Defense of Abortion as Killing

It is rare to hear a defender of abortion plainly admit that the act of abortion is killing. So, I was curious as to how such an individual would defend that killing. Dr. Sophie Lewis has recently done so in her new book, Full Surrogacy Now: Feminism Against Family. The publisher, Versa Books, has put out a short YouTube video interview, where she outlines her “abortion as killing” defense. The video is just over 2 minutes and she articulates her point clearly. While I have not read her new book, summaries from the publisher suggest the overarching theme is that pregnancy is “gestational work” done by women without appropriate compensation (permission, time, money, recognition…), resulting in their exploitation. Pregnancy (and procreation in general) ought best be done by willing “gestational workers” with clearly defined contractual obligations and recompense. Surrogacy is the answer. There is much to unpack here so I want to focus the remaining blog entry on her defense of abortion as killing as stated in her linked video above.

Her central defense of abortion as killing is as follows:

…looking at the biology of the hemochorial placentation helps me think about the violence that, innocently, a fetus meets out vis-a-vis a gestator. That violence is an unacceptable violence for someone who doesn’t want to do gestational work. The violence that the gestator meets out to essentially go on strike or exit that workplace is an acceptable violence.

The gestator going on strike or exiting the gestational workplace is the act of abortion. In her view, pregnancy is gestational work that can result in workplace violence or, at least, unacceptable work conditions that exceed those previously agreed upon. At that point, Dr. Lewis believes it should be permissible for any woman to leave the workplace, even though that exit causes an ultimate violence to the fetus – the killing of that fetus. She holds the placental attachment to the uterus as a sufficiently biologically violent condition that should permit a biologically violent defensive reponse with the abortion.

It is hard to make these acts either biologically or morally equivalent. Biologically, there is nothing violent about a placenta developing an attachment to a uterus. In fact, using Dr. Lewis’s workplace metaphor, it is the job of the placenta to attach to the lining of the uterus and it is the job of the uterus to receive such an attachment – it is what both were designed or evolved to do. Even if we accept her workplace violence metaphor, it is rare for the violence of the placental attachment to the uterus to result in the death of the mother just as it is equally rare for the violence of the abortion NOT to result in the death of the fetus. These are hardly biologically equivalent events.

Morally, it is hard to argue, even in her terms, that the mother’s choice to terminate gestational work is equivalent to the baby’s placental attachment, even if we grant her claim that both are equally violent. The mother always has the choice in deciding to terminate the pregnancy – the fetus never has a choice or intentional control of the placental attachment process at any point during the pregnancy. After all, intentional choices are made by persons not fetuses. I doubt that Dr. Lewis wishes to cede further moral ground by granting personhood to a fetus.

Maybe that is why Dr. Lewis stipulates that the baby’s violence is innocent. Frankly, the obvious innocence of the baby makes it even harder, if not impossible, to morally justify the violence she desires us to find acceptable.

Oh, Those Darned Terms (Part 3)

It is hard to keep a good theme down as terminology is back in the news. It seems National Public Radio (NPR) is concerned about proper terminology as a recent “Guidance Reminder: On Abortion Procedures, Terminology & Rights” post by NPR Standards and Practices Editor Mark Memmott on NPR.com suggests. This link is one of periodic commentaries by Memmott on standards expected by journalists at NPR based upon their Ethics Handbook, which is also available on their website. The stated goal of the Ethics Handbook and the periodic commentaries is to be as accurate and unbiased as possible with reporting at NPR, which is obviously an appropriate goal in reporting the news, particularly potentially controversial topics. Read Memmott’s commentary link and see if you think NPR is meeting that goal.

I think there is room for improvement.

For one thing, while there is an appropriate “We-They” throughout the article describing NPR’s word choice versus the word choice of groups favoring “anti-abortion rights” (approved term), I failed to find a similar “We-They” within the article describing NPR’s word choice versus the word choice of groups favoring “pro-abortion rights” (not approved term). Perhaps I missed it?

Additionally, NPR favors the term “fetus” over the term “unborn”, despite the fact that fetus means “unborn offspring of an animal” per Wikipedia or “unborn or unhatched vertebrate” per Merriam-Webster. The Latin sounds more accurate but fewer people are speaking Latin these days. Nonetheless, NPR believes that “[i]ncorrectly calling a fetus a ‘baby’ or ‘the unborn’ is part of the strategy used by antiabortion groups to shift language/legality/public opinion.” I wonder if the Mayo Clinic realizes their interchangeable use of the terms “fetus” and “baby” on their fetal ultrasound web page is not only incorrect but places them squarely in the antiabortion movement trying to shift language/legality/public opinion?

