The Ethics of "After-birth Abortions", Part 1

Last Friday, I noted in my Friday Link Wrap-up "Medical "ethicists" are seriously arguing that post-birth newborns are ‘not persons’ and can ethically be "aborted". I also posted this article on Facebook, and one of my friends took me to task on it. He said that "sloppy agenda laden journalism" has misinterpreted their intent, and that "the researchers are attempting to provoke debate on the ethics of abortion, not the desirability to kill newborns."

I’ve read the whole piece by Alberto Giubilini and Francesca Minerva, and I come to the conclusion that, while their stated intent may not be to suggest that it is desirable to kill newborns, the result will be the same. The main problem I see is that, while they have their personal moral stances regarding how often and in what circumstances what they call "after-birth abortions" would take place, their stances would not be what others use to make their determination. Would they accept a gun manufacturer’s statement that "I don’t intend my product to kill innocent people"? Perhaps not, but it can be used that way, and abortion kills millions upon millions because they are merely inconvenient. The authors’ morals will not be used to put into practice their suggestions. Keep that in mind.

(Note: While putting this blog post together, the article was removed from the Journal of Medical Ethics website. The link takes you to a "Not Found" page, and no amount of searching for title, text, or authors could find it. I’m not sure if it was taken down for some reason, or if, perhaps, only the most recent articles appear on the website. In any event, the article is no longer there. I’ll continue to look to see if it gets posted elsewhere.)

(Second note: This is why I haven’t posted anything this week so far. I’ve been spending my time working on this.)

I will not be quoting the entire article, but I will be summarizing as I go along with quotes as needed. Please follow the link for the full text of the article.

First, their abstract:

Abortion is largely accepted even for reasons that do not have anything to do with the fetus’ health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call ‘after-birth abortion’ (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled.

Please note that they are invoking morality from the start. Thus, I, too, will make my appeals to it as well. We will see how just that changes things entirely, especially regarding one’s "moral status as actual persons".

Introduction

Giubilini and Minerva start their introduction by noting various reasons for abortion:

1. Severe abnormalities of the fetus.
2. Physical and/or psychological health of the mother (sometimes in connection with #1; issues that may arise taking care of an abnormal baby).
3. Loss of partner after finding out she is pregnant, and not being able to take care of the child herself.

These situations may not be known, or may change, after birth, and the problem is that at that point there is no possibility of "abortion". As an example:

However, such rare and severe pathologies are not the only ones that are likely to remain undetected until delivery; even more common congenital diseases that women are usually tested for could fail to be detected. An examination of 18 European registries reveals that between 2005 and 2009 only the 64% of Down’s syndrome cases were diagnosed through prenatal testing.

They acknowledge that a diagnosis of Down’s virtually always results in abortion. "Once these children are born, there is no choice for the parents but to keep the child, which sometimes is exactly what they would not have done if the disease had been diagnosed before birth."

Abortion rates for diagnoses of Down’s hovers around 95% in the US and Europe. Are we to believe that every one of these mothers were physically or psychologically unable to care for their child, or that their partners left them after finding out the diagnoses? By removing reason #1 (calling Down’s "more common"), they seem to suggest that every diagnosis of Down’s results in #2 or #3. Had either of these situations been determined in those cases of abortion, or, as is more likely the case, the majority of them were a result of not thinking themselves able to handle it (when they quite possibly could have) or, worse, just not wanting to deal with the hassle?

Let’s not forget the percentages we’re talking about here. According to the Guttmacher Institute:

1% of all abortions occur because of rape or incest; 6% of abortions occur because of potential health problems regarding either the mother or child, and 93% of all abortions occur for social reasons (i.e. the child is unwanted or inconvenient).

The vast majority of women just don’t want to deal with the baby, healthy or not. And if Down’s babies are part of the 6%, then (if the percentages hold for unhealthy babies as for healthy ones), 93% (at least) of those with Down’s babies indeed don’t want to deal with the situation vs. those who actually can’t deal with it.

I’m spending a bit of time at the beginning here to deal with the abortion question, and why I find it grossly overused, because the authors intend to make an equivalence with it. My definition of a justified abortion is, however, not shared by much of society. I will note, then, that the authors’ definition of a justified abortion is equally irrelevant to society at large, though they will continue to appeal to it.

So keep in mind that Giubilini and Minerva have a "solution" looking for a problem, considering the actual percentages. This is not to say that there aren’t serious abortion situations that come up like they have described; only that they are very rare and, if the past is any indicator, their solution will be applied in situations far outside of this as well.

