Several leading bioethicists defend the practice of infanticide this week in leading medical journal

In February 2012 two bioethicists provoked international outrage with an article advocating infanticide.

Writing in the Journal of Medical Ethics (JME), Alberto Giubilini and Francesca Minerva argued in ‘After-birth abortion: why should the baby live?’,   that foetuses and newborns ‘do not have the same moral status as actual persons’.

They concluded that ‘after birth abortion (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled’.

The same journal (JME) has this week responded to the crisis with a special issue containing 31 commentaries from a range of ethicists, some of whom have argued for years that infanticide can be a moral action; others who believe that even suggesting it is a vile stain on academic integrity.

Editor Julian Savulescu introduces the issue with these words:

‘Infanticide is an important issue and one worthy of scholarly attention because it touches on an area of concern that few societies have had the courage to tackle honestly and openly: euthanasia. We hope that the papers in this issue will stimulate ethical reflection on practices of euthanasia that are occurring and its proper justification and limits.’

Savulescu claims to be ‘strongly opposed to the legalisation of infanticide along the lines discussed by Giubilini and Minerva’ but says that they are not alone in advocating it.

Infanticide is already practised openly and legally in the Netherlands under the ‘Groningen Protocol’ which allows doctors to end the life of neonates at the request of their parents if the infant is experiencing ‘hopeless and unbearable suffering’.

In addition some of the world's most famous living philosophers have written about its merits and justification over the last 40 years, including Michael Tooley, Jonathan Glover, Peter Singer, Jeff McMahan and John Harris.

Four of these five have contributed to this issue of JME and the full text of their articles is currently available on line.

McMahan argues that the permissibility of infanticide in some circumstances is not only implied by certain theories, but by beliefs that are widely held and difficult to reject.

Michael Tooley's book is entitled Abortion and infanticide.

Peter Singer wrote a book in 1985 with Helga Kuhse called Should the baby live?

Jonathan Glover's landmark Causing death and saving lives notes that ‘Dr Francis Crick (the Nobel Laureate who discovered DNA with Jim Watson in 1956) once proposed a two-day period for detecting abnormalities, after which infanticide would not be permissible’.

Many will be shocked by what these philosophers are saying but Savulescu argues that the issue throws up a broad range of ethical questions fundamental to medical ethics.

What constitutes a person with rights? Is there a moral difference between killing a baby of the same gestation inside and outside the womb? Is there a moral difference between euthanasia and withdrawal of treatment and/or sedation with the explicit intention that the baby will die? In what circumstance is ‘letting die’ morally different from killing?

These are all serious questions which many people, including many doctors, have not carefully thought through.

As I have previously argued these bioethicists have actually done us a service. If we don’t like their conclusions, then it should actually lead us to question the premises from which they logically flow.

Philosophers like Peter Singer believe that it is the qualities of rationality, self-consciousness and communication that make human beings special. What follows from this is those humans with less of these qualities are of less value and can, in some circumstances, be disposed of.

By contrast this Christian view of the sanctity of life, which Singer and others reject, is that human beings have value not because of any ‘intrinsic’ qualities, but for two main ‘extrinsic’ reasons. First, that they are made in the image of God for an eternal relationship with him, and second because God himself became a human being in the person of Jesus Christ and thereby bestowed unique dignity on the human race.

If we follow that view through to its logical conclusion it leads us to say that any human being, regardless of its age, appearance, degree of deformity or mental capacity, is worthy of the highest possible degree of protection, empathy, wonder and respect.

These bioethicists are arguing that infanticide is morally no different to abortion.

But we can draw one of two conclusions from that – either we should embrace infanticide or stop doing abortions.

But whatever view we opt for, we should have the courage of our convictions to draw out its full practical implications as these bioethicists have done.

Most people are just not that consistent. 

Doctor who killed seven new-born babies by cutting their spinal cords with scissors may face death penalty

The Daily Telegraph (see here and here) has this week run the story of a US abortionist who is facing a potential death sentence after being charged with the gruesome murders of seven babies and a mother.

Dr Kermit Gosnell (pictured), who is on trial in Philadelphia, Pennsylvania, allegedly ran a filthy and dangerous ‘abortion mill’ from his clinic, where he terminated pregnancies after the state's 24-week legal limit.

24 weeks is the age beyond which babies will generally survive in a neonatal unit although babies born as young as 22 weeks have been known to survive in exceptional circumstances.

The Telegraph reports it as follows:

The 72-year-old doctor is accused in a graphic 281-page grand jury report of forcing vulnerable women to give birth to live foetuses, which he and his colleagues killed using a method they called ‘snipping’.

‘He regularly and illegally delivered live, viable babies in the third trimester of pregnancy - and then murdered these newborns by severing their spinal cords with scissors,’ the grand jury states.

Dr Gosnell is charged with eight counts of murder. His case has generated widespread revulsion and rekindled the emotive and politically-charged debate over access to abortion across America.

Prosecutors allege that Dr Gosnell's legitimate-sounding Women's Medical Society was in fact a ‘baby charnel house’ in which foetal remains were left scattered around in freezers, bags and jars.

Charged with seven counts of first-degree murder, Dr Gosnell is now standing trial in a Philadelphia courtroom. 

An unlicensed medical school graduate delivered graphic testimony about the chaos at the clinic where he helped perform the late-term abortions.

Stephen Massof described how he snipped the spinal cords of babies, calling it, ‘literally a beheading. It is separating the brain from the body’.

He testified that at times, when women were given medicine to speed up their deliveries, ‘it would rain fetuses. Fetuses and blood all over the place.’

