Usually, when I read one of these common stories about people denying themselves reasonable medical care for religious reasons (such as the Jehovah Witness’s proscription against blood transfusions, or the Christian Scientist’s insane denial of illness altogether), I find myself siding with the doctor trying to overcome their foolishness, rather than the deluded theists. This one is an exception.
To make it short, a Jehovah’s Witness couple are expecting twins; one of the twins has a circulation defect that prevents pulmonary circulation, meaning it would suffocate to death as soon as it was born and needed to breathe air; they refuse any surgery to correct the problem; doctor gets a court order, operates at birth against the parent’s wishes, and saves the infant.
I think the doctor was way out of line. This is a case in which the parents were fully aware of the situation and knew that the fetus would die at birth, and elected (for screwy reasons, admittedly) to not pursue extraordinary measures to save its life. They had not deluded themselves into believing medical intervention was unnecessary and that magic would heal the child, they had resigned themselves to its death. And until the child has enough self-awareness to actually want to live, I think that is a decision parents have to be allowed to make. If they want that particular baby, they should be allowed to elect to have major surgery, but if they don’t, they should be permitted to allow its condition to run its course, unless the outcome is likely to be survival with serious damage.
The cost of these medical interventions can be prohibitive, and it can be entirely reasonable to decide not to invest money and time into a fetus who has neither autonomy nor unique qualities, nor an individual personality to which the parents have attached their affection. Let them die. Let the parents decide, not a doctor.
The article cites a particularly horrendous case.
In 1990, for example, a woman named Karla Miller went into premature labor at 23 weeks of gestation in Houston. Because a child born that early has a 75 percent chance of death or severe disability, the husband chose not to sign a consent form that would allow resuscitation. But the neonatologist resuscitated the girl, who grew up severely retarded, legally blind, and quadriplegic. The parents sued the hospital for ignoring their wishes, but in 2000 the Texas Supreme Court ruled for the hospital. George Annas, a medical ethicist at Boston University, later attacked the decision in the New England Journal of Medicine, since “the court implies that life is always preferable to death for a newborn . . . no matter how unlikely their survival is without severe disabilities.”
I wonder if that neonatologist has since taken responsibility for the round-the-clock care and various expenses and stresses of that kind of affliction?
“And until the child has enough self-awareness to actually want to live, I think that is a decision parents have to be allowed to make.”
When does that level of self-awareness set in? And how do we know?
We don’t know, and there is going to be no hard, sharp line defining the transition. But a doctor’s medical training (or a priest’s training in superstition) gives him no qualifications to make the judgment call, any better than the parents. Let the people with the responsibility decide.
When you get a child who will, in all likelyhood, be either dead or handicaped to a level where it is unable to function, then who are the doctors, or anyone for that matter, to tell the parent that they have to get the child and nurse it for the rest of their lives?
The emotional and financial cost of nursing such a person is enormous, not just to the parents, but to any siblings or future children whose parent will struggle to provide for their crippled child. The parent who choose to take on this enormous burden are to be commended for their compassion, love, courage and sacrifice, but noone should ever be forced to take on that burden. Unless the state is prepared to fully provide for the unborn, handicapped child, then it should mind its own goddamn business.
If we democratically decide that no child should ever die when it could live, no matter how slim the chances of survival or how high the cost, then the state should be obliged adopt the child and pay all expenses if the parents refuse to have it.
Subjective. The doctor no doubt felt he had a moral/ethical responsibility to save the child. You could restate it as “Let the people with the most vested interest decide”, but then one might conclude that the child is the one with the most vested interest (in living). There simply is no easy compromise in this ideological divide.
Hopefully, as the child grows up, the parents will think back to the reason this child is alive in the first place (because the doctor ignored their religion-based wishes). Hopefully, they will love the child so much, realize that they can’t imagine living without them, and they will begin to question their religion that would deprive them of this child.
(Admittedly, many religious people would deal with this situation post-hoc by claiming that the doctor was doing God’s will in this particular case; allowing them to avoid raising doubts about their religion.)
, but then one might conclude that the child is the one with the most vested interest (in living)
If the child is capable of having vested interests that argument might work. But it wasn’t. So, just as parents decide everything else…..
But we generally agree that parents, doctors, and the State in general have a duty of care towards infants, even though they are incapable of having vested interests themselves. If not, infanticide would be legal.
When does that level of self-awareness set in?
(looks around, sighs)
Sometimes, never.
While I agree that overriding the parents’ wishes in cases where the child will be severely disabled is reprehensible, that is NOT the case with the twin in the featured article. His condition was entirely correctable, and he is, according to this account, a normal, healthy child, post-surgery. To me this makes a difference, but what makes more of a difference is the actions of the parents throughout this decision making process. They appear to have been ambivalent, at best, about the prospect of the surgery. It was not the surgery itself that they objected to, in fact, but only that it would necessitate a blood transfusion. They are depicted as hopeful–HOPEFUL–that some loophole could be found.
A physician friend of mine has related stories of JW’s standing ’round the bedsides of their ill and injured family members, wringing their hands and saying in loud clear voices “Gosh I sure hope this hospital doesn’t get a court order to do the procedure on dear old Dad here. I really really really hope that doesn’t happen to the patient down here in room 203!” and the like. The article suggests that this was exactly the case here–lip service was paid to this stupid religious tenet, an end-run play was called, everyone went home happy. The parents, therefore don’t strike me as having made any sort of decision, other than to leave the door open for the decision to be made for them. They seem delighted that such a solution was found, as they now have two healthy babies and no one in the family–neither parent nor child–has done anything ‘wrong’ in the eyes of their church. Not so out of line, IMO.
My stepsister was such a child… her parents were not JW’s, but she was born extremely premature. The doctors realized that if they could “save” her, she would be a record-breaking preemie and terrifically good press for them. So, in order to sidestep her parents’ strident objections, they went to court and had custody vested in the hospital somehow. The hospital promised to pay all of the costs of the “lifesaving” procedures, and apparently did so. However, their interventions left the child permanently blind, partly deaf, and profoundly retarded. She might have been retarded, they said, but it was the experiments that took her sight and hearing. Is “experiments” too strong a word? We don’t think so. If the baby died, we think the hospital would have considered it unfortunate that they didn’t make their precious record-breaking “save.” Anyway, the responsibility for the upbringing of a severely damaged daughter was transferred back to the parents when the hospital was quite finished.
This is a question of choice. The parent has the right to choose. I wonder, if we lived in country where pro-life laws were mandated, would the pro-lifers be so quick to save the child in this situation? You can’t have it both ways.
The problem, I think, is that if the parents have made a decision for stupid reasons then in real terms they haven’t made a decision at all: they’ve deferred the decision to arbitrary superstition. I’d rather a doctor took that decision any day. I think he was out of line too, but I think he was between a rock and a hard place and I don’t know that the opposite decision would have been any better.
I worry that this argument may lead to “these people shouldn’t be allowed to have children”.
PZ, I actually disagree with you on this. The parents decided that base don *their* religion, they had to right to refuse care to an already-born child, one who, if properly treated, would have no long-term repercussions. Only if the medical consequences of treatment were severe would the parents have a right to choose, on their infant’s behalf, to forego them.
Parents have to make most of the early choices for their children. The children can’t make them on their own. But this does not give parents carte-blanche; it means instead that they must treat the children’s interests as their own. The parents in question did so, to the extent that their religious views clouded their judgment. When this happens, the state is right to step in.
There is obviously a fuzzy line. If the parents wanted to refuse treatment that would merely prolong the life of a child for a short time, while increasing the pain the suffering the child had to go through, we would find that acceptable. If they wanted to refuse treatment that will leave the child with no long-term disabilities of any kind, allowing him or her to grow up healthy, we should not find it acceptable. It is grotesque, and it raises the parents’ (religious) self-interest far above the interests of the child.
