JME - AFTER-BIRTH ABORTION

[paul&katie]

Journal of Medical Ethics Publishes Article Advocating After-Birth Abortion | BetterThanSacrifice.org

The Journal of Medical Ethics (JME), which describes itself as ‘an international peer-reviewed journal for health professionals and researchers in medical ethics’, has published an article which takes pro-choice arguments to their logical conclusion and advocates post-birth abortion. The journal is published by the BMJ Group, which is wholly owned by the British Medical Association, itself the professional organization representing the interests of British doctors.

In the article, entitled After-birth abortion: why should the baby live?, ethicists Alberto Giubilini of Monash University, Australia, and Francesca Minerva of the University of Melbourne, argue that fetuses and newborn babies share the same ‘moral status’, and that the arguments in favour of abortion therefore apply equally to newborns. They conclude:

If criteria such as the costs (social, psychological, economic) for the potential parents are good enough reasons for having an abortion even when the fetus is healthy, if the moral status of the newborn is the same as that of the infant and if neither has any moral value by virtue of being a potential person, then the same reasons which justify abortion should also justify the killing of the potential person when it is at the stage of a newborn. After-birth abortion: why should the baby live?

The equivalent status of pre and postnatal children has long been a key argument of pro-life advocates. Anthony Ozimic from the Society for the Protection of Unborn Children told The Huffington Post:

The paper proves what pro-lifers have long been arguing: that the common arguments for abortion also justify infanticide. There is no difference in moral status between a child one day before birth and a child one day after birth. Birth is merely a change of location, not a change from non-personhood to personhood. Killing Newborn Babies No Different To Abortion, Say Medical Ethicists

Some see the JME paper as potentially helping the pro-life cause by showing the inconsistency of the pro-choice position. Writing for the National Catholic Register, Matthew Archbold gave his reaction to the JME paper:

Here’s the thing – they’re right. If you accept their premises, they’re absolutely right.

The second we allow ourselves to become the arbiters of who is human and who isn’t, this is the calamitous yet inevitable end. Once you say all human life is not sacred, the rest is just drawing random lines in the sand.

An ethicist’s job is like a magician’s. The main job of both is to distract you from the obvious. The magician uses sleight of hand to pretend to make people disappear. But when ethicists do it, people disappear for real.

It’s almost a pro-life argument in that it highlights the absurdity of the pro-abortion argument.

Ethicists Argue for Post Birth Abortions

Giubilini and Minerva argue from the premise that unborn children and infants are merely potential persons, and so their intentional killing is permissible. This assumption is based upon the argument that sentience is a requisite attribute of personhood. The authors write:

In spite of the oxymoron in the expression, we propose to call this practice ‘after-birth abortion’, rather than ‘infanticide’, to emphasise that the moral status of the individual killed is comparable with that of a fetus (on which ‘abortions’ in the traditional sense are performed) rather than to that of a child. Therefore, we claim that killing a newborn could be ethically permissible in all the circumstances where abortion would be. Such circumstances include cases where the newborn has the potential to have an (at least) acceptable life, but the well-being of the family is at risk. Accordingly, a second terminological specification is that we call such a practice ‘after-birth abortion’ rather than ‘euthanasia’ because the best interest of the one who dies is not necessarily the primary criterion for the choice, contrary to what happens in the case of euthanasia.

The moral status of an infant is equivalent to that of a fetus in the sense that both lack those properties that justify the attribution of a right to life to an individual.

Both a fetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’. We take ‘person’ to mean an individual who is capable of attributing to her own existence some (at least) basic value such that being deprived of this existence represents a loss to her. This means that many non-human animals and mentally retarded human individuals are persons, but that all the individuals who are not in the condition of attributing any value to their own existence are not persons. Merely being human is not in itself a reason for ascribing someone a right to life. Indeed, many humans are not considered subjects of a right to life: spare embryos where research on embryo stem cells is permitted, fetuses where abortion is permitted, criminals where capital punishment is legal.

After-birth abortion: why should the baby live?

