The Price of Knowledge

Is it ever good to not know? Is all information good information? These questions, I would contend, are at the heart of some of the testing options during pregnancy. Now before I stick my foot in my mouth, I am not referring to any medically necessary tests or procedures for pregnancies. These offer options for therapeutic solutions.

What I am referring to are tests that are in an effort to uncover “birth defects”, such as Down syndrome and Cystic Fibrosis. These two happen to be the most contentious of diagnoses because knowing your developing child has either of them offers no therapeutic solution(s). (I say “therapeutic solutions” because abortions are rarely that and are definitely not in the case of either of these diagnoses).

Opting to receive this particular kind of information during pregnancy does not offer much resolve. There are only two answers that it offers. One is somewhat reasonable and the other is not.

The first answer is so that parents may prepare themselves. This foreknowledge gives parents an opportunity to say: “brace yourself”, but it offers no power or control over the things to come. (I would interject that having knowledge about temporal things we cannot change is often more enfeebling than it is empowering).

The second is to take the life of the child. This “solution” is the real concern. Parents are offered information/diagnoses that leave some feeling as if their only choice is to end the life of a person of potential. This is a travesty that neglects the inherent value of this person, which is abandoned in the act of placing value upon an external instead of the value given by God.

 

On Licensing Abortion Clinics

 

Should abortion clinics be required to meet minimum standards for patient access, medical record-keeping, sanitation, etc., as are medical facilities in which invasive procedures are performed?  More than twenty states have decided that question in the affirmative, including Virginia, whose State Board of Health is set to vote this Thursday on licensing regulations that would affect clinics in which 5 or more first-trimester abortions are performed per month.

In noting the support of staunch pro-life advocates for the proposed regulations, the editors of The Washington Post have raised their pens in moral indignation, writing that “IF SOMETHING about anti-abortion advocates pressing for “safer” abortion clinics rings false to you, trust your instincts.”[1] The editors were specifically targeting the Family Foundation and  the Virginia Catholic Conference, arguing, in effect, that consistency demands that abortion opponents disavow any serious concern for the health of women who choose to abort their children. One cannot, the editors would have their readers believe, advocate both for the criminalization of elective abortion and for the health of women who opt for abortion.

Sadly, The Post demonstrates in this “editorial board opinion” the willingness of supposedly “upper-tier”journalists to chuck the most basic rules of critical thinking when defending some cherished social ideal or policy. Surely they know they have committed the classic error of posing a false dilemma, which assumes only two options exist when, in fact, others are possible. It is not only possible for opponents of abortion to care about the health of the abortion clinic’s clientele, but such is a present reality as pro-life pregnancy crisis centers across our country routinely demonstrate in their ministrations to the health and well-being of post-abortive women. A commitment to the sanctity of human life, most pro-lifers would argue, requires not only concern for the baby’s life, but for the mother’s as well. So, while there should be no expectation that pro-lifers would cease from their efforts to outlaw elective abortion, one ought not to be surprised to see them advocating for the health and safety of aborting mothers.

Truly, as it concerns the issue of consistency, advocates of abortion who would stand in the way of regulating abortion clinics as medical facilities are in a tough spot. They generally desire that elective abortion would be viewed as healthcare (see my post from June 27, 2011), but when it comes to treating it as such, they object. The Post’s editors are willing, they claim, to accept some regulations, but not those requiring a significant outlay of capital. To that, I suspect, many hospital administrators will simply respond “Welcome to our our world!” Meeting medical facility regulatory requirements is, no doubt, a burden, but it is one that must be borne out of concern for patient safety and well-being.


[1] http://www.washingtonpost.com/opinions/targeting-bortions/2011/09/01/gIQAS7Fa2J_story.html

What’s in a name?

Interacting with students often reminds me of the importance of some very basic things.  Recently I was reminded of the importance of defining the terms we use in bioethics.  In reading reviews of case studies by some of my online students I saw how their unquestioning acceptance of definitions influences how they think.

The terms involved were “abortion” and “passive euthanasia” and the definitions were from a textbook by Lewis Vaughn that we use in the course.  Vaughn’s text, which I reviewed in the summer 2011 edition of Ethics & Medicine, is generally good at representing a wide spectrum of views on current issues in bioethics, but sometimes some less objective things slip in.

Abortion was defined as “the intentional termination of a pregnancy through drugs or surgery”, which sounds pretty straightforward.  From the way a student was using the definition in a case review I realized that the definition would include and equate abortion with such things as the induction of labor for the delivery of a healthy term infant or a C-section to save the life of an infant in distress.  The fact that an abortion is a termination of pregnancy that includes the intentional ending of the life of the fetus was left out.  That part of the definition makes a big difference.

Passive euthanasia was defined as “allowing someone to die by not doing something that would prolong life.”  That is how James Rachels defined passive euthanasia in his classic defense of active euthanasia that was based on there being no moral distinction between active and passive euthanasia.  What that definition leaves out is the idea that any euthanasia involves the intent to end another person’s life.  This definition of passive euthanasia includes all the times we allow a person to die by choosing not to initiate or continue any possible life-prolonging treatment, but there is a significant difference between allowing a person to die of his or her disease when treatment has become more of a burden than a benefit and doing something with the intent of causing the person to die.  Intending another person’s death is the key to what is wrong with euthanasia and leaving that out of the definition makes a big difference.

