Wednesday, March 31, 2010

Remembering Terri Schiavo

Five years ago today Terri Schindler Schiavo died from court-mandated starvation and dehydration after nearly two weeks without food or water. Terri was a severely brain-damaged (but healthy, needing only food and water through a feeding tube to survive) Florida woman whose estranged husband wanted her dead, against the fervent wishes of her loving family.

Let me make two points about this travesty. First, it reflected a "quality of life" ethic that had gained traction, and continues to gain traction, in our culture: human beings are not valuable in themselves, but only by virtue of functional abilities and characteristics (which are gained and lost) that our society deems necessary for a "meaningful" life.

It's the same thinking that largely undergirds the killing of unborn human beings by abortion and embryonic humans in laboratory experiments. These vulnerable human beings fail to meet our arbitrary criteria for moral respect, and may therefore be killed for our convenience or benefit. Abortion, euthanasia and embryo-destructive research are all direct assaults on the principle of human dignity and equality.

Second, the euthanasia death of Terri took the form of denying nutrition and hydration, a practice that is now fairly common. It is not the same as withholding artificial treatment and allowing a natural death. Terri was not dying; she was perfectly healthy, and would have lived many more years. Depriving her of ordinary food and water, which are not medical treatment but basic sustenance that all of us need in order to live, was a form of intentional killing by omission (non-voluntary, passive euthanasia).

On this five-year anniversary, Bobby Schindler, Terri's brother, reflects: "I wish I could say things have changed for the better since my sister's death or that people with cognitive disabilities are now better protected in response to the horror she had to endure. ... Tragically, however, it seems the rights of the brain-injured, elderly and others are still being violated."

Read the rest of Bobby's column, and learn about the Terri Schindler Schiavo Foundation, which works to protect the rights of disabled persons.

Assessing the 'quality-of-life' ethic

The following was published in the Sept.-Oct. 2009 issue of MCCL News.

Why the elderly, disabled should not be discriminated against
By Paul Stark

When health care is rationed, it usually is done according to a "quality-of-life" ethic that now dominates the field of bioethics and much of American culture. People who are disabled, elderly, sick or mentally incapacitated—whose quality of life is considered poor—are denied care in favor of younger or healthier patients.

"The death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities," writes Princeton ethicist Peter Singer in a recent argument for rationing health care. "[S]aving one teenager is equivalent to saving 14 85-year-olds." The use of quality-adjusted life-years (QALYs) in health care decisions puts such thinking into practice.

The quality-of-life view measures the worth of a human being by features of his or her life. These may include the ability to function in ordinary tasks, participate in community, have friendships and familial relationships, appreciate beauty, exercise rational faculties and experience happiness. On this perspective, there is such a thing as a "life not worth living" or a life without meaning.

The same kind of thinking is used to disregard the lives of unborn children. Bioethicists who support abortion argue that a human being must acquire certain qualities in order to become a rights-bearing "person" deserving of respect—and unborn humans, who are at a very early stage of their development, fail to meet those criteria.

So at both the beginning and end of life, humans beings are valued according to characteristics that some humans have and others do not. This contrasts with the pro-life view, or what is sometimes called the sanctity-of-life or equality-of-life ethic, which holds that human beings are valuable in themselves—not for their acquired properties or abilities—and are therefore equal in fundamental dignity and rights.

The quality-of-life view does not withstand scrutiny. Here's why.

First, proposed quality-of-life criteria seem largely subjective. Who is to say when life is not worthwhile? Many of those with a "poor" quality of life may (and do) lead admirable and very meaningful lives.

Second, all quality-of-life criteria come in degrees—abilities, happiness, cognitive functions, etc. If one's personhood (i.e., worth, dignity, right to life) depends on quality-of-life criteria, then personhood also is a matter of degree. That is, some people are more valuable than others, and some have "more" of a right to life than others.

Say that my friend is a happy, healthy, normal college student, but I'm just a bit happier or perhaps even a bit more self-aware and appreciative of life. It would follow, on the quality-of-life ethic, that my friend has a life less worth living than mine. And each quality-of-life "setback," whether financial, health-related or otherwise, would put him one step closer to rational suicide. This is radically contrary to our intuitive notion of human equality and the dignity of human life, irrespective of circumstances.

Third, quality-of-life criteria tend to exclude some human beings who we all agree are valuable persons with worthwhile lives. Newborn babies may not yet be self-aware, and reversibly comatose patients are not even conscious. Neither can have a good "quality of life" as it is usually defined, but almost no one argues that they are not persons deserving care.

