by Prof. Georges L. Kaiser, MD  


Thanks to the development of suitable surgical procedures and advancements in anesthesia and intensive care, it became possible in the second half of the 20th century to successfully treat numerous congenital deformities, and neonatal surgery became an important part of the special field of pediatric surgery already in existence for quite some time, and other surgical specialties. At the same time, during the second period of the mentioned time frame, prenatal diagnostics advanced at a fast pace, making it possible to detect a large portion of those deformities that can be treated surgically and to terminate a pregnancy in due time.

Lately, the killing of most heavily deformed newborns is propagated and practiced as well. The existing laws notwithstanding, there is an ongoing controversy in our society regarding the purposefulness and legality of the methods of solution mentioned in the case of deformed and potentially handicapped fetuses and newborns. Pediatric surgeons, as well as pediatricians, who have gained a vast knowledge of these deformities (e.g. treatment options, long-term progression) and who are used to take care of the child affected by a deformity, as well as to coach his or her parents, must imperatively assume the role of advocate of the not-yet-born, and must attend to the parents in case of continuation of the pregnancy.

In the decision-making process of life or death, treatment or non-treatment, parents - including socially underprivileged and/or single mothers - must be informed optimally and realistically, and must not be exposed to societal or institutional pressure. Therefore, the pediatric surgeon does not only need the prospective specialized knowledge, but also a broad education.

During my clinical practice I have been challenged and also touched time and again by encounters with handicapped long-term patients and their parents. One particular child who was contented at all times expressed his joy to see me at an annual check-up by giving me a friendly kiss at the end of the examination. That encounter has motivated me more than the clinic's annual income statement to be available to my patients at any time. Is the economic usability of a person really the only permitted normality?

Basel, summer of 2006, Georges Louis Kaiser