I thought the intent here in this context was “legal responsibility,” since parents usually have such responsibilities. I don’t know if that’s right, but that’s how I took the original comment.
A newborn has an “interest in living?” A newborn is sentient, granted — but I wouldn’t start injecting complex interests to a newborn. The interests of a dog are more complex than the interests of a newborn.
Not the sole right once the child is born. Parents are generally required by law to provide appropriate medical care to their children, including newborns. In this case, appropriate medical care appears to have been a relatively well-understood surgery with excellent prognosis. It was opposed because such surgery violated the parents’ religious beliefs.
I really don’t see how PZ can come down on their side in this case. This is not about “saving” a child who will have poor quality of life — it is about doing a relatively standard procedure that will let the child live a normal life. And that procedure was opposed because the parents didn’t want their baby to get a blood transfusion. How is that rational?
Bob – we are talking about legal interests here, not the ones you list on your online dating profile. The interest of any healthy (or fixably healthy) newborn is to continue life, provided it is of sufficient quality. Otherwise anyone could kill their newborn children with no repercussions.
The “of sufficient quality” is where so many of these cases get tricky, however, in this particular case the indications were clear: the child should have been treated.
PZ – how closely did you read the article? The parents essentially agreed to the treatment under the condition that the “sin” be on the heads of others. So they wanted their child to have the surgery; they just wanted somebody else to be *technically* responsible for the decision.
Many such situations are unique with variables making a decision one way or the other seem the better. Without knowing the drawbacks to the procedure the doctor performed on the newborn, I find myself incapable of judging the actions. If the procedure would give the child a normal, healthy life, then I can’t say I can condemn the doctor in this instance. If the situation is such that the child simply survives and is severely handicapped, then that would change my opinion.
that child is going to have an awwwwwwkward conversation with his/her parents later in life
PZ, you have hit a topic of great interest to me. This clearly places the point of individual rights after birth. Would you agree that parents can choose to end the life of a newly born baby with no clear medical ills. Isn’t this the same situation at root?
I am fascinated by the choice of boundry you are placing on when an individual gains rights as an individual.
I would agree that in questionable medical situations the parents should have a strong position?
It’s so tricky. I mean, it’s not the same as abortion. In this case the kid was born. It had a chance to live if it had a surgery after birth. In this case it was an independant being, it’s not as if they performed a still-in-womb surgery. I think parents do not have the right to refuse a life-changing surgery for their children the second they come out of there. And they don’t say that the kid had any permanent damage afterwards (Or at least none that forbid a normal life?)
The second case is far more tricky. It’s life with serious deficiencies… I think the father made the right choice and the doctors spat on it. If we can refuse to allow ressusitation for our parents… why for a child that will suffer?
I disagree, PZ. I think the parents were monsters for refusing a medical procedure that could save their infant’s life. The doctor was completely in the right in this case.
Nor am I suggesting any such thing. I’m only certain that some might try to do so for ideological reasons, and thus the divide will remain.
“And until the child has enough self-awareness to actually want to live, I think that is a decision parents have to be allowed to make.”
I completely disagree. I don’t think a one year old has the “self-awareness to want to live”. However, if the child falls ill, parents shouldn’t have the choice to with-hold treatment if such a choice would result in the child’s death.
You also refer to the child as a fetus. And that the “fetus” would die “at birth”. However, the article states, “But shortly after birth, when the umbilical cord is cut, the newborn would suffocate and die.”
We aren’t talking about an abortion here.
I sort of see the case as similar to abortion. And the way I see it, the parents/mother should be able to relinquish any claim to the child and have it removed from her body. But they/she shouldn’t be able to directly condemn it death. If the Dr/Hospital/State/Adopting-parent wants to pay for the surgery to keep the child alive, more power too them. But they shouldn’t be able to compel the parents to pay for the surgery. In CA, you can drop an infant off at a hospital, police or fire station, no questions asked…why would this be any different?
@#23:
We’re certainly not. This is made quite clear by the fact that the child survived, outside the womb, for the entire time it took for all representatives and interested parties to gather, conduct their legal proceedings, make the decision, assemble the surgical team, etc. There were, it seems, effective and permissible (according to the Watchtower) means with which to sustain the life of the child temporarily while the decision was being made. I think it would have been extremely unethical to have taken the child off whatever support treatment was used during this interim period and allow him to die when a proven medical treatment was available that could restore normal cardiopulmonary function with no long term disability.
I do not concede a human right to life automatically on individuals that merely have a genetic connection to human beings — and that means I think there is a legitimate argument for a humane form of infanticide. (Yes, I know — a lot of people gasp in horror at the very idea.) There is no bright clear line between unaware and aware, dependent and autonomous, and birth itself does not represent a magic boundary; there’s a lot of blurry shades of gray in there, and fair arguments can be made on either side.
Even a one year old might not be out of the gray area yet (although, personally, having known several one year olds, I’d give them the benefit of the doubt.) Remember, there was a time when parents might take a few months before getting around to naming a baby, because the infant mortality rate was so high that they were careful not to get attached until they were old enough that there was some surety of survival. I think we concede too much when we simply bestow the privilege of personhood on any incompletely differentiated blob with 46 chromosomes.
I disagree.
There’s no way to tell the future of a human being.
Suppose, that you knew that Stephen Hawking is going to suffer from amyotrophic lateral sclerosis before his birth. Would you advocate aborting the pregnancy?
Probably, you would. And the world would have lost the brilliant scientist in this case.
“We don’t know, and there is going to be no hard, sharp line defining the transition. But a doctor’s medical training (or a priest’s training in superstition) gives him no qualifications to make the judgment call, any better than the parents. Let the people with the responsibility decide.”
This begs the question. First you imply that the parent’s right to decide ends when the child has sufficient self-awareness to want to live but then you seem to say that there’s no way to say when that happens and neither doctors nor priests are qualified to make a judgment that the right has ever ended. There’s a helluva(n) argument that a five day old full-term infant has no such awareness, and your reasoning would then justify infanticide. I’m sure you didn’t mean that, but I don’t see how a doctor or prosecutor could decide when it is or isn’t based on your formulation.
You must be out of your brilliant mind.
Count me as another dissent here. If the child doesn’t have legit interests of its own, why can’t parents just kill any infant? This reasoning makes them into mere property until they’ve crossed some imaginary line. I can see this if, like the other quoted story, their will be a severe mental impairment that will keep them from ever being a valid actor, but otherwise the line is way too difficult to draw.
“I disagree, PZ. I think the parents were monsters for refusing a medical procedure that could save their infant’s life. The doctor was completely in the right in this case.”
I think this is an odd position to take. The motives of the parents could be any number of things that they choose hide behind the guise of their religion. By concluding that the parents choice is automatically wrong and that they are “monsters” for making that choice is silly. You are simply placing your personal ideologies and emotions into the case and concluding that the parents are somehow evil or heartless.
One thing about the case is certain, when that kid hits 13 he’s gonna be one pissed off teen.
“Probably, you would. And the world would have lost the brilliant scientist in this case.”
and suppose we aborted Hitler……
“There’s no way to tell the future of a human being.
Suppose, that you knew that Stephen Hawking is going to suffer from amyotrophic lateral sclerosis before his birth. Would you advocate aborting the pregnancy?
Probably, you would. And the world would have lost the brilliant scientist in this case.”
If only the world could run off Post Hoc.
Sorry SirEdwardCoke I can’t resist…
http://begthequestion.info/
I can’t help it. It’s my pet peeve. Carry on.
PZ has spelled out an example of infanticide earlier, but I don’t have the link at the moment.
I would say that at what point that we give someone/something rights is basically arbitrary. We decide it based on our culture/religion/personal feelings etc etc.
Basically, I agree with this part of PZ’s point: “There is no bright clear line between unaware and aware, dependent and autonomous, and birth itself does not represent a magic boundary; there’s a lot of blurry shades of gray in there, and fair arguments can be made on either side.”