This argument is not new. As Matthew Flannagan wrote in an article published in the Summer 2009 edition of Ethics and Medicine – An International Journal of Bioethics:

Common in the literature on feticide is the argument that killing an organism is not homicide unless the organism’s brain has developed enough for it to acquire sentience, the capacity for consciousness and the ability to perceive pleasure and pain.

Boonin’s Defense of the Sentience Criterion: A Critique Part I

Flannagan goes on to show the problem of using the non-sentience of the unborn child as justification for abortion:

Despite its pervasive appeal, there are some prima facie problems with such an account. In chapter 3 of A Defense of Abortion, Boonin reviews various accounts and notes that they all fail for similar reasons. Boonin notes that those who attempt to ground humanity in the amount of brain development an organism has undergone face a dilemma: “Any appeal to what a brain can do at various stages of development would seem to have to appeal to what the brain can already do. Or to what the brain has the potential to do in the future.”

Either option leads to problems for a defender of the permissibility of feticide who does not also want to endorse infanticide. This is because “by any plausible measure dogs, and cats, cows and pigs, chickens and ducks are more intellectually developed than a new born infant.” Suppose, then, one takes the first horn and appeals to what the brain can already do. However, unless one wishes to affirm that cats, dogs and chickens are human beings, “appeals to what the brain can already do” will “be unable to account for the presumed wrongness of killing toddlers or infants.”

Suppose, then, one takes up the second horn of the dilemma and appeals to “what the brain has the potential to do in the future.” Boonin notes that this will entail that feticide is homicide. “If [such an account] allows appeals to what the brain has the potential to do in the future, then it will have to include fetuses as soon as their brains begin to emerge, during the first few weeks of gestation.”

Boonin’s Defense of the Sentience Criterion: A Critique Part I

In the face of fierce criticism, Julian Savulescu, Editor of the JME, vigorously defended the article’s publication:

As Editor of the Journal, I would like to defend its publication. The arguments presented, in fact, are largely not new and have been presented repeatedly in the academic literature and public fora by the most eminent philosophers and bioethicists in the world, including Peter Singer, Michael Tooley and John Harris in defence of infanticide, which the authors call after-birth abortion.

The novel contribution of this paper is not an argument in favour of infanticide – the paper repeats the arguments made famous by Tooley and Singer – but rather their application in consideration of maternal and family interests. The paper also draws attention to the fact that infanticide is practised in the Netherlands.

Many people will and have disagreed with these arguments. However, the goal of the Journal of Medical Ethics is not to present the Truth or promote some one moral view. It is to present well reasoned argument based on widely accepted premises. The authors provocatively argue that there is no moral difference between a fetus and a newborn. Their capacities are relevantly similar. If abortion is permissible, infanticide should be permissible. The authors proceed logically from premises which many people accept to a conclusion that many of those people would reject.

Of course, many people will argue that on this basis abortion should be recriminalised. Those arguments can be well made and the Journal would publish a paper than made such a case coherently, originally and with application to issues of public or medical concern. The Journal does not specifically support substantive moral views, ideologies, theories, dogmas or moral outlooks, over others. It supports sound rational argument. Moreover, it supports freedom of ethical expression. The Journal welcomes reasoned coherent responses to After-Birth Abortion. Or indeed on any topic relevant to medical ethics.

What is disturbing is not the arguments in this paper nor its publication in an ethics journal. It is the hostile, abusive, threatening responses that it has elicited. More than ever, proper academic discussion and freedom are under threat from fanatics opposed to the very values of a liberal society.

“Liberals Are Disgusting”: In Defence of the Publication of “After-Birth Abortion”

Writing for the Telegraph newspaper, Will Heaven observes that it is unsurprising that there is reaction when supporting ‘freedom of ethical expression’ includes the provision of a platform for the overt advocacy of infanticide:

Now Julian Savulescu, the Editor of the Journal of Medical Ethics, is complaining that the authors – both leading ethicists – have received “personally abusive correspondence”, most of which is anonymous, “threatening their lives and personal safety”.

Which doesn’t surprise me, not that I approve of such harassment. You can’t be unashamedly pro killing babies and not expect controversy.

