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Merely Potential Persons


Posted on 03 March 2012

infanticide_2.jpgAn extraordinary paper published in that hot purple-top The Journal of Medical Ethics has ignited a storm of controversy. The naïve authors argue that a newborn is morally no different to a foetus – both being ‘merely potential persons’ – and thus infanticide – renamed after-birth abortion by the authors – should be permitted on the same grounds as those used for abortion. The pro-life lobby reacted predictably, and demonstrated forcefully that for many of them, pro-life sentiments do not extend to academic philosophers who espouse eugenic arguments. Quite the opposite, in fact: the authors, and the JME for publishing the paper, have been subjected to a torrent of hate, abuse, fire-crackers and death-threats.

The paper raises two distinct questions. The first is not in fact whether the authors have a point: it is the more general question of whether the paper, undoubtedly deeply repugnant to many in its content, should have been published in the first place. The argument is that, by sowing what Dr No once called Malicious Seeds of Mischievous Doubt, ivory tower academics introduce ideas into society that will then grow in to abhorrent practical applications; and that therefore the ideas should never be aired in the first place.

But Dr No, as he said in Malicious Seeds, has no truck with the suppression of ideas. Debate is always better than silence, however potentially or actually repugnant the idea, and so he applauds the courage of the JME in publishing the paper, and so forcing the debate into the open. In return, it is beholden on those who object to the ideas to advance not fire-crackers and death threats, but sound argument that exposes the flaw in the philosopher’s reasoning, and so ensure the mistaken idea is dealt a blow that is as legitimate as it is fatal.

On the face of it, there is a simple argument that appears to spike the after-birth abortion argument. We can turn the argument inside out: if a foetus is morally no different to a newborn, then, if infanticide is wrong, then so too is therapeutic abortion. We could even rename abortion ‘foeticide’, or – even better – before-birth infanticide; and at a stroke, the argument for after-birth abortion can be an equally powerful argument against before-birth infanticide. But there is a flaw, and it is called the real world; for while the logic may be inescapable, so too is the existence of induced abortion; and Dr No believes that it is the lesser of two evils that therapeutic abortion should occur in controlled medical settings than in back streets and kitchens. And so we are back at square one: if pre-birth infanticide is allowed in certain circumstances; then why not after-birth abortions? The argument is AC/DC – it can swing both ways – and so fails to provide a definitive answer.

The second, and for some, persuasive argument is our old friend the slippery slope. If we allow after-birth abortion on the grounds of non-personhood, then so too by the same measure can we exterminate imbeciles and dements. And why stop there? It is but a short step to Lebensunwertes Leben – the Nazi doctrine of life unworthy of life’ – and so to a programme to exterminate all those whom society deems unworthy. Nor is this argument speculative: the Nazis indisputably did slide from a false dawn of racial cleansing by sterilisation to the eternal darkness of the holocaust. Closer to home, some see a similar slide at work on the grounds for legal abortion, from the strictest of grounds in the early days to the convenience of sex-selective abortion today. Slippery slopes are real, and so, the argument goes, best not to open a door onto one in the first place.

But, convincing as slippery slope arguments may be to many, including Dr No, it is at heart one of consequences, and so is unlikely to satisfy the likes of Dr No’s long-term sparring partner, the formidable academic philosopher IB, who is no doubt at this very moment loading his deontological bazooka in readiness for battle. So what argument can Dr No come up with that might yet prove able to provide a foil to the apparently unassailable argument that if the foetus is a non-person, then so too is the neonate (and so too, by extension, the imbecile and the dement), and so all fair game for the smothering pillow?

This is where, in its way, it gets interesting. Despite pondering on and reading about the matter, Dr No has not been able to find a single solid reasoned argument that describes what it is about birth that confers personhood. We can all agree no doubt that somewhere between the unreleased egg sitting in a future mother’s ovary, and say the age of consent, personhood arrives. But when, and why? Indeed, the paper’s authors explicitly avoid giving an upper age limit for after-birth abortion. The smothering pillow’s reach is not given an upper limit: why not smother the toddler whose presence disturbs the health and well-being of siblings or mother?

Dr No suspects that, not without irony, the certainty of an answer lies precisely in this uncertainty, and it arises because the authors have deftly started from the wrong premise: that it is personhood which is central to the right to life; and that, as a consequence, ‘merely potential persons’ do not enjoy this right.

The trouble with placing personhood at the centre of the argument is that it is by nature something that evolves. There is no light bulb moment when the person switches on; instead, it emerges, by stages, over a considerable period of grey transition; it is even something that – as the authors admit - is open to interpretation. It is something that lacks absoluteness; and so, by placing personhood at the centre of the argument, we lock in that period of insoluble greyness; and in so doing allow an apparently reasonable academic argument to reach the most unreasonable practical conclusions. It is the uncertainty which leads to the breaking of the bounds of reasonableness.

So what better central premise might there be? The obvious candidate, it seems to Dr No, is that the argument should rest not on the sanctity of personhood – a unfamiliar concept flawed by uncertainty in its bounds – but in the familiar territory of the sanctity of life, by which Dr No means the sanctity of being. The concept of sanctity, we should note in passing, does not rely solely on a religious footing; it is common ground across all humanity, from the pious, through humanists, to the committed atheist.

It is a curiosity that we humans call ourselves human beings. We do not talk of dog beings, but we do of human beings, and, it seems to Dr No, in so doing we add to the sanctity of human life the concept of the sanctity of human being, and, for the purposes of today’s argument, it is, Dr No suggests, the sanctity not of personhood, but of human being-ness, that gives rise to the right to life.