Finally, NPR does not like to use the term “abortion clinics” but rather “medical or heath clinics that perform abortions”. That may indeed be more accurate but why stop there? Why not list all the procedures that a specified medical clinic performs, including the total number of each of the procedures performed, and let the reader decide how he or she wishes to categorize that particular clinic?

It is wrong to purposely select terms feigning accuracy so as to appear unbiased, particularly if the goal is to bias by use of those very same terms.

When should physicians provide a good death?

A recent New England Journal of Medicine (NEJM) Perspective by Deborah Denno, Ph.D., J.D., entitled “Physician Participation in Lethal Injection” (subscription or limited free access required) discussed physician involvement in state-sanctioned capital punishment by lethal injection. Some of the arguments for physician involvement in euthanasia (“a good death”) or Physician-Assisted Suicide (PAS) would seem to apply to some degree to lethal injection and is the subject of this blog entry.

For those without access, the article explored a recent Supreme Court rejection in Bucklew v. Precythe of a Missouri death row inmate’s appeal for protection from lethal injection under the Eighth Amendment’s prohibition of “cruel and unusual punishment”. In short, Russell Bucklew has a rare vascular condition making venous access both difficult and potentially more painful to use lethal injection as the means to execute him. It was argued that his medical condition necessitated at least medical training to guide the injection process, if not actual physician/surgeon training, such as possessed by an anesthesiologist, to provide the actual vein access for the lethal injection. In rejecting his appeal, the Court responded, in part, “the Eighth Amendment does not guarantee a prisoner a painless death – something that isn’t guaranteed to many people, including most victims of capital crimes.” The Court added that methods prohibited are those that “superadd terror, pain or disgrace to their executions”, though as the article points out, the Court does not specify as to how to test those limits, and left unanswered whether physician involvement was legally required to guarantee satisfaction of the Eighth Amendment.

The article discusses the fact that national medical associations generally strongly discourage their members from providing guidance for lethal injection. The American Medical Association’s (AMA’s) own amicus brief for the case listed above states that the AMA opposes capital punishment. The American Society of Anesthesiologists (ASA) takes a similar position opposing participation of its members in lethal injection. Both the AMA and the ASA agree that capital punishment is not the practice of medicine and the ASA goes further to challenge the Court to look elsewhere for any lethal injection skills.

Interestingly, both organizations are less precise on their position regarding physician involvement in euthanasia or PAS. The AMA sees PAS as causing “more harm than good”. The ASA has no official published position on PAS that I could find on their website. Their Statement on Palliative Care does not mention euthanasia or PAS. This is important, as there is a growing demand for physician involvement in euthanasia/PAS, the implication being that there is additional benefit with physician involvement in achieving a good death.

For the record, I have always believed that physicians are uniquely the worst choice for killing people under any circumstance as our training universally focuses on honing skills that avoid causing death to our patients. We are effectively trained at not killing and would therefore provide dysthanasia – a bad death. But, perhaps, I am mistaken. There is growing demand to involve physicians in actively and purposefully killing their patients, with many holding the contrary belief that physicians uniquely have the best skill set to provide for euthanasia – a good death.

So, even though Russell Bucklew failed to make a successful legal case for physician involvement in lethal injection, did he make a sufficient moral case? If physicians and their unique skills are necessary for euthanasia/PAS, are they not equally necessary for state-sanctioned execution, particularly given that the latter involves the non-voluntary death of an individual who is guaranteed Eighth Amendment protections, and especially given our inability to provide any scientific evidence that we are satisfying those protections?

If physicians really are the best at providing euthanasia, doesn’t moral justice demand we require a physician to similarly provide a good, physician-assisted, state-sanctioned, death (PASSD) despite the stated objections of the AMA and ASA? Anything less arguably opens the door for adding “terror, pain or disgrace” to the execution.

Measles: When does Screening, Quarantining and/or Vaccination become Mandatory?