‘After-birth abortion’ is logically sound: that’s why it will boost the pro-life movement

Kenneth Boyd, Associate Editor of the JME, was as unapologetic as Savulescu:

Coming up to me at a meeting the other day, an ethics colleague waved a paper at me. “Have you seen this ?” she asked, “It’s unbelievable!” The paper was “After-birth abortion: why should the baby live?” by two philosophers writing from Australia, Alberto Giubilini and Francesca Minerva.

Well yes, I agreed, I had seen it: in fact I had been the editor responsible for deciding that it should be published in the Journal of Medical Ethics; and no, I didn’t think it was unbelievable, since I know that arguing strongly for a position with which many people will disagree and some even find offensive, is something that philosophers are often willing, and may even feel they have a duty, to do, in order that their arguments may be tested in the crucible of debate with other philosophers who are equally willing to argue strongly against them.

Of course for that debate to take place in the Journal of Medical Ethics, many of whose readers, doctors and health care workers as well as philosophers, may well disagree, perhaps strongly, with the paper’s arguments, we needed first to make sure that the paper, like any other submitted to the Journal, was of sufficient academic quality for us to publish; and the normal way in which we determine this is to invite academics in relevant disciplines to review the paper critically for us, so that we can eventually make an informed decision about whether or not to publish it, either in its original or (as in this case) a form revised in the light of the reviewers’ reports.

Handling Editor Defends Decision: After – Birth Abortion

Whereas the authors of the article advocate for infanticide (though not under that name), and the editors of the JME have readily given them a stage from which to do so, Christians who accept the Bible as God’s Word have no doubt as to the ‘moral status’ of the unborn child as the very creation and work of God:

For You formed my inward parts;
You covered me in my mother’s womb.
I will praise You, for I am fearfully and wonderfully made;
Marvelous are Your works,
And that my soul knows very well.
My frame was not hidden from You,
When I was made in secret,
And skillfully wrought in the lowest parts of the earth.
Your eyes saw my substance, being yet unformed.
And in Your book they all were written,
The days fashioned for me,
When as yet there were none of them.

Psalm 139:13–16, NKJV

Then the word of the LORD came to me, saying:

“Before I formed you in the womb I knew you;
Before you were born I sanctified you;
I ordained you a prophet to the nations.”

Jeremiah 1:4–5, NKJV

Though moral outrage is a natural and proper reaction to the unabashed advocacy of child-murder, the same Bible reveals that all of us are guilty of breaking God’s Law, and therefore deserving of everlasting punishment:

What then? Are we better than they? Not at all. For we have previously charged both Jews and Greeks that they are all under sin. As it is written:

“There is none righteous, no, not one;
There is none who understands;
There is none who seeks after God.
They have all turned aside;
They have together become unprofitable;
There is none who does good, no, not one.”
“Their throat is an open tomb;
With their tongues they have practiced deceit”;
“The poison of asps is under their lips”;
“Whose mouth is full of cursing and bitterness.”
“Their feet are swift to shed blood;
Destruction and misery are in their ways;
And the way of peace they have not known.”
“There is no fear of God before their eyes.”

Now we know that whatever the law says, it says to those who are under the law, that every mouth may be stopped, and all the world may become guilty before God. Therefore by the deeds of the law no flesh will be justified in His sight, for by the law is the knowledge of sin.

Romans 3:9–20, NKJV

It also presents the remedy – the good news of Jesus Christ crucified in the place of sinners, and His perfect righteousness put to the account of all those who trust in Him and His finished work for them:

But now the righteousness of God apart from the law is revealed, being witnessed by the Law and the Prophets, even the righteousness of God, through faith in Jesus Christ, to all and on all who believe. For there is no difference; for all have sinned and fall short of the glory of God, being justified freely by His grace through the redemption that is in Christ Jesus, whom God set forth as a propitiation by His blood, through faith, to demonstrate His righteousness, because in His forbearance God had passed over the sins that were previously committed, to demonstrate at the present time His righteousness, that He might be just and the justifier of the one who has faith in Jesus.