The advantage of starting from this premise is that, unlike personhood, human being-ness is both easier and cleaner to define. The moment of human being-ness arrives, Dr No suggests, at the moment one achieves, or is capable at that moment of achieving, physiological independence from the mother; and once achieved, can never be lost: however insensible; however absent the person; the individual still remains a human being.

On this premise, we can make a distinction between early and even later but not yet viable foetuses; and say that they have yet to achieve human being-ness; and so avoid the indeterminate flippancy of the first argument. And because we have a clear moment, in contrast to the unbounded period of grey transition found in the second argument; we can know which side of the line of being we lie. And if we then attach sanctity, and so the right to life, not to personhood, but to human being-ness, then we can say with confidence that infanticide, after-birth abortion, call it what you will, is wrong.

49 comments:

"The moment of human being-ness arrives, Dr No suggests, at the moment one achieves, or is capable at that moment of achieving, physiological independence from the mother" - a state complicated by developing medical technology.

So do you mean unsupported independence, or independence contingent on breathing apparatus, medication, and all of the rest of the kit to be found on SCBUs?

Nowadays it MAY be possible to keep a prem baby alive at 22 or 23 weeks (allowing for the possibility of long term disability) - in 2010 there were 179 abortions after 24 weeks.

The new idea proposed by the medical ethicists is the notion of killing AFTER separation - we have more or less accepted that a foteus has no rights inside the mother, so in some circumstances can be killed despite the possibility of viability, but once outside of the body the question of a mothers right to self determination becomes rather more moot?

This paper saddens me more than I can say. I suppose in a world that has already accepted the Groenigen Protocol, you're going to see arguments like this put forward, but we appear to be going back to the Spartans who put their newborns out in the cold and if they did not survive they were deemed unworthy of life. One thing this paper certainly illustrates is the fallacy that everything that can be reasoned, is reasonable. I'm reminded of something that Chesterton said, 'A madman is not someone who has lost his reason; he is someone who has lost everything but his reason.' I wonder why we spend so much time and money searching for the least sign of life on other planets, when we treat life so cheaply here.

I remember once being on a course on education and learning aimed at university lecturers, some of them medics. A philosopher was facilitating one of the discussions. He suggested that education and the power of reasoning were the keys to morality and a better world. Guess who was the only one there who vehemently disagreed!

The trouble is that many of these supremely reasonable people do not believe in the principle that you can "feel" that something is inherently wrong. i.e. The concept of conscience has been reasoned away into oblivium and those of us who think we have access to that still small voice within us are designated as unreasonable thinkers.

I think it is unfair to compare the Groenigen protocol with either the Spartans or the crazed ramblings of Alberto Giubilini & Francesca Minerva - all three come very different places.

The Groenigen principles are discussed here
http://www.nejm.org/doi/full/10.1056/NEJMp058026

It is argued, "There are, however, circumstances in which, despite all measures taken, suffering cannot be relieved (for the baby) and no improvement can be expected. When both the parents and the physicians are convinced that there is an extremely poor prognosis, they may concur that death would be more humane than continued life. Under similar conditions, a person in the Netherlands who is older than 16 years of age can ask for euthanasia. Newborns, however, cannot ask for euthanasia, and such a request by parents, acting as the representatives of their child, is invalid under Dutch law. Does this mean that euthanasia in a newborn is always prohibited? We are convinced that life-ending measures can be acceptable in these cases under very strict conditions".

Surely this is a world apart from arguing that a healthy baby can be killed due its lack of status as a person - I mean this is the sort of nonsense one might expect from those with the luxury of having enough time (and money) for such pointless naval gazing?

The Spartans did not have access to the kind of medical care many of us (in places like the UK) have come to take for granted nowadays - but when environmental conditions are harsh enough (due to poverty, lack of resources, absent medical services, etc) some families really may be forced into the survival of the fittest, e.g. places like Sudan, or other extremely impoverished cultures.

But isn't this ultimately about the survival of the fittest, a&e cn?
Assuming that we are carrying forward the normal reasons for abortion to new-borns, then we're talking about disability, finance, long term prospects (ie if you have the baby,then you have to look after them to the exclusion of everything else.) And isn't it the same with the Groenigen protocol, where you're trying to separate out how much is about the child and how much is about the parents and how much is about the amount of money the state is prepared to spend on treating them? Does a normal 13 year old really understand what death is? Can we offer it as a choice to someone that age? If adults are going to take such a decision for a 13 year old who does not fully understand the implications, then isn't it a natural extension to take that decision for a one year old, who can't take the decision either?

"isn't it the same with the Groenigen protocol, where you're trying to separate out how much is about the child and how much is about the parents and how much is about the amount of money the state is prepared to spend on treating them? " - one of the factors made explicit in the Groenigen protocol is that parents have no legal authority to make medical decisions on behalf of their baby, although I accept the wishes of parents should form an important part of a doctors overall assessment of the needs of the child.

For me the key difference between the Dutch doctors and the medical ethicists is proximity to the problem.

The situation in Holland has arisen because of the direct experience of neo-natal intensivists looking after babies at the most extreme end of the sickness spectrum.
I am not saying this automatically makes them right just that their philosophy is bound to be shaped by the direct consequences of providing high tech medical intervention, for example by enabling a baby's life to continue, but with no meaningful prospect of ever enjoying all of the things that makes life worthwhile?

The academics, on the other hand, have probably had no direct clinical experience of a neo-natal unit for some time, and would probably balk at the idea of killing babies if they were asked to do it themselves?