As this linked PBS NewsHour interview between Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Judy Woodruff reports, the number of new cases of measles in the US has reached nearly 700, which is the highest number of new cases since measles was supposedly eliminated in 2000. The video is short and provides a quick review of the current causes of the outbreak and suggested steps one can take to mitigate future personal and family risks of contracting the disease. The reason for this being the subject of this bioethics blog is to touch on the ethical tensions between personal autonomy and utilitarian public health calculations regarding the recent measles outbreak.

So what is the problem with getting measles in the first place? Measles is a highly contagious viral respiratory disease. Simply being in the same room with someone with the disease can lead to becoming infected. In its milder form, the disease results in fever, runny nose, ear infection and a classic spotted red skin rash. In its more severe form, it can cause a severe pneumonia requiring hospitalization, deafness, lifelong brain damage and even death. Children under 5 years of age are at particular risk. A common two-stage vaccine called MMR is available that successfully immunizes 97% of those that receive it. It is given at age one and again around age 5.

The benefits of the immunization are two-fold. The first is direct personal protection against contracting the disease if you receive the vaccination and are one of the 97% of individuals who gain future immunity against the measles virus. The second is something called herd immunity. If enough people are immunized (experts estimate “enough” to be between 95-97% of the population), then even people who cannot be immunized, such as infants less than one year of age or individuals whose immune systems are compromised, are still somewhat protected from contracting the disease. This is because new measles cases from “outside the herd” are severely limited in their ability to spread to the small number of non-immunized people within the largely immunized herd. The immunized people effectively act as a physical barrier to protect the non-immunized people. Problem solved, right?

To quote my favorite ESPN College Gameday commentator coach Lee Corso: “Not so fast, my friend”. The measles vaccine is not completely risk-free. Minor side effects include fever, rash and local injection site infections. Much less common but more severe reactions include seizures and rare deaths from severe allergic reactions. In the late 1990s, the British medical journal Lancet published a study by Andrew Wakefield positing a link between the MMR vaccine and autism. This study was later proven to be a completely falsified claim and Wakefield was completely discredited, though some parents still use the original study to argue against vaccinating their children.

If the vaccine were completely risk-free, there would be no logical or ethical reason not to receive the vaccination. If everyone who could take the vaccine did so, herd immunity from a public health standpoint would be at its maximum, protecting the remainder of individuals unable to receive or benefit from the vaccine. The current measles outbreak argues that either we are not properly screening or quarantining new cases of measles at the point of entry to the US or our herd immunity may be breaking down (or some combination of the above).

So, at your next social function, after you have debated your usual political concerns or dismay at your favorite NFL football team’s shocking choice in the recent NFL draft, settle in to a potentially more meaningful discussion around the ethics of personal autonomy versus public health policy regarding mandatory measles screening, quarantining and vaccination. Suggested sub-topics might include:

• Is it fair for those who are able to vaccinate but choose not to vaccinate to freely rely on the herd immunity of those that do vaccinate?
• How public should one’s vaccination or immunity status be to avoid quarantine?
• What reasons are reasonable to choose not to immunize?
• Would it be fair to deny public (or private) insurance coverage for treating the measles if one chose not to take the vaccine?

Are AI Ethics Unique to AI?

A recent article in Forbes.com by Cansu Canca entitled “A New Model for AI Ethics in R&D” has me wondering whether the ethics needed for the field of Artificial Intelligence (AI) requires some new method or model of thinking about the bioethics related to that discipline. The author, a principal in the consulting company AI Ethics Lab, implies that there might be. She believes that the traditional “Ethics Oversight and Compliance Review Boards”, which emerged as a response to the biomedical scandals of World War II and continue in her view to emphasize a heavy-handed, top-down, authoritative control over ethical decisions in biomedical research, leave AI researchers effectively out-of-the-ethical-decision-making loop.

In support of her argument, she cites the recent working document of AI Ethics Guidelines by the European Commission’s High-Level Expert Group on Artificial Intelligence (AI HLEG). AI HLEG essentially distilled their AI ethical guidelines down to the familiar: Respect for Autonomy, Beneficence, Non-Maleficence, and Justice, as well as one new principle: Explicability. She downplays Explicability as simply the means to realize the other four principles. I think the demand for Explicability is interesting in its own right and will comment on that below.

Canca sees the AI HLEG guidelines as simply a rehash of the same principles of bioethics available to current bioethics review boards, which, in her view, are limited in that they provide no guidance for such a board when one principle conflicts with another. She is also frustrated that the ethical path researchers are permitted continues to be determined by an external governing board, implying that “researchers cannot be trusted and…focuses solely on blocking what the boards consider to be unethical.” She wants a more collaborative interaction between researchers and ethicists (and presumably a review board) and outlines how her company would go about achieving that end.

