Sunday 13 October 2013

Defending the ‘indefensible’? Twenty reasons to think twice about aborting a baby with anencephaly

Note: This is a long post but the main points can be easily scanned. You can listen to my interview on the Stephen Nolan show on BBC Radio Ulster on this issue here

A woman who is carrying twin girls with a fatal foetal abnormality has appealed to the Northern Ireland Minister for Health Edwin Poots to allow her have an abortion in Northern Ireland.

The woman, known as Laura, who is almost 22 weeks pregnant, said she was very recently informed that her babies have anencephaly and had no chance of survival. She is now arranging to travel to England for an abortion.

The case of another Northern Ireland woman, Sarah Ewart, who had an abortion last week in London for a baby with the same condition at 20 weeks has recently been highlighted by the BBC’s Stephen Nolan.

The 1967 British Abortion Act does not apply in Northern Ireland, where termination is permitted only where it is ‘necessary to preserve the life of the woman or there is a risk of real and serious adverse effect on her physical or mental health, which is either long-term or permanent’.

Currently only about 40 abortions are performed in Northern Ireland each year although 905 women from the province had abortions in England Wales in 2012.

A consultation is currently taking place about changing the guidelines on abortion and Minister of Justice David Ford has said that there is a need to widen it ‘to look at difficult issues like foetal abnormality to see if where the law is currently drawn is in the right place’ (see also here).

Anencephaly is a severe form of spina bifida where a failure of fusion of the neural rube in early pregnancy results in the baby developing without cerebral hemispheres, including the neocortex, which is responsible for cognition. The remaining brain tissue is often exposed, ie. not covered by bone or skin (see diagram above).

Those babies who survive to birth almost all die in the first hours or days after birth. There is no curative treatment available, only symptom relief.

Anencephaly is not uncommon, occurring in 1 out of 1,000 pregnancies, but only 3 out of 10,000 live births. Over 95% of parents opt for abortion in countries where this is legal and 208 babies with the condition were aborted in England and Wales in 2012. 

One cannot hear these tragic testimonies without being deeply moved by the emotions expressed. There are few things worse than losing a child and it is a huge thing for a mother to carry a baby to term, knowing that it will be born with a terrible deformity and die shortly afterwards.

It is perhaps not surprising therefore that the media coverage of these recent cases, along with the public reaction, has been overwhelmingly supportive of the decision to abort and that there is now growing pressure for a change in the law.

Very few people, even doctors or disabled people’s advocates, are willing to express a contrary opinion, and I do so only because I believe that the issue is so important that the arguments for the contrary position need to be heard.

Before I qualified as a doctor I probably would have taken the generally expressed view, but an experience I had as a junior doctor dramatically changed my attitudes both to disability and abortion.

More on that later, but first, at the risk of being accused of trying to defend the ‘indefensible’, let me give twenty reasons why I believe parents (and doctors) should think twice about aborting a baby with anencephaly, and why I believe we as a society should be advocating an alternative approach. I would stress that this is my sincerely held personal view.

1. A baby with anencephaly is a human being
Our humanity is not diminished or degraded by sickness, disability, fragility, intellectual impairment or by what people think of us or how they value us. Babies with severe conditions like anencephaly are human beings worthy, like all human beings, of profound wonder, empathy, respect and protection.

2. A baby with anencephaly is not brain dead
Babies with anencephaly, although not conscious, are not brain dead. Their brainstems are functioning at least in part which is why they can breathe without ventilators, often survive for several days and are  not permitted to be used as organ donors.

3. A baby with anencephaly is a dependent relative
Babies with anencephaly are profoundly dependent but are also biologically related to their parents and carry their genes. They are therefore dependent relatives and so should I believe be treated with the same love and respect as any other dependent and dying close relative.

4. A baby with anencephaly is a disabled person
Babies with anencephaly are profoundly disabled and have special needs. They are also people because personhood is not contingent upon intellectual capacity or function but conferred on every member of the human race. They are therefore just profoundly disabled people who should be treated the same as disabled people at any other age. There are other causes of similar brain dysfunction including birth asphyxia, trauma, stroke and brain tumour. 

