Occasionally, unfortunate babies are born with organs missing from their body. The technical term for this is agenesis of the organ. A rare example is lung (pulmonary agenesis) which is often associated with other malformations. The baby whose X-ray appears in this picture was born with the right lung absent. The left lung grew slowly over time to fill the space of both lungs and fortunately functioned close to normal.
In the early phases after birth, care of a child with severe congenital abnormality needs to be intensive. Over time, as the alveoli of the lungs multiply, the need for intensive care declines. It may take up to four years to allow a child to leave the continuous care of a hospital to be managed in the home environment. A big problem with long term hospitalisation for children is lack of educational care and socialisation (these services are highly variable; excellent in some places and poor in others). Educational and health care services can be disconnected impacting negatively on health and development of the children.
Such children with complex congenital abnormalities raise highly controversial philosophical issues;
– Should they be subject to maximal treatment despite the severity of their condition?
– Should they not be treated at all, especially where the prospect of survival is poor? This situation is already complicated because when those infants who have not been treated on the assumption that they will die sometimes survive, their prognosis is bleak, quality of life much poorer than if they had been treated in the first instance.
– Further, if a determination is to be made whether to treat or not, who should take the responsibility? – – The physician? The parents? Responsible legal bodies? These are some of the hard questions faced by carers every day.
The image contains three chest X-rays from this baby superimposed on three predominantly blue pictures; sky, sky reflections and water reflections to provide texture and colour. The filters interact to give a melange of colours to excite the eye. I have also tried to give an impression of movement and growth using swatches taken from reflections on the water.