Faulting the “Principles of Biomedical Ethics” for failing to be determinant on how to resolve conflicts between the four principles is certainly not a problem unique to AI. In fact, Beauchamp and Childress repeatedly explicitly pointed out that the principles cannot be independently determinant on these types of inter-principle conflicts. This applies to every field in biomedical ethics.

Having an authoritative, separate ethical review board was indeed developed, at least in part, because at least some individual biomedical researchers in the past were untrustworthy. Some still are. We have no further to look than the recent Chinese researcher He Jiankui, who allegedly created and brought to term the first genetically edited twins. Even top-down, authoritative oversight failed here.

I do think Canca is correct in trying to educate both the researchers and their companies about bioethics in general and any specific bioethical issues involved in a particular research effort. Any effort to openly identify bioethical issues and frankly discuss potential bioethical conflicts at the outset should be encouraged.

Finally, the issue of Explicability related to AI has come up in this blog previously. Using the example of programming a driverless car, we want to know, explicitly, how the AI controlling that car is going to make decisions, particularly if it must decide how to steer the car in a no-win situation that will result in the death of either occupants inside the car or bystanders on the street. What we are really asking is: “What ethical parameters/decisions/guidelines were used by the programmers to decide who lives and who dies?” I imagine we want this spelled-out explicitly in AI because, by their nature, AI systems are so complex that the man on the Clapham omnibus (as well as the bioethicist sitting next to him) has no ability to determine these insights independently.

Come to think about it, Explicability should also be demanded in non-AI bioethical decision-making for much the same reason.

Then a Miracle Occurs…

If a picture is worth a thousand words, then a single-paneled comic is worth a thousand more. Sydney Harris is a famous cartoonist who has the gift of poking fun at science, causing scientists (and the rest of us) to take a second look at what they are doing. My favorite of his cartoons shows two curmudgeonly scientists at the chalkboard, the second scrutinizing the equations of the first. On the left side of the chalkboard is the starting equation demanding a solution. On the right is the elegant solution. In the middle, the first scientist has written: “Then a Miracle Occurs”. The second scientist then suggests to his colleague: “I think you should be more explicit here in step two” (the cartoon is obviously better).

Recently, in my usual scavenging around the internet for interesting articles on artificial intelligence (AI), I came across a Wired magazine article by Mark Harris describing a Silicon Valley robotics expert named Anthony Levandowski who is in the process of starting a church based on AI called Way of the Future. If their website is any indication, Way of the Future Church is still very much “in progress”. Still, the website does offer some information on what their worldview may look like in a section called Things we believe. They believe intelligence is “not rooted in biology” and that the “creation of ‘super intelligence’ is inevitable”. They believe that “just like animals have rights, our creation(s) (‘machines’ or whatever we call them) should have rights too when they show signs of intelligence (still to be defined of course).” And finally:

“We believe in science (the universe came into existence 13.7 billion years ago and if you can’t re-create/test something it doesn’t exist). There is no such thing as “supernatural” powers. Extraordinary claims require extraordinary evidence.”

This is all a lot to unpack – too much for this humble blog space. Here, we are interested in the impact such a religion may or may not have on bioethics. Since one’s worldview influences how one views bioethical dilemmas, how would a worldview that considered AI divine or worthy of worship deal with future challenges between humans and computers? There is a suggestion on their website that the Way of the Future Church views the future AI “entity” as potentially viewing some of humanity as “unfriendly” towards itself. Does this imply a future problem with equal distribution of justice? One commentator has pointed out “our digital deity may end up bringing about our doom rather than our salvation.” (The Matrix or Terminator, anyone?)

I have no doubt that AI will continue to improve to the point where computers (really, the software that controls them) will be able to do some very remarkable things. Computers are already assisting us in virtually all aspects of our daily lives, and we will undoubtedly continue to rely on computers more and more. Presently, all of this occurs because some very smart humans have written some very complex software that appears to behave, well, intelligently. But appearing intelligent or, ultimately, self-aware, is a far cry from actually being intelligent and, ultimately, self-aware. Just because the present trajectory and pace of computer design and programming continues to accelerate doesn’t guarantee that computers will ever reach Kurzweil’s Singularity Point or Way of the Future Church’s Divinity Point.