Romans 3:21–26, NKJV

“Therefore let all the house of Israel know assuredly that God has made this Jesus, whom you crucified, both Lord and Christ.”

Now when they heard this, they were cut to the heart, and said to Peter and the rest of the apostles, “Men and brethren, what shall we do?”

“Repent, and let every one of you be baptized in the name of Jesus Christ for the remission of sins; and you shall receive the gift of the Holy Spirit. For the promise is to you and to your children, and to all who are afar off, as many as the Lord our God will call.”

Acts 2:36–39, NKJV

[readytogo]

"After birth abortion" is just a euphemism for murder.

[livin_in_the_Son]

I was completely incapable of reading the entire article. I am a mother of a special needs child, and of another that required intensive care post-birth, and in a social-economic dynamic that would mean it would have been better for me to not have children.

Regardless of the intent of this article, it WILL be used someday to kill infants, just like Roe vs. Wade was used to legally kill unborn babies due to maternal death during an illegal abortion. The ethical position might have been to show the greivous nature of what defines a baby vs. a blob of tissue.....but given the evil of this world, it will come back and be used as justification for infantcide...or the murder of babies after they have taken a breath of air. I am so appauled and horrified by this that I'm stricken.

[mattfivefour]

"After birth abortion" is just a euphemism for murder.

Amen! And that is the TRUTH!

[YeuEmMaiMai]

It all comes down to "I am going to do what I want and there is NOTHING you can do to stop me" It is the ultimate expression of a Godless society when life is worth nothing.

[Robert]

Being born: the new capital offense punishable by death.

[RanYakumo]

I took the time to read the paper. It was far shorter than I thought. Here are some of the quotes I found to be the most disturbing (although the rest of the paper was a close second):

Source: http://jme.bmj.com/content/early/201...11-100411.full

In spite of the oxymoron in the expression, we propose to call this practice ‘after-birth abortion’, rather than ‘infanticide’, to emphasise that the moral status of the individual killed is comparable with that of a fetus (on which ‘abortions’ in the traditional sense are performed) rather than to that of a child. Therefore, we claim that killing a newborn could be ethically permissible in all the circumstances where abortion would be. Such circumstances include cases where the newborn has the potential to have an (at least) acceptable life, but the well-being of the family is at risk. Accordingly, a second terminological specification is that we call such a practice ‘after-birth abortion’ rather than ‘euthanasia’ because the best interest of the one who dies is not necessarily the primary criterion for the choice, contrary to what happens in the case of euthanasia.

So...you admit it's murder, but still endorse the idea any way? I'm sorry if this is harsh, but are you daft?

If a potential person, like a fetus and a newborn, does not become an actual person, like you and us, then there is neither an actual nor a future person who can be harmed, which means that there is no harm at all. So, if you ask one of us if we would have been harmed, had our parents decided to kill us when we were fetuses or newborns, our answer is ‘no’, because they would have harmed someone who does not exist (the ‘us’ whom you are asking the question), which means no one. And if no one is harmed, then no harm occurred.

Oh wait, you're not daft. You're just a nihilist. Or maybe both.

A possible objection to our argument is that after-birth abortion should be practised just on potential people who could never have a life worth living.9 Accordingly, healthy and potentially happy people should be given up for adoption if the family cannot raise them up. Why should we kill a healthy newborn when giving it up for adoption would not breach anyone's right but possibly increase the happiness of people involved (adopters and adoptee)?

Our reply is the following. We have previously discussed the argument from potentiality, showing that it is not strong enough to outweigh the consideration of the interests of actual people. 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. On this perspective, the interests of the actual people involved matter, and among these interests, we also need to consider the interests of the mother who might suffer psychological distress from giving her child up for adoption. Birthmothers are often reported to experience serious psychological problems due to the inability to elaborate their loss and to cope with their grief.10 It is true that grief and sense of loss may accompany both abortion and after-birth abortion as well as adoption, but we cannot assume that for the birthmother the latter is the least traumatic. For example, ‘those who grieve a death must accept the irreversibility of the loss, but natural mothers often dream that their child will return to them. This makes it difficult to accept the reality of the loss because they can never be quite sure whether or not it is irreversible’.11

We are not suggesting that these are definitive reasons against adoption as a valid alternative to after-birth abortion. Much depends on circumstances and psychological reactions. What we are suggesting is that, if interests of actual people should prevail, then after-birth abortion should be considered a permissible option for women who would be damaged by giving up their newborns for adoption.

