Recent eLetters
Displaying 1-10 letters out of 349 published
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Newborns, really?
Submit responseThis article is so shameful. Newborn babies feel,breathe,bleed, and learn. Once a baby is born, (I believe the moment it is conceived but that is a different discussion), it is a person with rights. Who are you or their parents to take away their opportunity to make a contribution to the world? No one took away this author's opportunities in life by killing them the moment after birth. No, no one had the right, no one even thought about it. Once you were here that was it. Also, there are plenty of people who would love to adopt a baby(disabled or not) and what right do you have to suggest that opportunity should be destroyed? Babies are such innocent creatures that have the potential to become anything if given some encouragement let alone a chance to survive. Trying to "play God" is a dangerous road and I don't recommend it for anyone.
Conflict of Interest:
None declared
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Re:My opinion on controversial paper published about infanticide
Submit responseEstablishing Personhood A recent publication of modern philosophical thought by two ethicists from Melbourne, Australia, both with ties to Oxford University, Dr. Alberto Guibilini and Dr. Francesca Minerva's "Afterbirth Abortion: Why Should the Baby Live?" published February 23, 2012 in the Journal of Medical Ethics, takes Descartes founding principle of modern philosophical thought: "I think, therefore I am," to its logical conclusion. The authors rationally demonstrate their premise: since it is thinking that defines a human being's existence, a human being that does not think is not a "person" and in that lack, does not exist. Therefore, they argue, if the philosophical term "personhood" is not conferred to a fetus, why would it be conferred to an infant after it is born? Of course, based on their premise, they are right. Intellectually and biologically an infant and a fetus are basically the same. So the authors use the same philosophical argument that an infant is as worthless as a fetus and the value of an infant's life should be determined by the same parameters as that of the fetus' life: whether it is wanted or not. Guibilini and Minerva's paper opens a Pandora's Box that segues Western society to freely confer or remove "personhood" and ergo the legal protections from any human being whose thinking may be compromised: dementia patients, the mentally ill, stroke victims, PTSD, brain injuries, autistic persons and those under 25 years of age whose pre-frontal cortex is not yet mature. Realizing that the argument further injects a "value" judgement that becomes the very definition of human life, should cause all thoughtful persons to remember that scientific theories underpinned laws leading to horrors in human history: the Laws of Human Slavery and Chattel; Hitler's Operation T-4; the Lebensborn Experiment; the Nuremberg Laws; based on the American Jim Crow Laws; and those based on the Statutes of Kilkenny. The obvious problem with Guibilini and Minerva's argument is that the premise is flawed. To accept as a philosophical truth Descartes "I think, therefore I am," defies logic. To fix the failed logic in the premise and force it to work, philosophers assigned value to function (think) and separated potential function from actual function. What wasn't done was to focus on the agent that compels the verb "think" to action--"I". Man is not merely function, but force as well. There is no effect without a cause. "It is not thought that determines existence, but existence, 'esse,' that determines thought" -- St. Thomas Aquinas. Thinking is merely one process in the state of being. The part does not equal the whole. Rather, the whole is greater than the sum of its parts. No one can have any function without first existing. If a philosophical principle can be doubted prima facie intellectually, linguistically and logically, then it is not a universal truth applicable to reality. If it were, then replacing think with any other intransitive verb should not make the sentence less true, but it does: I throw, therefore I am; I eat, therefore I am; I lie, therefore I am--all are functions of a human's nature, not the definition of it. Modern philosophy failed to question the validity of its premise. Our duty is to ask why ? If we don't, as history attests, once a society freely agrees to the definition of a dehumanizing "value" for one segment of the population for the "greater good," slowly but surely the definition of those that qualify expands.
Conflict of Interest:
None declared
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After-birth abortion
Submit responseYou are soul-less monsters.
If and when you have children of your own, may you drop to your knees and ask that child for forgiveness for ever entertaining such thoughts.