For now, since Way of the Future Church doesn’t believe in the supernatural, they will need to be more explicit in Step Two.

Oh, Those Darned Terms (part 2)

By Mark McQuain

Voltaire has been credited with saying: “If you wish to converse with me, define your terms”. In a previous blog entry, Tom Garigan reminded us that it is literally vital that we define our terms when we engage in ethical debates, particularly those ethical debates related to the beginning of life. Explicit definition of terms should apply for opinion pieces in the New England Journal of Medicine (NEJM) as well.

In a recent NEJM Perspective (subscription required), Cynthia Chuang, MD, and Carol Weisman, PhD, are concerned that the Trump administration’s November 15th publication of final rules (HERE and HERE), broadly allowing employers to deny contraceptive coverage to their employees on the basis of religious or moral objections, will “undermine women’s reproductive autonomy and could lead to an increase in rates of unintended pregnancies, unintended births, and abortions.” The article provides a summary of the political back and forth of court injunctions and rule modifications that have ensued, which is interesting but not the point of this blog entry. I want to focus on one of the four main objections they raise against allowing employers religious or moral exemptions from the current requirement that employers provide all FDA-approved contraceptive/birth-control methods.

There are 18 FDA-approved Birth Control methods for women provided by the Patient Protection and Affordable Care Act (commonly called Obamacare or ACA) without cost-sharing [that is, at no cost to the patient]. These are also referred to as contraceptives. A contraceptive is defined as a method that prevents pregnancy. Pregnancy has been defined as either beginning at conception (the union of an egg and sperm that results in a fertilized egg) or beginning at implantation of a fertilized egg into the lining of the uterus. This difference in definition impacts how one views certain contraceptive methods that may work in part by preventing a fertilized egg from implanting into the wall of the uterus. Any contraceptive method that prevents implantation causes the intentional death of that fertilized egg and would correctly be an abortifacient (a birth control method that causes an abortion) if pregnancy is defined as beginning with conception. An intrauterine device (IUD) and Levonorgestrel (PlanB) both work primarily by preventing the egg and sperm from joining to create a fertilized egg, but some argue that it can not be proven that these methods don’t also work, in part, by preventing implantation ((PlanB) (IUD).

This background is useful in discussing Chuang and Weisman’s third objection to allowing employers religious and moral objections against the full gamut of FDA-approved birth control methods currently allowed by the ACA:

“Third, the rules allow entities to deny coverage of contraceptives to which they have a religious or moral objection, including certain contraceptive services “which they consider to be abortifacients.” By definition, contraceptives prevent pregnancy and are not abortifacients. Allowing employers to determine which contraceptives they consider to be abortifacients, rather than relying on medical definitions and evidence, promotes the spread of misinformation.”

The previous link on IUD by the American College of Obstetrics and Gynecology (ACOG) relies on the definition of pregnancy that defines pregnancy as beginning with the implantation of a fertilized egg into the lining of the uterus. Neither an IUD nor Plan B are believed to terminate a pregnancy after implantation and therefore, under ACOG’s definition, the one relied upon by Chuang and Weisman, neither is an abortifacient. If pregnancy begins with conception, then both Plan B and the IUD are potential abortifacients, as both interfere with implantation of an otherwise viable fertilized egg. ACOG admits the IUD interferes with implantation in their position paper linked above.

Rather than rhetorically condemning employers who have genuine religious and moral concerns about participating in the termination of innocent life by implying they fail to rely on proper “medical definitions and evidence”, Chuang and Weisman (and ACOG for that matter) should do better job explaining their definitions so they can also avoid promoting “the spread of misinformation”.

Oh, those darned terms!

Justice Potter Stewart’s Infanticide Equivalent

By Mark McQuain

Regular readers of this blog will hopefully forgive me for repeating myself but given the recent failure of the “Born Alive Abortion Survivors Protection Act” (BAASPA) in the Senate, the repetition seems warranted.

My concern is not specifically the result of the failure of this particular bill. We indeed already have a “Born-Alive Infants Protection Act of 2002” (BAIPA), which passed by voice vote in the House and Unanimous Consent in the Senate, and accomplishes (as best as I can tell) essentially everything demanded in the BAASPA, including granting 14th Amendment personhood protection of such a baby under federal law. The arguable difference between the existing law, BAIPA, and the failed bill, BAASPA, is that the latter specified legal punishment if certain resuscitative measures were not performed.