It is true that newborn babies and reversibly comatose patients will soon be able to function in the proper way and have a good quality of life; their current state is only temporary. But in order to say that they are persons, despite their present inability to function as such, we must ground their personhood in something other than those functions. Namely, they are persons because they are human beings, who by nature have the inherent capacity to develop certain abilities, whether those abilities are immediately exercisable or not.

And this means that all disabled or elderly patients—not just the reversibly comatose—are deserving of full moral respect and protection by virtue of their membership in the human family. Those with an allegedly poor "quality of life" should not be discriminated against in the provision of care and treatment.

Monday, March 29, 2010

Babies can cry in the womb

Do unborn babies cry? Yes, they do.

As Dr. David Chamberlain explains, "The emotional turmoil which provokes crying already exists in the womb and may be heard if air reaches the area around the fetal larynx. This intrauterine crying is termed 'vagitus uterinus' (literally, squalling in the womb) and is well documented in medical literature both ancient and modern."

Apparently fetal crying can be audible when air is present in the uterus (which is rare). But even without air, the fetus can perform exactly the same crying motions as a born child, just without sound.

A 2005 study suggests that unborn children can cry in the womb by 28 weeks gestation, and perhaps as early as 20 weeks.

Researchers led by Jeannie L. Gingras, M.D., concluded in the Archives of Disease in Childhood -- Fetal and Neonatal Edition: "The fetus is capable of responding to sound and other perturbations with highly coordinated movements that mimic temporal and behavioral components of the extrauterine cry. These observations may have further developmental implications, as the expression of crying implies more than execution of a motor pattern."

The Discovery Channel has an ultrasound video of an unborn child crying here.

Will you help us stop the killing?

"Most people who say they oppose abortion do just enough to salve the conscience but not enough to stop the killing."

-- Gregg Cunningham (quoted in The Case for Life by Scott Klusendorf)

Friday, March 26, 2010

Thinking clearly about abortion and health care

After withholding their support for the health care overhaul recently passed, Rep. Bart Stupak and some other pro-life Democrats agreed at the last minute to support the bill -- even though it still contained provisions that will significantly expand abortion.

There's a video circulating online from last fall that gives some insight into Stupak's thinking. He says in the video that even if his pro-life amendment to the bill were voted down, he would probably support the final legislation. He would at least have given it (getting abortion funding out) a shot, and his conscience would be clean.

Stupak is a liberal who largely supports President Obama's health care effort and wanted to see it become law. He tried his best to get abortion funding out of the legislation (and he wrongly claims he got a little something to minimize the abortion problems), but it may be that he was never willing to kill a bill that, from his perspective, was still mostly good.

That's one theory, at least. But does Stupak's vote make sense, given his commitment both to the pro-life position and to a liberal universal health care system? Nope.

The bill, on Stupak's own view, would sanction, fund and promote the unjust killing of members of a vulnerable segment of the human family. And that's impossible to justify on the grounds that the bill would (arguably) benefit other human beings (those who are not killed).

Scott Klusendorf writes, "Suppose the bill in question was near perfect, but funded the destruction of two-year-olds to provide comprehensive health care for the rest of us. Can you imagine, even for a moment, [someone] saying, 'Well, let's not reject the whole just because of something we don't like.' "

But apparently that was Stupak's conclusion: "Let's not reject the health care legislation just because of this one bad element (abortion)." Any pro-lifer who takes that view is not thinking straight -- or worse, isn't really pro-life.

Update (3/29):

Rep. Stupak has written an op-ed in the Washington Post, and in fairness I should mention that his explanation adds a new wrinkle to my evaluation. He says he faced a situation in which Speaker Nancy Pelosi already had garnered the votes to pass the bill, even without Stupak's support (or at least so he thought). So Stupak was left with two options: vote "no" and see the bill pass as it was, or offer to vote "yes" in exchange for something (the Obama executive order) that would arguably have at least some benefits. Since something is better than nothing, he chose the latter option.

Unborn babies respond to mother's mood

A new study suggests that the movement of an unborn child in the womb is affected by whether her mother is happy or sad. The study, from Nagasaki University in Japan, "investigated the relationship between fetal movements and acute maternal emotional changes during pregnancy," and found that "induced emotions in pregnant women primarily affect arm movements of their fetuses, and that positive and negative emotions have the opposite effects on fetus movement."

Dr. Kazuyuki Shinohara and colleagues in the Department of Neurobiology and Behavior of Nagasaki University in Japan showed 10 pregnant volunteers a cheery 5-minute clip from the Julie Andrews musical The Sound of Music. Another 14 watched a tear-jerking 5 minutes from the 1979 Franco Zeffirelli film The Champ, in which a boy cries at the death of his father.

