After-birth abortion: why should the baby live? A disability perspective
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- Created on Thursday, 20 December 2012 03:40
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Martin Sullivan
When I first heard reports of a couple of bioethicists promoting the idea of after-birth abortion I thought, “they’re at it again; coming up with more justifications for killing us; the b******s!” Of course not all bioethicists hold to this position (as evidenced by the number who have since expressed outrage at the notion of after-birth abortion) but I find it profoundly alienating and quite sad that the only time the discipline or bioethicists themselves seem to show any interest in disability and disabled people is when they are arguing over when its OK to kill us.
As a disabled person who knows his history, I can never separate these kinds of arguments from the situation which occurred in Nazi Germany when over 200,000 disabled people – ‘useless eaters’ ‘life unworthy of life’ - were murdered in the Aktion T4 euthanasia programmes[i]. Justifications for after-birth abortion sound awfully like a reopening of that door, a rekindling of the Silent Holocaust; that is why my response is so personal, so visceral.
Unfortunately, this after-birth abortion debate flows logically from the zeitgeist of consumer capitalism where the body is seen as a prime site of consumption and the neoliberal precepts of individual freedom and choice rule. In this environment ableism thrives. Ableism promotes a particular kind of ‘able’ self and body as fully human. In light of that, any impairment or disability is seen as inherently negative and should be ameliorated, cured or eliminated[ii]. While Giubilini & Minerva’s argument is not entirely ableist insofar as they hold that after-birth abortion should apply to any abled or disabled infant who qualifies for abortion as a fetus, it begins with and builds upon ableist assumptions about children with ‘severe abnormalities’ whose lives are consequently judged as not worth living.
They begin by accepting that while it is easy and common for many in our contemporary society to conclude that living with severe abnormalities is not in the best interest of the child, it is hard to find definitive arguments supporting the case that such life is not worth living. At this point an article of faith transmogrifies into scientific certainty as they assert that the potential of a child with Down syndrome can never equal that of a “normal’ child”. Somewhat conveniently, their paper overlooks the question: potential for what? Next, Giubilini and Minerva, somewhat incredulously, note that, despite this lack of potential, people with disability “are often reported to be happy.” But these two important pieces of evidence – no definitive support for the “unworthy lives” thesis and severely impaired people reporting that they in fact have happy lives – are overridden by Giubilini and Minerva appealing to the “unbearable burden” thesis as justification for after-birth abortion.
The “unbearable burden” thesis states that a child with severe impairments will impose “unbearable” emotional and financial burden on the family and the financial costs of social provision on society as a whole. Now the argument about the permissibility of after-birth abortion of such infants is justified on the basis of empirically verifiable claims about an infant’s financial impact on the family and broader society. This marks an adroit shift – a claim that rests on assertion is suddenly presented as having a degree of ‘logic’ and legitimacy it does not warrant. Also, somewhat conveniently, the burden thesis overlooks those parents who report that while not necessarily without struggle, their lives have been enriched by the child they refused to abort.
This is very much a ‘final solution’ which is not only abhorrent to me, but one which I find deeply ableist and difficult not to take personally. I would argue that notions of “lives not worth living”, “potential” and “unbearable burden” are so context dependent, so deeply embedded in the social milieu, that it would be far more humane to address those variables before adopting a final solution. Ultimately, the solution lies in how much tax we are prepared pay in order to provide a just social wage which covers education, health and housing as well as a high enough welfare safety net so people don’t bruise themselves when they fall into it.
To be fair, Giubilini and Minerva do spend some time in philosophical reflection on when a human becomes a person and at what point after-birth abortion is no longer permissible. For someone who sees dignity and value in all human life, Giubilini and Minerva may as well be philosophising about how many angels can fit on the head of pin for all the good it will do in justifying after-birth abortion to me.
But I guess this is what many philosophers and bioethicists do: they engage in logic games and in this particular one they reduce themselves to playing the role of instrumental technocrats. It is a dangerous game they have begun playing because it is all theory about vulnerable lives and this is far too serious an issue to play with.
Undeniably, the most chilling aspect of this paper is its advocacy of after-birth abortion for those infants not wanted. Not-wanted! As someone who lives with the shadow of the Silent Holocaust, these logic games are the opening gambit in a deadly game taking place in straitened times; times where it is quite possible the “unbearable burden” thesis may gain traction. Under these conditions, no matter how repugnant, the bioethicists’ argument that after-birth abortion is permissible in cases where the potential life is deemed not worth living, too much of a burden or too expensive, may sound like commonsense. I cannot help thinking that it would not be too long before the justifications for a euthanasia programme for those ‘useless eaters’ began to be heard again.
Martin Sullivan, PhD, is a Senior Lecturer in disability studies and social policy at Massey University.
