Right Wing Nut House

When is the killing of helpless infants justified and when should it be considered infanticide?

Jim Holt’s excellent article in the New York Times places that question in both an historical and religious context and asks “Are we humans getting more decent over time?”

Infanticide — the deliberate killing of newborns with the consent of the parents and the community — has been common throughout most of human history. In some societies, like the Eskimos, the Kung in Africa and 18th-century Japan, it served as a form of birth control when food supplies were limited. In others, like the Greek city-states and ancient Rome, it was a way of getting rid of deformed babies. (Plato was an ardent advocate of infanticide for eugenic purposes.) But the three great monotheistic religions, Judaism, Christianity and Islam, all condemned infanticide as murder, holding that only God has the right to take innocent human life. Consequently, the practice has long been outlawed in every Western nation.

Holt then outlines the practice of the Groningen Protocols that provide legal guidelines to physicians for ending the life of a suffering infant. But when is it ever morally correct to kill a live baby? Mr. Holt gives a fair definition of the “sanctity of life’:

At first blush, a call for open infanticide would seem to be the opposite of moral progress. It offends against the ‘’sanctity of life,” a doctrine that has come to suffuse moral consciousness, especially in the United States. All human life is held to be of equal and inestimable value. A newborn baby, no matter how deformed or retarded, has a right to life — a right that trumps all other moral considerations. Violating that right is always and everywhere murder.

That would be the absolutists view - a view held by many social conservatives. But living as they do in the real world, doctors and parents must sometimes deal with tragic circumstances that make the absolutist view ring hollow:

Take the case of a baby who is born missing most or all of its brain. This condition, known as anencephaly, occurs in about 1 in every 2,000 births. An anencephalic baby, while biologically human, will never develop a rudimentary consciousness, let alone an ability to relate to others or a sense of the future. Yet according to the sanctity-of-life doctrine, those deficiencies do not affect its moral status and hence its right to life. Anencephalic babies could be kept alive for years, given the necessary life support. Yet treatment is typically withheld from them on the grounds that it amounts to ”extraordinary means” — even though a baby with a normal brain in need of similar treatment would not be so deprived. Thus they are allowed to die.

Clearly, there are exceptions to the sanctity of life precept. But is it morally right to cross the line between allowing a baby to die and doctors and parents actively participating in the killing of the infant? Holt frames the question fairly:

The distinction between killing a baby and letting it die may be convenient. But is there any moral difference? Failing to save someone’s life out of ignorance or laziness or cowardice is one thing. But when available lifesaving treatment is deliberately withheld from a baby, the intention is to cause that baby’s death. And the result is just as sure — if possibly more protracted and painful — as it would have been through lethal injection.

And that’s the dilemma that Groningen is supposed to “solve.”

My own view is that while the morality of the Groningen Protocols can be justified in extremely rare cases, the potential for abuse of its guidelines is so great that adoption of its rules will be fraught with danger.

The problem arises when there is a conflict between a Doctor’s obligation to his patient (the suffering infant) and his desire to serve the interests of the parents. It may be difficult and painful to contemplate, but the fact is that there are some parents who would view a malformed child as a burden they would not wish to bear or worse, an inconvenience they could do without.

At one time, there were federal guidelines regarding such cases that prevented Doctors from allowing these infants to die. Called “Baby Doe Guidelines,” they mandated giving life sustaining care to infants with Downs Syndrome, Spina Bifida, and other non-fatal conditions. The Supreme Court eventually struck down some of the guidelines, rejecting the Reagan Administration’s arguments that they were a civil rights matter. The medical community has since generally followed the guidelines but many pediatric professionals believe them to be too constraining and, in many cases, simply ignore them.

And this brings us to what Mr. Holt calls “passive euthanasia.” The case that precipitated the Baby Doe Guidelines is a good example:

A famous test case occurred in 1982 in Indiana, when an infant known as Baby Doe was born with Down syndrome. Children with Down syndrome typically suffer some retardation and other difficulties; while presenting a great challenge to their parents and families, they often live joyful and relatively independent lives. As it happened, Baby Doe also had an improperly formed esophagus, which meant that food put into his mouth could not reach his stomach. Surgery might have remedied this problem, but his parents and physician decided against it, opting for painkillers instead. Within a few days, Baby Doe starved to death.

Another grey area would be the condition known as spina bifida. The condition occurs approximately once in every 2,500 live births. There are 4 different types of spina bifida, ranging from the mildest form where there are few complications, to the most severe type that is painful for the infant and would entail a lifetime of intense and constant care by the parent. The fact is, that nearly 9 out of 10 spina bifida patients will survive if given the proper care and treatment. Surgery is mandated for the most severe cases. The point is, that it is treatable 90% of the time.

My concern with the adoption in the United States of any Groningen-type guidelines is that the decision to euthanize a child - either passively or otherwise - will have input from the Doctors and parents, which is well and good.

But who speaks for the child? Who stands up for the innocents to insure that both the parents and Doctor are truly acting in the interest of the infant? And while wide latitude must be granted the family and their primary physician in any decision like this, the sanctity of life doctrine demands the maximum protection for any life - be it a week old or a century old - be maintained. The question that I’m asking is before any decision to end life is made, who represents the weakest, the most vulnerable members of society - those who cannot speak for themselves?

I don’t know the answer or even if there is one. All I know is someone from a higher pay grade than I should be asking before we adopt the Groningen Protocols or something similar here.

UPDATE

My blogbud Raven who blogs at And Rightly So gives some valuable input in the comments section below (#2). Raven has extensive experience in this field and is a compassionate, caring person who asks some of the same questions I do:

Who answers for the one who stands to lose it all?

We place a higher value on the life of others by deciding that if they aren’t LIKE US, they wouldn’t want to be alive. Who are we to do this?

This is the issue that I believe our liberal and libertarian friends tend to dance around and not address. If you’re an atheist like me, the kind of moral authority to end life comes from the collective conscience of society. This collective conscience is expressed in a variety of ways, most notably by decisions of the courts or by legislation. But what if the majority believe one thing and the courts and legislative bodies express another?

In a case like that, shouldn’t we fall back on - dare I say it - tradition? I don’t want to hear about polls or surveys that show “X” percentage of Americans support this or that. Everyone reading this knows that those polls can be radically skewed by the way the question is framed. I would hazard a guess and say that if an infant’s condition is treatable, the overwhelming majority of Americans would be in favor of life rather than passive euthanisia or some kind of Groningen type solution regardless of the “burden” on the parents or society.