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Mrs. M. was 32 weeks into her pregnancy with twin boys when, during a routine prenatal ultrasound examination, the physician noticed a significant abnormality affecting the heart of one of the boys. Andrew, the twin with the abnormality, had appeared well up to this point; the other twin still appeared quite healthy. After being presented with the
news, Mrs. M. was admitted to the hospital, and she and her husband had to decide what to do next. Over the next several hours additional tests were performed and Andrew’s parents were faced with the following decisions: (1) Deliver both twins via cesarean section in 3 days with the hope that Andrew’s heart could be repaired before any additional damage was done or (2) treat Andrew with medications to strengthen his heart while in utero and allow the pregnancy to continue for a few more weeks. Either option was risky for the other twin due to the risks associated with preterm birth and the risks associated with the medications that would need to be administered to strengthen Andrew’s heart.
Later that night, Andrew’s parents decided the best course of action would be to have the boys delivered the following week. Andrew was delivered first and immediately taken to the heart catheterization lab. His brother was delivered a couple of minutes later and was allowed to remain with his parents for a few minutes before being taken to the neonatal intensive care unit.
The day Andrew was born he spent 12 hours in the heart catheterization lab and undergoing surgery before he was stable enough to be moved to a suite in the pediatric intensive care unit (PICU). Andrew was placed on a ventilator and was kept alive by medications infused into his body by several infusion pumps. Andrew’s heart and the blood vessels exiting the heart were profoundly damaged. Mr. and Mrs. M. were again presented with many difficult choices. Eventually, Andrew’s parents decided to have the vessels carrying blood from the heart repaired to see if the heart could recover. Following another long day in surgery, Andrew returned to the PICU where he was attached to even more machines than before.
Over the next 2 1/2 weeks Andrew’s condition remained the same: He was unable to live without the support of several machines. The hospital staff was very supportive and caring. Once again facing a tough decision, Andrew’s parents decided to remove Andrew from the life-sustaining machines; Andrew died in his parents’ arms a few minutes later.
Andrew’s twin brother spent about 3 weeks in the hospital before going home with his parents. He is currently a happy kindergartner.
How might the relationship between Mr. and Mrs. M. be affected by this situation?
Should the parents tell their surviving child that he had a twin brother? Why or why not?
If you said yes, at what age would it be appropriate to do this?
What roles might the grandparents play in this situation?
What conflicts might result?
What services might be required?
Do you think this experience would bring the parents closer together or drive them apart? Support your answer.
Do you anticipate the parents would consider having another child? Why or why not?
Expert Answer
Question 1: How might the relationship between Mr. and Mrs. M. be affected by this situation?
Answer: The situation of Mr. and Mrs. M is not easy to explain or understand they must be facing the terrible dilemma of choosing the emotion. Should they be happy to welcome the Andrew’s brother in this world or should they be sad for Andrew’s demise. This is a heartbreaking condition for any parent. Mr. and Mrs. M’s decision power is commendable, they opted for best possible decision out of two bad choices. No doubt it is obvious the decision was so stress generating and it is hard to comment how this might have affected their relationship as human coping of such stressful life events is very unique with every individual. However, as they both were involved in taking that decision to do best possible to revive Andrew’s condition, though their efforts were not successful, still they remained together in all event. On the basis of their all efforts and unity we can assume that this situation might have positive impact on their relationship, as they were together firmly in hard times. Though tragedy do change people in different ways but higher probability seems to be of positive & respectful relationship in future.
Question 2: Should the parents tell their surviving child that he had a twin brother? Why or why not? If you said yes, at what age would it be appropriate to do this?
Answer: They should share this with surviving child in properly explained manner but need to wait for correct time. The child should be old enough to understand the complexity of situation and decision taken. Immature child can take this news in wrong direction and it may put stress on him. Its vague to quote appropriate age, as it’s more dependent on child’s maturity of handling emotional situations. So parents need to be vigilant about child’s understanding level while sharing this information and should provide all support to help surviving child to cope with this news when shared.
Question 3: What roles might the grandparents play in this situation?
Answer: Grandparent and other family members can be extra moral support but it is always better that in such situation parents of child should take lead, much should not be expected from grandparents or relatives. As every individual has his/her way of dealing with situations, which can differ from Mr. & Mrs. M’s way of dealing the situation and can be cause of conflict.
Question 4: What conflicts might result?
Answer: Difference of opinion from others on handling the situation may impact the relationship between Mr. & Mrs. M. Extra unwanted love to surviving kid from relatives or grandparents may create problem in his healthy development. Which may worsen the already terrible situation and can be the reason of rift between Mr & Mrs M.
Question 5: What services might be required?
Answer: Consulting counselling services, healthcare provider services, social and religious services & recreational services can help in understanding situation better and learn how to cope with stress effectively.
NOTE: As per Chegg internel policy and allowed time limit possible questions are answered rest can be asked again.