So you think you're going to make the pain of the mother all better by outright killing the newborn instead of giving him/her up for adoption? And newborns aren't people?

I don't...what...no....but...

Okay, is there some sort of scientist recall system in Australia? Where you can get a scientist fired for his views or something? Because if there was a time to use it, it'd be now.

The JME's reply doesn't help (from the first link):

Many people will and have disagreed with these arguments. However, the goal of the Journal of Medical Ethics is not to present the Truth or promote some one moral view. It is to present well reasoned argument based on widely accepted premises. The authors provocatively argue that there is no moral difference between a fetus and a newborn. Their capacities are relevantly similar. If abortion is permissible, infanticide should be permissible. The authors proceed logically from premises which many people accept to a conclusion that many of those people would reject.

Of course, many people will argue that on this basis abortion should be recriminalised. Those arguments can be well made and the Journal would publish a paper than made such a case coherently, originally and with application to issues of public or medical concern. The Journal does not specifically support substantive moral views, ideologies, theories, dogmas or moral outlooks, over others. It supports sound rational argument. Moreover, it supports freedom of ethical expression. The Journal welcomes reasoned coherent responses to After-Birth Abortion. Or indeed on any topic relevant to medical ethics.

Look, I can understand trying to present multiple views, but I wouldn't call this scientific paper a "well reasoned argument", a "coherent case", or "sound, rational argument". If anything, it's the exact opposite of them all. Scary really.

I really hope someone takes on the bolded portion of that quote though. Not only would it put the Journal's word to the test, but it would also counter some of the lies this paper spews.

[Kist]

"After birth abortion" is just a euphemism for murder.

Abortion is always a euphemism for murder, regardless if it's after two days or after birth.

[followerofjesus]

"After birth abortion" is just a euphemism for murder.

Amen!

[followerofjesus]

Abortion is always a euphemism for murder, regardless if it's after two days or after birth.

And Amen!

[Kist]

I feel like I need to add something to my previous posts. The sheer fact that there are women that think they need to murder their child shows how much of a failure our current churches are. Too many of us offer no real alternative, or we don't offer it with enough love and with no judgement about what has gotten them in a certain situation. We as the church should be out there in the field, making sure those girls/women know there are other options, that they don't have to do this, and that God wants to help them, and that we want to help them. Too many of us just step out, with a judgement, but when push comes to shove, we won't even give them the most simple of helps without muttering something under our breaths about them. So before we step out in this one, and look at this in disgust, we should look at ourselves. Do we do enough? Do we love enough? Are we willing to lay things down so this people have hope? If we can't say yes, then we should first look to ourselves. And I know that our possible failures aren't made right by them doing these things. But I dare not to say that I understand what a young girl goes through, when she falls pregnant when she is fourteen, the guy runs off, and the parents, grandparents, and other surrounding people pressure her and push her towards abortion.

[micah719]

First, the "un-born", now the "just-born"....next is the "shouldn't have been born". Welcome to the fourth reich. No prizes guessing which folks are being lined up for removal. Say Shibboleth, please....

[FaithInChrist]

I feel like I need to add something to my previous posts. The sheer fact that there are women that think they need to murder their child shows how much of a failure our current churches are. Too many of us offer no real alternative, or we don't offer it with enough love and with no judgement about what has gotten them in a certain situation. We as the church should be out there in the field, making sure those girls/women know there are other options, that they don't have to do this, and that God wants to help them, and that we want to help them. Too many of us just step out, with a judgement, but when push comes to shove, we won't even give them the most simple of helps without muttering something under our breaths about them. So before we step out in this one, and look at this in disgust, we should look at ourselves. Do we do enough? Do we love enough? Are we willing to lay things down so this people have hope? If we can't say yes, then we should first look to ourselves. And I know that our possible failures aren't made right by them doing these things. But I dare not to say that I understand what a young girl goes through, when she falls pregnant when she is fourteen, the guy runs off, and the parents, grandparents, and other surrounding people pressure her and push her towards abortion.

