Hazel McHaffie

adoption

To act or not to act

Remember last week I mentioned the cases of child abuse or mistreatment that go to court? That got me thinking.

I’ve been creeping uncomfortably close to this area in my current novel, Killing me Gently – the delicate relationship being built up in the early weeks and months following the birth of a new baby and mysterious things happening which perplex the professionals responsible for ensuring everyone’s safety. We know that some children can be very difficult to love; some appear to reject overtures of maternal affection; some parents struggle to bond with their child for assorted reasons; some parents actually harm and even kill their children. Cruelty and rejection can come in many guises (as I’ve had brought home to me recently in the experiences foster carer Cathy Glass recounts), but so sensitive and nuanced is this whole topic that primary care teams and social services can be unsure of how best to support such families, when to intervene, when indeed to remove the child from the biological family.

Perhaps it was this preoccupation in my writing life that reminded me of a recent news report that I filed away for reference purposes. At the beginning of August a serious case review found that professionals had missed a series of opportunities to save the life of a little girl, Elsie Scully-Hicks, in Cardiff. Pause for a moment and just look at that gorgeous little smiling face … And then take in the fact that this precious life was snuffed out before she even saw her second birthday.

Elsie had been placed with fitness instructor, Matthew Scully-Hicks, and his husband, Craig, at the age of 10 months, and following due process, formally adopted by them just two weeks before her death aged 18 months. The couple were described as well educated and articulate, and highly regarded by each of the involved agencies as good positive parents. They’d already successfully adopted an older child. Indeed, such was their standing that a catalogue of significant bruises and fractures were dismissed as normal childhood accidents (as Elsie’s adopted father alleged). There was indeed a conspicuous lack of professional curiosity about each of her many injuries.

In reality the stay-at-home dad was struggling with her care – he described her as ‘Satan in a babygro’. And when she was just 18 months old, he shook her so violently before throwing her to the floor, that he killed her. Last year he was jailed for life after being convicted of murder at Cardiff Crown Court.

The agencies concerned have promised to learn lessons from this review, but of course, nothing can bring little Elsie back. No one involved in this case will ever forget her. I rather suspect some professionals will never forgive themselves. I shudder to think what it’s like to live with these weighty responsibilities; just getting inside the skin of health visitors and social workers grappling with such judgements in my fictional world is more than enough for me – and I know the outcome! Pause for a moment and think of all those courageous people engaged in making these momentous decisions every day. And living with the consequences. I salute them.

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Modern medical challenges: What do you think?

I’ve just had another filing morning – yawn, yawn. (For new visitors to my blog, that means tucking an accumulation of snippets and ideas into files on different medical ethical topics which might or might not become novels one day.) So I thought I’d share some of the news items with you and throw out a few thoughts for you to ponder or not as you feel so inclined. I’ve supplied links for extra information if you’re interested. No pressure.

Gender issues

An 8 month old Canadian baby has been issued with a health card that doesn’t specify the child’s gender. Single parent Kori Doty is a non-binary transgender person who wants baby Searyl to decide for *themself how *they wish to be recognised.
(*parent’s chosen pronouns)

Over here, the number of children under 10 being referred to gender identity clinics has quadrupled  in the past five years – figures showed that of the 2,016 referrals for children between the ages of 3 and 18, no less than 165 were under 10. (stats from the Gender Identity Development Service – the NHS’s only such facility)

Two young British men (Hayden Cross and Scott Parker – one 21, one 23) have gone public about putting their gender reassignment on hold until they’ve given birth. Both were born female, both have been living as men for a number of years.

And now there’s talk of transgender women receiving donated wombs. It’s a complicated enough process in biologically female patients, with significant risks to mother and fetus during pregnancy. But those who are born male have other issues to contend with such as an inadequate pelvis for giving birth naturally.

A hotter topic seems to be the growing number of transgender people who are seeking reversals, quoting crippling levels of depression and suicidal thoughts, but this development is being kept very quiet according to Prof Miroslav Djordjevic who runs a clinic in Belgrade. Some specialists fear that money plays a part in this with patients accepted for reassignment as long as they can supply the requisite cheque without adequate psychological evaluation and counselling.

Q. What do you feel about
the move to have non-gender specific loos and forms and facilities?
– a lower age limit for reassignment?
– young people who’ve started to transition wanting to call a halt to have babies while they still can?
those subsequently wanting to reverse the process?
transgender women having a womb transplant and giving birth?

Genes and inheritance

The Chief Medical Officer has advocated DNA gene sequencing for every cancer patient in Britain to prevent misdiagnosis, needless hospital visits and ineffective chemotherapy. Testing can correctly identify not just the actual illness but also specific mutations which play a significant role in the success of treatments. On the face of it it’s a big ask: more than 350,000 people are diagnosed with cancer annually and at the moment each DNA test costs around £600. But centralising the testing would reduce the individual costs and personalising the drugs used should speed up treatment and save the NHS a lot of money.