I would be curious to see what Wilkins’ take would be.
Oops, I’m an idiot with a stupid itchy trigger finger. Please accept my apologies. *creeps away*
Which makes it a lot like abortion. Keeping the child could cause great implications, whether it be the health of the child, the lives of the parents, or even their wallets.
Actually, it was less radical than abortion; this was simply a matter of letting nature take its course.
Still, someone should invent a Fetus Mindreading Device so we can determine the fetus’ opinion on things like this.
“Doctor, this woman is considering having an abortion. Shall I get the FMD?”
Now that would make for interesting news.
nothing like polluting the gene pool with defective genes.
I don’t want to shoot myself in the foot here, but I’ll open up that this is the perspective of a liberal pro-lifer…
The first case is different than the second. The first case only simply required a medical procedure in order to (presumably) live a perfectly normal life. No extraordinary measures had to be taken, and there was a great survival (with a normal life no less) rate. Would this situation be any different than a 3 year old? It is born, which for *most* pro-choicers is where personhood begins, where their legal right to life begins. The second case though is similar to a DNR in that it takes extraordinary measures that were against the parent’s wishes-and these apply throughout the time span too. When children are dying from a disease, sometimes it is best to let them go naturally, and there is nothing wrong with that. The claim that “at least it’s alive” is erroneous. There is a time to live and a time to die, whoever says that keeping the person alive is ALWAYS better than a natural death is absolutely mistaken. If extraordinary measures were outside of the parent’s wishes the court has very little room to intervene. I would ask for a different ethics board if I lived in that area.
Agreed. But that wasn’t my point.
Well I’m not sure where the legal precedent is for this claim. (I’m not saying it’s nowhere; I just don’t remember coming across such a thing in the way you state.)
But, aside from this, the argument that “it needs to have an interest, else we would be able to kill it” is simply not valid. The absence of an interest doesn’t mean that we can do whatever we want to it. (And the presence of an interest doesn’t necessarily mean it overrides.) There might be other, more compelling reasons for doing, or not doing, something to it — but not because it happens to be, or not to be, in its interest. We clearly have this view when it comes to artworks or the environment.
Don’t take any of this to be claiming that I disagree with your conclusion in #13. On the contrary, I actually think you’re right, and that PZ’s wrong on this. I just have a problem with the inferences.
a) The parents could choose to abort both twins at an earlier stage and this would be ok.
b) One was going to die naturally and it’s decided to stop this happening.
c) Euthanasia is not allowed.
B&C prevent natural death, whereas A prevents natural birth.
Dignity should be a human right. The parents should have the dignity of being able to choose to follow a natural birth* just as a human should have the right to a dignified death.
(* admittedly the JW reasons were whacko, but that’s beside the point)
Hence, PZ is right, although for secular ethical reasons, rather than the boundary-line reasons.
http://www.cnn.com/2008/HEALTH/conditions/03/12/pillow.angel/index.html
This story raises what seems to me to be the same issue. Who makes these decisions and how are individual rights maintained and honored – here when the individual cannot make the decision – as with a baby.
And I wonder if that neonatologist also supports increased social spending so that such people can be more easily cared for all their lives, reducing the burden on their families. My guess is that he doesn’t, since most Texas physicians I know of are overwhelmingly Republican/Libertarian and opposed to social spending.
@Wrought: Thing is, I think the kid did have a natural birth. It was when the cord would be cut that it would suffocate. And there was a way to save the child and have it lead a most likely totally normal life.
So why not? I believe it’s a moral duty to try to make sure the kid survive. When it’s in the body of the woman, it’s her business, when it’s out, it’s very different.
In the 2nd case the kid would be defficient… So it makes my heart bleed for the 2nd brat here. I think it would’ve been better to let it go.
I think this is one of those rare occasions where unsound reasoning applied to faulty premises manages to produce a conclusion which is nonetheless right. Even a stopped clock is showing the right time twice a day.
Sometimes, there are no obvious boundaries; every case has to be judged on its own merits. In an ideal, rational world, people’s feelings would be considered strictly in accordance with their interest in the outcome (i.e., the views of assorted rabid pro-lifers who aren’t going to be the ones giving birth and having to look after the child wouldn’t count for as much as those of the mother), but we humans are irrational creatures by nature and our emotions tend to get in the way.
Well, this was a once in a century thing for you, PZ.
If this had taken place 50 years ago, 60, even 100 years ago, there would have been no way to save this fetus. And from the sounds of it, without reading the article or knowing the family’s history, this is a genetic mutation/condition and thus with the doctor, using the law to step in where he shouldn’t have, is helping to propogate genetics that should have not been passed on.
Several respondents seem to let an almost vestige of
religious emotionalism, though not consciously admitting
to this, of equating a life or death situation with the
idea that all life is sacred. Life is not sacred, as this
can be demonstrated throughout human history and is only
quantified by our repulsion to interfere with matters of
life and death. Leave the question of the sanctity of life
to it’s religious adherents, and not to sensible human
beings who can reason on a higher plane and not let their
emotions dictate the outcome of theirs or others decisions.
To many of you,PZ’s opinion is akin to heartlessness and
future grief, but I agree and respect his stance and laud
him for expressing it so honestly and without agenda.
“There was a way to save the child…”
And if it had not worked? ALL medical procedures carry risk. So, if you are saying that we OUGHT to save the child, how about you stepping up to take care of the ones where it didn’t work out so well?
Pardon me for being rude, but I think that the people who are going to have to eat the s**t sandwich had better be the ones deciding how it gets made.
The genetics thing isn’t as clear cut as all that. The article states that they were monozygotic twins, i.e. genetically identical. One twin appears to have been completely unaffected by this structural problem, making me think the defect is probably something downstream of gene expression. Even if it is a genetic defect, it isn’t a particularly penetrant one, as evidenced by the unaffected twin. Moreover, even if the effective child had died, his twin (who also carries the faulty genes, if it is indeed genetic) is free and clear to reproduce. There have been some thought provoking arguments against medical intervention in this case, but the argument from eugenics isn’t one of them.
Sometimes it happens, but I find I’m in disagreement with PZ on this one. Reading the article, it is clear the parents had no desire to let their child die, but were hamstrung by their idiot beliefs. Everyone involved in this decision (even the JW liaison) sought whatever loophole was available, and lo and behold one presented itself, which tells me more about the fallibility of Witnesses and their idiot beliefs than anything else.
My position is pro-choice, but I cannot see what PZ suggested for this particular case as being anything other than infanticide: The child, following a routine operation with a high success rate, is likely to have a completely normal life (albeit, as MLF @ #18 said, an extremely awkward one later on when he discovers this article and understands what it could have meant). This case is nothing like the one discussed with the child ending up severely retarded, blind, and deaf, and is the reason why the doctor who wrote this article chose to include it: The reverse decision in that one would have been more humane had the doctors not chosen to go for the glory.
I’m just sorry that PZ has such a dim view of what constitutes a human being (“I think we concede too much when we simply bestow the privilege of personhood on any incompletely differentiated blob with 46 chromosomes.”). This baby was by no means an “undifferentiated blob” as PZ suggests, but a child with a fatal, but easily correctable, birth defect. (And for genesgalor @ #38: I’m sure PZ would argue that the genes themselves were not defective, but rather the defect was in the development sequence. Otherwise BOTH twins would have had the defect, you twit.)
I see that the “pillow baby” example has been broached (George @ #42), and I feel this is another matter entirely: The child was normal at birth but her neurological development stopped for whatever reason. This could not be foreseen, and the decision to have her surgically altered deserves none of the wailing, hand-wringing and rending of garments that have been presented in the media. The parents chose to save their child the pain, frustration, and terror of having no idea what was happening to her developing body. This child was never ever going to have a normal life, and the idiots that have accused the parents of denying her one are themselves the ones in denial.
And John @ #48: Everything carries risk, even supposedly normal childbirths (see above). Yours is a flawed argument, moreso since it is clear the risks of the operation were minimal.