Book Review - The ethics of abortion: Women's rights
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- Created on Tuesday, 22 November 2011 22:23
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John Flynn LC provides a broad overview of the key arguments offered by Christopher Kaczor in his book, The ethics of abortion: Women's rights, human life and the question of justice. While religion provides cogent arguments against abortion, the case as to why it is ethically unjustifiable can also be made on philosophical grounds.
Editorial - Allowing Grace to Catch Up
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Michael McCabe
At the 2015 Synod on the Family held in Rome, there was considerable reflection on the moral principle of gradualism, a principle whose roots lie in the thinking and writing of Blessed Paul VI and which has been further developed by Saint John Paul II in Familiaris Consortio (nn. 9 & 34) and Pope Francis in Amoris Laetitia (nn. 295 & 300).
Simply put, people grow in different ways and at different times on their faith journey – and that is just as true for each community as it is for each person. The personal and pastoral challenge for each of us is living with that reality; living with ourselves and living with it in our relationships, our families, our faith communities and society.
The key moral question is how to retain compassion and charity towards those who think and act differently to us? Do we run away? Do we seek out a like-minded group? While flight is necessary for our soul’s growth at times, it does not always lead to growth, compassion, better understanding or wisdom simply because we may be avoiding a deeper issue.
The Gospel passage about the two sons, Matthew 21:23-32, provides a picture of gradual growth:
‘What do you think? A man had two sons; he went to the first and said, ‘Son, go and work in the vineyard today.’ He answered, ‘I will not’; but later he changed his mind and went. The father went to the second and said the same; and he answered, ‘I will go, sir’; but he did not go. Which of the two did the will of his father?’ They answered, ‘The first.’
In his commentary on this Gospel passage, Father Michael Hayes, tells the story of a Catholic High School teacher who was running into difficulty presenting the Catholic position on abortion to her class. The students seemed to be rejecting the viewpoint that she was presenting, so she asked the school’s guidance counsellor for help. He began his presentation to the students by saying how difficult the practical decisions surrounding abortion can be. The counsellor also spoke of the need for compassion and charity when people make decisions we cannot accept.
At that point the students seemed to change their response. They had no difficulty in acknowledging the objective wrong of abortion. But, unbeknown to their teacher, the issue that had tied them in knots was a classmate who had recently had an abortion – they did not want to turn their back on their friend.
So what seemed to be a ‘No’ for an issue of faith and morality actually contained a ‘Yes’ hidden within – a ‘Yes’ to compassion and charity.
Reading that story reminded me of a couple who called the Presbytery one Saturday morning. The woman, from Europe, was in the early stages of pregnancy. I agreed to meet her and her partner in the chapel. They wanted to talk with me about having an abortion. Their relationship had ended and she was returning to Europe the following week and had already booked into Auckland Hospital for an abortion on the Monday morning. I listened to them both and we prayed. I then asked if I might give them both the Sacrament of Anointing. They agreed to that. The woman told me that this sacrament would not change her mind. It would be her decision, and hers alone. I simply replied, as I have in similar cases, “I pray, that whatever you decide, and fully respecting your conscience, that this child will be a blessing to you both…”
They both cried during the anointing and asked me to leave them in the chapel. That Saturday, a grey wet day, I later saw them out walking and I again prayed for them and their baby.
The woman called me later that week to thank me. She had flown to Auckland to have the abortion. While on the gurney, waiting to go into the theatre, she hopped off the trolley, went back to her room, got dressed, and discharged herself. She had decided to keep the baby. Her former partner had promised to help her raise it, even while they both acknowledged their relationship was finished. She was returning to Europe. She then said, “I never want to see you again but I do want you to know how grateful I am for your time and for the Sacrament of Anointing.” She added that she still felt “very raw” and faced an “uncertain future” but knew she had “made the right decision" and was at peace.
So, what looked like a ‘No’ was actually a ‘Yes’ masking as a ‘No.’
In the Gospel parable, the first son changes his mind. In other words, he allows God’s unfailing grace to catch up with him.
I think it was the same for that woman and her former partner. Likewise with the High School class and likewise for ourselves. In reaching out to those on the peripheries, and in our own moral development, the gradual responding to grace takes time and requires great wisdom.
Rev Michael McCabe (PhD) is founding director of The Nathaniel Centre and Parish Priest of Our Lady of Kapiti Parish
Confronting the Distortions: Mothers of Children with Down Syndrome and Prenatal Testing
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- Created on Monday, 21 November 2011 21:58
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Dr Lisa Bridle
Prenatal diagnosis represents the most immediate and widespread application of the current explosion of genetic knowledge and technology. Presently hundreds of genetic conditions can be identified through prenatal diagnosis, although testing commonly focuses on chromosomal analysis and testing for neural tube defects (Wertz 1992:162). The major diagnostic tests are diagnostic ultrasound, amniocentesis and chorionic villus sampling (CVS). In recent years, there has been a drive to confirm test results earlier in pregnancy both by performing these tests earlier and by developing faster methods of chromosome analysis. The development of screening tests, including first trimester ultrasound and maternal serum screening tests, has already reshaped the landscape of prenatal diagnosis. Prenatal testing, once limited to women considered "high risk", is increasingly a routine part of all pregnant women's antenatal care.
