Anencephaly IIIInfants with this disorder fail to develop a normal head and brain structure FFFFailure of the neural tube closure at the 23 – 26 day of pregnancy ensures that the baby will have a lack of development of the cerebrum and cortex portions of the brain RRRRudimentary development of the brainstem, however, may allow for a live-birth -autonomic function continues (unassisted for a relatively short time) -consciousness and “human characteristics” not possible- EVER

Diagnosis: Ultrasound can detect the deformality at an early stage 1000 – 2000 births per year At risk: Insulin dependent women & epilepsy treatments increase the risk Point of note: Folic Acid has been shown to reduce significantly the occurrence of anencephaly Options?

What to do?  Options are few  Abort the pregnancy (95%)  Obvious moral and ethical dilemmas  Go to term with the child  Of remaining, 55% are stillborn  For the rest, sustinence until natural death  Keep alive using extraordinary measures  Possible, but at what cost?  Money (up to 750 G’s per year and more)  Resources (doctors, nurses, bed space, etc.)  Other option?  Great source of pediatric organs (organ farms)

Assignment:  Part 1:  Imagine you had the unfortunate circumstance of having a positive ultrasound for an encephalic child  What would you elect to do and why?  Part 2:  You are a doctor and you must advise a family that tested positive for the disorder. What would you say to them and what would you advocate for them to do? Be sensitive: this is a very touchy subject!!

Details for writing assignment :  For each part, 2 paragraphs:  First, describe the problem and situation  Second, YOUR decision and why  In Bioethics, JUSTIFY, JUSTIFY, JUSTIFY

Rubric:  Rubric:  4 points: Focus  4 points: Content  Details of subject  4 points: Justification, reasoning  4 points: Conventions  Sentences, spelling, transitions, etc.