That’s my two cents…
Whatever happened to, “Primum non nocere?”
“Since at least 1860, the phrase has been a hallowed expression for physicians of hope, intention, humility, and recognition that human acts with good intentions may have unwanted consequences.”
I’m a little torn. The first case does sound like a pretty simple procedure being objected to for only non-rational reasons, and allowed by non-rational responses. A truly hard call. I’m glad that the kid lived, but if it had been allowed to die I wouldn’t want to see charges pressed.
The second case is altogether wrong. I understand the blind, ignorant passion that some people have for preserving life at all costs-this same urge has helped us along the way to great achievements in medicine. But in a case with a bad prognosis, the doctor was way out of line and should be punished. The only fair remedy would be to have the doctor and hospital help pay for the child’s needs, but of course the suit was thrown out. I say of course, because there is no way that authoritarian moralizers will ever be held accountable
for their abuse of other’s rights in Texas.
Petty things like responsibility and accountability are just for us poor sinners, not some beacon of god’s love like this busybody doctor.
You who think that a potential parent should have their rights stripped just because they don’t feel the life-preserving urge as strongly as you, I really think you should resist that urge and learn to mind your own a bit better, unless you really feel like sharing in the responsibilities. You can vote for universal healthcare or help raise millions in charity money, but that’s just a drop in the bucket. Better kick in some cash yourself,
for the lifetime of medical expenses. Help out with the years of bathing, asswiping, lifting from wheelchair to bed. Help with the endless feeding and training that will go on for decades without improvement. Give up the rest of your functional life to care for this human that you just had to save.
Otherwise, you are being a sweet, sentimental, and completely useless and despicable hypocrite!
I agree with PZ. The parents chose abortion and the doctor was out of line intervening. Even if they made the choice for all the wrong reasons.
I’m really torn on this. End of life issues have been quite a bit on my mind, since I lived fairly near the hospice where Terri Schiavo was facing her end of life issues. I strongly object to interference in the legally responsible party’s choice, be it husband, parent, or health care surrogate. I hope I never suffer because someone over-rides my own health care surrogates decisions.
In the second case, what happened was awful, no doubt about that. Having raised 4 kids with varying handicapping conditions, from moderate to severe, I know how destructive that can be to a family, and the huge financial and emotional burdens. In my case I was lucky, my kids improved in functioning over time, but that isn’t always the case. Also in my case, if I’d taken the advice of the doctors (or they had obtained a court order), my little Tay never would have likely been dead.
On the other hand, I’m acquainted with a woman whose abusive husband almost killed her in car crash he engineered. At the hospital, he signed orders to deprive her of treatment, and if her other relatives and the doctors hadn’t stepped in and done something, this lovely lady would be dead today (yes, the now EX hubby did hard time). …oh, and she is very pleased to be alive.
We also have laws protecting children from medical neglect, and I think that’s necessary also. I’ve met enough parents who’d rather spend their money on a bottle of vodka than the bus ride to get their kids vaccinated.
The problem in my mind is that there are so many places where these issues overlap. I don’t think it was right for the JW parents to deny their child medical care on the basis of their religion (that was obviously a foolish reason to deny their child care. I don’t think it’s right for the doctor to have made the decision for them, since they ARE the legal caregivers for the child and should make choices in the best interest of the child.
PZ talks about age and interests. At what age should you legally not be able to deprive a child of medical care? Right now it seems protections and rights come with birth. If we assume an infant isn’t a full human with interests and rights, what protection do infants have under the law? If a baby-sitter strikes an infant and kills him, is that murder? Or doesn’t it matter because the baby isn’t old enough to have interest in his existence?
Finally, what makes you assume that the JW parent’s weren’t attached to their child or that the child is unwanted? Remember, they believe that they will have their child forever in eternal life on New Earth if they allow this “first, earthly death” where as allowing the doctor to operate will mean they will likely never be reunited.
I typically agree with what you say PZ but this post struck me as pretty cold. It seemed to be a pro-abortion argument really. And that’s fine, but this isn’t abortion.
Letting an infant die of suffocation after birth makes me cringe. That’s like allowing your child to die of starvation by not feeding it, and then saying “hey, nature took its course.”
I’m not saying the Doctor had any standing to do what he did. I’m just saying that it’s pretty messed up that the parents were willing to let their child die like that.
oops. that’s what I get for not proofreading. Tay never would have lived, or would have been dead… not “never would have been dead”
@John #48: If it wouldn’t have worked the kid would’ve died. What’s the problem? You try to save a kid, the kid had good chances of living, and have a normal life. Hey, do it. It’s out of the womb. It was NOT an abortion, it’s deciding over the life of a 100% formed child that came out of the womb! The parents wanted the kid to die while it was out there, available to be saved! That doesn’t work. Sure it got a surgery on its first day of life, but so what? It’s out there, they had the tools to fix it! And I hope that child will live a long and successful life.
That kid will have a story to tell.
No, that case IS NOT IN ANY WAY like abortions.
Aborted fetus can not survive, with or without medical support. You cannot save it.
However, in this case the potentially viable baby was extracted. And there was a possibility that it can develop into a normal human being.
That’s the difference. We must preserve life whenever it’s possible.
PS: I support abortions.
It’s a tough call. My grandfather grew up motherless as a result of religious considerations overriding simple medical considerations, which I find reprehensible.
PZ, I agree with your last comment more than with your original post. While there is no magic line, but rather a gray area encompassing “personhood”, and while we should respect parents as the best arbiters of true health dilemmas facing a non-autonomous newborn, that does not mean that dancing around religious loopholes is an acceptable legal or medical practice.
As others have said previously, it sounds from the article as if the parents are happy with the outcome of this low-risk medical procedure, provided they and their community are able to absolve them of moral responibility. This is not a fair consideration morally, medically, or parentally. If they are unwilling to accept responsibility for the decision, they are attempting to abdicate their parental responsibility, and that is precisely the situation in which the state ought to override. Were this a high risk procedure, my opinion would be otherwise. Were the child older, my opinion would be stronger. There are many borderline issues here, but to allow parental superstition to override child welfare is a dangerous precident.
I see an argument for universal healthcare in this thread.
I don’t think that was genetic. I think his batshit insane father is to blame for a lot.
Yay! A living, breathing eugenicist! :-D
And another! Wow. I had no idea so many eugenicists were left.
What makes you think the lack of pulmonary circulation was genetic? I bet it’s an issue of regulation in development: the other twin suppressed the development of pulmonary circulation anywhere too close to his own. It’s fairly common that one twin of two has all internal organs in mirror-image.
Eugenics is ignorance.
Naturalistic fallacy. :-|
I see an argument for universal healthcare in this thread.
I don’t think that was genetic. I think his batshit insane father is to blame for a lot.
Yay! A living, breathing eugenicist! :-D
And another! Wow. I had no idea so many eugenicists were left.
What makes you think the lack of pulmonary circulation was genetic? I bet it’s an issue of regulation in development: the other twin suppressed the development of pulmonary circulation anywhere too close to his own. It’s fairly common that one twin of two has all internal organs in mirror-image.
Eugenics is ignorance.
Naturalistic fallacy. :-|
Taking me out of context David?
That was just my ,perhaps poor, attempt to counter the “what if they aborted Hawking” illogic.
I am pretty fucking far from a eugenicists.
Nope. Hitler was a perfectly viable and healthy baby. There was no reason to abort it.
However, in Hawkins’ case there _is_ a medical reason (genetic disease, diagnosable before the birth).
Again I thank you, PZ, for eloquently voicing my own thoughts on this issue far better than I could. I agree with you 100%, although I think the idea of “acceptable infanticide” is a complete public non-starter. And aside from any emotional hard-wiring we have on this idea, I do wonder if there aren’t other indirect negative consequences to the adults involved, socially or psychologically speaking. I’m open to arguments.