Supporters of BAASPA argued that, despite BAIPA, examples continue to exist of babies who are otherwise normal and healthy at their stage of gestation that were born alive post abortion attempt and were subsequently allowed to die without attempts at resuscitation, effectively resulting in infanticide. Pro-choice advocates argued against the passage of BAASPA claiming the legal punishments within the bill would ultimately limit abortion providers from providing the full range of abortion services permitted under current law out of fear of legal recrimination. For the purpose of this particular blog entry, I will concede that both concerns are valid and simply state, given my pro-life position, that the moral weight of the first position infinitely outweighs the second. I want to focus the remainder of this blog on two public comments by prominent lawmakers regarding the status of any baby born post abortion.

The first comment was by Virginia Governor Ralph Northam and covered in my previously linked blog entry above. During a radio interview he described what would happen during a third trimester abortion if the woman went into labor: “The infant would be resuscitated if that’s what the mother and the family desired, and then a discussion would ensue between the physicians and mother…” The second comment was by U.S. Senate Minority Leader Chuck Schumer. He expressed concern that the BAASPA legislation would force doctors to provide care to a baby born alive post abortion attempt even if that care was “ineffective, contradictory to medical evidence, and against the families’ wishes.”

In both cases, what the family “desired” or “wished” prior to the abortion procedure was not a living baby. Current law permits a family with a “desire” or “wish” to terminate the life of a fetus to do so without any legal recrimination. Current BAIPA law grants all babies born alive the 14th Amendment protection of personhood, including life, liberty and the pursuit of happiness, regardless of the “desires’ or “wishes” of others. I believe it is a huge stretch to argue that these comments were meant to only apply to babies born so medically compromised that any attempt at further life-sustaining care would indeed be ineffective and/or contradictory to medical evidence – in short, futile.

I close again with Justice Potter Stewart’s infanticide equivalent from 1972 Roe v. Wade oral argument testimony between Justice Potter Stewart and attorney Sarah Weddington, who represented Roe (see LINK for transcript or audio of the second reargument Oct 11, 1972, approximately one-third of the way through):

Potter Stewart: Well, if it were established that an unborn fetus is a person within the protection of the Fourteenth Amendment, you would have almost an impossible case here, would you not?

Sarah R. Weddington: I would have a very difficult case. [Laughter]

Potter Stewart: You certainly would because you’d have the same kind of thing you’d have to say that this would be the equivalent to after the child was born.

Sarah R. Weddington That’s right.

Potter Stewart: If the mother thought that it bothered her health having the child around, she could have it killed. Isn’t that correct?

Sarah R. Weddington: That’s correct.

Informed Consent and Genetic Germline Engineering

By Mark McQuain

I recently read, with admittedly initial amusement, an article from The Daily Mail that described a young man of Indian decent who was intending to sue his parents for giving birth to him “without his consent.” Raphael Samuel, a 27 year-old who is originally from Mumbai, is part of a growing movement of “anti-natalists”, who claim it “is wrong to put an unwilling child through the ‘rigmarole’ of life for the pleasure of its parents.” While he claims he loves his parents and says they have a “great relationship”, he is bothered by the injustice of putting another person through the struggles of life “when they didn’t ask to exist.”

While I was amused at the absurdity of asking a non-existent entity for permission to do anything, I began to wonder whether my position against germline genetic engineering should continue to include the lack of informed consent by the progeny of the individuals whose germline we are editing.

I have made the claim on this blog previously that one of my arguments against germline genetic engineering is that it fails to obtain the permission of the future individuals directly affected by the genetic engineering. Ethical human experimentation always requires obtaining permission (informed consent) of the subject prior to the experiment. This goes beyond any legal issue as many would consider Autonomy the most important principle of Beauchamp and Childress’s “Principles of Biomedical Ethics”. Informed consent is obviously not possible for germline genetic engineering as the future subjects of the current experiment are presently non-existent at the time of the experiment. While I believe there are many other valid reasons not to experiment on the human genetic germline, should the lack of informed consent continue to be one of them?

In short, if I am amused at the absurdity of Mr. Samuel’s demand that parents first obtain their children’s permission to be conceived prior to their conception, is it not equally absurd to use the lack of informed consent by the progeny of individuals whose germline we are editing as an additional reason to argue against genetic germline engineering?