Conflict of Interest:
None declared
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Unfortunately, my prediction of 34 years ago was correct.
Submit responseIn my senior year at Case Western Reserve University, I took a course on satiric writing. I wrote a paper responding to the Roe v. Wade decision, showing the logical result of proclaiming unborn babies were not human. Sadly, Minerva & Giubilini have fulfilled one of my predictions. Here is the paper from 34 years ago:
The Final Solution to Overpopulation
Of course, abortion is the best form of birth control. Condoms break, you can forget to take the pill, and IUDs can pierce a woman's uterus and scar and injure her. Spermicidal jellies and foams are messy and not likely to be used. Tubule ligation and vasectomies work only for those who are willing to make such a commitment, as does abstinence. Pregnancies caused by birth control mistakes are proverbial in our culture. The surest solution to the world's greatest problem, that of overpopulation, is abortion. It is safe when done early in pregnancy, and 100% certain to eliminate an unwanted pregnancy. However, abortion doesn't go far enough in reducing population growth, and in reducing population itself.
The world's population has increased nearly three billion since the landmark Supreme Court decision, Roe v. Wade in 1973. World population under the best estimates will stabilize at eleven billion after 2050. The world's ecosystem is already severely stressed with the six billion people on the earth. More needs to be done to reduce population. What is the next step?
Roe v. Wade determined the first 23 weeks of pregnancy are eligible for abortion since the fetus is not yet viable. More recent court rulings have permitted abortions through the last trimester of pregnancy for the health of the mother, mental and physical. Using the principle of "viability" and the principle of what is best for the mental and physical health of humanity, the next logical step is to permit "post natal abortions" (PNAs) on non-viable "post natal fetuses" (PNFs).
Although the majority of PNFs are wanted, not a single PNF is viable. It cannot survive without an adult caregiver. Further, they are a mental and physical burden upon the caregiver and should not be permitted to live without the full and willing desire of the caregiver. Why should PNFs be permitted to burden our sorely taxed ecosystem by allowing unwanted ones to grow to full maturity? Is it not kinder, gentler, and more humane to safely terminate them should the caregiver find them a burden? Is not the caregiver fully within their privacy rights to manage this life form within their own home as they see fit?
There need be no moral qualms about this policy whatsoever. Our society has already established the legal morality of abortion up through the end of the third trimester. What difference should the simple process of parturition make to morality of removing a non-viable life form from a possibly miserable existence? Just as abortion removes the burden of an unwanted fetus from society, so a PNA can terminate the mental and physical burden of an undesired PNF. A simple injection of potassium cyanide or a pill of the same can quickly and painlessly remove this ecological disaster waiting to happen.
The benefits of PNA's cannot be exaggerated. They are safer than abortions in the third trimester. They alleviate a financial burden on the family and society in general, reserving resources for those individuals chosen to enter the human family. With a worldwide policy of PNAs, all individuals will be wanted. Without undesired PNFs, the negative influence of humanity upon the earth will decrease, not increase. Air and water pollution will begin to decrease. The welfare rolls will decrease, reducing the tax burden.
Yet, even a vigorous, worldwide program of PNAs, administrated under the auspices of the United Nation's World Health Organization (WHO) does not go far enough. There are millions and billions of individuals worldwide who are no longer viable. Although they were human at one time, they are no longer self-supporting. Many can no longer communicate and are not conscious. They are all draining society's resources and all require care of some other human being. Using the same moral principle as Roe v. Wade and other pro-abortion rulings, we may safely and ethically consider such entities as "post human lives" (PHLs). In view of human induced global warming and the possible worldwide catastrophe that is pending, is it not nobler to remove these life forms from existence than to permit them to continue to consume the world's limited resources? Such an act of mercy would spare the functioning, productive humanity this unwanted burden, and more importantly, would reduce the space pressures humanity puts on endangered species worldwide. Concurrent with a program of PNAs there must be a worldwide program of "post human abortions" (PHAs).