One argument I’m not open to, however, is the “You just euthanized Hawking” argument. It seems to me this is arguing that what something MAY be is in some sense actual, real and present…that to abort (or euthanize) a fetus is in some genuine sense to kill the adult it might have been. I’ve yet to hear a good defense of that proposition. On the other hand, if it’s merely an argument that the “opportunity cost” of the practice outweighs the benefits, I’d say the Hawking argument easily fails, unless perhaps we could demonstrate that humans with his affliction tend significantly toward his genius.
And yes, I know that nearly all of us, myself included, chuck the cost-benefit perspective out the window when it becomes too personally uncomfortable. I guess we have differing thresholds for that one. Though I wouldn’t be surprised if I dropped it the second it was my infant we were discussing.
No. You don’t get it. There’s no way to save fetus’ life when you abort it. Personally, I don’t have problems with that.
Also, I don’t have problems with letting a fetus die if it saves the life of a pregnant woman during childbirth.
However, it WAS possible to save the life of a newborn without adverse effects for woman. That’s the crucial difference. In this case all measures must be undertaken to save child’s life, no matter what parent’s believes are.
Of course, it is also the parents’ right to give this child to orphanage or foster parents.
No. You don’t get it. There’s no way to save fetus’ life when you abort it. Personally, I don’t have problems with that.
Also, I don’t have problems with letting a fetus die if it saves the life of a pregnant woman during childbirth.
However, it WAS possible to save the life of a newborn without adverse effects for woman. That’s the crucial difference. In this case all measures must be undertaken to save child’s life, no matter what parent’s believes are.
Of course, it is also the parents’ right to give this child to orphanage or foster parents.
Oh, by the way people with ALS doesn’t tend to be geniuses. However, they tend to die young and have horrible lives.
BTW, you come awfully close to eugenics with your arguments.
It’s monumentally ignorant to assume that all people who are mentally retarded and disabled have awful lives and therefore shouldn’t be given the chance to live.
I would call this a case in which reasonable people can disagree. That said, I have to chime in with the many disagreeing with PZ’s position here — “first do no harm” is indeed a guiding principle here. If you get an object from the store with a single loose fitting (a knob or whatever) and it is easily repaired, do you take it back on general principle or do the simple fix and go as if it had arrived in perfect condition? (My mother would do the former, but she seems to have buyer’s remorse about almost everything.) Religious beliefs aside, it would be unconscionable in my opinion for a doctor to let an easily-repaired medical condition to kill a child before it has a chance to live.
Now that I’ve likened a child’s life to a toaster, I wish to acknowledge the opposite point — that of the damage wrought by trying to save a severely pre-term fetus. Yes, it is not always good, but there are also success stories. Two of the McCaughey septuplets have cerebral palsy, but they live as normal lives as possible under the circumstances (even if the smallest, a girl, may never walk). And in my personal experience I’ve met two people — one the next door neighbors’ granddaughter, the other a friend of a cousin of mine — who were severely pre-term. The little girl has hearing loss in one ear but seems destined to be the sort of independent and fearless young lady that gives anti-feminists conniptions, while the other, though profoundly deaf, lives a fairly normal live and has an extremely hot (hearing) girlfriend.
So unless serious disability is a given, IMHO it’s a gamble that must be made.
This strikes me more as a ‘slippery slope’ argument.
In this particular case it was a routine procedure with low risk and high benefit. Next time it might be a physician of a different persuasion who may decide that its “life above all else” and perform High risk low benefit procedures where the child would be technically alive but never really have a chance to ‘live’.
This is one of those cases that cuts both ways and it makes me very, very nervous.
Personally I’m a bit miffed that parents would rather let their infant die rather than take a low risk, high benefit procedure due to their back asswards superstitions. But there is no cure for stupid and humans are flawed creatures on many levels and we simply have to accept that or go mad.
I do wonder how they intend to hide this story from the child as he gets older. Once it appears on the internet it is there forever (hail google cache) and chances are pretty good he’ll run across it one day.
The other issue PZ brought up is ‘forcing’ the parents to deal with a lifetime of care, bills and emotional distress. Again, no one (let alone the state) should be allowed to force that on anyone. And this is were the even trickier part of the equation lays.
What if a simple, yet expensive surgery would repair all the damage but leave the family bankrupt and unable to support themselves?
What if it were an inexpensive procedure but it would require a lifetime of care? Or necessitate one parent quitting their job and solely tending to that child for the next several years?
While horrible positions to be put in, those sort of situations can ONLY be decided by the family in question. People always ‘say’ they will be there with time, money, etc to help, but how many come through in the end?
*shrugs* its just not a good situation anyway you look at it. But if it involves my child ‘I’ want to be the one making the decisions and not have to defend myself to a legal court or the court of public opinion. It is a difficult enough decision to make and live with.
I have to disagree with PZ on this one. My thoughts on reading the article were that the parents were perfectly happy with this loophole in their religion. They have some crazy idea that consenting to save their son would have been an unforgivable sin, but it’s okay if the decision is taken out of their hands. The JW grandmother asked for the judge to save her grandson (and, yes, I realize that “save” could refer to his soul or his life, or even both).
I think DanioPhD (#9) and Jane E. Valentine (#13) summed up my thoughts on this very well.
I do actually agree with you on a lot of your other points, including the gaspworthy one you made at #26. This was not a case of going “against the parent’s [sic] wishes.” Their wishes were that their son be saved, and the doctor did that. The hospital lawyer found that loophole whereby the surgery could be performed using donated blood and yet the parents remain sin-free. I think that’d be an interesting conversation with Jehovah.
Whatever I may or may not be getting, Alex, you certainly are failing to get MY point. Theoretically, I don’t give a damn about the newborn’s potential quality of life or the fact that it was out of the womb vs. in. Theoretically, I don’t think a few months and trip to the Fetus Frightening Room ™ change a fetus you don’t have a problem aborting into a child we must take all measures to save. As PZ says, this is about the (in my opinion) fact that birth is not a magic boundary.
Alex, Erica, I’m well aware of the ethical minefield this is. When I’ve already pointed that out once, why would you think I don’t know this touches on things like eugenics and disregard for the disabled? Just because I disagree with you?
What difference does the risk make if the alternative is death?
BTW, I wouldn’t use words like “never really have a chance to ‘live'”. We may soon have enough technology (like direct neural interfaces) to let even quadriplegics live more normally.
That’s up to parents. They can give their child to orphanage if they can’t support him.
Alex,
Coming from the medical field QUALITY of life is VERY important. We have the technology to sustain the human body nearly indefinitely but it isn’t always a good idea to do so.
Sometimes death is simply a better option for the patient and their families. (think of cancer, severe MS, CF or a host of other diseases)
The ‘life above all else’ mentality isn’t a particularly healthy one.
That being said, YES our technology is advancing at a remarkable rate and something that was incurable 5 years ago MAY be curable next month. But forcing a patient or their family to endure pain or burden for that (unknown) length of time for the slim possibility that ‘something’ may come along? I find that a bit cruel.
The blood transfusion prohibition by the Jehovah’s Witnesses is a deadly MAN-MADE dogma that kills people.
Watchtower plays God with what PARTS of blood can be used by followers.This playing God with life is why the Blood transfusion dogma is WRONG.
God Bless the red Cross
The Biggest issue with the blood supply is there isn’t ENOUGH DONORS.
Patients like Jehovah’s Witnesses DO use the blood banks for their various blood ‘fractions’ but refuse to donate themselves.
Jehovah’s Witnesses allow blood components but they are too brainwashed to realize that there is no difference between taking components and taking transfusions. They say that blood should be poured out and then they take products of blood.
Can you see the hypocrisy? Why will they take blood and not donate it? If they are going to ban it, they could at least ban all forms!
It’s just like not being allowed to eat a ham sandwich but you can scrape the mayo off the bread and eat it, eat the ham, eat the cheese and eat the bread but not all in the same bite.