To my mind the best interest of a new born who is suffering terribly is a very real problem but I cannot think of many reasons why any sane mother would wish to go to term then kill her child. Deep down the academics I suspect the academics probably recognise such distinctions as well, so perhaps we can at least comfort ourselves with the fact their silly ramblings about non-person are unlikely to impinge on clinical practice.

The economic argument is undoubtedly a factor when it comes to abortion, for example 80% of women who terminate are not married, but as far as I know doctors in Holland are not killing babies to save the Dutch tax payer a few bob - they do it for honorable motives, albeit motives that may not sit easily with all parties?

Can I add an anecdote - I can still remember the euphoria of bringing somebody back following cardiac arrest - I later learnt that patients often suffered anoxic brain injury and would be very unlikely to ever return to their pre-arrest state.

Instead of dying in A&E some patients are resuscitated only to die on ITU a few weeks later, or are left with severe brain and functional disability.
In one review of 500 patients who suffered nontraumatic, anoxic brain injury (excluding drug-induced coma), 16% of patients had a good recovery, or were left with a moderate disability, 11% of patients were left with severe disability, and the remaining 73% never improved beyond a vegetative state.
http://cmbi.bjmu.edu.cn/uptodate/critical%20care/Neurologic%20critical%2...

Almost 3/4's left in a vegetative state - horrible for the patient, and certainly for the patient's loved ones.

I suspect you might remember this, Julie?
http://www.guardian.co.uk/uk/2007/jul/12/ukcrime.health

A&E CN - separation is indeed the key event - placenta shuts down, neonate's circulation switches over to independent running, and (normally) breathing starts. This is what makes the neonate a being in its own right; a state of being that is unchanged even if it is then hooked up to all manner of equipment and pumped full of all manner of chemicals - it is still a (human) being.

There is nothing fixed in time for ever about the gestational age at which this being-ness is achieved/capable of being achieved. As neonatal care advances, one supposes it will get ever earlier. One might even suppose a day when we can do without the womb altogether, and grow real babies in test-tubes - but the moment of establishing being-ness will still be the same: when the neonate achieves/is capable of achieve physiologically independent life, separated from the mother/womb/test-tube (which is of course in this scenario acting as an artificial womb).

Dr No is not however unduly concerned that this gestational age threshold will creep inexorably downwards to zero, for the simple reason that below a certain gestational age, the foetus lacks the bits needed to be capable of becoming a separate being. To use a crude analogy, there is a moment in the assembly of a car at which it changes from a collection of mechanical parts into something capable of independent motion under its own steam. It may be by no means finished - it may lack trim, seats, perhaps even body parts, but it is capable of being driven round the factory floor, and so has achieved the state of car-being-ness.

Julie/WD - I am sure someone somewhere said words to the effect that if we are forced to live at the extremes, it is better to sail the sea of life unreasonably under a moral compass, than to sail that sea reasonably, but with no compass at all. But the extremes are absurd - perhaps the essence of what makes us truly human is the ability combine a moral compass and reason.

A&E CN - in response to your latest comments about neonates with hopeless prospects - BBC2 aired a programme almost a year ago which DN covered here. One suspects that more often than not the parents will be grievously overwhelmed. And, more generally, DN still sees the practical wisdom in the old doctrine of neither killing, nor striving officiously to keep alive. It seems the near-perfect bedside compass to use when called upon to navigate these so very difficult decisions.

It is interesting to read a report in the Telegraph in 2004 covering the thinking of a prominent UK philosopher on the subject of infanticide at a time when a late abortion took place because of cleft palate.

http://www.telegraph.co.uk/news/uknews/1452504/Infanticide-is-justifiabl...

“Prof Harris added that it was up to individual families to make a decision on the future of their child and that he was not concerned that such a course of action could lead to infanticide for cosmetic reasons.

"I don't believe there is any such thing as a slippery slope," he said. "I think that we are always on one. It is our responsibility not to avoid the moral choice.”

Being a simple soul who believes in Creep, but doesn't understand philosophers' thinking patterns very well, The Witch Doctor could not really work out from this statement what his views really were concerning slippery slopes.

However, like Alberto Giubilini and Francesca Minerva, Professor Harris too, has felt it necessary to clarify his position on infanticide recently.

http://blog.practicalethics.ox.ac.uk/2012/02/john-harris-clarifies-his-p...

Do you suppose he too was at the receiving end of abusive and threatening e-mails, My Black Cat?

Or do you suppose the philosophers are backing down and starting to think like witches?

Hey, it does seem that at least one philosopher might be almost (but not quite) conceding there is a place for a moral compass after all:

Comment here:

http://blog.practicalethics.ox.ac.uk/2012/03/why-infanticide-is-worse-th...

"Of course, the tradition of looking to the poets for some guidance goes all the way back to Plato, and maybe we do need to admit that some questions are better settled by the poets then by the philosophers, but that certainly goes against every analytic fiber in my brain."

You are no doubt aware that there are many ‘proper philosophers‘ as Iain Brassington calls them, and indeed some bioethicists that reject the concept of personhood. As a theoretical category in this context it fails on many fronts, some of which you outlined. Of course it has been used by Descartes, Locke, Kant, Rawls, Habermas and others, but for the most part these concepts of personhood are of little use to bioethics (we can but hope) because they apply to adult humans that are, in Rawls’ terms, willing to accept the “burden of judgement” and abide by the limits of reason.