5. Palliative care is the best response to terminal illness
Babies with anencephaly are human beings with a terminal condition. They are dying babies for whom no curative treatment is possible. The appropriate management in treating patients in this condition is palliative care – food, water, warmth, human company and symptom relief. Perinatal hospice is a wonderful concept that should be promoted much more widely. 

6. We should not be making judgements about the worth of other people 
None of us has right to make value judgements about the worth of another human being; especially when that person is unable to express an opinion about the matter. Equally we do not have the right to end their lives regardless of what burden we perceive they impose on us. 

7. Abortion for anencephaly is discriminatory
Anencephaly is usually diagnosed at the time of the 18 week anomaly scan so abortion is inevitably later than this. Most people however strongly oppose abortion beyond 20 weeks. The recent parliamentary inquiry into abortion for fetal disability (Bruce Inquiry) concluded that the current law on abortion for severe disability was discriminatory in two ways. First it allowed abortion up until 24 weeks for able-bodied babies but until birth (40 weeks) for disabled babies. Second it allowed abortion for babies with significant risk of a serious abnormality, but not for those with lesser degrees of special need. 

8. Abortion for anencephaly is often a coercive offer
The Bruce Inquiry revealed that there was a strong presumption from doctors that parents with disabled babies would choose to have them aborted. This led to a huge amount of subtle or direct pressure being placed on parents who decided not to abort. They were repeatedly asked to reconsider their decisions and treated like pariahs – in short they were discriminated against. It is just this sort of pressure that has led some commentators like Melinda Tankard Reist to talk about abortion for disability as a ‘coercive offer’. Reist’s book ‘Defiant Birth’ tells the personal stories of women who have resisted ‘medical eugenics’ and dared to challenge the utilitarian medical model and mindset.  

9. Abortion for anencephaly is contrary to every historic ethical code 
Historic codes of medical ethics such as the Hippocratic Oath and the Declaration of Geneva prohibit abortion. The latter states as one of its central tenets, ‘I will maintain the utmost respect for human life from the time of conception; even against threat I will not use my medical knowledge contrary to the laws of humanity’.

10. Abortion for anencephaly exchanges one problem for a whole set of different problems
Abortion may appear to offer a solution but the mother is still left to deal with the guilt, emotional trauma and unresolved grief of loss of what is almost always a wanted baby. These inward scars may take a lifetime to heal.

11. Saying goodbye properly is important for resolving grief and achieving closure
Achieving effective closure after the loss of a baby is best achieved if parents are able to spend time with their dying, or dead, baby, saying what they would have wanted to say and treasuring the precious moments. Covering the baby’s head with a woollen cap may enable them to focus on the eyes and face which are usually normal to look at (see the story of Rachel). ‘Saying Goodbye’ is a charity which is running very welcome thanksgiving services for couples who have lost babies before or after birth. 

12. Abortion for anencephaly can be profoundly damaging to a mother’s mental health
Mothers who abort babies for fetal abnormality are highly susceptible to mental health problems afterwards. This is because the abortions are late, the babies were generally ‘wanted’, an emotional bond with the baby has usually been established and there has been no opportunity properly to say goodbye. There is a better way than abortion.

13. Pregnancy is the most intimate form of hospitality
A mother’s womb offers protection, warmth, shelter, food and water within the body of one’s closest relative. There is no form of hospitality that is more intimate or more suited to one whose life is going to be very short.

14. There are real dangers of incremental extension once we embark down this route
The British Abortion Act 1967 was driven through on the back of the thalidomide disaster and was meant to authorise abortion only in severe circumstances. Now there are 200,000 abortions a year with one in five pregnancies ending in this way. Babies have been aborted for cleft palate and club feet. Recent statistics showed that between 2002 and 2010 there were 17,983 abortions of disabled babies in Britain. The overwhelming majority of these were for conditions compatible with life outside the womb and 1,189 babies were aborted after 24 weeks, the accepted age of viability. 