Editorial - Why are abortion advocates afraid of informed choice?
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- Created on Monday, 12 June 2017 02:15
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The polarising issue of abortion has come to the fore again, triggered by the Abortion Supervisory Committee’s annual report to Parliament. Despite the ASC chairwoman saying that the committee had no opinion on major reform of the abortion laws – that it was solely a matter for parliament – many commentators who want further liberalisation have taken the opportunity to lambaste the current law, labelling it a legal obstacle course, archaic, hypocritical, a charade, cumbersome, and intrusive.
The simple solution, they say, is abortion on demand – no need to ask any questions. As articulated by David Seymour MP: “The right thing to do is reform abortion law to reflect what actually happens: women exercise choice for their own reasons.” He and others argue that the current law disempowers women. As one blogger wrote: “At the heart of it all is a distrust of women, innit? … a failure to understand that women are full moral adults.”
The debate that has ensued highlights an important point: the current abortion law is being consistently undermined by the way in which it is being implemented. This is what undoubtedly leads supporters as well as some opponents of abortion to label the present regime as hypocritical.
While the debate raises many interesting questions, the one critical question not often asked is whether removing the procedures that are part of the current law will in fact lead to better choices and better outcomes for women contemplating an abortion.
Our choices are limited by the constraints of our knowledge and context. These constraints generally take two forms: (i) a lack of proper information and (ii) the presence of coercion. Informed and free consent based on full, balanced and factual information, while allowing time to adequately consider that information, is the ‘sine qua non’ for making quality choices.
Research into the potentially negative health effects of abortion is characterised by claims and counter-claims. For example, research reported by the Health Research Council of New Zealand (by Professor David Fergusson of the University of Otago’s Christchurch Health and Development Study, 2008) suggests “women who undergo an abortion face a 30 per cent increase in the risk of developing common mental health problems such as depression and anxiety.” Conversely, other overseas studies have concluded that the rates of mental health problems for women with an unwanted pregnancy were the same whether they had an abortion or gave birth. Academically speaking, the question of potential harm to women remains a contested one.
The strongest evidence that there are real negative health effects following an abortion arises out of the day-to-day work done by clinical psychologists and counsellors. Their consistent experience is that they encounter many women whose mental well-being has been adversely affected on a number of levels by their experience of abortion.
Further reflection on “what actually happens” to women who have had abortions highlights the reality of coercion. Many women, after the event, report feeling that they had no other option at the time but to proceed, often because of pressure from parents, partner and/or peers. At times this pressure is also experienced as coming from staff at the Termination of Pregnancy Units. For other women, the pressure they feel is generated by employment or social factors. In the words of another commentator, in such situations, the decision for an abortion is best described as a tragic response to lack of choice.
Section 14 of the Contraception, Sterilisation and Abortion Act, which details the functions of the Abortion Supervisory Committee, states that they are “to take all reasonable and practicable steps to ensure that sufficient and adequate facilities are available throughout New Zealand for counselling women who may seek advice in relation to abortion.” When women repeatedly recount they were offered five to ten minutes with a social worker before the abortion ‘if you want it’, and when there is reliable evidence that abortions are signed off by some consultants over the phone with no face-to-face interview, it is hard to argue that this provision is being properly implemented.
In which case, it becomes impossible to argue that the current New Zealand practices surrounding abortions consistently promote informed and free choice.
There is surely no greater expression of “distrust of women” than society paternalistically deciding, whether through law reform or the inadequate implementation of its current laws, to censor the information provided to women contemplating an abortion. Equally, it is surely also a failure of care to neglect to put in place mechanisms that can help women contemplating an abortion to recognise and deal positively with any feelings of ambivalence as well as the actualities of coercion.
It is in the interest of free and informed consent and empowerment that all women are offered independent counselling that addresses the coercive realities surrounding many abortions and which makes them aware of all the risks as well as all the options they have. Honest reflection on what is actually happening only reinforces the fact that abortion on demand will not achieve this.
If as a society we truly want to respect choice, then why would we be afraid of promoting free and informed consent?
Cynthia Piper has over 20 years’ experience as a trained volunteer lay counsellor working with pregnant women and teens and their families, and with Project Rachel, a post-abortion healing and support service.
Dr John Kleinsman is director of The Nathaniel Centre.