It was a little noticed article, unless, of course, you lived in Hawaii: Woman who refused chemo to save unborn child dies

As docs, a problem we run across is what to do when a woman is found to have cancer, but is pregnant?

Part of the question is medical: If it’s an early and slow growing cancer, and she is halfway through the pregnancy, let her deliver and then treat the cancer. So, for example, if you have an early cancer of the cervix of the womb, you let her deliver.

If the cancer can be treated surgically, you treat it surgically: although usually you wait until the baby is “formed”, i.e. past 12 weeks and has all his fingers and toes.

But for Radiation and Chemo, it depends. Both can kill the child. So if the cancer is fast growing, you advise abortion and then treat. But if mom is near delivery (past five months) you usually can wait until after delivery. For most doctors, Moms count more than babies, especially if the moms might not make it to the point to deliver a live kid.

Well, what about people whose religious values don’t allow abortion? Let’s examine Catholic ethics (and I use the example of Catholic ethics for two reasons: One, I am a Catholic, and two: everyone knows that Catholics are strict pro lifeethicist, so their arguments are probably valid for other Christians).

Well, Catholic ethics says you can’t abort the child, but you can treat the mother even if the treatment will kill the child, using the principal of double effect: if you do a good deed, and it has a bad side effect, it’s not the same as doing a bad deed for a good reason.
Splitting hairs? Well, maybe. But it’s like the concept of collateral damage: Not a good thing, but if you are shooting a really bad guy, and there is risk to his hostage if you shoot him, but a greater risk to the public if you don’t shoot him, you shoot him.

Yet in this case, the mom chose not to have her chemotherapy for her leukemia. Adult leukemia often kills quickly, and even with treatment has a lousy cure rate unless you can do a bone marrow transplant, so I would advise her to get immediate treatment, knowing that her chances of living long enough to deliver were small.

But Sharnell Onaga chose life, and chose the increased risk of death to herself that the baby would live.

And Someone Up There must have approved, because her leukemia went into remission, and she indeed delivered a healthy baby girl in December.

And at that point, Sharnell Onaga started her chemotherapy to put her leukemia into remission, while waiting for a bone marrow or Umbillical cord blood stem cell transplant.

Mrs. Onaga, you see, didn’t just feel sorry for herself. She used her own case to publicize the need for people to join bone marrow registries and to publicize that their child’s umbilical cord blood could be frozen and stored in case that person or family member needed stem cells in the future. This registration requires only giving a sample of blood, and signing a card that you are willing to be used as a donor. The greatest need for donors is with minorities, which is why many Native American tribes sponsor booths at ceremonies to register potential donors.

Sharnell Onaga never did find anyone whose bone marrow was close enough to her own for the transplant to be done, so Mrs. Onaga died from her leukemia.

The irony is that in retrospect, the “smart” choice of treatment and abortion would probably not have saved her life, only prolonged it.

But because Mrs. Onaga chose life, she has a twofold legacy.
One, her daughter lives.
Two: thanks to the publicity from her story, there will be an increased awareness of the need to that bone marrow and cord blood can save lives.

A good life giving legacy of a great lady.
The National Marrow Donor programLINK describes how to join the registry and how to donate your baby’s cord blood.

This story has links for donation toward her children’s education.
Nancy Reyes is a retired physician living in the rural Philippines with her husband. Her website is Finest Kind Clinic and Fishmarket, and she writes medical essays on Hey Doc Xanga blog.

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