Each clip was sandwiched between two "neutral" film clips so that the team could measure any changes in fetal movements against a baseline.

The women listened to the movies using headphones to guarantee that only the effect of the mothers' emotions was being measured and that their unborn babies were not being influenced by the movie's soundtrack.

"Fetuses can hear by the last trimester," explained Dr. Shinohara.

The team counted the number of arm, leg and whole body movements via ultrasound and found that during the happy film clip the unborn babies moved their arms significantly more than when the pregnant women watched the neutral clips.

However, the unborn babies of the women watching the sad clip moved their arms significantly less than normal.

Tuesday, March 23, 2010

MCCL GO commends efforts to improve maternal health in developing world

The following is a news release from MCCL GO.

World Water Day highlights need, opportunity to reduce maternal mortality

Yesterday, March 22, 2010, was World Water Day as declared by the United Nations; most people missed it, but we shouldn’t have. United Nations Secretary-General Ban Ki-moon issued a very important statement, which reads in part:
Water is the source of life and the link that binds all living beings on this planet. It is connected directly to all our United Nations goals: improved maternal and child health and life expectancy, women's empowerment, food security, sustainable development and climate change adaptation and mitigation. Recognition of these links led to the declaration of 2005-2015 as the International Decade for Action "Water for Life."
Scott Fischbach, Executive Director of MCCL Global Outreach, is pleased with the Secretary-General's statement regarding the link between safe water and maternal mortality.

"For too long the obvious facts have been overlooked in trying to reduce maternal mortality rates in developing countries," Fischbach says. "It is clean water, a clean blood supply and an adequate health care delivery system that can prevent maternal deaths, not legalized abortion as some have suggested."

In connection with World Water Day, the U.N. released a report entitled "Sick Water," in which it claims:

1. 3.7 percent of all deaths world wide are attributable to unclean water.

2. More that half of all the hospital beds in the world are occupied by patients sick from contaminated water.

3. 2 billion tons of contaminated water are discharged every day on the planet.

Working towards an adequate supply of clean water, clean blood supply and health care services not only will help all human beings, but women and pregnant women will benefit the most.

"Focusing on these three areas will bring us closer to fulfilling Millennium Development Goal 5—to reduce maternal mortality—than any and all efforts to legalize abortion in developing countries," Fischbach adds.

MCCL GO is the international outreach arm of Minnesota Citizens Concerned for Life (MCCL), the state's oldest and largest pro-life organization.

Two arguments from bodily autonomy

Let me briefly present and critique two versions of a "bodily autonomy" argument for the moral permissibility of abortion -- one simple and common, the other sophisticated and philosophical.

The simple argument

The first argument is something we hear all the time: "Women have a right to control their own bodies." Or: "It's my body, I'll decide."

These claims beg the question, or simply assume the pro-choice conclusion without actually giving reasons for it. Namely, they assume only one body is involved, and thus that abortion is not the killing of a separate, valuable human person.

The science of embryology tells us that the unborn is its own whole organism, genetically and functionally distinct from (though living inside of) the woman. A pro-choice advocate could argue that this unborn human being is not yet a "person" or a subject of rights, but that's the real issue at hand (whether or not the unborn has a right to life). The issue is not "a woman's right to control her body," for the body at stake is not hers.

Peter Kreeft observes, "If the fetus is a part of the mother, then the parts of the fetus must be parts of the mother. But in that case, every pregnant woman has four eyes and four feet, and half of all pregnant women have penises! Clearly, the absurd conclusion came from the false premise that the fetus is only part of the mother."

Crux of the debate

Most sophisticated defenders of abortion do not make question-begging claims, and instead give reasons for their view that the unborn human is not a valuable, rights-bearing person. Thus the primary substantive debate over abortion has been on the moral status of unborn: pro-life advocates contend that human beings are intrinsically valuable, and so all humans have a right to life, irrespective of stage of development or cognitive functions; pro-choice advocates say that human beings only become valuable when they acquire certain properties that are deemed morally relevant (like the immediate capacity for self-awareness), and these criteria exclude the human embryo and fetus, who may therefore be killed by abortion. (For more on this debate, go here and here.)

The sophisticated argument

But other sophisticated defenders of abortion have taken a different approach. They concede, for the sake of argument, the pro-life view of the unborn (i.e., that the unborn is a valuable human person with a right to life), but then argue that abortion is still morally permissible. This is the second argument from bodily autonomy.

The basic claim is that a pregnant woman has no moral obligation to let the unborn human being use her body for sustenance and protection, just as she would have no obligation to let any other person use her body in that way. Thus, abortion is permissible. The argument was introduced by philosopher Judith Jarvis Thomson in a 1971 journal article (she used a famous thought experiment to make her case), and versions of it have since been defended by academics such as Eileen McDonagh and David Boonin.

