The Nathaniel Centre

Editorial: Bioethics and the Paradox of the Human Condition

John Kleinsman
Issue 33, April 2011

Humankind and the world we are a part of are defined by paradox; we constantly experience life in ways that highlight the contradictory nature of our existence .

The recent earthquakes in Christchurch and Japan serve to remind us of the fragility of human life in the face of the brutal and amoral forces of 'Mother Nature'. Photographic images of the devastating aftermath are permanently etched into our minds as we watched, appalled, the breaking news. We are confronted by our utter powerlessness.

At the same time, as a result of the damage suffered by the Fukushima Dai-ichi nuclear plant, we have become conscious again of the immense destruction that we humans are able to cause. We are simultaneously confronted by our power to destroy the planet.

We are at once powerless and powerful. We are called to be stewards of the planet we live on even while we recognise that it is part of our human nature to overcome obstacles and to modify the world and ourselves. We also experience paradox at a more personal level. On the same day a family grieves the loss of a husband, father, grandfather and great-grandfather a young woman goes into labour and a new child is born; death and grief coexist and are intermingled with life and love. Paradox is also something each of us encounters within; we draw on our strengths while gradually becoming aware that they also define our weaknesses. And, through our weaknesses, we discover new strengths.

Because it lies at the heart of human existence, the question of paradox is particularly relevant for the discipline of bioethics.

Understandably, we struggle to make sense of the paradoxical nature of human existence which calls us to hold together contradictory realities. How do we reconcile the cognitive dissonance that characterises paradox and seems to defy rational logic? We do it in different ways.

All too often, in the face of the existential anxiety that flows from the awareness of our mortality and powerlessness, we draw on technology to try and exert ever greater control over the world in which we live. Rather than opting for a simpler lifestyle and reducing our carbon footprint in response to the environmental crisis, we look for solutions that won't interfere with our consumerist lifestyles. Rather than live and struggle with the challenges raised by disability we start to use prenatal testing to deny certain persons the right to life. Rather than caring for people with terminal illnesses in ways that invite us deeper into the mystery of suffering we start to argue for the legalisation of euthanasia to make a pre-emptive strike against death at the time of our choosing. Rather than acknowledging and reflecting on our responsibility to the common good we argue even more loudly for the right of the individual to choose.

What these responses have in common is that they attempt to cope with paradox by seeking to dissolve it. But this approach comes at a heavy price; it demands a degree of disconnection from our own bodies, other people, our environment, our universe and ultimately God. As Daniel O'Leary notes in an article titled " They shall be comforted" (The Tablet , 5 March 2011) , this disconnection results in a state of alienation that causes psychic damage. It is at odds with what we know deep within – that we are part of a loving unity that holds all things together, including those things that we experience as contradictory realities. It is also at odds with the findings of quantum physicists who have recently come to understand that the universe is interconnected in much more subtler ways than was previously thought.

Therefore, instead of dissolving or denying paradox, bioethics faces the challenge of holding in tension what is paradoxical. In our bioethical arguments this calls for us to protect and promote the inherent connectedness that exists between all things. It also calls for us to be wary of those ethical approaches which, in the way they seek to resolve dilemmas, rely on a fragmented description of reality that ignores or attempts to deny what is paradoxical.

The paradoxical nature of our existence offers a useful point of reference for critiquing the different human responses to the many dilemmas thrown up in the world of bioethics. More specifically it gives rise to a key question: To what extent do our reflections and thinking take adequate account of the reality of human paradox?

While the notion of paradox might present a philosophical conundrum for some, it is straightforwardly logical to those who are contemplatives. In the words of the prayer attributed to St Francis: For it is in giving that we receive; it is in pardoning that we are pardoned; and it is in dying that we are born to eternal life.

John Kleinsman
Director
The Nathaniel Centre

Preventing births of the poor: Birth control proposals and welfare reform

Lisa Beech

More children from the fit, less from the unfit – that is the chief issue of birth control.
                             U.S. eugenics and birth control advocate Margaret Sanger, 1919

The Pharaoh of old, haunted by the presence and increase of the Children of Israel, submitted them to every kind of oppression and ordered that every male child born of the Hebrew women was to be killed. Today not a few of the powerful of the earth act in the same way.
                                                             Pope John Paul II, Evangelium Vitae #16, 1995

The idea that poverty and other social problems can be solved by controlling who is and who is not permitted to have children has been a long favoured idea of the eugenics movement. It has been explicitly or implicitly part of global debates on population control as a means of poverty reduction, as well as a significant aspect of United States and European welfare debates. In contrast, the Catholic Church has been a powerful advocate for the rights of the poorest families not to be subjected to coercive birth control.