Charlotte Raven was unaware that there was Huntington’s Disease in her family until her father – newly officially diagnosed himself – told her when she was 36 and already had one child. Now aged 48, she’s had symptoms for 7 years and estimates she has at best 10 years to live. She has two children both of whom have a 50% chance of inheriting the illness.

Q. What do you feel about
– the proposal to gene sequence every cancer patient?
the potential discrimination in favour of cancer patients when other disciplines are seriously strapped for cash?
– having the definitive test for a crippling inherited disease yourself?
– the optimal age to tell a child they have a 50% chance of inheriting a degenerative condition?

Fertility

According to research led by a Hebrew university which tracked over 40,000 men, since 1970s sperm counts have fallen by almost 60%. These findings have been likened to the canary in the coalmine – indicative of changes in society and the environment that are damaging health far beyond fertility. Just what should we be doing about chemical pollution, stress, obesity, tight underpants?

A British-born Sikh couple, Sandeep and Reena Mander, whose parents came to this country from Punjab, have launched legal action against the adoption service in their county, Berkshire, after being refused permission to adopt a white child because of their ‘cultural heritage’. The council have only white babies on their register. This professional couple are in their early thirties and have already undergone 6 years of fertility treatment (privately financed to the tune of c£150,000) unsuccessfully. And they have the backing of their local MP – the prime minister, no less! They have now been cleared to adopt in the USA – another extremely expensive procedure.

The senior council of the Royal College of Obstetricians and Gynaecologists – without balloting its members – has voted by a majority to decriminalise abortion at any stage of a pregnancy on the grounds that it has a responsibility to protect women’s health by ensuring access to key services. It isn’t, however, advocating changing the current 24-week cut off period for abortions; rather it seeks to have the restrictions governed by professional regulations not the criminal law.

Scotland has introduced two new changes this month:  women from Northern Ireland can now get free abortions here, and women are allowed to take the abortion bill at home instead of having to be admitted to a clinical setting. i

Q. What do you feel about
– the implications of falling fertility? Should society be being more proactive in your view?  If so, how?
– i
nfertile couples incurring massive expense trying to have a baby?
adoption agencies discriminating in terms of ethnicity, faith, geography, etc?
the availability and legality of abortion?
– the risks to women of inducing abortions at home?
– medical tourism?

Not to mention all sorts of stories and news and stats on NHS resources, performance targets, shortage of health care professionals … never any shortage of material to fire the grey cells and indignation, and get the creative juices flowing. What if …? Supposing …? Imagine if …

 

PS. I’ve done my best to check various sources but please do post a comment if you have more information that runs counter to the brief synopsis I’ve offered.

 

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Adoption, AIDS and attitudes

It’s 22 years since homosexual acts were decriminalised in Ireland. Civil partnerships for gay couples have been legal there since 2010. But this Saturday Ireland became the first country in the world to legalise same sex marriage by popular vote. So it seems timely to review a book I read a while ago, which sets a context against which this latest development seems the more extraordinary.

Roll back to 1952 … An unmarried teenager, Philomena Lee, is sent to a convent for ‘fallen women’ – to spare the blushes of her family and society. There she gives birth to a little boy, Anthony. For three years she remains closeted with the nuns and her fellow unwed mothers, caring for him, loving him devotedly, and working like a slave. Life is harsh and the Catholic sisters severe, endlessly reminding the girls of their sinfulness. Those mothers and babies who die aren’t even buried in consecrated ground but in unmarked graves in a nearby field tended by no one. For the ones who survive, part of their endless punishment is to form deep emotional bonds with their child which are destined to be suddenly and irrevocably broken.

And so it is for Philomena: after three years Anthony is taken away by the church and ‘sold’ to an American couple. The authorities condoned the export and sale of Irish children at that time, trading them, choosing them on a whim, like ‘valuable pedigree animals’.  They turned a blind eye to the irregularities within the religious orders. 

PhilomenaThe real life story of Anthony’s experiences growing up in America, as told by TV presenter Martin Sixsmith in Philomena, is both painful and sad. Though reinvented and re-named – Michael Hess – he nevertheless remained full of ‘Catholic guilt’. All his life he believed he jinxed those whom he got close to – even presidents of the USA! And indeed bad luck did seem to follow him, although reading his story with a dispassionate eye, suggests that his own behaviour and innate sense of unworthiness was the cause of much of the unhappiness in his private life and relationships. As one therapist explained to his adopted father (himself a doctor) orphans make up a disproportionate percentage of inmates at treatment centres, detention facilities and special schools: ‘The orphan is always looking for acceptance but always expecting rejection.’ True to form, Michael was dogged by the adoptee’s sense of ‘never going to be good enough’, a belief reinforced by the nuns’ false report that he was abandoned at birth because his mother didn’t want him.