And what if a certain Georgian peasant woman pregnant with a child that probably wasn’t her husband’s decided to have an abortion? The world would never have heard of Stalinism.
In other words, that stupid, pointless, irrelevant argument works just as well in reverse.
nothing like polluting the gene pool with defective genes.
Nice. If that were the prevailing attitude, I wouldn’t exist. My father was type I diabetic, and on your argument, should not have polluted the gene pool, and wouldn’t have reached sexual maturity. I’m not diabetic, but I guess I still carry the ‘pollution’ recessively or something.
On the bright side, being an atheist, the ‘I wouldn’t exist’ premise doesn’t bother me at all, for reasons most here would find obvious.
Maybe the loophole works out well for people who want to take advantage of it, but what about everyone else for whom said loophole screws. I completely understand the outrage at defying someone’s wishes and then sending them the bill. What this is really an argument for is socialized medicine. Yes, the rules as PZ sees them would leave children at the mercy of their parents, but thats our society as its currently set up, not giving a shit about anyone else but ourselves and our own. If thats not how we want it, we need to pay to have a say in other people’s care. As long as hospitals and doctors send individuals the bill, they have to do what those individuals say, and if they want to intervene, eat the cost.
Are we running short on people or something? Geez. I hadn’t realized the war was that bad.
Performing medical procedures on a non-consenting patient? What is this, House?
just wow! that is singerism at its finest ( worst, most absurd, what ever… ) unless you can’t actively defend your right to live, anyone can let you die, prevent others from saving your life, or just kill you . In short, you don’t count as a human. You are just chattel.
It is pretty sad that PZ agrees with that crap
It is pretty sad that PZ agrees with that crap
hmm, if you are basing this on #26, I think he is just extending a logical argument. the only position he is really arguing is:
Let the people with the responsibility decide.
meaning that he feels it should essentially always be the parents responsibility to decide, not society, not a doctor, etc., provided they are of sound mind to make such a decision.
whether one wants to extend how far chronologically the parents get to decide is what he was talking about in #26.
now, there is plenty one might argue with that position, but I think the list of arguments you listed is your OWN extension of what he said in #26, not what PZ himself said.
Well, I guess that this means the Jehovah Witness’s will have a hard time with pro-life Catholics.
I agree with PZ on this issue, and am slightly pleased to find that there are people willing to admit that they hold such views. I think that, if the child were going die through natural means, it should be the parents’ choice to elect to have a life saving surgery or not. (I do feel that infanticide is quite a different issue though.) Especially if there is even the slightest chance that such a condition could be genetic, I see nothing wrong with letting nature take its course. A lot of resources go into raising a child, and parents should be able to make the best choices they can to insure that their offspring have the best start possible in life. (Otherwise the parents would be forced into pouring resources into offspring that, in the long run, would clearly not be good avenues for passing on their genes -not that this is the only reason for having children.) In both of the situations mentioned it should have been the parents’ choice to decide whether to have the surgeries, regardless of the reasons that prompted them to make their choice. I also think that the idea that the parents in the first case wanted their children to have the operation but could not ask for it, is a ridiculous reason with which to argue for performing the surgery. It is not society’s job to save people from the evils of their own religious beliefs. Let people act according to their own convictions. In such cases as these, I believe we should trust parents to decided what is best for their families and place the responsibility for making such difficult decisions on them and not society.
I just want to say that this is a topic that can often get really heated in debate. Its an issue that involves emotions as well as facts and with any of this type of topic ( euthanasia, abortion etc etc ) it can, and often turns nasty in the exchange. HOWEVER, Pharyngulites I think have done PZ proud here. I have read different points of view, different angles and rational arguments that have teased out issues on both sides. Nowhere has any resorted to heated emotional name calling or ridiculous statements. Without wanting to sound patronising, well done people!
well. that was exactly what I meant. If your parents can decide to do to you what ever they want, your are not their child any more. you are their w property
If your parents can decide to do to you what ever they want, your are not their child any more. you are their w property
noooo….
that is an entirely DIFFERENT argument.
the argument here is WHO should decide your fate, if NOT your parents.
Insanity can be found in a government body just as easily, or moreso, than any two parents. Who would you rather have decide the issue for your kids?
are we on the same page yet?
are we on the same page yet?
yuck ! Framing detected !
So you try the old good complex question fallacy ?
you frame the question in such a manner that implicitly assumes
that responsibility means exclusive right to do what ever you consider right
, and then presents a false dilemma between granting such “responsibility” to the parent
or to someone else thus depriving the parent of it because it is exclusive.
But that is not responsibility for a child. That is ownership.
“I do not concede a human right to life automatically on individuals that merely have a genetic connection to human beings — and that means I think there is a legitimate argument for a humane form of infanticide.”
This isn’t a case of “individuals that merely have a genetic connection to human beings.” Every living creature on this planet has a genetic connection to human beings, as we all share certain genes. You yourself have pointed this out more than once.
Infants (be they sick or well) do not “genetic connection” with human beings. They are human beings. Allowing for variation between individuals, all humans have the same genome, regardless of age. Infants is not genetically different from adults. You’re born with this stuff, as you obviously know.
This statement is honestly alarming to me, PZ. It’s bad science, it’s dishonest, and it reeks of dogma.
Let’s try this without quite so many typos:
This isn’t a case of “individuals that merely have a genetic connection to human beings.” Every living creature on this planet has a genetic connection to human beings, as we all share certain genes. You yourself have pointed this out more than once.
Infants (be they sick or well) do not have a “genetic connection” with human beings. They are human beings. Allowing for variation between individuals all humans have the same genome, regardless of age. Infants are not genetically different from adults. Your genes don’t change with your voice.
This statement is honestly alarming to me, PZ. It’s bad science, it’s dishonest, and it reeks of dogma.
T_U_T said:
The only problem with this argument is that a baby is not really in a position to decide anything for itself is it? Making tough calls on behalf of a baby is part of what parents are for when the child is at such a young age. Thus, although I agree that the parents in this case made their call for dumb reasons, in principal I would support their right to make whatever one they felt was best in the circumstances.
The only exception to this rule that I can think of for a baby at this age is when parents make decisions that cause unnecessary pain and suffering to the infant. It may be arguable that this decision may fall into this category, (I can’t imagine that suffocating to death is a very pleasant experience) which would be my only reservation about acceeding to parental judgement calls in this case. However, since I don’t believe that either the parents or the doctors were sadistic monsters, surely they would not have objected to doing the uttermost to ensure that the child would not suffer during it’s brief life?
Ted said:
Point taken completely. Such decisions as PZ was blogging about should be taken on the basis of informed patient and/or parental consent, not someone else’s opinion about who is or is not “fit” to contribute to the gene pool. Eugenics was bad enough the first time around, no one wants a repetition!
Bride of Shrek #85
You are quite right about all the very well presented points of view. This thread has given me allot to think about.
Next time some idiot troll calls us all sheep just point to this thread.
human DNA is as common as snot. with 6 billion on a planet made for 2 billion, it’s past time to wise up.
“There is no bright clear line between unaware and aware, dependent and autonomous, and birth itself does not represent a magic boundary; there’s a lot of blurry shades of gray in there, and fair arguments can be made on either side.”
“And until the child has enough self-awareness to actually want to live, I think that is a decision parents have to be allowed to make.”
So birth is not a magic boundary but “want to live” is?
Are there “magic” boundaries at all?
There are no magic boundaries for meat in motion. Might makes right. One 46 chromosome lump of electrically animated meat has the “right” to do to any other electically animated lump of meat (with however many chromosomes) WHATEVER it wants, WHENEVER it wants.
A series of electrical impulses has no more inherent value and deserves no more respect than an electronic circuit board (which this 46 chromosome lump of meat can smash whenever it wants).