I won't address the argument in detail, but let me highlight a few problems. Apart from cases in which pregnancy is a result of rape or incest, a woman is responsible for the sexual activity that leads to pregnancy. It seems reasonable to say that she bears some sort of responsibility for the vulnerable human being whose existence and dependency on his mother are a natural result of the woman's own choice. (Of course the father also bears responsibility.) And that would make the bodily autonomy argument, at best, only effective in cases of rape and incest -- less than one percent of Minnesota abortions.

Second (and I think this stems from the first point), the argument from bodily autonomy does not take into account the parent/child relationship: Parents seem to have a special obligation to their dependent offspring, and unborn children seem to have a rightful claim to the womb in which they grow. As philosopher Stephen Schwarz puts it, a mother "does have an obligation to take care of her child, to sustain her, to protect her, and especially, to let her live in the only place where she can now be protected, nourished, and allowed to grow, namely the womb."

This idea (that parents have unique responsibilities to their children) is well-reflected in our laws. Estranged fathers are required to pay child support, even if they never desired to be a father. If I abandon and let starve to death my two-year-old daughter, I will go to prison -- it simply will not work to say that my daughter is not entitled to my care and resources.

Francis Beckwith writes, "Most people ... agree that in ordinary circumstances a born child has a natural moral claim upon her parents to care for her, regardless of whether her parents 'wanted' her. This is why we prosecute child abusers and parents who abandon their children." If -- as proponents of the sophisticated bodily autonomy argument concede -- the unborn is a valuable person, like a born child, then the same parental obligation that applies after birth would seem to apply before.

Third, we seem to have some obligations as members of a community to persons who are weak, vulnerable and defenseless -- even if we are not related to them and are not responsible for their existence. Judge John T. Noonan relates the story of a Minnesota court case that makes this point well:
On a January night in Minnesota, a cattle buyer, Orlando Depue, asked a family of farmers, the Flateaus, with whom he had dined, if he could remain overnight at their house. The Flateaus refused and, although Depue was sick and had fainted, put him out of the house into the cold night. Imposing liability on the Flateaus for Depue's loss of his frostbitten fingers, the court said: "In the case at bar defendants were under no contract obligation to minister to plaintiff in his distress; but humanity demanded they do so, if they understood and appreciated his condition. ... The law as well as humanity required that he not be exposed in his helpless condition to the merciless elements." ... The American Law Institute, generalizing, has said that it makes no difference whether the person is a guest or a trespasser. He has the privilege of staying. His host has the duty not to injure him or put him into an environment where he becomes nonviable. The obligation arises when one "understands and appreciates" the condition of the other.
Fourth, abortion is usually not a case of "unplugging" the unborn human being from his or her mother, as an analogy used by Thomson suggests. Rather, it is direct, intentional killing, often by dismemberment. There is a significant moral difference. If a stranger has been surgically connected to my body -- against my will -- in order for him to survive, perhaps I may legitimately "disconnect" him and withhold life support, predictably (but not with intention) resulting in his death. But clearly I may not use a machete to chop him into pieces.

Even if a pregnant woman has no responsibility or obligation to the unborn, abortion does not seem to be justified, because it is the intentional killing of an innocent human being.

Turning justice on its head

For these and other reasons, I think the bodily autonomy argument fails completely. Conceding the full dignity and rights of the unborn is a startling admission, and it's impossible for a defender of abortion to recover. But I would go further: I would suggest that the special circumstances of pregnancy actually make abortion worse than other forms of homicide (rather than, as the bodily autonomy proponent claims, a justified form of homicide). I'll explain in a future post.

For much more pro-life criticism (both popular and scholarly) of this argument, see "The Case for Life" by Scott Klusendorf (Chapter 15), "Defending Life" by Francis Beckwith (Chapter 7) and "Abortion and Unborn Human Life" by Patrick Lee (Chapter 4). Also see online essays addressing the argument here, here and here.

Monday, March 22, 2010

Abortion-expansion health care bill will become law

Yesterday the U.S. House passed the massive health care overhaul legislation, which will now be signed into law by President Obama. The bill is loaded with provisions that will expand and subsidize abortion on demand, and it will lead to the rationing of care for the most vulnerable.

Some "pro-life" Democrats, including Rep. Bart Stupak, agreed to vote for the bill after the White House released the text of an executive order that Obama will issue after the bill is enacted. But the executive order does nothing to prevent abortion funding through the legislation.