15. Deformity does not define us
Our worth as human beings is independent of any disabilities we might have.

16. Easing our own pain is not sufficient reason for ending another person’s life
Given that babies with anencephaly do not feel pain, the question has to be asked whose pain their deaths are actually relieving. Any interventions should primarily be aimed at benefiting the babies themselves.

17. Anencephaly forces us to acknowledge and face our deepest prejudices
In a society that values physical beauty, athletic prowess and intellectual capacity highly it is easy to see why babies with anencephaly are low down the pecking order. They fall foul of our deep societal prejudice toward people who are ‘ugly to look at’, ‘unintelligent’ and ‘physically inept’. The only effective way of overcoming such prejudices is to cultivate attitudes of compassion and care for people with severe disabilities. Caring collectively for those who are suffering, disabled and dying makes our society less selfish.  

18. Major life decisions should not be made at a time of crisis
Major life decisions, like choosing to abort one’s disabled baby, should not be made at a time of great emotional trauma. Parents need to be given the time, space and support necessary to make an unpressured and unhurried decision and need to be told that keeping the baby is an alternative option for which full support will be given.

19. We should not allow ourselves to be manipulated by the media or those with an agenda
I was deeply shocked that the BBC would interview a deeply traumatised grieving woman who had just heard the most devastating news of her life in front of a national audience just days before one of the most horrendous experiences a woman can go through – aborting her own baby. More than this, such hard cases should not be used by media presenters with a wider political agenda of liberalising abortion laws (see Melanie McDonough in the Spectator). This was I believe both exploitative and abusive. Huge sensitivity is also needed with the language we use. These are babies living with anencephaly. They are not ‘anencephalics’, ‘dead babies’ or ‘non-persons’. These are dehumanising terms. Just as we would not accept the terms ‘spastic’, ‘moron’, ‘imbecile’ or ‘vegetable’ to describe human beings, neither should we accept these.

20. Death is not the end
I have attempted to address the points above to a general audience but allow me one explicitly Christian argument. As a Christian I believe that human beings are made for eternity. This earthly existence is just the ‘Shadowlands’. So when we think of loved ones, who have died with dementia, we do not think of them as they were but as they will be. Because of Christ’s death and resurrection we look forward to the resurrection of the body into a world where there is no dying, mourning, death or pain. In this new world there will be no anencephaly. The Christian ethic is to treat all people as we would treat Christ and to treat others as Christ would have done. The bottom line is that we should treat babies with anencephaly as if they were Jesus himself, and treat them in the way he would have done.

I mentioned above an experience I had as a junior doctor which changed my attitudes to abortion and disability.

The administrative clerk on the medical ward where I was working was heavily pregnant and I asked her when she was due. She gave me the date and before I could say anything else said, ‘my baby has anencephaly’. While I was inwardly asking why she had not had an abortion, she added, ‘I could not bring myself to end the life of my own baby’.

The baby was born a few weeks later and survived about a week. She held it, nursed and cared for it and said her goodbyes before its inevitable death.

Up until that point I had not contemplated that such an approach was even possible. She not only demonstrated that it was but taught me a huge lesson about courage, compassion and how to face and handle tragedy, grief and bereavement. I have never forgotten it and resolved then, that if I was ever in the same situation I would want to do the same.

I have heard many similar testimonies since from women in similar situations who have made similar decisions and have become even more convinced that this is best way to handle it (See testimonies here, here, here, here and here and resources for parents here).

Having a baby with a severe disability changes one’s life forever whatever choice one makes. But choosing to offer the hospitality of pregnancy and a mother’s care and compassion to a dependent and severely disabled relative, and to be willing to shoulder the inevitable pain of separation and bereavement, is I believe the best way through this tragic situation. 