That aside, I am more concerned about why the paper was published. I have asked the authors in a post to their open letter on the JME blog whether any of the peer-reviewers and/or the editors asked them what they hoped to achieve with their paper? It is recognised by the authors and Savulescu (editor of JME) that the concept of person they use (the premise of the paper) dates back to Tooley’s 1972 paper, so what we are left with is the so-called “logic” of their argument. This is also well worn stuff and, given the premise, glaringly obvious. We are nonetheless informed by the authors and Savulescu that the paper was not meant for public consumption but was supposed create an academic debate. Difficult to believe that such an unoriginal paper could provoke much debate beyond ’Oh no, not this again.’ I also do not believe anybody can be that naïve. The paper reads like a policy proposal, or, as John Harris calls it, a White Paper. It was obviously going to go virus on the net and would be splashed over the media. But apparently nobody thought that a paper that sanctions infanticide on the grounds that infants are non-persons and might be inconvenient would generate a hostile public response. The peer-reviewers and editors cannot claim they are so utterly unworldly that they did not know that this paper, in the form they publish it, would create such controversy. If the paper was for intellectual discussion, they should have informed the authors to make it explicitly and implicitly clear that it was a Green Paper. Not sure it would have defused the issue much, but at least the JME could claim it had tried.

What really rankles me, however, is the notion that bioethics should be like some obscure branch of mathematics. It is not, it is applied ethics and should be accessible and understood by any reasonably intelligent person (I am not creating another category of “person”, although who knows it might become one). Even if sincere, all this tripe that the paper can only be understood and appreciated by a small cadre of academics only goes to demonstrate how insular and isolated bioethics has become. Either way, I think the editors of the JME should apologise and ensure that this type of “misunderstanding” does not happen in the future. I will not be holding my breath.

" Dr No has not been able to find a single solid reasoned argument that describes what it is about birth that confers personhood. We can all agree no doubt that somewhere between the unreleased egg sitting in a future mother’s ovary, and say the age of consent, personhood arrives."

The ancient Egyptians considered this moment to be when a heart is fully formed and starts it's first beat. As they could not find then measure 'soul', they considered 'heart' to be the bearer of that too, the reason why when mummifying, they removed all intestines, had the brain sucked out through the nose, then put the heart back in place in preparation for the after life. Heart to the Egyptians had a much wider philosophical meaning with regards to 'person', maybe I should write a post about that. Meanwhile, I too am convinced the ancients were right, hence any attempt to abort after this point is proper murder.

I know this sounds like a volte face, having dismissed the content of the paper as 'naval gazing' but a few thoughts that have been nagging me.

[1] inside the mother a viable foteus has no legal status (leaving aside cases of 'child destruction) so can be killed irrespective of viability - in other words we have already accepted the principle of killing late term babies (under certain circumstances)
http://en.wikipedia.org/wiki/Child_destruction

[2] Holland has gone further, having accepted a form of infanticide (for medical reasons) outside of the mother.

[3 - and most importantly] however much we may dislike the idea it seems inevitable that humans are on course for an epoch changing mismatch between demand and resources due exponential population growth - this mismatch I suspect will profoundly affect the relationship between society and sanctity of life?

Given the current and prospective climate around the treatment, or perhaps mistreatment of babies isn't the conversation about 'meaning of personhood', or 'life' worth having, even though we may find it hard to stomach some of the avenues such conversations may veer toward?

Anonymouse - we do indeed use the figure of speech 'having a heart' (and connected ones like 'warm-hearted' and cold-hearted') to convey something that is part of the spark of humanity, but to Dr No, to jump from that to the first beat of the heart (at - if Dr No's embryology is correct - it is a long time since he studied such things - around three weeks foetal age/five weeks gestational ie post LMP age) being the moment human-ness arrives is a jump too far. Vital, (quite literally) as a beating heart is, it remains to Dr No necessary but not sufficient to being human. And so it is that he suggests that the arrival of person-hood (the paper's chosen moment) is a bar to far (and vague), the first heart beat a bar necessary but not sufficient, and so he plumps for the moment, achieved or at that moment achievable, of separation, of independent life.

Plus, abstract reasoning apart, there is the practical problem that induced abortion will always occur, and if we were to say that the right to life starts with the first heart beat, at about five weeks gestational age, ie when most women have only just realised they are pregnant, if at all, then just about every induced abortion will violate the right to life, and so be pre-birth infanticide/murder. This is, of course the pro-life position, but it carries with it the burden of criminalising every induced abortion, and so takes us back to the dark and dreadful days of back street abortions. And while no abortion can ever be 'good', back street abortion is always very very bad; and so it is for both humane and practical reasons that we allow - to use another figure of speech - the lesser of two evils.

A&E CN - Dr No does not see your latest comment as a volte face at all. We can reject the Giubilini/Minerva paper, and its implied conclusions, on the grounds that it starts from the wrong premise, but the question of what does define human-ness, and so the right to life, is, ahem, still very much alive.

KT - Dr No agrees that the paper was bound to be provocative, all the more so because it reads more like a white than green paper (and further agrees that the authors editors would need to be very thick indeed not to see that), but he has no difficulty with its publication - quite the opposite, in fact. Dr No is about as fervently pro-debate as pro-lifers/pro-choicers are in their respective positions. By the same token, he agrees that 'proper' bio-ethicists should stop being so precious and at the same time exclusive, as if mere mortals (Dr No's lamentable efforts ended up even further down the pecking order, as 'tripe') are not worthy of a place at the bio-ethics table. As you so rightly say, the questions raised, however they may be treated in academic circles, also have real application in the real world.

As you have kindly explain, thank you, I should not have said 'first' beat then, since that does not indicate a fully formed human heart @ 7-8 weeks. Ancient Egyptians considered the fully functioning heart as the meaning of 'person' because of that beat from movement in the womb to death. Hence, I've always wondered if the unborn is aware of it's surroundings from that moment on, any idea?