As good as PNAs would be, PHAs would be even better. PHLs consume far more resources than PNFs. All the benefits enumerated for PNAs would be multiply true for PHAs. Society would become free of all individuals who are not productive. Taxes could be reduced, or the freed up funds could go toward art, literature, and good public works. Cares and worries of old age would be a thing of the past. Once a person becomes a burden to anyone, they are simply considered a PHL and given a gentle PHA. The social security trust fund will become adequate and even generous, with a reduced future burden upon working humanity.
PNAs and PHLs have benefits even beyond these. They will give birth to a new age of medical research. There will be an unlimited supply of organs and stem cells for the benefit of human population. Very likely, the human lifetime will be considerably extended. This will create additional population pressure, so PNAs and PHAs need to be executed and enforced ubiquitously.
How is a sweeping, worldwide program of PNAs and PHAs best to be administrated and implemented? It should start with the UN. As part of UN membership, every country should have laws that require every caregiver to sign a certificate of humanity to their offspring or to any non-viable entity in their care. At a minimum, these certificates should be renewed annually, like drivers' licenses. Each country may add additional requirements for their definition of viable humanity. This allows each country to retain its own sovereignty and cultural distinctiveness. By entrusting such a critical definition to each federal government, we can be sure the same care and wisdom shown in governmental taxing and welfare programs will be applied toward this critical program of PNAs and PHAs.
It is expected that some countries will put political requirements into their definition of humanity, some will put religious requirements, some physical requirements, such as a certain height, weight, body build, or skin color. Aside from promoting cultural diversity, this mosaic of laws will catch PHL's who travel from one country to another and further reduce world population. The varied laws will also purify the human gene pool, catching the ignorant and unwary, classifying them as PHLs and terminating them, protecting mother Earth from the corrosive effects of their former human existence.
Even such a beneficial program will surely have opposition. Religious extremists and radical anarchists are likely to resist blessing mankind with a healthier, less intrusive life upon this earth. A simple and effective method of dealing with such evil-minded beings is to classify them as PHLs and perform PHAs upon them. This action will quickly bring about worldwide consensus for this uniquely effective approach to population control.
With unwanted PNFs eliminated through PNAs, with burdensome PHLs removed through PHAs, with humanity's genetic lines improved through the forced evolutionary selection of diverse laws worldwide, a new age will dawn. No longer will pollution wreck our planet's rivers, lakes, and oceans. No longer will smog dominate cities. No longer will teeming millions suffer and starve. No longer will species die out through human encroachment upon their habitats. With the moral principles put forth in Roe v. Wade, logically extended and applied, humanity will joyfully march forward into a brave, new world.
Conflict of Interest:
I am a Christian, subject to Jesus Christ. There are no other competing interests.
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Academic, ageist, immoral, or desperate for citation metrics?
Submit responseMy first response is: this is sickening.
My second response is: this is one long attempt, disguised in pseudo- learned language and academic words, to justify and rationalise the killing of infants. The language, and the reputation of the journals in which it is published, are meant to blind us to the sheer immorality of what they propose. But with however much academic pomp they propose their theory, even a child (or perhaps especially a child) can see that they are not wearing any clothes, and should be exposed as naked and ashamed.
Firstly, the authors propose that some human beings are more actual persons than other human beings. The pigs in Animal Farm used the phrase 'some animals are more equal than others' to justify the abuses and oppression of their rule over all other animals. [George Orwell, 1945.] Likewise, Giubilini and Minerva use the concept of 'person' to make the evil and morally repulsive act of infanticide sound right. Welcome Newspeak 2.0.