These debates are unfamiliar in the New Zealand social welfare context. It is therefore shocking to hear community voices advocating not only for beneficiaries to be required to take contraception, but even explicitly using the language of eugenics. “I was raised on a farm,” argued one well-respected social worker recently in support of greater birth control of beneficiaries. “And on a farm, you do not permit the unfit to breed”.

On 22 February, the New Zealand government appointed Welfare Working Group recommended that long-lasting reversible contraception be made ‘available’ to parents receiving benefits. The recommendation also states that further measures should be considered if this alone does not reduce numbers of children born into beneficiary families. Since contraception already widely available in New Zealand, there is a concern that availability may translate in practice into contraceptive use being a requirement of benefit eligibility.

This concern is shared by diverse groups including churches, beneficiary groups, women’s groups and disability groups.

The Welfare Working Group was appointed by the Minister of Social Development in 2010 to consider whether reform of the welfare system would address perceived problems of welfare dependency. At the same time various churches and community groups joined together in an Alternative Welfare Working Group which saw benefit receipt as a symptom, rather than the cause of poverty, and looked for wider measure to address the economic hardship and exclusion of people on benefits.

As a relatively isolated country with a small population, many New Zealand Catholics, as well as our wider society, are somewhat removed from international population control debates and have an impression that Catholic teaching on sexuality and birth control is primarily a private and personal matter. Therefore, the Welfare Working Group’s focus on birth control as a solution to poverty represents a significant shift in our social welfare debates, one that demands consideration of the Catholic Church’s teaching against population control as an imposition placed on the poor.

Historical background: birth control in welfare and international development debates
Debates around sterilization and contraception as requirements of welfare programmes for poor and vulnerable citizens have long been explicit in United States social security policy, as well as in wider debates about population control as a solution to global poverty.

The eugenics movement of the early 20^th century was at the forefront of debates around the shaping of populations. It was based on assumptions that society could – and should – be reshaped by promoting more births among ‘desirable’ groups, and reducing births amongst ‘less desirable’ groups. People with psychiatric illnesses, and physical and intellectual disabilities were among those targeted for population reduction. There was also a strongly racist element, with Caucasian people seen as most desirable, while many other racial groups were seen as less desirable or even undesirable.

Despite the discrediting of eugenic theory in Hitler’s extreme application of these ideas in Nazi Germany, involuntary sterilisations of psychiatric patients continued in certain European countries and the United States past the end of World War II. Proposals for compulsory sterilization of sole mothers on welfare benefits were readily evident in the United States during the 1950s and were explicitly justified using racist and eugenic arguments at that time. These days the language of birth control has become more subtle. Nevertheless, the 1950s U.S. stereotypes of ‘welfare queens’ who continue to have additional children in order to maintain their eligibility for benefits continue to the present day. As already noted, these stereotypes have now found their way into New Zealand political rhetoric about beneficiaries.

In more recent times these ideas have been fostered by a population movement that sees reduction in fertility as the key solution to poverty and an answer to overuse of the world’s resources. This agenda has been promoted on the world stage by a number of groups and at various gatherings including the United Nations sponsored Population and Development conferences in Budapest (1974), Mexico (1984) and Cairo (1994).

Pope Pius XI’s injunction against sterilisation for eugenic reasons in 1930, Pope Paul’s encyclical Humanae Vitae were all written against a backdrop of movements and world conferences aiming to reduce poverty by preventing births of the poor rather than by addressing the behavior of the rich.

Within the global population control movement, methods of contraception were sought that could be widely distributed with minimal medical oversight. Matthew Connelly details a flagrant disregard for women’s safety as contraceptives were trialled on the women of the third world despite significant evidence of negative outcomes such as perforated wombs and pelvic inflammation. Adoption of coercive population control programmes reached their extreme in the emergency period of Indira Gandhi’s government in India (1975-77) during which time 1774 people were officially recorded as having died from botched sterilisations, with many thousands more affected.

From the early 1990s, a number of U.S. states introduced family caps, which reduced assistance to welfare recipients with additional children, alongside financial incentives and, in some cases, requirements to use Norplant, a long-acting reversible contraceptive. In response to this, Catholic groups, including the United States Catholic Bishops Conference and Catholic Charities USA, were concerned that moving people off welfare would not move them out of poverty. Among their concerns was that the intended reduction in births to beneficiaries would not necessarily mean a reduction in pregnancies, but could mean an increase in abortions.

Supporters of United States style welfare reform in New Zealand have pointed to an overall decline in United States abortion numbers since the welfare changes. However, some studies taking a closer look at specific target groups have shown a different picture. Joyce et al (2004) cite an experimental evaluation of New Jersey’s family cap policy as showing an overall increase of abortions by 12 percent among welfare recipients, and by 32 percent for black welfare recipients.