Check out 'sentience' on wikipedia because the spam filter won't allow it here

This is a very difficult topic, IMO this difficulty arises because we are trying to legalise the illegal really, and that will always remain on our 'conscience' as 'sentient persons', and will always give us nagging thoughts - and hopefully that in itself will always make us oppose abortion, unless the mother's life is in great danger.

Anonymouse - a bit like the development of person-hood, the development of the heart is a development of stages. First there is a space - the pericardial sack; and into that two lone and trunkless tubes turn, and in time begin to pulse, generating not a circulation, but an ebb and flow. Later, vessels form, and the tubes, outgrowing their allotted pericardial space, are forced to bend and form in upon themselves, like sausages forced into a bag, and the bends so formed in time give rise to the structured heart we know from anatomy. But where, in those stages, is the moment?

Dr No has a lot of sympathy for the Ancient Egyptian idea of a vital cord that runs from the moment of onset of life to the moment the door of earthly death closes, with everything in between inviolate. The difficulty we have today is that modern medical science has at both ends smudged the line of certainty. That is why we need to have these difficult but important discussions.

I'm going to try and make the case for 'unreasonableness' here in these matters. I'm a Christian and so my starting point for these kind of arguments is 'thou shalt not kill'. But that's not exclusive to religious believers. If you look at the law, really look at it, you will understand that that is the base of all our laws. Every law we have is to do with protecting life either directly against bodily harm, or indirectly (healthcare, free speech, education, a fair wage and so on). This is our gut instinct, the unspoken base of our law and it is what we judge all our actions against. That is why when a law goes against that principle (abortion, euthanasia, war, capital punishment) it is so contraversial. Now if you analyse that gut instinct, it's not reasonable. Why should we go out of our way to preserve life? What justification can you give for that? There isn't actually one. It's just our gut or conscience, that life should be respected. That's our bottom line for judging right or wrong.

Now, ethicists are taking advantage of this unreasonableness. If we cannot come up for a reason for preserving life, then the argument is that this base could be changed. We could add caveats about quality of life, financial considerations etc. And it is possible to present a reasoned argument on all these things in a way that it is not possible to provide a reasoned argument for the sanctity of life. And this is the point that Chesterton is trying to make. It is possible to rationalise any action at all and give a logical argument for it. It doesn't mean that the person isn't mad. And the people who make these kind of arguments such as this nonsense from Alberto Giubilini and Francesca Minerva are usually in an ivory tower somewhere away from the unpleasant business of actually carrying out the act as you correctly say, a&e cn. In a philosophy classroom, it is possible to take a neutral position and argue out all these things as a philosophical exercise. I did it myself when I was at uni and I remember how mind bending some of those classes were. But out in the real world, there is no such thing as a neutral position. Things maun be some way as we say up here, and choices have to be made. And choices have consequences. The trouble is, is that some of the arguments from the ethics classroom are creeping into our lawmaking. One of those ideas is that autonomy is a neutral position and that it should trump all. When you break this down, this is simply a refusal to make a choice about the rightness or wrongness of an action. And here we come to the nub of the problem. How do we define right and wrong now? Is the base line still the preservation of life, or is it moving? And who is defining where the line is drawn? From where I'm sitting it looks to me Alberto Giubilini, Francesca Minerva and others are doing that right now from the comfort of their classrooms and the rest of us are being asked to suck it up. I do not want to argue logically why it's wrong to kill a newborn with these sophists; I just want to say that every fibre of my being screams against it and punch them around the head for not instinctively understanding that. And if that makes me unreasonable, then so be it.

You're a great teacher, concise, systematic and easy to understand :-)

" But where, in those stages, is the moment?"

The moment 'sentience' sets in, whenever this is, be it in the womb, during, or upon birth

" Why should we go out of our way to preserve life? What justification can you give for that? There isn't actually one"

Yes there is; preserving life is preserving 'mother' is preserving continuity - works whether you are religious [those are required to do so] and non religious [preserving species, or nature]. Which then makes you wonder if there is a 'real' defining line between those two groups, ie is there really one religious person and one who is a true ethicist, or it it just that religion and how you interpret 'experiences' defines your believe and makes it a very personal matter, and experience, and that even includes one's own definition of 'god'?

And it all rets on one word you mentioned Julie; 'Conscience'.

Personhood defined in philosophy is a being characterised by consciousness, rationality and moral sense and thus the premise on which Giubilini and Minerva base their paper is sound. A newborn cannot be a person, it is a potential person.

Also defined is the traditional thought that a person has a body and a mind (or soul) and a newborn has both and therefore the premise (in philosophy) on which Giubilini and Minerva base their paper is also wrong.

At what point does a newborn become a person? To me the very moment the cord is cut for each child that I have given birth to (in a few days after the initial shock of being born) has shown their individuality and thus (to me) their personhood, their potential, their natural instinct to survive, to be, to continue to exist.

“If a potential person, like a fetus and a newborn, does not become an actual person, like you and us, then there is neither an actual nor a future person who can be harmed, which means that there is no harm at all. So, if you ask one of us if we would have been harmed, had our parents decided to kill us when we were fetuses or newborns, our answer is ‘no’, because they would have harmed someone who does not exist (the ‘us’ whom you are asking the question), which means no one. And if no one is harmed, then no harm occurred.”

What a convoluted rationale!

I am a newborn and I am killed at birth (or after a few days, weeks, whatever) and thus do not become a person (as defined in philosophy) - I am not harmed at all as according to the authors rationale I am neither an actual person nor a future person (to me as I have been killed there is no likelihood that I could become a future person as I have been terminated - but if not it surely follows that I would have become a ‘future person’?)