I have to disagree with PZ on this one, as I see quite a few others have. I just hope he doesn’t assert Atheist High Priest infallibility and force us to agree with him ;)
To me, in some senses, it smacks of a post-birth abortion – I’m certainly pro-choice, but legally the point of having an upper limit on the time when you can have an abortion is because the foetus is counted as a bit more than just a bundle of cells at that point. You may argue about whether you think that should be true or not, but it’s certainly the current legal standpoint. PZ’s “self-awareness” criterion is too sloppy and undefined to ever be acceptable, I think.
So, my own personal ethical take on this would be:
* By maintaining magical beliefs that their child would just get better, the doctors were right to intervene and save the child upon birth. I’m assuming here that post-surgery the child will not be left with major problems. If the child *would* be left with major disabilities, then non-resuscitation (or preferably termination at an earlier time) should be an option, although then the parents should receive some blame for their ridiculous beliefs that resulted in the situation.
* In the case of Karla Miller, though, the parents should have had the right to stop resuscitation due to the severe physical and mental damage the child would have. In her case, there was no opportunity to intervene earlier in any way to avoid this.
I’m not speaking about body, but about mind.
Yes, if there’s just no way to cure the disease and death is certain – it may be better just to let a patient die.
However, none of this applies to this case.
On the contrary, I think it’s the only good mentality.
We have but one life, so it’s the greatest misdeed to let it go wasted.
As I said, parents may refuse the child and give him/her to an orphanage. It’s their right, I don’t deny it. I also know enough success stories about people with sever disabilities.
Alex Besogonov said:
As do I, however I don’t really see this as the point here. The point is that medical decisions such as this are not made by you or I as we are not the ones who will have to live with the consequences. They are made by the parents of babies after receiving the best advice doctors are in a position to give. Obviously as children grow their own views get given more and more weight but since we are talking about babies here they are too young to have an opinion one way or the other.
I thus think that the severe disability issue is a bit of a red herring here. Obviously the level of disability a child may have to deal with may, or may not, be a factor in parents reaching the decision that they do. But once those parents have made their decision on whatever grounds, that decision needs to be respected simply because they are the people whose job it is to make decisions like that for any baby, disabled or otherwise.
It is also arrogant, in my opinion, for someone to assume that we feel more empathy for a severely disabled baby than it’s own parents do, simply because they disagree with them about the decisions they are making on it’s behalf.
But we don’t believe that parents have the sole right to make such decisions, as they have a duty to provide reasonable medical care to their children, and not doing so is, in many cases, prosecutable as abuse. The legalities might not apply in this particular case, but that is likely because of the weird deference the law gives to JW’s irrational beliefs.
One can easily construct scenarios that are parallel to this one where I think most people’s intuitions would argue for intervention. For example, what if the infant was born with some fluid in its lungs, and a simple procedure to clear them would save its life? What if the infant was somehow cut during delivery, and losing blood, and a simple application of a pressure bandage would keep it from bleeding to death? In those cases, should a parent be able to refuse medical care for the infant? Or does the infant have interests that supercede those of the parents? I’d argue the latter.
I see nothing wrong with the doctor here, indeed, I’d fault him if he’d allowed the child to die, just as much as if the child had been perfectly healthy, but the parents had said they weren’t going to feed it because they were Breatharians.
The following website summarizes over 500 U.S. court cases and lawsuits affecting children of Jehovah’s Witness Parents, including 350 cases where the JW Parents refused to consent to life-saving blood transfusions for their dying children:
DIVORCE, BLOOD TRANSFUSIONS, AND OTHER LEGAL ISSUES AFFECTING CHILDREN OF JEHOVAH’S WITNESSES
http://jwdivorces.bravehost.com
“First do no harm” is relative.
Performing an abortion is certainly harmful to the foetus, but there are cases when not performing an abortion can cause more harm to the mother, or to Society At Large.
Tulse said:
Fair point, I think we can all agree that children need protection from sadistic or insane parents. However I think I’ve already covered such eventualities as you have noted in your examples with regards to babies and children in the below statement in one of my earlier posts (#91):
In this case, the parents (I would argue anyway) did not go over this line and so the decision certainly remains theirs.
Lilly, if I understand correctly, not clearing the infant’s windpipe and not performing this surgery would both cause the same effect in the infant, namely suffocation. I don’t see how you can argue that in the former case the parents would be obligated to act to prevent “unnecessary pain and suffering to the infant”, but not act in the latter case when the pain and suffering would be similar.
So, you propose to give parents the right to, basically, kill their children at will?
After all, a parent might decide that a perfectly healthy child born under the wrong sign of Zodiac must be killed. In his mind it may be as great disability as quadriplegia.
In this case, I think that I _do_ have more empathy for this child. He must be given at least a chance to live.
It’s MUCH easier to kill than to resurrect…
Problem: such a child would not need medical intervention to survive so the parents would not be in a position to make such a decision (I am not advocating being able to actively kill anyone). The nearest they could do would be to refuse to look after it, at which point they have ceded responsibility for the baby’s welfare and it is no longer “their” child – in refusing to look after the child they have chosen to abandon it, not kill it.
It’s deciding on whether or not to medically intervene to save a baby that is the issue. As I have said, since the baby is not able to form, let alone voice, an opinion on it’s own medical care, the decision reverts to next of kin (parents) whose decisions should be respected.
Tulse says:
Again fair point, I must’ve misread your example, sorry about that. I’d agree your example of non-intervention intuitively feels more reprehensible on the part of the parents, even though the suffering experienced by from the baby’s point of view is similar.
I think the difference lies in the nature of the intervention, there is a big difference between been subjected to a minor tube clear or having a bandage applied to your leg and going through major surgery which can easily involve it’s own set of pain and suffering – often to no avail. I can understand a parent not wanting to subject an already desperately-ill newborn to that kind of trauma, especially if there is a good chance of that trauma being all the life it will ever know.
Would you accept a compromise of the pain/distress intervention is likely to cause the baby vs the alternative being used as a guide to whether or not the state has a right to interfere in the parent’s decisions?
Ok, suppose that they refuse treatment for a non-fatal curable disease. Like pneumonia, for example.
Yes. Thats’s exactly what I’m saying. Let the parents abandon the child if they don’t want it.
But the alternative is death. Don’t you see it?
You can’t have it both ways.
Either we don’t care about newborn’s feelings because it doesn’t have self-consciousness and use whatever treatments are necessary (as we would use it on a laboratory animal, for example), or we treat a newborn as a human being (in this case its life is sacred and we must do whatever we can to save it).
And the end result of the surgery could well also be death, possibly a much more painful one than the baby would otherwise have suffered. This is a very difficult judgement call to make, and not one that anyone not intimately connected with the baby (i.e. next of kin) can make.
False dichotomy there. I think of the baby as a human being who is unable to form their own opinions about their care – this being the case the decision about their medical treatment in such a situation falls on their next of kin to decide. That decision should only be interfered with if it obviously and grossly causes the baby more suffering than any alternative. This is not a decision to be interfered with unless the circumstances are extreme, especially by people who are not directly connected to the baby.
I am a eugenicist. Picture years from now when parents are given the option to alter genetic defects in utero. It’s hard to say what JW’s will do then, being that they happily partake of In Vitro Fertilization procedures now, but if parents choose to “let nature take its ugly course” and the child grows up with a foot growing out of its head, then what legal recourse should the child have for its parents’ disregard for its future embarrassment and suicidal tendencies? I think the child would have a good case in court. How do you tell the difference between sadism and neglect?
I think we should all take a good, hard look at genetic manipulation for the sake of humankind. We haven’t let nature “take its course” since we started helping women deliver children. Obviously, women would have developed bodies more capable of delivering children had midwives not intervened. Now we have such a thing as a scheduled C-section. No, it has been eons since we let nature take its course. IVF is the strongest case of genetic manipulation against the natural world. Humans leaped beyond “natural” selection long ago and fortunately ended up in the land of “artificial” selection. Our only next “artificial” choice is eugenics. It may be the only way we survive our misuse of the planet. Sure, we’re all against it now, but what if it ends up being the only way to keep this planet inhabited? If we don’t practice, we won’t perfect it in time for it to be an option. It’s not about creating a super-race, it’s about maintaining the one we have.
