Medical ethicist Art Caplan joined Jim Braude and Margery Eagan on Boston Public Radio Thursday to take on a wide range of topics. Caplan discussed a German woman who at 65 is pregnant with quadruplets; he revisited a topic from the previous week about Alzheimer's and sexual consent; and also spoke about the "free-range parenting" movement.
Caplan's responses are edited where noted [...], and questions are paraphrased.
Annegret Raunigk is a 65-year-old German woman pregnant with quadruplets. She used in-vitro fertilization. Is this dangerous?
I think it's absurd and irresponsible. I can't believe any clinic in the world [...] would take her on as a patient. Sixty-five years old. When you're female you're trying to carry the baby in your body. That is an automatic, high-risk pregnancy for the fetuses. When you have four together it's an automatic high-risk pregnancy. They're going to be born with disabilities. I don't think they'll ever make it to term. She'll have to be C-sectioned, which is another risk for her at that age.
There's a non-trivial chance the parent could die just as the child enters early adulthood, right?
If you're going to be entering a nursing home when your kid enters high school, and you know that, that's bad! That's really a bad thing. And if you're not headed in that direction — and I don't want to hear all the '65 is the new 55' stuff — you just look at the statistics. There's a lot of Alzheimer's, a lot of osteoporosis, a lot of frailty, a lot of chronic disease when you get to be 80.
Should fertility treatments be more tightly regulated here in the US? Or are we okay?
The infertility industry keeps saying, 'Well, we're heavily regulated, don't worry about us. The FDA keeps an eye on our labs.' That's all that true, but that's all the safety features. There's no rules about who can use this technology. If you have the money, you can find somebody to do it.
We're just not equipped to have kids decades later than we used to.
You lose some of the energy. The body just ages no matter how far you job. [...] There's just aging that's taking place.
We talked last week about Henry Rayhons, a former Iowa state representative charged with sexually abusing his wife, Donna Lou Rayhons. She had Alzheimer's and, according to the charging documents, couldn't 'consent' to having sex. Now the case has gone to trial. Have you changed your mind in thinking this is ridiculous?
This has an ethics category description, we call this 'meshugganah.' That means, this is completely nuts. This is crazy-ville. A third-degree felony? I mean, whatever else you want to say, maybe they should sit down and have a talk and say, 'Look, let's establish a policy here. You might hurt her, or we're not sure she would really want this. Can you convince us that she would think it would be okay?'
I have a feeling there may be some family dynamics [at play].
But it's conceivable this could be okay in cases of advanced Alzheimer's?
Alzheimer's people, they still like their meals, they watch television. It's not that everything's evaporated. I don't know whether she would like this intimacy, or wouldn't like it. I do know a couple of other things though. One is, there's no place in most our nursing homes and long-term care facilities to do this even if she was mentally with it. We don't have private areas. The reason is, the kids and grandkids don't like to think of the old folks as having sex. And some do, and some would like to. And by the way, some want to do it with people they're not married to, because they formed a romance in this institution.
We could make it easier for older people to be intimate in the nursing home.
If you're going to design these buildings you need to make a private space, a private area just for people to go and be together even if they're not going to have sex. They're just going to hold hands, or they want some place where their roommate isn't there. This is kind of like college-gone-crazy. What are they going to do, put a tie on the door if they're inside the room and having at it?
Danielle and Alexander Meitiv are Maryland parents who subscribe to the 'free-range parenting' school of thought. They encourage their kids to wander and spend time by themselves. All was well until someone called 911 because their kids, ages 6 and 10, were out by themselves. What do you make of free-range parenting?
You're talking to Art Caplan, 'little Art' who walked many miles to Saxonville Elementary School in Framingham, unaccompanied, usually shoved out the door by his parents, unwilling to take that dangerous walk. Didn't want to go to school. But, up and down the streets of Framingham he trotted. No one saved him, no one called the cops, they just left him out there wandering around in the second, third and fourth grade. And by the way, [it was in] snow, sleet and hail. [...]
There was a time when this was not some kind of movement, it was just life. [Despite all the headlines] you know it's never been safer to be a kid. The data says child abductions and all that sort of stuff [are] blown way out of proportion by heavy media coverage when they happen. But they're almost always by people who are married and somebody's stealing the kid as part of divorce [problems].
>>You can hear Art Caplan every week on BPR. Caplan is head of the division of medical ethics at NYU's Langone Medical Center. He hosts the Everyday Ethics podcast.
