Lakeberg Twins
* As a practicing neonatologist with a longstanding interest in bioethics, Barry Siegel’s articles on the Lakeberg twins (Nov. 7 and 8) were long awaited. Siegel did an excellent job at portraying the very complex medical facts and the very human qualities of the family and the health care providers, both of which are critical to the understanding of such a tragic situation. I would like to offer several thoughts.
The pain and suffering of these babies has led to a horrible quality of life, which continues for Angela. In my medical opinion, Angela will most likely die, never having left the intensive care unit. Amy is the fortunate twin; she is no longer suffering.
The primary issue is one of medical futility, i.e., whether doctors have an obligation to provide treatments that have minimal success rates and conversely, whether patients have a right to demand such care. The father’s personality and substance-abuse problems are not material and the family’s ability to pay for this care should not be a deciding factor, although the total expense of the care is a consideration, no matter who pays.
I agree with Dr. David Thomasma in the appropriateness of not offering surgery.
Although the definition of medical futility is far from clear and much more professional and public debate is needed, there do exist individual clinical situations which are clearly futile and this is one of them. We, as health care providers, must have the courage, in the face of threats of lawsuits and public sentiment, but backed by sound medical facts and judgment, to say, “I am sorry, this treatment is not beneficial and therefore should not and cannot be done.”
GLEN KOMATSU MD
Torrance
* I believe that what Ken and Reitha Lakeberg did to their conjoined twin daughters is truly criminal. Anti-abortion advocates speak of the embryo’s right to life as that compared to any other human being already born. It seems that one of the twins had her rights violated. Could this operation have taken place on an adult and been considered legal? I think not.
The Lakebergs were selfish and ignorant (not to mention the media also). The twins should have been protected and allowed to live their brief lives without interference of such a brutal kind! I feel for the doctor who struggled with the Lakebergs’ stubbornness.
CAROLE LYLE
Los Angeles