The argument that one person or people group is less human or worthy of respect than others, has been used to rationalise the worst evils in human history. The Romans argued that Barbarians could be oppressed, taxed and crucified, as opposed to Roman citizens. Abusers at Abu Ghraib prison walked their victims on a leash like dogs, degrading them to the status of animals or less. Blacks were argued to be less human than whites, so that they could be sold as chattel, used and abused. Hitler justified his "Endlosung" (final solution) to all of Germany's problems by defining Jews and any non-Arians as being less human than Arians. Is that the kind of society we want? Giubilini and Minerva merely substitute 'person' for 'human'. Otherwise the argument is similar. If we follow it, we will become a society more callous and evil than that of Nazi Germany. Killing our own newborns as if they were commodities. Treating babies as disposable objects to keep or discard as we like.
Secondly, they play word games. There is the game of handpicking their definitions to suit the purpose of supporting their proposal. For instance "We take 'person' to mean ..." and "our definition of the concept of harm ..." (italics mine). This is private opinion dressed up as academic argument. Also, the whole proposition is based on a clever game of circular definitions: a person is defined as one who can value harm or benefit, and harm is defined as the loss of aims and plans which only a person can value. Circular definitions prove as little as circular reasoning - nothing.
Thirdly, the authors' argument centres on the false assumption that the difference of a few days before or after birth makes so little difference that it is zero. But little is not the same as zero, as anyone with arsenic in their tea might appreciate. Africans are famous for claiming that anyone can eat an elephant 'one slice at a time'. Giubilini and Minerva must have asked themselves, 'How can we make infanticide look philosophically sophisticated?' Answer: 'One day at a time.'
If parents can change their mind about keeping their baby one week after his or her birth, why not a month or a year after birth? Or five years, when other diagnoses may have come to light, such as Duchenne's muscular dystrophy?
If one day makes no difference (even as momentous a day as that of a baby's birth), then each one of us readers is at risk of being killed at will, whatever our age. Indeed, the authors hint at this when they say, 'we do not put forward any claim about the moment at which after-birth abortion would no longer be permissible'. If birth makes no difference, then any limit is arbitrary, and someone will argue for 'just one day more' until the victim has received their 100th birthday card.
Fourthly, the authors consistently refer to the foetus and newborn eligible for abortion or killing by the pronoun 'she'. Though this most likely represents a poor attempt at inclusive language, it does not explicitly exclude covert support for selective abortion of female foetuses or infanticide of baby girls. This is reinforced by their statement that 'Indeed, however weak the interests of actual people can be, they will always trump the alleged interest of potential people to become actual ones, because this latter interest amounts to zero.' (italics mine). In plain English this means that the flimsiest interest of an older human has more value than the life of a newborn baby. That means that if parents have any interest whatsoever to want a boy but not a girl, they should be allowed kill their newborn baby girl and try again for a boy.
My third response is one of surprise. Ironically Giubilini and Minerva's reasoning serves the pro-life argument equally well. If killing a newborn baby is called post-birth abortion, then equally abortion could be called pre-birth killing. That is what the pro-life movement has argued all along. The pro-choice movement has always meticulously avoided words such as killing, insisting instead on euphemisms like 'termination' and even 'abortion treatment' as if abortion cures a disease [Website of the British Pregnancy Advisory Service, http://www.bpas.org/bpaswoman (accessed 30th March 2012)].
Further, the authors claim that 'killing a newborn could be ethically permissible in all the circumstances where abortion would be.' The exact same reasoning can be used to argue that aborting a six week old embryo or a 16-week old foetus could be ethically wrong in all the circumstances where killing an infant or adult child is wrong. Surely the direction in which the argument moves cannot make a substantial difference; whether it moves forward in time from foetus to newborn, or backward in time from child to newborn and foetus.