Abortion and after-birth abortion

While Giubilini and Minerva agree that life may still be worth living, even if the child has Down’s, they find a reason to suggest that killing it is acceptable.

Nonetheless, to bring up such children might be an unbearable burden on the family and on society as a whole, when the state economically provides for their care. On these grounds, the fact that a fetus has the potential to become a person who will have an (at least) acceptable life is no reason for prohibiting abortion. Therefore, we argue that, when circumstances occur after birth such that they would have justified abortion, what we call after-birth abortion should be permissible.

Let me highlight that first sentence: "Nonetheless, to bring up such children might be an unbearable burden on the family and on society as a whole, when the state economically provides for their care." The potential, then, for a happy future life is not enough to outweigh the economic factors, in the eyes of the authors, such that an "after-birth abortion" is justified. Deciding that a life is worth taking because of economic considerations is something that you’re only likely to hear in countries where the national government is the ultimate source of health care benefits (whether as a single payer or as one that manipulates private insurance companies to act on its behalf). As the US edges closer to that, I expect to hear more of this sort of justification.

But setting aside the heartlessness of this, again we’re seeing a situation that likely is true in a minority of cases. Further, is economic aid from the state truly a burden, when it provides what those who get a chance live it consider happy? That’s not a burden, as far as I’m concerned, and if we’re going to appeal to morality, I’d say that’s an overall moral good. But to Giubilini and Minerva, it’s just not good enough to provide a happy life for a child who would have otherwise been aborted.

Next, they play with words so as to make what they’re suggesting not sound as bad.

In spite of the oxymoron in the expression, we propose to call this practice ‘after-birth abortion’, rather than ‘infanticide’, to emphasise that the moral status of the individual killed is comparable with that of a fetus (on which ‘abortions’ in the traditional sense are performed) rather than to that of a child. Therefore, we claim that killing a newborn could be ethically permissible in all the circumstances where abortion would be.

In order to avoid the term "infanticide", the authors have to argue that the newborn is not a person. The idea that a newborn baby isn’t a person, on its face, just goes against any bit of common sense one might have. Yes, it is not independent, but this line — birth — has been a line that even pro-abortionists wouldn’t cross. Now, however, we see people trying to push the envelope further out, and, as we’ll see, leave the door open for further redefinition of "person", beyond what the authors themselves may intend.

They define personhood rather specifically, so let me quote the relevant paragraphs.

Failing to bring a new person into existence cannot be compared with the wrong caused by procuring the death of an existing person. The reason is that, unlike the case of death of an existing person, failing to bring a new person into existence does not prevent anyone from accomplishing any of her future aims. However, this consideration entails a much stronger idea than the one according to which severely handicapped children should be euthanised. If the death of a newborn is not wrongful to her on the grounds that she cannot have formed any aim that she is prevented from accomplishing, then it should also be permissible to practise an after-birth abortion on a healthy newborn too, given that she has not formed any aim yet.

There are two reasons which, taken together, justify this claim:

The moral status of an infant is equivalent to that of a fetus, that is, neither can be considered a ‘person’ in a morally relevant sense.

It is not possible to damage a newborn by preventing her from developing the potentiality to become a person in the morally relevant sense.

First, they say that allowing the death (or "failing to bring … into existence") of someone requires that one be able to form a life goal in one’s mind; "future aims", as they express it. Now, if they aren’t speaking as sweepingly as this (if "a life goal" is too long a time period and perhaps the future aim could be, for example, their next meal), then even a newborn has a few short-term future aims; to satisfy their hunger, as an example. And they’re more than willing to let you know about their future aim, or at least their lack of something that they want fulfilled. But since a newborn fits this definition, clearly the authors’ intended the timeframe to be longer than the next meal, but less than a life goal; a rather wide range subject to all manner of manipulation and goal-post moving.

Does a 3-year-old who’s autistic have a life goal or future aims far enough out for Giubilini and Minerva? We’ll see later that they find the question — the very heart of the ethics of this — too much to deal with for their medical ethics article. The purpose of this article is to try to erase one one line (birth) but refuse to draw any new one. They only ever say "newborn", but their own definitions come back to haunt them. Thus, the article, rather than solidifying any ethical conclusion, merely opens wide the floodgates leaving no restraint in place. They say that are not advocating infanticide, while at the same time not being able to ethically curtail it.

I will say this, though. I do agree with part of their first reason: The moral status of an infant is indeed equivalent to that of a fetus, which is what pro-lifers have been saying since there were pro-lifers.

[To be continued.]

Filed under: Abortion • Christianity • Doug • Ethics & Morality • Medicine • Religion • Science

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