So if you ask me if I had been harmed my parents had decided to kill me then I would say “Yes” as I did exist (in body and mind and as vulnerable as I was) and I was someone, I was me, an individual in my own right and thus a person (with much to learn).

I applaud the JME for publishing and welcome the debate that has followed (and if I were more awake I would dissect it more (intelligently)) and do not consider Giubilini and Minerva naïve at all – I think they achieved totally what they wanted.

Anna :o]

The Witch Doctor is glad the Giubilini and Minerva paper was written, the editors published it, and the public participated in a vociferous outcry that some might find offensive.

However, it seems that in the process of apologising, clarifying, and justifying, the various parties involved in publicising this and some similar papers in the past by others regarding infanticide, are diverting the debate into the unworthiness of the comments made by those members of the public who not only talk “tripe” but, Heaven forbid, also make angry threatening noises.

Most of these threatening superlatives are probably little more than figures of speech generated by indignant anger.

That is what The Humankind do when they are upset!

Furthermore, this is the blogosphere, for Heavens sake.

Just-get-over-it!

And-get-back-to-the-point-of-the-paper!

Anyway, even if some of the life threats to authors and editors are real, then surely it is better to know that somebody, somewhere is planning your demise than not knowing it. You can then watch your back. The fear of life threats might make other philosophers consider whether it is wise to publish a debate worded in such a way that it is interpreted by lesser beings as guidance for the lawyers to follow i.e. a white paper rather than a green one. i.e. use plenty of "ifs" and "supposings" to their logic.

So if this paper makes academics worldwide consider how they present their debates in writing to a global readership in future, then publishing this paper is worth it for that reason alone.

Meanwhile, My Black Cat is bombarding The Witch Doctor with her thoughts on certain aspects of this paper that she finds very disturbing. She is even considering that an outcry (but not quite so vociferous) might have the intentional outcome of the authors, so maybe, by the witching hour tonight, we might visit Bad Med again to elaborate further.

On the other hand, we might not.

I think we have to consider the possibility that this bunch of academics knew what they were doing when they published this paper. Many bioethicists like to making-up stuff they know will make headlines. Sometimes one thinks that they believe you cannot be a proper bioethicists without having been threatened or blogged against. Unfortunately this paper will only encourage this vanity.

I am all for open debate on any subject (on most days I answer to being a “discourse ethicist”), but this paper and the JME’s defence of it does not promote discursive discourse and no doubt discourages people from doing philosophy. This paper marks a low spot in philosophy and the JME needs to recognise it.

Some years ago, a learned friend and colleague exclaimed to The Witch Doctor:

“You are a pantheist!”

The Witch Doctor just blinked. Maybe she is. She doesn’t really know. She does know, however, that any philosophical thoughts she might ever have, need to start with the premise that she not only acknowledges the sanctity of human life but of animal life too, amphibian life, mollusc life, insect life, bacterial life etc. It gets even worse - she even acknowledges the sanctity of inanimate natural objects, the moon and the stars, and of potential life where two cells have not yet met!

As you can imagine, this makes life very difficult for a witch, because with every footprint she destroys life and has to live with that knowledge. As she is not vegetarian, she has to live with that too. Things become very uncomfortable indeed when she considers the human species. So much so, that even if she were so inclined (which she never was), it is unlikely she would ever have become a gynaecologist - such is her discomfort with the concept of aborting a human foetus.

The Witch Doctor thought she had better mention this because what she is going to say now might precipitate death threats.

The Giubilini and Minerva observe that “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’

Due to the possible unbearable burden to the family and the economic burden on the state of a person with a chromosome abnormality that results in Down's Syndrome, they argue: “when circumstances occur after birth such that they would have justified abortion, what we call after-birth abortion should be permissible.”

This is what The Witch Doctor calls “Creep most Logical.” i.e the existing law has set the scene for an unlawful act eventually becoming lawful without too much thought or too much fuss.

A foetus with a cleft palate, might be aborted too. Such a person might cost the state some money for surgical correction plus maybe speech therapy but a drain on the economy is not a major issue. The reason for abortion must therefore be that it is not twee to have a baby whose face is not completely formed at the time of birth. A baby born with a severe cleft palate will likely cause the mother and other members of the family some distress and it is that potential “ family upset” that leads to abortion in the first place. If a baby with undiagnosed cleft palate is seen at birth, and the mother turns her head away and says she would have had an abortion if she had known, then it is “Creep most Logical” to kill, euthanase or “after-birth abort” that baby.

And so it goes on, and on until the "designer baby cult" takes over.

Some of those threatening the authors of the paper with death threats could see where this might lead. Ethnic cleansing, euthanasia, eugenics, Nazi Germany have all been quoted. This too is Creep Most Logical” and it upsets many people.

Taking into account parental poverty, narcissism, or wider economic factors that justify abortion, then this Creep Most Logical opens many doors into destructive activities that most of society would find totally repugnant -hence the anger and insults. Indeed The Witch Doctor has even thought the unthinkable - an activity that could result from such “Creep Most Logical” that it would repel most of the human race and as such will not be elaborated upon by The Witch Doctor at any time.

The authors of this paper will have been better trained than the Witch Doctor to think logically, and so it is unlikely they also will not have thought through most of the unthinkable consequences of what they have said in this essay. Although she cannot be sure, The Witch Doctor suspects they are probably normal sensitive human beings, as sensitive as any philosopher can be, who are issuing a warning to society to “take heed” because “Creep Most Logical” is alive and well.

They won’t call it that of course.

For it is a witching term.

