9/28/2005

Ultra Orthodox vs. Ultra Sound

After reading this article, I was reminded of a conversation that I had with a fairly well known and respected poseik, originally American, now in Jerusalem. He is of the opinion that it is forbidden for women to undergo ultrasounds while they are pregnant. His rationale is based on anecdotal evidence of stress caused by misdiagnosis, and some examples of cases where misdiagnosis resulted in unnecessary operations, from which the infant died. He felt that the potential costs far outweighed the potential benefits that may result from such a procedure.

Mind you, I am far from neutral on this issue. My oldest child was born with a very serious condition that was diagnosed in utero, and which allowed us to make all of the necessary preparations for the birth, which included prearranging a specific time for a Caesarean delivery so there would be no surprises, researching the condition, finding the right doctors, etc. Not knowing about it beforehand would have meant that my child wouldn’t have made it; babies with this condition didn’t make it until very recently, like the last 30 years or so. I was basically confronting this poseik with the fact that, according to him, my child should have died, and he did not deny that point.

Of course, he and I are both marshalling anecdotal evidence; it just so happens that my anecdote is sleeping peacefully in the room next door, so it hits a bit closer to home. Nevertheless, I think that his entire analysis is junk, and here’s why:

  1. Ultrasound technology, genetic testing (amniocentesis), and magnetic resonance imaging (MRI) are all constantly improving, medicine learns from its mistakes, and the threat of lawsuits, at least in the U.S. is a strong deterrent against cavalier diagnoses.

  2. There are techies, and there are pros. There are second opinions. There is common sense. From my (now extensive) experience with the medical establishment, I know the value of doing the research and asking good questions. Whenever we learned about something new, we researched it on the web, and came back armed with all kinds of questions and ideas.

[Side story on this point: once, my oldest had a pneumonia – related to the birth condition – and wound up in the PICU. After the condition stabilized, my oldest’s lips were bluish. I asked the doctor about it, and he responded “Oh, that’s labial cyanosis”. I responded, “Labial cyanosis is Latin for ‘blue lips’; calling it a funny name isn’t going to satisfy me; what is going on?”. His next response was much more substantive and detailed. I’m glad I asked]

  1. Did I mention the common sense thing? Whatever. I can’t emphasize it enough.

I don’t know the people who were victims of ultrasonic misdiagnosis; whomever they are, my heart truly goes out to them. But it’s essential to realize that they were not the victims of technology, rather, the victims of human error and human failure. If anything, it’s reason to turn the brain back on and try to make things more foolproof (though the quality of fools seems to be improving as well), minimize the potential for human error, and for God’s sake (really!) corroborate the initial findings with some other evidence!

Needless to say, that particular poseik didn’t get any more queries from me.
I would also add that his position doesn’t reflect the mainstream halakhic position, haredi or otherwise.
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