfully in the congressional debate over partial-birth abortion - a gruesome late-term procedure often carried out on children at about the age Samuel was at when he underwent surgery in utero.

Commenting on the picture, Kate Michelman, president of the National Abortion and Reproductive Rights Action League, told The New York Times last year that such dramatic evidence "does make our job harder, because the images are very powerful."

David Curtin writes from Toronto.