In their own research, Joyce et al observed a fall in birth rates and an increase in abortion rates among poor women in states both with and without family caps. While they found that a link between family caps and abortion rates was inconclusive, they reported an overall increase in abortions among poor women – the target groups for welfare reform – contrary to the general decline in United States abortion rates.

Meanwhile, in response to the persistent argument that the birth rates of the poor need to be controlled, the Catholic Church has consistently argued that over-consumption by wealthy nations is more of a strain on the world’s limited resources than family sizes of the poor. Despite falling fertility rates in developed countries, the wealthiest 20 percent of the world’s population consumes 80 percent of its resources. Catholic social teaching recognises the human dignity of every person, regardless of the situations into which they are born, and also calls for the structural causes of poverty, such as unequal distribution of resources, to be addressed.

Present social welfare reform debates in New Zealand
New Zealand has been substantially influenced by United States views on welfare policy, and since the early 1990s has frequently looked to the United States welfare policies. The current move to frame the New Zealand government’s public policy welfare discussion in terms of ‘welfare dependency’ is a particular reflection of United States welfare debates. A direct consequence of this is that it places the onus for poverty on the behavior and lack of motivation of the poor rather than structural causes.

Similar debates and welfare reforms are currently underway in many countries including Great Britain, Australia and Europe, following the 2008-2009 global financial crisis. It needs to be noted that, both locally and globally, the language of ‘unsustainability’ of welfare systems is taking place against a backdrop of financial institution bailouts costing millions – or billions – of dollars. Looked at like this, the use of such language appears as part of a strategy for (unfairly) shifting the burden of paying for the economic crisis to the poor.

Underlying the welfare reforms aimed at women raising children alone are certain assumptions about sexual promiscuity and irresponsibility. Most New Zealanders would generally agree that a stable married family is the best environment for raising children. However, there is also a realization that there are a wide range of circumstances in which women find themselves raising children alone.

Among the many circumstances that lead to sole mother households are the death of a husband or partner; women pregnant as a result of rape or sexual abuse; women who have escaped domestic violence; women who have been abandoned by husbands and partners; and women who have found themselves pregnant and alone but have chosen not to have abortions. It is nothing less than offensive to imply that sexual irresponsibility has caused the poverty of many of these women and their children.

Even in circumstances where a range of informal and changing sexual relationships mean that children are growing up in fatherless households, it needs to be asked whether encouraging contraceptive use is going to increase committed partnerships. It seems more likely to increase the attitude that women alone are sexually available for men who do not wish to make long-term commitments.

However, allowing the debate to focus on sole mothers overlooks the significant fact that the Welfare Working Group recommendation is not restricted to sole parents, meaning that married couples who find themselves on a benefit resulting from unemployment, natural disaster (such as the Christchurch earthquakes), illness or disability would also be discouraged from giving birth to children. For disabled couples, who may always require some benefit support, this is equivalent to a permanent discouragement of children.

The Welfare Working Group recommendation about reducing numbers of children born to beneficiary families is not the only recommendation which offends Catholic concepts of human dignity and protection of the vulnerable. Also of concern are proposals which would redefine most sick and disabled people as ‘jobseekers’ and force them into a labour market at a time when it cannot currently accommodate those already seeking work. Proposals such as reductions in hardship assistance and restructuring base benefit levels will potentially cut incomes of New Zealand’s poorest citizens.

Concluding remarks
The argument about the Welfare Working Group’s contraceptive proposals are most critical because they reveal underlying attitudes towards the poor which imply that some people are of more value as human beings than other people. The unstated assumption is that bringing fewer poor children into the world can and will resolve complex social problems. Among other things this absolves other New Zealanders from facing up to the inequalities resulting from historical injustice and structural poverty.

In contrast to perceptions of poor children as burdens on the state, parents in developing countries often choose large families for precisely the opposite reason – because they see them as their most precious resources and their social security in old age. New Zealand society depends no less on the next generation for our old age provision. New Zealand’s superannuation entitlements for current decision makers and voters also depend on the earnings of the children who are being born – or being prevented from being born – today.

It is important to see the Welfare Working Group’s birth control recommendation as being more than a matter of personal choice or personal morality. Proposals to reduce poverty by discouraging or preventing births to the poor have deep eugenic roots, based on the idea that some people have greater value than other human beings. There should be no place for this sort of thinking in New Zealand’s social welfare system.

Lisa Beech is Research and Advocacy Coordinator for Caritas Aotearoa New Zealand