The effect on his relationships was corrosive from a young age, but when he started to have homosexual feelings the problems escalated. This was, after all, an age where same sex relationships were outlawed, hated and punishable. And his strict Roman Catholic upbringing meant that personal guilt was superimposed on inculcated religious guilt. It’s heart-wrenching to read of this naïve young man, while his urges still remained fantasies, researching the indulgences which promised a lessening of his punishment in purgatory, and concluding that ‘he could not hope for a plenary indulgence, a complete remission of his sins, because his offending thoughts were still within him, but he strove as best he could to minimize the retribution he would suffer for them.’

Once he began to actually indulge in gay liaisons his behaviour became increasingly erratic, risky and debauched, his attitudes to those who grew close to him was brutal, and again and again he destroyed the chance of private happiness offered by others. His public persona though, was quite different. There he was debonair, suave, kind, gentle, ambitious, successful. He rose through the ranks of law and politics until he was a right hand man to President Ronald Reagan; moving in the highest circles, respected, listened to, courted. The price he paid was high. In order to pursue the career he wanted he was obliged to join a party which promoted a harshly punitive anti-gay message, suppressing his principles, hiding his real proclivities. A tortured and destructive dual existence, lived on ‘a dreary carousel of recrimination and unspoken resentment’.

And throughout, even though he had risen ‘from illegitimate birth in an obscure Irish convent via the lottery of adoption to a position of influence in the world’s most powerful nation’, the lurking sense of his own unworthiness never left him. He was, he felt, like an imposter just waiting for his secrets to be exposed; both ‘a gay man in a homophobic party’ and ‘a rootless orphan in a world of rooted certainties’. His ‘addiction was secrecy and the rush of being in the wrong – of proving he was the flawed being he always knew he was.’

And what of his biological mother, Philomena? In her teens she was forced to sign official papers relinquishing all rights to contact or to try to trace him, but she never forgot him, and remained convinced that he would try to find her one day. We can only mourn with her that his efforts to do so were thwarted by the nuns, and she could only weep at his grave.

Philomena, then, is a much bigger book than I expected; much more than a story of their search for one another. It’s also an unravelling of attitudes; attitudes to homosexuality in America as well as to illegitimate sex in Ireland. Hypocrisy, double standards, condemnation in both cases. And it particularly resonated with me because as a midwife I cared for unmarried mothers terribly damaged by clandestine treatments and society’s cruelty before the abortion law was passed in this country; and as a university researcher I carried out empirical research into the attitudes and practices of people in relation to HIV and AIDS in the UK during the years when AIDS was incurable and gay men were fighting for equality and fair treatment. I saw at first hand what ignorance and fear and secrecy and a lack of human compassion could drive people to do. And how extraordinary acts of kindness can illuminate the darkness of misunderstanding and guilt.

And reading this haunting story of Philomena and her baby, of Michael’s life as a gay man with AIDS, I was reminded all over again of Irish philosopher, Edmund Burke’s adage: The only thing necessary for the triumph of evil is for good men to do nothing.

 

 

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Children – ill, abandoned, adopted, murdered, massacred

‘It’s not fair!’

How often have we all heard that lament? Especially from children. If a sibling gets a bigger slice of cake; if a schoolmate gets them into trouble; if a parent doesn’t humour them … But there can surely be few scenarios more legitimately unjust than a baby having cancer.

Olivia Stanca who died this past week in a rooftop hospital garden in London after her life support machine was switched off, was born with adrenal cancer. How cruel, how unfair, is that? It spread to her liver. She was just one year old when she died.

In her short life she had survived two rounds of chemotherapy but was very vulnerable to infections. Having pulled out all the stops, in the end the medical staff at Great Ormond Street regretfully said there was nothing more they could do for her. Olivia’s story reached the papers only because her parents fought against medical opinion for her to be kept alive, desperately wanting to hang on to their little girl, but eventually this past week even they bravely conceded that it was simply not possible. As their lawyer said, there are no winners in this tragic scenario. Indeed.

But thinking about this little family and all they’ve endured made me reflect on books I’ve read recently about children. So I thought I’d share my thoughts on three of them as my little tribute to all families everywhere, like the Stancas, who are grieving today. Three books moreover by the same author, herself a mum, which I read consecutively – a useful way of getting a feel for a particular person’s writing … if you don’t get too jaded by the third one, that is!