There are countless programs for young girls that end up pregnant. There are miles long adoption waiting lists for newborn babies. The problem isn't' that there aren't enough resources, it's the resources that are allowed to be in our children's schools are not pro-life ie: planned parenthood. Many of these kids have never been to a church and don't have a clue that they could get non-judgmental help. Unfortunately, churches are not allowed to "advertise" where they could have the most effect.

As for the article.

‘After-birth abortion’ is logically sound: that’s why it will boost the pro-life movement

Perhaps, but in the world we live in it could easily go the other way and the horrific act of murdering un-born babies could turn into the horrific act of murdering newborn babies too. If it were ever considered legal to murder a non-sentient human being, then severe mental retardation would be an allowable murder, any elderly with dimentia would also be on the chopping block (so to speak), perhaps somebody with severe depression, or schizophreia when they are heavily sedated on their control meds would also be considered non-sentient. The list could be limitless and could grow to include just about anybody that was deemed "unnecessary". I would never, ever, ever consider abortion an alternative for anybody, but the proposal in this article does not necessarily help the case for pro-life in the world we live in. Some people readily agree with that article and would find the opportunities endless.

[arapahoepark]

I am beginning to see why the Amish want nothing to do with anything. I feel like doing the same thing most of the time now....

[WKUHilltopper]

Why not kill them at 1, 2 3, 10, 12, 40, 50, 100? Heck, 0-forever years old. If you're a burden to the state, you have a patriotic duty to die. Who is a burden? Anyone who we say is. See how easy this is? Sucking babies from the womb isn't a big deal--we're used to it now, so what's the big deal of just going ahead and killing anyone we say isn't "worthy of life"? And yet, many in this country don't see the move (priming the pump) to a fascist state...

That this is even being debated (in a medical journal of all things!) should be a wake up call --but it won't be. They may figure it out once they're finally tied down on the gurney in prep of their shot.

===========================================

After-birth abortion: why should the baby live?

Alberto Giubilini1,2,
Francesca Minerva3,4

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.
Abortion and after-birth abortion

Euthanasia in infants has been proposed by philosophers3 for children with severe abnormalities whose lives can be expected to be not worth living and who are experiencing unbearable suffering.

Also medical professionals have recognised the need for guidelines about cases in which death seems to be in the best interest of the child. In The Netherlands, for instance, the Groningen Protocol (2002) allows to actively terminate the life of ‘infants with a hopeless prognosis who experience what parents and medical experts deem to be unbearable suffering’.4

Although it is reasonable to predict that living with a very severe condition is against the best interest of the newborn, it is hard to find definitive arguments to the effect that life with certain pathologies is not worth living, even when those pathologies would constitute acceptable reasons for abortion. It might be maintained that ‘even allowing for the more optimistic assessments of the potential of Down's syndrome children, this potential cannot be said to be equal to that of a normal child’.3 But, in fact, people with Down's syndrome, as well as people affected by many other severe disabilities, are often reported to be happy.5

Nonetheless, to bring up such children might be an unbearable burden on the family and on society as a whole, when the state economically provides for their care. On these grounds, the fact that a fetus has the potential to become a person who will have an (at least) acceptable life is no reason for prohibiting abortion. Therefore, we argue that, when circumstances occur after birth such that they would have justified abortion, what we call after-birth abortion should be permissible.

In spite of the oxymoron in the expression, we propose to call this practice ‘after-birth abortion’, rather than ‘infanticide’, to emphasise that the moral status of the individual killed is comparable with that of a fetus (on which ‘abortions’ in the traditional sense are performed) rather than to that of a child. Therefore, we claim that killing a newborn could be ethically permissible in all the circumstances where abortion would be. Such circumstances include cases where the newborn has the potential to have an (at least) acceptable life, but the well-being of the family is at risk. Accordingly, a second terminological specification is that we call such a practice ‘after-birth abortion’ rather than ‘euthanasia’ because the best interest of the one who dies is not necessarily the primary criterion for the choice, contrary to what happens in the case of euthanasia.