There’s an ongoing undercurrent in this debate regarding the nature of harm via action vs. harm via inaction. In principle, I side with those who say that harm by inaction is similar to harm by inaction, yet I’m also aware that there are an infinite number of actions that I could take to ease global suffering, yet do not. Does this make me a hypocrite? Probably. But maybe it also suggests the immorality of that harm by inaction is proportional to one’s level of responsibility for the situation in question, relative to the responsibility of other people. E.g.: The whole world has some responsibility to help tsunami victims, therefore little of the ethical burden falls on any one individual. But parents have a more direct, less distributed responsibility for the welfare of their children. It is therefore an more immoral act for a parent to harm their child via inaction than for them to harm an unknown tsunami victim half a world away via inaction.
And obviously, when a parent clearly harms a child through action or inaction, our society steps in to protect the child’s welfare.
No, a person’s welfare cannot be decided on the basis of suffering alone. Otherwise, universal infanticide would be the most humane approach. Suffering muct be weighed against what I can best describe as a conscious mind’s right to persist. As is often noted, the emergence of a conscious mind is not an abrubt, threshold event, but rather a gradient of mental development – and that’s precisely what makes these issues difficult.
to my mind, it’s not a matter of eugenic but a matter of allowing cacogenics to proliferate. in the overall scheme of things, with the halocene or anthropocene or whatever you want to call it, happening at breakneck speed before our very eyes, it probably doesn’t matter much.
#108:
“…harm by inaction is similar to harm by inaction”
Yeah, I’d say they’re pretty similar. (but I know what you meant)
you frame the question in such a manner that implicitly assumes
that responsibility means exclusive right to do what ever you consider right
, and then presents a false dilemma between granting such “responsibility” to the parent
ok, since you refuse to view the actual question at hand, and instead choose to insert your own issues, I’ll hand you off to someone who wants to address it.
you can BS your own self into thinking this has anything at all to do with “framing”, or try to BS somebody who cares.
Yeah!! People actually getting to the real meat in the entire ‘right to life’ thing. Shouldn’t be surprised, since it is on Pharyngula.
An entity which is not aware it exists (conscious) cannot be murdered. The potential to become self-aware confers a different status than say, a slug… but not ‘person-hood’.
We are talking degrees and gray areas… which is fully proper, considering the theoretical dividing lines are unmeasurable (at this point). I vote for taking a pretty strong conservative position, which would be placing the fetus-child dividing point at birth… though moments after birth (allowing non-interference to ‘correct’ problems at the state of birth) is quite an arguable position to take.
To the best of our knowledge, infanticide should actually be fine… but there are societal consequences (skewed sex ratio being a big one) and enough uncertainty about the actual time (and variance in that time) self-awareness takes hold.
the actual question at hand is : have you stopped beating your wife ?
In this case the alternative was exactly the same – painful death of suffocation.
This is not a completely false dichotomy.
We have a good history of bat-shit insane next-of-kins. JW almost surely fall into this category. That’s the problem – we can’t trust parents to make a good decinsion.
But we have a fairly good solution – any matter of life and death must be weighted at a court with the jury of peers. If there’s not enough time – then it’s up to doctor to decide.
@Alex Besogonov: I admire your patience, but the people you are arguing with just won’t get it.
@All those people here supporting infanticide: even if “self-awareness” was any kind of criterion (and of course it isn’t a criterion any more than “ensoulment” is), how do you know whether or not a neonate has self-awareness? The answer is, of course, that you have no idea, you’re just bullshitting.
the actual question at hand is : have you stopped beating your wife ?
nice projection of exactly what you are doing.
did you intend it to serve that purpose?
For what it’s worth, I agree with PZ here. This issue affects me about as personally as any could, because my identical twin brother was in exactly this situation, and when my mother said `let him die’, the doctors did as she asked, without a qualm, and then went to enormous effort to keep the one living baby (me) alive.
It was better for the rest of us that they did that (he’d probably have been horrendously brain-damaged had he been saved, with an awful quality of life).
(I’m not sure when humans become conscious individuals, but I’d suggest that it’s some uncertain time *after* birth.)
Nix:
As I said in my own post, it really is a matter of degree. This child had a minor and easily repaired defect. Your twin, on the other hand, was evidently very badly damaged by whatever went wrong in utero. They really are two completely different situations despite being separated only by a matter of degree.
In any case, there’s a tremendous amount of grey area, but I’m not terribly convinced either your case or the one PZ is discussing fall within it.
Alex Besogonov #27 disagrees with a hilariously self-contradictory argument.
First he says, “There’s no way to tell the future of a human being.”
Then he immediately presumes that futures are already fixed, assuming Stephen Hawking inevitably becomes a brilliant scientist in every universe he hasn’t been aborted in.
The version of Stephen Hawking we share this universe with is laughing his ass off on that one.
At root of all again is speciesism: the sacred 46. Little if any argument if the genome involved were ever so slightly expanded.
Ah, Brian, nothing went wrong in utero. This is where it moves from `oops’ and towards `painful’ and I’m amazed my mother managed to make the right decision. The twin was damaged by medical error! (They cut the umbilicus before it had fully emerged… and it bifurcated further down and was supplying oxygen to one emerged twin and one non-emerged one. Nearly twenty minutes without oxygen -> oops.)
(I sometimes wonder what life would have been like with an identical twin. Unbearable for the people around us, probably. :) )
These days I’m very much in favour of hot spares and good backups.
Who are Jehovah’s Witnesses?
No tolerance,the Jehovah’s Witnesses are a cult because they try to cut you off from others who do not have the same beliefs, including family.
The Watchtower is an oppressive cult if there ever was one!
It’s amazing they are still around after 100 years of 100% failed prophecies. Truly amazing,that they can prompt their followers to actually go door to door with a 100% bogus message.
Their Message is a Watchtower Gospel that,Jesus had his second coming in 1914 and they were the only ones who saw it and consequently the only hope for mankind.
The Watchtower is a truly Orwellian world.
Mind control is a terrible thing.
I don’t understand your reasoning here. I understand totally it might be better for a baby to die at birth if it is going to be severely handicapped but this baby is going to be just like a normal person. For the rest of his life it will be as if this surgery never happened so not allowing parent to ban it on the grounds that he needed to “actually want to live” could also be used as grounds to let parents shoot their babies in the head when they’re born, it could also be used to justify the same thing on the whim of a human to the vast majority if not all animals and the severely mentally handicapped. On a purely happiness/suffering utilitarian standpoint, since the vast majority of people later in life don’t want there life taken away, we should assume these babies won’t when they grow up. On the subject of self-awareness you say “We don’t know, and there is going to be no hard, sharp line defining the transition. But a doctor’s medical training (or a priest’s training in superstition) gives him no qualifications to make the judgment call, any better than the parents. Let the people with the responsibility decide.” but we do know the baby can experience suffering and pleasure and why should it be up to the parents to decide whether to take the potential for that away from the baby? There are people far more educated to judge. I am absolutely pro-choice up to the point when the fetus can experience happiness and suffering. True, this is hard to figure out but I think we should try our best.
To be fair, if one is pro-choice, then one must also allow parents to not undergo surgery to save their baby, even if that choice is made for all the wrong reasons.
It’s “pro-choice”, not “pro-intelligent-and-informed-choice-only”. If we supported the second, we’d have to make the decisions for far too many people.
On the other hand, if, as the Witnesses probably would immediately claim, you are an opponent of partial-birth or late-term abortion, then it would be hypocrisy to not operate when operation would save the child’s life; the moral culpability is identical.
Unless you base your morals not on logic, but on fiat.