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March 11, 1988

A Dip in the Pool

Author Affiliations

Kankakee, Ill

Kankakee, Ill

JAMA. 1988;259(10):1496. doi:10.1001/jama.1988.03720100018016

To the Editor.  —As a member of the pediatric house staff, Dr Marion1 was faced with a complex situation involving an impoverished 11-year-old girl, pregnant by her older, teenage brother. The issues raised by this situation include incest, teenage pregnancy, poverty, abortion, inadequate prenatal care, child abuse, and others. Dr Marion has approached these difficult and frustrating, yet all too common, problems in a compassionate manner. However, he appears to have made two errors that warrant comment.First, he fails to recognize that for many patients abortion is not a morally acceptable solution to the problem he describes. Once that is made clear, it only angers and distances one's patient to continue to try to convince her to consider it. At that point, it is prudent to suggest other available options, such as adoption, and refer the patient to the appropriate agency.Second, there is rarely any justification for