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Octuplet doc more at fault than the mom

The hits keep coming for octuplet mother Nadya Suleman. News that taxpayers will likely foot an estimated $1.3 million hospital bill for the infants' care has spiked public ire against the unemployed single mom.

Right sentiment. Wrong target.

The way I see it, the prime villain here is not an unstable woman with a history of depression and a psychological need that only an Instant Eight could fill. From her, I expect irresponsibility.

The character wearing the biggest black hat here is the one in the lab coat: Beverly Hills fertility doc Michael Kamrava. Of all of the cast in this sad soap opera, he is clearly the one who should have known better.

Suleman gave birth to premature octuplets last month only because Kamrava agreed to implant the embryos. Maybe he was blinded by a buck (or, likely, a five-figure sum). Perhaps he, at some point, underwent an ethical bypass procedure -- or had his common sense surgically removed. Whatever the case, the guiding hand who morally and ethically was supposed to raise the red flag instead waved this abomination on through.

Sure, Suleman -- who already has six young kids and lives with her divorced, already overwhelmed mother -- bears a full share of blame. It is too bad we cannot implant common sense into people as easily as we can implant embryos. But irresponsible folks come by the truckload. Having kids you cannot take care of is a symptom of a life out of control. Most of those people, however, do not have a doctor riding shotgun.

Nobody can force Suleman to visit a sterilization clinic. Nobody could convince the unbalanced single mom that Eight Is Excessive, let alone 14. But we can pull the license of the fertility doc who went along with Suleman's not-so-bright idea to fill her psychological void by overfilling her uterus.

The world is full of Nadya Sulemans, people for whom bad decisions are a way of life. Plenty of folks live under the astrological sign of Irresponsibility, from the unemployed single mom with, say, five kids by five fathers, to the men who father the kids and then disappear. It is a huge problem -- for the society that pays the bills, for the kids who do not get the care they need.

It is a problem, however, that does not involve a physician's consent. I think that is what separates run-of-the-mill irresponsibility from Suleman's physician-assisted recklessness. The doctor who did the in-vitro fertilization was an accomplice to stupidity.
The physician is supposed to be the ethical compass whose needle points to "no." Instead, Kamrava ignored professional guidelines against mass implantations. He disregarded the risk to Suleman and to her multiple fetuses. He forged ahead despite high odds that kids born too soon will face a lifetime of developmental problems. He was deaf to Suleman's mother's pleas against the eight-pack procedure.

"If you depart from [medical] guidelines, there ought to be a very good reason," said Dr. Stephen Wear, speaking in general terms. "If a patient has a bad idea, we can suggest a better option, or simply say we are not comfortable doing this."

Wear is co-director of the University at Buffalo's Center for Clinical Ethics. He served for 10 years on the state's board for physician discipline. He applauds the California medical board's investigation of Kamrava.

"Based on my experience," Wear said, "my guess is [this doctor] did not simply have a bad day, he has made bad judgments before. There is an issue of whether this doctor should be allowed to continue to practice."

We cannot stop Nadya Suleman from having more kids. But we can stop her doctor from helping more Nadya Sulemans.


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