Researchers should continue to be allowed to publish, even if their material 'outrages' others, because publishing encourages debate, and you do need that to 'learn' then find solutions - sometimes better ones too

Dear Dr No,

I am with the WD on this. There is a peril in logic that comes to this conclusion. Rather like a string of complex mathematical equations that leads to an impossible answer, this conclusion demonstrates that there is a flaw in one of the steps. My philosophical knowledge is not so good as to be able to locate the flaw, but it is definitely there. I suspect that the point of the paper is to try to instigate a search for the flaw in the logic.

There have been too many cases over the years where declaring other people "unpeople" have led to atrocities, and people never learn. Just look at Homs where "unpeople" were dealt with in a logical way.

Dr Phil

" Rather like a string of complex mathematical equations that leads to an impossible answer"

A string?! It's always just the one equation that has no solution, unless of course you are talking about simultaneous equations where the rule will still apply, if one doesn't solve then the second will not solve too because there will be no definite values to your xs and ys and that will be true to all equations that follow the same pattern - was that string of equation 'logic' how you arrived to the 'unpeople' idea?

The Witch Doctor in her ignorance needs to ask philosophers two questions:

1. Why is the sanctity of life "tripe?"

2. Why do many of them not acknowledge "The Slippery Slope" i.e. Creep?

Please Witch Doctor - don’t think philosophers are bioethicist. Some very quick answers to your questions.

Sanctity is not tripe. Sanctity is what Bernard Williams called a “thick concept” and cannot be swept away by “thin concepts” like ‘person’ because it looks reasonable and fits into the theoretical enterprise. Thick concepts are “world guided” and bring into question reason and logic because we have to ask questions about the “position” of ourselves and reason.

Many bioethics claim that slippery slopes do not exist because their existence undermines their theories. There is obviously a slippery slope from the concept of person to eugenics, but the facts of history have little impact of theorists unless they support the theory. For the most part the history of eugenics has been distorted by bioethics by removing the slippery slopes until the Nazis enter the picture. Slippery slopes in Nazis Germany did exist, but this is not Nazis Germany so there are no slippery slopes now. Simple.

WD - "Creep most logical" - Dr No thinks YBC may have been talking to Hercule Poirot, for it has the sound of a phrase la plus Belgique.

Boots - Dr No thinks the flaw in the paper is not the logic, but the starting point or premise, which is that it is person-hood that confers the right to life. The logic is then: person-hood confers the right to life; person-hood requires certain attributes; if you don't have those attributes you are not a person; and if you are not a person, you don't have a right to life.

KT - thank you for your contributions. The idea of a 'thick concept' make sense, in that it is a given, it just is, and cannot be arrived at by logic alone (although of course there is a logical argument that can me made for the sanctity of life, but that doesn't prove that the sanctity of life 'is'); nor can it be, as I believe the word most popular in philosophocal circles to be, 'unpacked'. One can imagine unpackable things make philosophers feel le plus queasy.

Slippery slopes: Dr No does not argue here and now is Nazi Germany - clearly it is not. Instead, the argument is (a) a slippery slope did happen in Nazi Germany (b) slippery slopes are therefore known to happen (c) a slippery slope could happen here. It is a bit like saying because one patient can get pneumonia, so too can another quite different patient; of if we see one black swan, then we might see another round the next corner. It is reasoning based on observation: once we know something exists in one time/place, then it is possible it may (note may, not will - it depends on circumstances) exist in another time place. It is quite beyond Dr No why philosophers/bioethicists have such appalling difficulty with such ideas.

On a more general note, Dr No wonders if philosophers can be divided into thick philosophers and thin philosophers. Here he uses thick, as Williams does, as a non-pejorative term, perhaps in the sense of solid, feet on the ground philosophers. Thin philosophers, on the other hand, might be those who forever pace the steps of an Escher stairwell, getting nowhere.

Thanks for the clarification KT. It makes sense to me. And I apologise for not recognizing the difference between bioethicists and philosophers. In my day we were taught medical jurisprudence. It was much simpler. Presumably, though, many of those originally trained in philosophy have branched out or at least influence the subject of Bioethics.

Quite like the idea of thick and thin philosophers too. Maybe the thin ones should be banned from dabbling in bioethics because of the danger of those at the coalface being sucked into the muddle and becoming so confused they can't do their jobs properly.

Incidentally, here is a discourse supporting "That Paper." This looks to me like more Creep Most Logical.

Maybe if you want to kill your newborn, rather than put in in a dustbin to suffer pain, better take it to a hospital and have the medics kill it painlessly for you.

http://bigthink.com/ideas/more-danger-further-thoughts-on-post-birth-abo...

"But, even if it was policy: it would only really apply to those who want/need to kill their newborns, just as abortion only really applies to those who want/need abortions (I realise this is a slight simplification). Would we not want death occurring in places where it can be done painlessly and without complications, like hospitals? There are already laws against murdering infants and people, but laws do not stop us. The many newstories of babies being found in dumpsters - which happens nearly everyday in South Africa, for example - surely can't be better than allowing these same babies to die painlessly, in a safe environment? Again, just because I'm saying killing babies in hospitals is better than mothers forcing the babies to starve to death in filthy dumpsters, does not mean we ought to legalise post-birth abortion; but it does attempt to set our priorities straight. Furthermore, if the newborn is painlessly killed in a hospital, the organs of the infant could be used to save even more lives, such as of those children whose parents do want them."

The Witch Doctor, silly soul, has another quaint idea that is doubtless unethical. If infanticide enters a mother’s head, why not take the baby to hospital or other safe place where it can be looked after properly and the mother is given practical help.

As I say Dr No, bioethics have a problem with slippery slopes, and indeed history and the real world, because it gets in the way of their theorises. I think I should quote a couple of passages from Williams because it saves time.