Useful Links 

Testimonies 
A Life precious to God 
Waiting with Gabriel 
Baby Rachel's Legacy 
Love poured out is never wasted 
How to cope when you find your baby has special needs 
Our journey with anencephaly
Vapour and Mist - Sophia's story

Face book Groups 
Perinatal Hospice 
Waiting with Gabriel 
A Gift of Time
Anencephaly.info

Resources 
Perinatal Hospice 
Saying Goodbye
Links about anencephaly 
Defiant Birth
Anencephaly.info
NINDS Anencephaly information page 
Inquiry into Abortion on grounds of disability




45 comments:

  1. I was really struck by the story of Teresa Streckfuss in Melinda Tankard Reist's Book "Defiant Birth", who carried not one but two children to term with anencephaly and who wrote so movingly about how love was the reason - she loved her children. And they lived for a short time, which I don't remember hearing in lectures when I was a medical student. Her account is here http://webspace.webring.com/people/nt/teesieau/whycarryadyingchild.html and there is an amazing page of resources for parents here http://www.anencephalie-info.org/e/links.php

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    1. Many thanks. I've also added these links to the article.

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  2. Your arguments are not really relevant, since the pro-abortion lobby are only concerned about "choice", not disability. And, seriously, were you pro-abortion yourself, until the incident with your pregnant clerk? I find that hard to believe, given your views on faith and faith-related matters.

    And as for "if I was ever in the same situation I would want to do the same" - how on earth can you ever be in the same situation, when you're a man?!

    But otherwise a good blog post - I'm just not sure your arguments apply exclusively to anencephaly. Normal babies are related to their mothers too, and are dependent on them - yet are being aborted in droves. Hardly unique to anencephaly, is it?

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    1. I won't speak for the author, but in my experience in carrying a baby with anencephaly to term, I learned that even people who are pro-life support the right to abort terminally ill babies/fetuses, such as anencephalic babies. So, while of course the arguments apply to all unborn babies, it seems people need to be particularly reminded of the dignity of all humans when they are considering anencephalic babies, one called "monsters" even in the medical community.

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    2. James (and Andrea),

      It is true that some Christians and prolifers support abortion in cases like this and this is precisely why I wrote this blog post to challenge them.

      I know that many people who are pro-abortion will never change their position on this and are in fact using this extreme case to further their agenda. My intention however is to get people in the middle ground to consider another viewpoint than that which they are getting from the media.

      Yes the arguments do have wider application than just anencephaly but it is over the hard cases that the argument is lost or won.

      Re being in the same situation myself every baby has two parents and it is generally couples who together make these decisions.

      Peter

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    3. Re appealing to those in the middle ground - Ok, fair enough.

      Re every baby having 2 parents - of course, but only one gets the absolute right to terminate, and that is the mother.

      Unfortunately the father does not have a say, under our legal system - the mother can over-ride his decision. A pathetic state of affairs, but there you go.

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  3. There is a support group for parents of a baby with anencephaly who choose to carry their child to term after the prenatal diagnosis.

    Their goal is to show that while the life expectancy of their babies is brief, they do have a life. A life precious and valuable, worth to be protected and cherished. A ‘Life compatible with love’.

    See https://www.facebook.com/groups/anencephaly.info/

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  4. I am a mother who carried my third child full term, despite a fatal diagnosis with cognitive heart disease. I can fully empathise with all the agonies this poor mother in Northern Ireland is going through. However, I do not regret not having an abortion, and I hope that if my husband and I were ever in the same situation again, we would make the same decisions. We gave our baby the best life we could and have so many happy memories of his three days with us.

    My main reason for posting here is to recommend a book called 'A Gift of Time: Continuing Your Pregnancy When Your Baby's Life Is Expected To Be Brief' by Amy Kuebelbeck and Deborah L. Davis. It is American so uses slightly different terminology but I found it a very helpful book. There are many examples of mothers who carried full term their babies with anencephaly, as well as many other fatal conditions.

    Thank you for your article, some very good reasons, most of which which I'm glad the medics in our case also agreed with - and Number 20 is what keeps me going!

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  5. Sorry, that should be congenital heart disease, not cognitive.