What’s in a name?  The difference between right and wrong.

Abortion Prevention

Nigel Cameron wrote that it is important to see elective abortion as a symptom, not the disease.  Because this is true, if Roe v. Wade were overturned tomorrow, and some states started to outlaw abortion, the abortion problem would not end;  because even if Roe v. Wade goes away, all of the reasons that women have abortions will still exist.  What will those of us who call ourselves Pro-Life do to address some of those underlying causes?  What are we doing to address those underlying causes?  (Do we even think about what the underlying causes are?)  What are we doing to promote a social and cultural environment that is less inimical to the raising of and providing for children?  What are we doing to help those who do choose to carry their babies to term, particularly among the poor in whom abortion is so prevalent?  What are we doing to support them in feeding and housing and providing a safe environment and medical care to their children?  (Why are Pro-Lifers so heavily represented among those who are most vocally opposed to health care reform and gun control?)

 

I hope and pray that some day Roe v. Wade is overturned.  But I believe that we as a Christian community must work more energetically to show that being Pro-Life means more than picketing and praying.  At the very least, it means making sacrifices to help women and families with children.  It means getting more involved in the messy lives of those around us.  If we can address some of the reasons so many women feel that abortion is their best or only option, maybe we can go a long way towards accomplishing what we can never accomplish merely by overturning a Supreme Court decision.

 

From Eugenics to Genocide (A Short Walk)

Last week I wrote about the practice of eugenics in modern American obstetrics:  induced abortion performed because prenatal testing shows a potential chromosomal abnormality or birth defect.  This past week, the BBC News Online ran a series of stories under the headline “India’s unwanted girls.”  These stories tell of the practice in India of induced abortion performed because prenatal testing shows a particular unwanted chromosomal “abnormality”:  the presence of the XX chromosome pair, i.e., aborting a baby simply because she is female.  Because of long-standing prejudices and practices, in many parts of Indian society a female child is considered undesirable.  There is widespread availability of prenatal ultrasound clinics for sex determination, and so many parents  avail themselves of  these clinics’ services to guide abortion decisions that in some areas of India there are less than 840 female children for every 1000 male children.  Some Indian activists use the word “genocide” to describe this selective killing of girls.  Lest anyone suspect that Indian families thought up this novel use of medical technology on their own, the following quote from the story provides chilling evidence to the contrary:  “In 1974, Delhi’s prestigious All India Institute of Medical Sciences came out with a study which said sex-determination tests were a boon for Indian women.  It said they no longer needed to produce endless children to have the right number of sons, and it encouraged the determination and elimination of female foetuses as an effective tool of population control.”

Three observations:  First, given the rationalizations for the unfettered right to abortion that pro-choice advocates have promulgated in this country, they would be have to be mute in the face of sex-selective abortion.  They cannot say that it is wrong to abort girls, because if it is wrong to abort girls, then it is wrong to abort boys.  If they admit that it is wrong to distinguish — and extinguish — foetuses on the basis of an arbitrary criterion such as gender, then they would have to admit that it is wrong to do so on the basis of any arbitrary criterion — such as the presence of a disability.

Second, the term “genocide” used by certain Indian activists seems extreme, but it may not be such a long walk from eugenics to genocide.  The justification used to commit foeticide on the basis of gender can be employed to commit foeticide, say, on the basis of  a genetic predisposition to obesity (A 1993 March of Dimes poll found that 11% of parents said they would abort a  fetus whose genome was predisposed to obesity), and is not far from the justification used to commit murder on the basis of whether one belongs to the Hutu or Tutsi tribe.

Third, this tragic story shows yet again what happens when medicine abandons its Hippocratic ethos of commitment to the patient and instead uses its considerable power to pursue goals such as “population control,” social stability — or eugenics.

 

How Important Are Those with Moral Status to Us?

I have a friend who is from Africa.  She sees a lot of things in this country from a different perspective that makes me think, and sometimes makes me uncomfortable.  We were recently in a discussion in a group at church about how we define who has moral status and how that impacts our moral decisions about human embryos and fetuses.  After the discussion she said she had noted that many Christians in America were quite passionate about the value of the life of those who were unborn, but didn’t seem to care as much about those who were born.  She said we stand up for the value of the lives of the unborn whom we will never know and who do not put any demands on us, but seem to neglect the value of the lives of those around us who are in need because valuing their lives would put demands on us.

I think my friend is right.  If we really believe that all human beings have full moral status we need to help people see the moral problems with abortion, destructive research on embryos, and the making and discarding of excess embryos in IVF, but we need to do much more.  We need to affirm the moral worth of those who have been born.  We need to care for widows, orphans, the poor, and those who are oppressed.  We can see God’s heart for them in the prophets and in Jesus.  There are many Christians who reach out to those in need and love them in tangible ways that express their understanding of their value as human beings.  More of us need to do that.  I need to do that more.