‘The belief that you can look critically at all your dispositions from the outside, from the point of view of the universe, assumes that you could understand your own and other people’s dispositions from that point of view without tacitly taking for granted a picture of the world more locally familiar than any that would be available from there; but neither the psychology nor the history of ethical reflection gives much reason to believe that the theoretical reasonings of the cool hour can do without a sense of the moral shape of the world, of the kind given in everyday dispositions.’ (Ethics and the Limits of Philosophy. p.50)

‘Once we see that it is impossible to rationalize everything [in ethics], the project of rationalizing as much as possible need not be understood as doing the next best thing. We may conclude instead that we were looking in the wrong direction.’ (ibid p.113)

Williams was by no means the only anti-theorist (he did not like this label), but he did have such good style.

Your quote Witch Doctor is typical. It’s so simple - all you have to do is get your priorities straight. The suggestion that ‘Would we not want death occurring in places where it can be done painlessly and without complications, like hospitals?’ is not so much a slope more a sheer drop. Language has become completely distorted if ‘in a safe environments’ for babies means “the place where they are killed“! Madness. As usual there is not a word about who is going to be doing the killing. (Even Himmler realised that killing non-persons could psychologically unhinge hardened SS thugs because they might view their victims as a bit human which might make them a little depressed). But it’s all very reasonable, especially when you consider the bonus of all those organs for the lucky children that are wanted by their parents. What they call a win win situation.

Must go because I have to do some proper philosophy.

As a child I used to cry over the nursery rhyme "Who killed Cock Robin."

The cat has just brought in a dead robin and I'm upset (truly).

It's awful being a soft, sentimental, stupid, illogical, and possibly pantheist witch doctor. Oh to be a carefree bioethicist.

One lesson of history is how easy it is to train willing executioners. We do not need to have nazi thugs. Bomber Harris trained British volunteers to drop incendaries on wooden german towns full of refugees. Ordinary people can be turned into killers quite easily, indeed it is a core part of army training.

Desensitising people to death is also part of medical training, but sometimes it goes too far. The road from sensitive bereavement counselling to "whoopee! ash-cash!" is a short one, and one that I have seen travelled a little too often. Infanticide is not a very different destination. Doctors need to spend more time with sensible grounded people, and medical ethicists as much as surgeons.

Sorry to hear of your black cats killing spree, WD.

Dr Phil,

What you are referring to is reframing and that is closely related to Creep. I suppose most doctors need a degree of desensitization in order to do their jobs properly but for many it might be more a switch that goes off and on as they concentrate on fiddling about inside a patient’s abdomen or consider a difficult differential diagnosis i.e. situations where some detachment is in the best interests of the patient. I think the "ash cash" is more black medical humour than anything else. Most doctors, although many may not flaunt it, probably manage to retain compassion for their patient's suffering, and perhaps that is because many of their patients are themselves sensible grounded people. Bioethicists do not have that wide exposure to those who are very ill, so perhaps they are more vulnerable to reframing by those around them whom they respect for their apparent "clear and novel thinking" and creep starts with emulation.

That is not to say doctor's don't creep and for some that might involve killing as the medical atrocities in Nazi Germany prove. We all creep but surely the secret is to recognise when it is happening in order to pinch yourself long before you reach the darkness. For some reason, perhaps many reasons, it did not seem possible to do that in Nazi Germany and some doctors crept into a mindset where they permitted themselves to commit atrocities. Perhaps all medical students should be made to read Kater’s “Doctors under Hitler” as an introduction to bioethics.

However, It hasn’t passed me by that there is a kind of patronizing “oh, here we go again” attitude of some “deep and logical thinkers” when Nazi Germany is introduced into a debate. Perhaps as Keith Tayler has written above, this is related to it getting in the way of some types of utilitarian thinking.

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Our own society criticizes infanticide but our thoughts are quite liberal for those who kill newly born children. According to a report, more than 300 women charged with neonaticide in the U.S. and not even one spent more than a night in jail. Margaret Spinelli has gathered a group of professionals to study the subject of maternal infanticide from psychosocial, biologic and lawful, perceptions. She addresses some misconceptions in her book Abortion, Euthanasia and Infanticide: A Slippery Slope in an endeavor to promote a more humane view of women who kill their infants. She believes that many of these mothers have been the victims of psychiatric disorders and have lacked the family and societal supports that could have prevented the misfortune.

Our own society criticizes infanticide but our thoughts are quite liberal for those who kill newly born children. According to a report, more than 300 women charged with neonaticide in the U.S. and not even one spent more than a night in jail. Margaret Spinelli has gathered a group of professionals to study the subject of maternal infanticide from psychosocial, biologic and lawful, perceptions. She has addressed some misconceptions in her book Abortion, Euthanasia and Infanticide: A Slippery Slope in an endeavor to promote a more humane view of women who kill their infants. According to her- many of these mothers have been the victims of psychiatric disorders and have lacked the family and societal supports that could have prevented the misfortune.

The opinions of the church in these deaths reflects an awareness of one of society's first attempts to understand the severe problem of overpopulation and overcrowding. England has traditionally viewed infanticide as a "special crime," passing its first Infanticide Act in 1623 under the Stuarts and more recently in the Infanticide Acts of 1922 and 1938. Most recently England passed the Infanticide Act of 1978 which allows a lesser sentence for attempted infanticide. Unlike England and other European countries, the United States has not adopted special statutes to deal with infanticide or neonaticide. Nonetheless, juries and judges, as reflected in their verdicts and sentences, have consistently considered the difficulties and stresses of a mother during the post-partum period. Klick Hier

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