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    1. Many thanks for sharing this Helen.

      For those wanting to follow this up I have previously blogged on Amy's book and have linked it, along with Melinda's book referred to above and other similar testimonies, from this blog post - see http://bit.ly/VX47Oj

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  6. I left this comment on FB where I saw this linked to and realised I should have come here to leave my comment!

    Our first daughter had significant congenital abnormalities incompatible with life and we were offered termination as an option for her. We said that this was not something we would consider.

    To the credit of the doctors and midwives caring for us, it was never mentioned again and instead we were offered weekly viability scans to see if she was still alive. (She did die in utero.) We were treated with such compassion. We were never made to feel that we were wasting their time.

    Having faced that, I loved your paragraph about "Pregnancy is the most intimate form of hospitality." It was a great comfort to us that, for however short her life was going to be, she was safe and warm in my womb where I could care for her until God chose to take her home.

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    1. Thank you for sharing this. Every life however short is a complete life and the time you had with your baby was a precious gift from God. When you see her again she will be pulsing with life and you will have her then for all eternity. We live here in the Shadow lands - the real substance is yet to come (1 Corinthians 2:9)

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  7. Such a beautiful and compassionate post.

    I think that it is the compassion and humility of your arguments that wins me over Peter. I find that people who argue ethics from a classically humanistic standpoint (apologies for the sweeping generalisation) are more interested in being right than in showing humility or compassion, and that is one of the things that alienates me most from what they are saying.

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  8. Thank you for your post. Rang very true with me: I am currently 5 months pregnant with a baby who will not survive beyond a few hours at most. Very tough. But we do not regret our decision to continue. It also strikes me that this discussion would not have even happened just a generation ago, before scans became so detailed.

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    1. Thank you for sharing this Katharine. I'm so sorry to hear this. Can I particularly recommend Karen Palmer's post linked above - http://bit.ly/1658lZf

      I think a good way to look at it is that you have four precious intimate months from now to share with your baby and make the very most of.

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    2. God bless you all, my prayers are for you and your child.

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  9. Powerful and persuasive post, Peter, thank you. Yet to see any of the pro-abortion lobby even try to respond to this tidal wave of points. And amazing to read of those of you facing these very real issues in your lives, may God bless you in these times

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  10. The clarity of your reasoning and your deep compassion in this very difficult area is helpful, thank you. Shared to my fb wall.

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    1. http://babyfaithhope.blogspot.co.uk/ Please go to this link where someone I know had such a little girl who lived thrived 6 weeks after birth and even giggled and sucked.. this is a blog with some video footage which is proof of all you have said here.

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    2. Thank you so much for this link Dawne. I have linked it above under testimonies.

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  11. Hi Peter. I love this compassionate and thoughtful post. I was just wondering if there were any published studies linking abortion for anencephaly (and presumably other life limiting conditions) to elevated mental health risks. (Beyond those associated with social abortion). I have heard anecdotally that women who carry terminally ill babies to term do better than those who abort but are there any studies that confirm?

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    1. I would have to search for any on anencephaly specifically but there are a number of studies on the mental health effects of termination for fetal abnormality (TFA). Here are the conclusions from a recent one just published this year:

      'Despite using mostly adaptive coping strategies, women's levels of grief were high and varied according to obstetric and termination variables. Grief was predicted by behavioural disengagement, venting, planning, religion, self-blame, being recently bereaved, being childless at the time of TFA, not having had children/being pregnant since TFA and uncertainty about the decision to terminate the pregnancy.'