Giubilini and Minerva have given us much to consider. They have created a perfect ethical storm without saying much new. I remember reading their fellow Melbourne professor Peter Singer's work nearly thirty years ago and encountering exactly the same arguments. [Kuhse H, Singer P. Should the Baby live? The Problem of Handicapped Infants. Oxford: Oxford University Press, 1985.] The title 'Why should the baby live?' points clearly to Singer's 'Should the baby live?'. The authors' only innovation is to widen the allowable reasons for infanticide from 'severe abnormalities' (Singer); via diagnoses which come to light at some point after birth; to 'the same reasons which justify abortion' (Giubilini and Minerva). They even claim that any interest of any actual person (read: adult, older child or even those animals they regard as persons!!), however weak, is always of greater value than that of any newborn baby, since the interest of the latter is zero. In plain English that means infanticide on demand for the flimsiest of reasons. An adult dog has more rights than a human newborn since the latter has none.
But what does their argument really show? That post-birth killing is acceptable, or that pre-birth abortion is killing? That society is ageist, protecting human babies after birth but allowing them to be killed before birth? That baby P.'s abusers were not wrong to kill him but only wrong to cause him pain and suffering in the process? That human capacity for rationalising evil is endless? That ethicists can supply reasons to justify any evil they wish to justify? That philosophy is like a knife that can either kill or heal, depending on the decisions of the person who manipulates it? That digging up old controversial ideas is the best way to improve one's citation metrics and revive a flagging academic career?
Most of all, I believe, their argument shows that philosophical ingenuity cannot make values for us human beings to live by, any more than political spin can weave clothes for an emperor. The emperor will have to find an honest tailor, and we human beings need to look elsewhere for a reliable foundation for ethics.
Conflict of Interest:
None declared
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Ask them first
Submit responseSome people with very bad prognosis at birth and with a pack of bad diagnoses grow up to become relatively happy people. Some don't. There are many cases when fetuses that were presumed to have Down syndrome, apperaed healthy babies at birth. Courts try to avoid capital punishment and usually wait for years before executing people with death sentence because of possible errors. Still, sometimes (hovewer, rarely) truth comes up after a person was executed. So before even starting to think about the possibility of implementing the "after-birth abortion" I would recommend authors to study at least several thousands cases where infants were given bad prognoses, let's say, not less than 20 years ago. If 99.99% will say that their lives was(is) not worth living, that they are dreaming aboout being aborted or killed after birth, then yes, the idea is worth thinking. I even would let authors to include those who are already dead in this 99.99%. I assure you, many of these "sentenced to death" will appear valuable and often happy people. Take Ruben Galliego, a quadriplegic, father of two(?) who recently won a prestigious literature award for his authobiography. Or, take Hitler. He was healthy at birth, his mother did not do an abortion, neither she wanted to have him up to the state. I believe, no one in the human history caused so much grief and, yes, economcal losses as this person, who definitely deserved to be annihilated at birth. We will not solve the mankind problems by killing unwanted babies. Even the sick ones. However, severely ill babies really can ruin their families' lives. This is a sad truth. Not everyone is capable of meeting such a challenge as caring for a child that makes no progress. So even if the idea of institutionalization didn't prove itself to be the best one, maybe it is the solution that can, on the one side, gives babies with bad prognosis (or unwanted ones) at least a chance to pull through, and, on the other side, will let parents not to carry the burden they are not prepared to. Or will give them time to reconsider. So I believe economical resources should be used to build facilities where the goal would be not to necesserily make an ill baby to survive, but rather give him a chance to survive. Or, if his body fails, help him to die without suffering. Sorry for errors, English is not my first language.
Conflict of Interest:
None declared
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Re:Re:A response to 'After-birth abortion: why should the baby live?
Submit responseI notice you don't have the Giubilina and Minerva -paper on line. No doubt you have publisher's remorse, and wish to sweep this horror under the rug. The paper would have been all right in a Nazi journal, perhaps edited by Dr. Mengele. It has no place in your precious, effete Journal of Medical Ethics The storm of criticism is richly deserved. If the authors are M.D.s, their degrees should be rescinded. God knows I wouldn't want them treating me or anyone else. Freedom of expression, yes, but with lawful consequences. William Goldsmith, M.D. LC (ret) USAFConflict of Interest:
Primum non nocere. Anti-Nazi
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You people are sick in the head
Submit responsePlease, for the love of God, make a career change.