Failing to bring a new person into existence cannot be compared with the wrong caused by procuring the death of an existing person. The reason is that, unlike the case of death of an existing person, failing to bring a new person into existence does not prevent anyone from accomplishing any of her future aims. However, this consideration entails a much stronger idea than the one according to which severely handicapped children should be euthanised. If the death of a newborn is not wrongful to her on the grounds that she cannot have formed any aim that she is prevented from accomplishing, then it should also be permissible to practise an after-birth abortion on a healthy newborn too, given that she has not formed any aim yet.

There are two reasons which, taken together, justify this claim:

The moral status of an infant is equivalent to that of a fetus, that is, neither can be considered a ‘person’ in a morally relevant sense.

It is not possible to damage a newborn by preventing her from developing the potentiality to become a person in the morally relevant sense.

We are going to justify these two points in the following two sections.
The newborn and the fetus are morally equivalent

The moral status of an infant is equivalent to that of a fetus in the sense that both lack those properties that justify the attribution of a right to life to an individual.

Both a fetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’. We take ‘person’ to mean an individual who is capable of attributing to her own existence some (at least) basic value such that being deprived of this existence represents a loss to her. This means that many non-human animals and mentally retarded human individuals are persons, but that all the individuals who are not in the condition of attributing any value to their own existence are not persons. Merely being human is not in itself a reason for ascribing someone a right to life. Indeed, many humans are not considered subjects of a right to life: spare embryos where research on embryo stem cells is permitted, fetuses where abortion is permitted, criminals where capital punishment is legal.

Our point here is that, although it is hard to exactly determine when a subject starts or ceases to be a ‘person’, a necessary condition for a subject to have a right to X is that she is harmed by a decision to deprive her of X. There are many ways in which an individual can be harmed, and not all of them require that she values or is even aware of what she is deprived of. A person might be ‘harmed’ when someone steals from her the winning lottery ticket even if she will never find out that her ticket was the winning one. Or a person might be ‘harmed’ if something were done to her at the stage of fetus which affects for the worse her quality of life as a person (eg, her mother took drugs during pregnancy), even if she is not aware of it. However, in such cases we are talking about a person who is at least in the condition to value the different situation she would have found herself in if she had not been harmed. And such a condition depends on the level of her mental development,6 which in turn determines whether or not she is a ‘person’.

Those who are only capable of experiencing pain and pleasure (like perhaps fetuses and certainly newborns) have a right not to be inflicted pain. If, in addition to experiencing pain and pleasure, an individual is capable of making any aims (like actual human and non-human persons), she is harmed if she is prevented from accomplishing her aims by being killed. Now, hardly can a newborn be said to have aims, as the future we imagine for it is merely a projection of our minds on its potential lives. It might start having expectations and develop a minimum level of self-awareness at a very early stage, but not in the first days or few weeks after birth. On the other hand, not only aims but also well-developed plans are concepts that certainly apply to those people (parents, siblings, society) who could be negatively or positively affected by the birth of that child. Therefore, the rights and interests of the actual people involved should represent the prevailing consideration in a decision about abortion and after-birth abortion.

It is true that a particular moral status can be attached to a non-person by virtue of the value an actual person (eg, the mother) attributes to it. However, this ‘subjective’ account of the moral status of a newborn does not debunk our previous argument. Let us imagine that a woman is pregnant with two identical twins who are affected by genetic disorders. In order to cure one of the embryos the woman is given the option to use the other twin to develop a therapy. If she agrees, she attributes to the first embryo the status of ‘future child’ and to the other one the status of a mere means to cure the ‘future child’. However, the different moral status does not spring from the fact that the first one is a ‘person’ and the other is not, which would be nonsense, given that they are identical. Rather, the different moral statuses only depends on the particular value the woman projects on them. However, such a projection is exactly what does not occur when a newborn becomes a burden to its family.
The fetus and the newborn are potential persons

Although fetuses and newborns are not persons, they are potential persons because they can develop, thanks to their own biological mechanisms, those properties which will make them ‘persons’ in the sense of ‘subjects of a moral right to life’: that is, the point at which they will be able to make aims and appreciate their own life.