      Ref is http://www.ncbi.nlm.nih.gov/pubmed/23943597

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  12. This is a difficult area I think. I would always have veered in my own mind towards following through with the pregnancy should I be in that position - mainly because that way I could be sure that all that could have been done was done and I could have peace about it. Since then, through the abortion debates in the Republic of Ireland, where I am from, I have become aware of a situation involving a couple known slightly to me and outlined as part of the article linked below which I suggest is worthy of prayerful consideration. For one thing it reminds me of the need for compassion and of being aware of what I may not be aware of that may be going on in the lives of peope I discuss these issues with or in front of. http://www.terminationformedicalreasons.com/news-and-events/i-believe-in-a-loving-god-and-that-i-wont-be-damned-for-what-i-did/

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    1. It is a difficult area, but do articles like the one you've posted give the whole picture? The article just assumes that carrying on with the pregnancy is medically unsound and lacking in compassion. Why not include stories of women who carried on with the pregnancy instead of travelling to England?

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    2. Hi, I posted it as a balance to the original post rather than as the 'whole picture', the original post already includes the story of someone who carried on with the pregnancy. The compassion I referred to is compassion towards those who are grieving the loss of their baby and whose grief may be compounded by not feeling able to tell people what has happened.

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  13. Thank you so much for this article. I am currently 37+ weeks pregnant with an anencephalic baby in the US where 98% of these babies are aborted. As I approach my due date your article gave me the peace and closure I have been seeking since I found out about his condition in June and decided to carry him .
    We had a friend in May who was left nearly brain dead from a fall this past spring. It was inevitable that he would die - ultimately he did after bring removed from life support. When the doctors initially discovered the damage was the option given to actually kill him due to his prognosis !? Of course not that would be murder ! Why then in the case of babies should it be OK ?

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    1. Thank you for sharing this. You might find the testimonies I have linked above an encouragement on your journey.The story of your friend is very helpful too. I agree with you about treating all people with brain damage from whatever cause with the same love and care.

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  14. Thank you for this amazing and beautifully written post.

    Blessings to you!

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  15. Thank you for writing this, I recently carried my baby girl, Sophia (diagnosed with anencephaly at 20 weeks) to term and we not only made it our aim to celebrate her life weekly as she grew in my womb, but to celebrate with her when she was born. God gave us 10 precious hours with her alive after she was born. Though our hearts hurt now we have no regrets of the choices we made to carry our little girl! We have chronicled our story with her on my blog. I pray more and more women know they have another option, and the option to give life is so incredibly rewarding!

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    1. Our story is found here... www.vaporandmist.wordpress.com

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    2. Thank you so much for this and for the link. I have added it to the list of testimonies above.

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  16. Peter, thank you for this post. Sometimes even pro-lifers have tended to overlook the importance of defending the right to life of anencephalic babies. If we do not defend, above all, the right to life of the most vulnerable of the vulnerable the pro-life movement has no credibility. Thank you for this compassionate post.

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  17. A very useful description of what anencephaly actually is which I was not aware of. People talk of it as if there was no brain at all or even "being without a head" (see Melanie McDonagh's article to which you refer) when the facts are rather different.

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  18. Does it ever happen that there is no brainstem either i.e. there is no brain at all? Would I be right in thinking that in such an event there would be a natural miscarriage at a much earlier stage?

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    1. As far as I know yes and yes. A large proportion of miscarriages are due also to chromosomal abnormalities and especially trisomies. Only trisomies 13, 18 and 21 ever make it to birth. All the others are fatal in utero.

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  19. While I appreciate that this post shows a lot more compassion and avoids a lot of the vindictive comments that have been a feature of this debate from those advocating carrying to term in all circumstances, I do take issue with a number of points. It makes a massive assumption / generalisation that those who make the incredibly difficult decision to tmfr do not regard their child as a human being, that they have no respect for them or view them as less valuable and that the mother is not interested in saying goodbye. Having been through the experience myself and knowing several others in similar circumstances, I can say that this is definitely not the case. Tfmr is NOT the same as an abortion - it can and often takes the form of a mother giving birth prematurely. Yes, it is physchologically difficult to deal with - losing a much loved child will always be but parents should not be made to feel guilty that they opted for tfmr. I dont believe it is the only route, those who opt to carry to term have every right to do so but it is hugely unfair that those who chose to deliver early should be accused of discriminating against their child, of not valuing their life or regarding them as a human being.
    My child had every right to life but her illness meant that that was possible - It was not I who took that right away from her. Please consider the effect of these claims of couples such as us.