Gudenkauf novelsIn previous posts I’ve shared with you my enjoyment of several writers who tackle challenging issues similar to the ones I dabble in – Jodi Picoult, Diane Chamberlain, Lisa Genova. This time it’s Heather Gudenkauf who gets the ‘fans of Jodi Picoult will devour this‘ sticker. She’s a classroom teacher living in Iowa, who tucks writing novels into free moments between work life and bringing up three children of her own. Already I’m impressed.

These Things Hidden tells the story of three girls bound together by circumstance and horror, of a prison sentence, of a childless couple whose lives are transformed when a baby is abandoned in a fire station and becomes theirs to adopt. These Things HiddenParental love swells as little Joshua grows up, overcomes his phobias and tantrums, and takes his place in the swell of children starting school.  But all is not what it seems. Gradually a back history emerges … mental instability, fractured relationships, murder and intrigue … that keeps the pages turning from beginning to end and the brain whirring. What makes a good parent? How much should any one person be asked to sacrifice for their nearest and dearest?

A school shooting forms the core of One Breath Away (definitely shades of Jodi P here!)  Parents are waiting at the gates in agony, news of what’s going on inside patchy and conflicting – parents with unresolved issues, parents who didn’t say proper goodbyes, who are not dressed for publicity. And then – horrors – there’s the mother who thinks the gunman could be her son. Inside, the lone gunman is holding a classroom full of 8-year-olds at gunpoint. One Breath AwayIntrepid teacher, Mrs Oliver, tries to bargain with him: if she correctly guesses why he is there will he let the children go free? ‘Yes,’ he replies, ‘and for each wrong answer I get to shoot one.‘ But the blame, the gunman says, will lie not with the teacher but with a single police officer: ‘you get to live with the knowledge that the death of these kids and their teacher is all because of you.‘ Gudenkauf maintains the suspense through short sharp chapters to the very end. We’re left wondering how such tragedies can happen. How would we respond if our child/grandchild was held hostage by a madman? How would we weigh the lives of other people’s children against the welfare of our own families? It’s a bit like the question: should we ever pay ransoms to terrorists? Would you pay up if your son/daughter was the one held hostage? … isn’t it?

In The Weight of Silence two six year old girls go missing. One of them, Callie, has selective mutism, Petra is her best friend and her voice. Her mother Toni grows increasingly frustrated … and scared. The Weight of SilenceSuspicion mounts. Her brutal husband seems to be missing; the man she has loved since childhood is behaving oddly; her son is convinced his sister is in the woods; there are two sets of footprints in newly raked soil but one of them is made by a man’s boot. The whole neighbourhood is on the alert. And then suddenly mute Callie rushes out of the trees, alone, and utters just one word, a word that conjures up a scenario too appalling to contemplate. Just how far would any of us go to protect our families? How loyal would you be to your abusive partner?  Who would you believe?

As with all Jodi Picoult lookalikes, Gudenkauf’s novels are the staple diet of book clubs. Meaty topics, haunting questions, a tense plot, literary challenges. Plenty to get your teeth into. But it’s all just fiction. The last thought must be with real live parents who really are enduring loss or life-or-death struggles with their children. My heart goes out to them.

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Frozen

I’m shocked, frankly.

Newborn babyBabies are precious and special, aren’t they? And couples who can have them naturally are well blessed. Yes?  Ask any infertile couple going through expensive and emotionally draining treatment. So what do you think of the latest recruitment incentive?

Apple and Facebook are offering a perk for female employees: the company will pay to freeze their eggs (and you’re talking about c£13,000 a pop here). Why? To help them ‘avoid having to choose between motherhood and professional progression.’ To ’empower them’. Hello?

Apparently there’s a dearth of top women in Silicon Valley and this offer is designed to encourage them to defer motherhood until they are well up the promotional ladder. The frozen eggs bit is part of a package already in existence in Facebook in the States and due to roll out with Apple in the new year (although there are currently no plans to bring it to the UK). Facebook is also offering adoption and surrogacy assistance and other fertility services for both male and female employees. The mind boggles. Serious serious issues all; the kind of topics I grapple with on a regular basis.

When I think of the heartbreak and tragedy of couples who turn to fertility treatment or surrogacy or adoption as a desperate last measure for medical or other devastating situations, I want to weep at this news. To offer these things as a job-inducement seems to me bordering on sacriligious. I bet the small print doesn’t tell them there are no guarantees for women who voluntarily mess about with their biological clocks.

That’s my personal rant, but what do YOU think? Would you allow your employer to pressure you into something this private and personal? How does this square with your values and personal lifestyle and choices? I’m quite sure there are plenty of people out there who disagree with me or the offer would not be on the table.

 

 

 

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