R.C. Christian
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After-birth abortion: why should the baby live? -- Giubilini and Minerva -- Journal of Medical Ethics
After-birth abortion: why should the baby live?
Alberto Giubilini1,2,
Francesca Minerva3
+ Author Affiliations
1Department of Philosophy, University of Milan, Milan, Italy
2Centre for Human Bioethics, Monash University, Melbourne, Victoria, Australia
3Centre for Applied Philosophy and Public Ethics, University of Melbourne, Melbourne, Victoria, Australia
Correspondence to Dr Francesca Minerva, CAPPE, University of Melbourne, Melbourne, VIC 3010, Australia; [email protected]
Contributors AG and FM contributed equally to the manuscript.
Received 25 November 2011
Revised 26 January 2012
Accepted 27 January 2012
Published Online First 23 February 2012
Abstract
Abortion is largely accepted even for reasons that do not have anything to do with the fetus' health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call after-birth abortion (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled.
Introduction
Severe abnormalities of the fetus and risks for the physical and/or psychological health of the woman are often cited as valid reasons for abortion. Sometimes the two reasons are connected, such as when a woman claims that a disabled child would represent a risk to her mental health. However, having a child can itself be an unbearable burden for the psychological health of the woman or for her already existing children,1 regardless of the condition of the fetus. This could happen in the case of a woman who loses her partner after she finds out that she is pregnant and therefore feels she will not be able to take care of the possible child by herself.
A serious philosophical problem arises when the same conditions that would have justified abortion become known after birth. In such cases, we need to assess facts in order to decide whether the same arguments that apply to killing a human fetus can also be consistently applied to killing a newborn human.
Such an issue arises, for example, when an abnormality has not been detected during pregnancy or occurs during delivery. Perinatal asphyxia, for instance, may cause severe brain damage and result in severe mental and/or physical impairments comparable with those for which a woman could request an abortion. Moreover, abnormalities are not always, or cannot always be, diagnosed through prenatal screening even if they have a genetic origin. This is more likely to happen when the disease is not hereditary but is the result of genetic mutations occurring in the gametes of a healthy parent. One example is the case of Treacher-Collins syndrome (TCS), a condition that affects 1 in every 10 000 births causing facial deformity and related physiological failures, in particular potentially life-threatening respiratory problems. Usually those affected by TCS are not mentally impaired and they are therefore fully aware of their condition, of being different from other people and of all the problems their pathology entails. Many parents would choose to have an abortion if they find out, through genetic prenatal testing, that their fetus is affected by TCS. However, genetic prenatal tests for TCS are usually taken only if there is a family history of the disease. Sometimes, though, the disease is caused by a gene mutation that intervenes in the gametes of a healthy member of the couple. Moreover, tests for TCS are quite expensive and it takes several weeks to get the result. Considering that it is a very rare pathology, we can understand why women are not usually tested for this disorder.
However, such rare and severe pathologies are not the only ones that are likely to remain undetected until delivery; even more common congenital diseases that women are usually tested for could fail to be detected. An examination of 18 European registries reveals that between 2005 and 2009 only the 64% of Down's syndrome cases were diagnosed through prenatal testing.2 This percentage indicates that, considering only the European areas under examination, about 1700 infants were born with Down's syndrome without parents being aware of it before birth. Once these children are born, there is no choice for the parents but to keep the child, which sometimes is exactly what they would not have done if the disease had been diagnosed before birth.
After-birth abortion: why should the baby live?
Alberto Giubilini1,2,
Francesca Minerva3
+ Author Affiliations
1Department of Philosophy, University of Milan, Milan, Italy
2Centre for Human Bioethics, Monash University, Melbourne, Victoria, Australia
3Centre for Applied Philosophy and Public Ethics, University of Melbourne, Melbourne, Victoria, Australia
Correspondence to Dr Francesca Minerva, CAPPE, University of Melbourne, Melbourne, VIC 3010, Australia; [email protected]
Contributors AG and FM contributed equally to the manuscript.
Received 25 November 2011
Revised 26 January 2012
Accepted 27 January 2012
Published Online First 23 February 2012
Abstract
Abortion is largely accepted even for reasons that do not have anything to do with the fetus' health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call after-birth abortion (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled.
Introduction
Severe abnormalities of the fetus and risks for the physical and/or psychological health of the woman are often cited as valid reasons for abortion. Sometimes the two reasons are connected, such as when a woman claims that a disabled child would represent a risk to her mental health. However, having a child can itself be an unbearable burden for the psychological health of the woman or for her already existing children,1 regardless of the condition of the fetus. This could happen in the case of a woman who loses her partner after she finds out that she is pregnant and therefore feels she will not be able to take care of the possible child by herself.
A serious philosophical problem arises when the same conditions that would have justified abortion become known after birth. In such cases, we need to assess facts in order to decide whether the same arguments that apply to killing a human fetus can also be consistently applied to killing a newborn human.
Such an issue arises, for example, when an abnormality has not been detected during pregnancy or occurs during delivery. Perinatal asphyxia, for instance, may cause severe brain damage and result in severe mental and/or physical impairments comparable with those for which a woman could request an abortion. Moreover, abnormalities are not always, or cannot always be, diagnosed through prenatal screening even if they have a genetic origin. This is more likely to happen when the disease is not hereditary but is the result of genetic mutations occurring in the gametes of a healthy parent. One example is the case of Treacher-Collins syndrome (TCS), a condition that affects 1 in every 10 000 births causing facial deformity and related physiological failures, in particular potentially life-threatening respiratory problems. Usually those affected by TCS are not mentally impaired and they are therefore fully aware of their condition, of being different from other people and of all the problems their pathology entails. Many parents would choose to have an abortion if they find out, through genetic prenatal testing, that their fetus is affected by TCS. However, genetic prenatal tests for TCS are usually taken only if there is a family history of the disease. Sometimes, though, the disease is caused by a gene mutation that intervenes in the gametes of a healthy member of the couple. Moreover, tests for TCS are quite expensive and it takes several weeks to get the result. Considering that it is a very rare pathology, we can understand why women are not usually tested for this disorder.
However, such rare and severe pathologies are not the only ones that are likely to remain undetected until delivery; even more common congenital diseases that women are usually tested for could fail to be detected. An examination of 18 European registries reveals that between 2005 and 2009 only the 64% of Down's syndrome cases were diagnosed through prenatal testing.2 This percentage indicates that, considering only the European areas under examination, about 1700 infants were born with Down's syndrome without parents being aware of it before birth. Once these children are born, there is no choice for the parents but to keep the child, which sometimes is exactly what they would not have done if the disease had been diagnosed before birth.