As National Right to Life explains: "The executive order promised by President Obama was issued for political effect. It changes nothing. It does not correct any of the serious pro-abortion provisions in the bill. The president cannot amend a bill by issuing an order, and the federal courts will enforce what the law says."

Wednesday, March 10, 2010

What we all have in common

If all adult human beings should be treated equally, then there must be something equal about all adult human beings -- something truly the same that we share. But it can't be age, size, cognitive abilities, athleticism, appearance or IQ. We all differ when it comes to those things. In fact, there's only one thing we all have in common: a human nature (i.e., we are all human).

And we have that human nature from the time we begin to exist as a zygote (and then as an embryo, fetus, newborn, toddler and so on). So the very thing that makes each of us equal in fundamental dignity (our humanity) is what gives unborn human beings that same dignity.

The killing of abortion and embryo-destructive research is a violation of that dignity, and a rejection of the principle of human equality.

New DVD: 'The biology of prenatal development'

A new DVD, distributed by National Geographic, shows the facts about life before birth. Here is part of the description:
This award-winning science documentary features rare imagery of the living human embryo and fetus, while growing inside the womb. Produced in conjunction with and endorsed by human development experts, this DVD combines facts gleaned from the medical literature with images produced from six different imaging technologies. This visually compelling program is intended for general audiences and communicates an unparalleled visual appreciation of early human development.
Dave Andrusko reviews the film here.

Tuesday, March 9, 2010

Is abortion necessary for women's equality?

"[Some] popular abortion-choice rhetoric ... asserts that women cannot achieve social and political equality without [abortion access]. ... But the assumption behind this rhetoric -- that equality can only be achieved through special surgery (abortion) -- implies that women are naturally inferior to men, that they need abortion (a form of corrective surgery) to become equal with men. This is hardly consistent with any feminism that claims that men are not naturally superior to women. ... It seems to me that this argument is rhetorically powerful in some circles because it taps into an unconscious sexism that assumes that male sexuality is the paradigm of human sexuality. Consequently, the inequality does not lie in the nature of women but in the disordered way in which our society places value on that nature. The key to ending this inequality is not to socialize women into the male paradigm, but to celebrate and honor the indispensable role that mothers play in caring for the most vulnerable and defenseless members of our population, the unborn."

-- Francis J. Beckwith (Defending Life, p. 111-112)

Abortion in health care bill is no fantasy

"Some of the more recent utterances by Speaker Pelosi and other top House Democrats [regarding the health care legislation] suggest that they have stumbled down some sort of rabbit hole into a fantasy world," says Doug Johnson of National Right to Life.

The massive health care overhaul bill (H.R. 3590) has already passed the Senate, on December 24, 2009. In order to enact it, however, President Obama and Pelosi must convince a majority in the House of Representatives to also vote for the bill.

And despite what Pelosi and others say, the Senate bill is the most pro-abortion single piece of legislation that has ever come to the House floor for a vote, since Roe v. Wade. Read about how the bill would significantly expand abortion here.

Please contact your member of the U.S. House, urging him or her to oppose the Senate-passed bill because of its pro-abortion provisions. The vote in the House will probably come before the end of March, perhaps as soon as March 16.

Wednesday, March 3, 2010

Abortion is 'might makes right' ethic

"Why do doctors kill fetuses rather than fetuses killing doctors? Fetuses do not want to die. They struggle to live. ... The answer is power. Doctors have power, fetuses do not. If fetuses came equipped with suction tubes, poisons, and scalpels to use to defend themselves against their killers, there would be no abortions."

-- Peter Kreeft

The argument from ignorance

Pro-choice advocates sometimes defend their view by saying something like, "We don't know when life begins." The implication is that if we are uncertain about the moral status of the unborn -- whether abortion does, in fact, kill a valuable human being -- then abortion should be permitted.

Pres. Barack Obama, for instance, has said the question of whether the human embryo or fetus has human rights is "above [his] paygrade," yet he strongly believes that killing the embryo or fetus should be legal for any or no reason.

But this doesn't make much sense. If we are unsure whether or not a building to be detonated has a person still inside, it is gravely irresponsible to proceed with the detonation. Similarly, if a woman is unsure about whether abortion kills a valuable person or just a meaningless clump of cells, then she should not have the abortion. It would be terribly irresponsible if she did, a risk of unjustified homicide.

So ignorance works in favor of the pro-life view, not the pro-choice one.

In any case, appeals to scientific ignorance are simply not justified because we aren't ignorant: we know that a new human organism, a member of our species, comes into existence at conception. The question is not when the life of a human being begins (a matter of biological fact), but whether or not human beings at certain stages of development are valuable and deserving of protection, like the rest of us.