    You talk of the dangers of incremental extension. I agree wholeheartedly and I would not want to see these hugely sad cases used as pawns in the argument for abortion for all. However, neither do I think it is fair to tar couples who have made the difficult decision to tfmr in the case of a fatal diagnosis with the same brush as those who terminate for Downs or Club foot.

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    1. Thank you for sharing this. As you say terminating the pregnancy in this case involves inducing labour early. This action shortens the baby's life as it cannot survive outside the womb. The reason some mothers decide to carry the baby to term, as you will see from above, is that they wish to have as much time as possible with their babies before they die and don't wish to take steps to precipitate their deaths.

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  20. Thank you. Simply thank you.Very difficult times here in NI where the dehumanisation of the child in the womb gathers pace aided by the most partial of media coverage.

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  21. Dear Peter,

    I enjoyed reading your post on this subject. It was very thoughtful and caring.

    My question, although it's probably not for you to answer, is when it is reasonable to accept that a human body, though alive, does not contain a person? For example, were a person genuinely brain-dead, and being kept alive through artificial means, would we accept as Catholics that this was a respiring collection of cells, and not a person? The Church does accept this I believe - that this is good enough evidence that the body has been "de-souled" as it were.

    It is not a massive leap towards accepting that an active brain-stem (which does not regulate any conscious function, as I understand it) but no cerebral cortex, constitutes the same state. That is, that the brain's higher functions are so inextricably linked with personhood and the soul that, lacking these, we can assume we have a body, not a person. While the Church may not accept this yet, it doesn't seem a leap in doctrine too far for an organisation that accepted for 1.5 millenia that abortion before the quickening was in fact contraception, especially as the evidence we have today is far greater.

    Could it be that the Church draws the line here because, if they did not, they would have to re-address the moral issue of early abortion of normal embryos? That the line, in other words, would become too probabilistic and grey to manage, or campaign upon.

    Just a possibility, and I hope you take this message in the right way, I'm genuinely not trying to be contrary or troublesome!

    Best

    N

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  22. I am afraid I am pretty ignorant of the medical aspects but what Anonymous suggests is interesting.

    However I would argue that consciousness is not the criterion. Even less is personhood. What is personhood? Is it having one or two A-levels?

    If on the operating table I have been rendered unconsciousness for the purpose of having my appendix removed is it okay to kill me?

    What exactly is consciousness? It seems to me it is some awareness of the world around me. But does this not require some "thing" that becomes aware at some stage? Can that thing or soul not be present from the moment of conception? The lack of a cerebral cortex may mean that one is not conscious or aware of anything but can we be certain of this?

    Surely killing an embryo just because it is not or not yet conscious is most probably preventing a wonderful good from taking place? It always amazes me how people go bananas over a new born baby but seem indifferent to abortion.

    As to death I again ask why consciousness should be the criterion. I would have thought one has to be certain that the body is providing no useful function to the soul. Can we be certain that brain death is sufficient evidence of such? I would have thought the first sign of putrefaction was a better indicator.

    Lastly I am not sure that everyone thought that killing an embryo prior to quickening was contraception rather than abortion. Some surely believed that the spermatozoa was a human being and the woman merely provided lodging. Whether contraception or abortion though it was still considered wrong.

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    1. Hi Nicolas,

      "What is personhood? Is it having one or two A-levels?" - no, for me it has nothing to do with intelligence. A dog has personality, but is stupid. But it does have to have some level of consciousness. A doll we buy from Toys-r-us is animate when the batteries are full, it even speaks. The computer in it might even be quite sophisticated and clever. But it isn't a person, because it lacks the basic apparatus necessary for consciousness.

      "If on the operating table I have been rendered unconsciousness for the purpose of having my appendix removed is it okay to kill me?" - no, because while dulled by anaesthetic, it is clear to all that there is an ongoing consciousness. Even if it is blind, deaf, and barely aware, there is an "it" to be "aware".