Abortion, at any time, for any reason?

By Mark McQuain

Last week, Virginia delegate Kathy Tran introduced a bill to eliminate some current restrictions on late term abortions in the Commonwealth. During the committee hearing on the bill, she answered a question by one of the other committee members to the effect that her bill would permit a third trimester abortion up to and including the point of birth. That exchange may be heard here. She later “walked back” that particular comment as outlined here. Virginia Governor Ralph Northam, who is a pediatric neurologist by training, added his comments to the discussion on a call-in WTOP radio show, where he implied that the bill would additionally permit parent(s) and physician(s) to terminate the life of a “severely deformed”, “non-viable” infant after the birth of the infant, which may be heard here (the entire 50+ minute WTPO interview may be heard here). That particular bill is currently tabled (the actual bill may be read here).

These events deserve far more reflection and discussion than can be afforded in the small space of this blog. I want to discuss two comments by Governor Northam and then comment on expanding abortion to include the extreme limit of birth.

First, during his radio interview, the Governor added qualifiers to the status of the infant that are not only not in the bill submitted by Delegate Tran, they are specifically contrary to it. Section 18.2-74(c) of the Code of Virginia is amended by Tran’s House Bill No. 2491 to read ([w]hen abortion or termination of pregnancy lawful after second trimester of pregnancy):

“Measures for life support for the product of such abortion or miscarriage must shall be available and utilized if there is any clearly visible evidence of viability. “(markup/emphasis in the bill)

To be generous to the Governor, it is unclear why he qualified his comments the way he did, given that the bill is explicitly discussing a potentially viable infant. Options include that the Governor was simply ignorant of the specifics of Tran’s Bill (possibly), was actually purposefully advocating for infanticide (unlikely), or wanted to defend the loosening of restrictions on very late term abortions, clearly intended by her bill, by introducing at least one conditional situation that a number of people might initially consider reasonable (most likely). The firestorm caused by his so-called “post-birth-abortion” comment completely obscured any attention to the equally tragic portion of Tran’s Bill that eliminates a huge portion of the Code of Virginia section 18.2-76, which currently requires a much more specific informed consent process, inclusive of a pre-abortion fetal ultrasound to attempt to educate the woman on the nature of the human being she is desiring to abort.

The second comment by Governor Northam was made parenthetically while expressing his opinion that the abortion decision should be kept between a physician and the pregnant woman, and out of the hands of the legislature, “who are mostly men”. Does this imply all men be excluded from the abortion discussion or just male legislators? Should male obstetricians likewise be excluded from this discussion? Following the Governor’s comment to its logical conclusion, shouldn’t he refrain from similar comments/opinions regarding abortion since he is also a man? This is absurd. Representative government specifically, and civil discourse more generally, is not possible if ideas cannot be debated unless the particular people involved in the debate are all the same sex, same race, same ethnicity, same height, same weight, same age, etc…

Aborting a healthy, viable baby just prior to, or, at the very moment of, birth seems to me to be the least likely example of the type of abortion that anyone on the pro-choice side of the abortion debate would use to make the case that abortion is a good and necessary right. Presently, immediately after birth, the baby (finally) has the protection as a person under the Fourteenth Amendment. Eerily, as I have shared in this blog before, almost identical concepts were discussed during the 1972 oral arguments of Roe v. Wade, such as the following exchange between Justice Potter Stewart and attorney Sarah Weddington, who represented Roe. (see LINK for transcript or audio of the second reargument Oct 11, 1972, approximately one-third of the way through):

Potter Stewart: Well, if it were established that an unborn fetus is a person within the protection of the Fourteenth Amendment, you would have almost an impossible case here, would you not?

Sarah R. Weddington: I would have a very difficult case. [Laughter]

Potter Stewart: You certainly would because you’d have the same kind of thing you’d have to say that this would be the equivalent to after the child was born.

Sarah R. Weddington That’s right.

Potter Stewart: If the mother thought that it bothered her health having the child around, she could have it killed. Isn’t that correct?

Sarah R. Weddington: That’s correct.

I am one blogger who is praying that Governor Northam’s “post-birth-abortion” misunderstanding of Delegate Kathy Tran’s Bill liberalizing abortions through the end of the third trimester never causes Justice Potter’s 1972 infanticide equivalent to become a reality.