Conflict of Interest:
None declared
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You b*
Submit responseI had to vomit after reading your article praising the murder of babies. I am the mother of 3 special needs children, two adopted from China. My children are a precious gift who enrich all the lives they touch. Which is a great deal more than I can say for you!!!! Just who do you think you are to decide life or death for another. Is your name God? Be thankful your parents let you live even though you have become the greatest argument for your position.
Conflict of Interest:
None declared
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When medicine descends into darkness from the long shadow of the past
Submit responseColaianni cautions that "the long shadow of Nazi medicine" can engulf the current practice of medicine because of thriving "moral vulnerabilities in contemporary medical culture" (1). We add to the list of moral vulnerabilities: the integration of "principlism" as the dominant, if not the exclusive, ethical model of decision making in clinical medicine and healthcare policy. Although Beauchamp and Childress (the main proponents of principlism) (2) , have tried to answer the charges that principlism is mechanistic and deductivistic, principlism shares the problem shared by modern theories of ethics in general: excessive abstraction. Principlism is grounded in four principles: autonomy, beneficence, nonmaleficence, and social justice. Critics have argued that principlism has no unifying theoretical moral foundation (3). However, principlism is intended to provide the "global solution" for practicing medicine ethically in modern society (4). Anyone can memorize the list of principles and "apply" them to specific situations--and can come to any moral conclusion they wish due to the abstract nature of all formal rules. Lacking intrinsic moral cohesiveness, principlism can serve as an illusionary moral guardian of life-ending practices in medicine (5). It has already permitted the integration of a range of life-ending acts from retrieving transplantable organs by redefining human death (6) to medical assistance with dying (7) into medical practice. Principlism represents a form of secular moral reasoning that centralizes respect of individual autonomy, but which also is embedded within a utilitarian healthcare system. This presents a moral vulnerability in the medical culture threatening human dignity and the sanctity of life. The moral compass of principlism can turn the shadow of the past into the nightmare of the future in medicine.
Mohamed Y Rady, B.Chir, M.B (Cantab), M.A , M.D (Cantab), FRCS (Edin. & Eng.), FRCP (UK), FCCM, Professor, College of Medicine, Mayo Clinic. Consultant, Department of Critical Care Medicine, Mayo Clinic Hospital, Phoenix, Arizona, USA.
Joseph L. Verheijde, PhD, MBA, PT, Associate Professor, College of Medicine, Mayo Clinic. Department of Physical Medicine and Rehabilitation, Mayo Clinic,Phoenix, Arizona, USA.
Michael Potts, Ph.D, Professor of Philosophy, Methodist University, Fayetteville,North Carolina, USA.
References
1. Colaianni A. A long shadow: Nazi doctors, moral vulnerability and contemporary medical culture. J Med Ethics2012:Published Online First: 3 May 2012 doi:10.1136/medethics-2011-100372
2. Beauchamp T, Childress J. Principles of Biomedical Ethics. 6th ed. New York: Oxford University Press; 2008.
3. Clouser KD, Gert B. A Critique of Principlism. J Med Philos1990;15(2):219-36.
4. Engelhardt HT. Critical Care: Why There Is No Global Bioethics. J Med Philos1998;23(6):643-51.
5. Engelhardt HT. Confronting Moral Pluralism in Posttraditional Western Societies: Bioethics Critically Reassessed. J Med Philos2011;36(3):243-60.
6. Rady MY, Verheijde JL, McGregor JL. Scientific, legal, and ethical challenges of end-of-life organ procurement in emergency medicine. Resuscitation2010;81(9):1069-78.
7. Rady MY, Verheijde JL. Distress from voluntary refusal of food and fluids to hasten death: what is the role of continuous deep sedation? J Med Ethics2011 October 29, 2011:Published Online First 29 October 2011. doi:10.1136/medethics-2011-100278
Conflict of Interest:
None declared
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