      "But does this not require some "thing" that becomes aware at some stage? Can that thing or soul not be present from the moment of conception"

      It could be. My point was that:

      (a) "from the moment of conception" is as much as theological hypothesis as "from the moment of the quickening" was.
      (b) that if "a human being is a substantial union of body and rational soul", why would you have a rational soul in an irrational cell? It is not unreasonable to suspect that the ensouling happens when the body has at least a rational capacity to match the soul's, just as the de-souling happens when the body ceases to have a rational capacity (the brain dies, or is removed) despite the rest of the body working.

      "The lack of a cerebral cortex may mean that one is not conscious or aware of anything but can we be certain of this?"

      AS the National Catholic Bioethics Centre says:

      "The Catholic Church looks to the medical community to determine the biological signs that indicate with moral certainty that this event has already occurred."

      Brain death is accepted as a sign of this. http://www.ncbcenter.org/page.aspx?pid=1285

      "Surely killing an embryo just because it is not or not yet conscious is most probably preventing a wonderful good from taking place?"

      This is a different evil: contraception. Not murder. Early abortion, under the Augustinian view of delayed ensoulment was seen as contraception.

      "I would have thought one has to be certain that the body is providing no useful function to the soul."

      And this is key to the argument. If the soul is rational, what useful function can be provided without the cerebral cortex? Hence the Church accepting brain death as a criterion for death.

      "Can we be certain that brain death is sufficient evidence of such?"

      According to the Church, yes.

      "Lastly I am not sure that everyone thought that killing an embryo prior to quickening was contraception rather than abortion."

      I'm sure not everyone thought it, just as not everyone thinks that killing an embryo now is murder not contraception. I'm talking about generally accepted doctrine, rather than absolute unanimity.

      "Whether contraception or abortion though it was still considered wrong."

      Yes. But you see the point of the argument despite this, right? That there could be a shade of grey in the abortion debate, even for Catholics. And perhaps Church doctrine about ensoulment might have more to do with avoid this grey area than with rational engagement on the issue.

      N

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  23. Anencephaly, a word unknown to me until I lived it, a very long time ago when hospitals and staff virtually forbade a mother from even seeing her child. My 2nd born son's stay was brief, but long enough to lead me onto the path of adoption. It took almost 40 years to actually SEE my choice was the right one, for the first born of my adopted daughter looked enough like my first born son for them to be brothers. There is NO biological connection. So, for a brief while the soul/spirit of my dear lost one came to show me the WHYof anencephaly in my life. I so look forward to reuniting with his spirit when my time here on earth is finished.

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  24. Simply thank you.Very difficult times here in NI where the dehumanisation of the child in the womb gathers pace aided by the most partial of media coverage...!!

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  25. It saddens me that there are those who refuse to belive abortion is a kindness and death is a wonderfull thing.

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  26. I strongly believe that when faced with the news that your much longed for baby has anencephaly people cope and react in a way that is right for them. Yes this article shows compassion to those mothers who decide to continue their pregnancy to term, but what of those mothers (like me) who could not comprehend carrying their baby to term and to watch them die if not before birth in the next few hours following it. This is a decision that affects the entire family and one that is made because its the right decision for them as a whole. Having other children in the family watch with excitement as mummies tummy grows, the tears and heartbreak that will happen when they watch their sibling die and mummy cope with the lose of her baby. I am not under any illusion this is the right choice for everyone, in fact i believe that for many mothers carrying their baby to term and holding them in their arms if even only for a few moments will bring them so much comfort and help them cope with this absolutely heartbreaking situation. It is very unfair to say however that every woman should have to cope with this situation in the same way. Women deserve to be shown the same compassion and care needed to cope in this situation no matter what they choose to do. i will always grieve for my much longed for baby but i made a decision that was right for my family and if there had been any chance of a different outcome for my baby my decision would have been very different. This is a heartbreaking outcome for all women told their baby has anencephaly not just those who choose to carry their baby to term. :-(

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