According to the Atlantic, the story has been played down in the American media – possibly because the allegations of a homicidal abortion doctor don't fit into their pro-choice narrative (more on this here, here,  here, here and here)

There was also evidence of a cover up suggesting that there may have been many other cases – from the Telegraph:

While records for most of these are said to have been destroyed, Dr Gosnell has been charged with seven counts of first-degree murder in cases where investigators discovered documentary evidence.

One, ‘Baby A’, weighed about six pounds and was breathing and moving after his 17-year-old mother gave birth, prosecutors say. Joking that the baby was big enough to ‘walk me to the bus stop,’ Dr Gosnell allegedly disposed of his body in a shoebox.

Dr Gosnell is also charged with the third-degree murder of Karnamaya Mongar, a 41-year-old refugee from Nepal, who died after being sedated.

Prosecutors claim that before paramedics arrived, her body was rearranged to appear as though she had been undergoing a ‘routine, safe abortion procedure’.

The clinic was raided by the FBI in February 2010 and Dr Gosnell's medical licence was suspended.

Two academic bioethicists stirred up huge controversy a year ago by saying that infanticide was ethically equivalent to abortion.

Their point was that if we can justifiably abort babies beyond 24 weeks, then it must be equally justifiable to kill them after birth at the same (or possibly even younger) age.

Their logic is difficult to fault.

But if people are shocked by infanticide– and I hope that most are especially after reading a story like this – then they should surely be equally questioning late abortion.

There were 2,729 abortions carried out in England and Wales in 2011 on babies at 20 weeks gestation or beyond, of which 146 were beyond 24 weeks.

No wonder that sections of the American media were reluctant to run the story.

I wonder how much of the British media will touch it. 

PS. Finally, on 16 April there is massive media coverage on both sides of the Atlantic after the BBC covered it on 15 April..

Some of the public reaction to Virginia Ironside advocating smothering a suffering child was deeply disturbing

Many viewers watching BBC1’s religious programme Sunday Morning Live last weekend will have been shocked to hear agony aunt Virginia Ironside advocating smothering a suffering child as an act of motherly love.

Her actual words? 'If I were the mother of a suffering child - I mean a deeply suffering child - I would be the first to want to put a pillow over its face... If it was a child I really loved, who was in agony, I think any good mother would.' She added, 'If a baby's going to be born severely disabled or totally unwanted, surely an abortion is the act of a loving mother.'

Another guest on the programme, Rev Joanna Jepson (pictured), was left open-mouthed and presenter Susanna Reid looked visibly shocked during the live debate, responding: 'That's a pretty horrifying thing to say, that you would put a pillow over a suffering child.'

Ironside’s comments understandably sparked a storm of complaints from viewers and an outcry from disability rights spokespeople but personally I was left even more deeply disturbed by the amount of apparent public support for her views.

If the rapid responses on the Daily Mail website represent in any way the views of the general population (and are not simply those of a vocal minority drafted in for the occasion by eugenic activists) then it seems that many British people actually agree with Ironside. Furthermore, those comments supportive of Ironside’s position attracted the most ‘thumbs up’ from readers whilst those criticising her stance were uniformly given the ‘thumbs down’.

One respondent, calling herself, ‘Widget’ of ‘Broken Britain’, attracted over 1,400 stars from fellow readers for writing, ‘I can see what she is saying - or rather trying to say - and I completely agree. What loving, caring mother would make the conscious decision to bring a child into the world that would live in continual pain and agony and have zero quality of life for its whole existence?’

We are now in Britain well used to pro-euthanasia advocates Dignity in Dying’s calls for a change in the law to allow ‘mentally competent adults suffering unbearably with terminal illness’ to receive lethal injections to end their lives.

But it seems that many members of the public, undoubtedly affected by the protrayal of seemingly desperate cases on the media, now wish to go much further than this. And in fact to do so actually follows logically from what we are already doing. If we abort over 95% of all babies with Down Syndrome diagnosed before birth on the basis that their lives are judged not to worth living, then why not allow infanticide just a few months later, or equally, why not legalise euthanasia for mentally incompetent patients with brain injury or dementia at the other end of life? Wouldn't this be simply taking the principle to its logical conclusion?

Historic codes of medical ethics, like the Hippocratic Oath and Declaration of Geneva, however, forbid all compassionate killing for very good reason.

Some years ago I came across the words of a doctor given in defence at a euthanasia trial and was struck by how compassionate they seemed.

'My underlying motive was the desire to help individuals who could not help themselves... such considerations should not be regarded as inhuman. Nor did I feel it in any way to be unethical or immoral... I am convinced that if Hippocrates were alive today he would change the wording of his oath... in which a doctor is forbidden to administer poison to an invalid even on demand... I have a perfectly clear conscience about the part I played in the affair. I am perfectly conscious that when I said yes to euthanasia I did so with the greatest conviction, just as it is my conviction today that it is right'.

It was seeing the name attached to the testimony that brought me up short. The words were actually spoken at Nuremberg by Karl Brandt, the doctor responsible for co-ordinating the German euthanasia programme during the Second World War. Ironically, many of those involved were in doctors who seemed to be motivated initially by compassion for their victims. But their consciences, and that of the society which allowed them to do what they did, gradually became numbed.

The Nazi holocaust, contrary to popular opinion, did not begin with jack-booted Nazis in death camps like Auschwitz and Treblinka in the mid 1940s. Rather it had far subtler beginnings with doctors in hospitals and psychiatric institutions in the 1930s. And the very first victims were 6,000 disabled children whose lives were judged not to be worth living and who were killed for reasons of ‘compassion’.

You see, once you start killing out of compassion, it can be very difficult to draw a line. And like a frog who makes no attempt to escape from water which is gradually brought to the boil, if the change in temperature is gradual enough, it can be very difficult to perceive what is happening until it is too late. Given some of the reaction to Ironside’s comments it might already be too late for Britain.