Question

Baby John Doe. Sarah and Mike’s baby boy was born with a defect called spina bifida, which involves an opening in the spine. In his case, it is of the more severe kind in which the spinal cord also protrudes through the hole. The opening is moderately high in the spine, and thus they are told that his neurological control below that level will be affected. He will have no bowel and bladder control and will not be able to walk unassisted. The cerebral spinal fluid has already started to back up into the cavity surrounding his brain, and his head is swelling. Doctors advise that they could have a shunt put in place to drain this fluid and prevent pressure on the brain. They could also have the spinal opening repaired. If they do not do so, however, the baby will probably die from an infection. Sarah and Mike are afraid of raising such a child and worry that he would have an extremely difficult life. In a few cases, however, children with this anomaly who do not have the surgery do not die, and then they are worse off than if the operation were performed. What should Sarah and Mike do? Why?

Answer 1

Sarah and Mike are considering surgery for their son with myelomeningocele, a severe form of spina bifida. Surgery is generally advised to prevent infection and manage symptoms, though neurological damage may persist.

Step-by-step explanation:

Baby John Doe's condition, known as myelomeningocele, is a severe form of spina bifida where the meninges and spinal nerves protrude through an opening in the spine. This condition can result in significant neurological issues and potential lifelong disabilities including lack of bowel and bladder control and mobility challenges. Parents, Sarah and Mike, are facing a complicated decision regarding surgical intervention for their son.

Surgery is commonly recommended for spina bifida, with the goal to close the opening in the spine, which can limit further damage and prevent infection. Inserting a shunt may also be necessary to treat hydrocephalus caused by the accumulation of cerebrospinal fluid, preventing brain pressure and potential damage. While surgery does not guarantee the absence of neurological symptoms later in life, it can significantly improve quality of life and overall life expectancy.

The decision for Sarah and Mike involves balancing the potential benefits of surgery and the management of neurological symptoms with the significant responsibilities and challenges of raising a child with disabilities. In some cases, children who do not receive surgery may survive but have a lower quality of life than if they had undergone the procedure. Comprehensive care and support are crucial regardless of the decision made.