It might be claimed that someone is harmed because she is prevented from becoming a person capable of appreciating her own being alive. Thus, for example, one might say that we would have been harmed if our mothers had chosen to have an abortion while they were pregnant with us7 or if they had killed us as soon as we were born. However, whereas you can benefit someone by bringing her into existence (if her life is worth living), it makes no sense to say that someone is harmed by being prevented from becoming an actual person. The reason is that, by virtue of our definition of the concept of ‘harm’ in the previous section, in order for a harm to occur, it is necessary that someone is in the condition of experiencing that harm.

If a potential person, like a fetus and a newborn, does not become an actual person, like you and us, then there is neither an actual nor a future person who can be harmed, which means that there is no harm at all. So, if you ask one of us if we would have been harmed, had our parents decided to kill us when we were fetuses or newborns, our answer is ‘no’, because they would have harmed someone who does not exist (the ‘us’ whom you are asking the question), which means no one. And if no one is harmed, then no harm occurred.

A consequence of this position is that the interests of actual people over-ride the interest of merely potential people to become actual ones. This does not mean that the interests of actual people always over-ride any right of future generations, as we should certainly consider the well-being of people who will inhabit the planet in the future. Our focus is on the right to become a particular person, and not on the right to have a good life once someone will have started to be a person. In other words, we are talking about particular individuals who might or might not become particular persons depending on our choice, and not about those who will certainly exist in the future but whose identity does not depend on what we choose now.

The alleged right of individuals (such as fetuses and newborns) to develop their potentiality, which someone defends,8 is over-ridden by the interests of actual people (parents, family, society) to pursue their own well-being because, as we have just argued, merely potential people cannot be harmed by not being brought into existence. Actual people's well-being could be threatened by the new (even if healthy) child requiring energy, money and care which the family might happen to be in short supply of. Sometimes this situation can be prevented through an abortion, but in some other cases this is not possible. In these cases, since non-persons have no moral rights to life, there are no reasons for banning after-birth abortions. We might still have moral duties towards future generations in spite of these future people not existing yet. But because we take it for granted that such people will exist (whoever they will be), we must treat them as actual persons of the future. This argument, however, does not apply to this particular newborn or infant, because we are not justified in taking it for granted that she will exist as a person in the future. Whether she will exist is exactly what our choice is about.
Adoption as an alternative to after-birth abortion?

A possible objection to our argument is that after-birth abortion should be practised just on potential people who could never have a life worth living.9 Accordingly, healthy and potentially happy people should be given up for adoption if the family cannot raise them up. Why should we kill a healthy newborn when giving it up for adoption would not breach anyone's right but possibly increase the happiness of people involved (adopters and adoptee)?

Our reply is the following. We have previously discussed the argument from potentiality, showing that it is not strong enough to outweigh the consideration of the interests of actual people. 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. On this perspective, the interests of the actual people involved matter, and among these interests, we also need to consider the interests of the mother who might suffer psychological distress from giving her child up for adoption. Birthmothers are often reported to experience serious psychological problems due to the inability to elaborate their loss and to cope with their grief.10 It is true that grief and sense of loss may accompany both abortion and after-birth abortion as well as adoption, but we cannot assume that for the birthmother the latter is the least traumatic. For example, ‘those who grieve a death must accept the irreversibility of the loss, but natural mothers often dream that their child will return to them. This makes it difficult to accept the reality of the loss because they can never be quite sure whether or not it is irreversible’.11

We are not suggesting that these are definitive reasons against adoption as a valid alternative to after-birth abortion. Much depends on circumstances and psychological reactions. What we are suggesting is that, if interests of actual people should prevail, then after-birth abortion should be considered a permissible option for women who would be damaged by giving up their newborns for adoption.
Conclusions

If criteria such as the costs (social, psychological, economic) for the potential parents are good enough reasons for having an abortion even when the fetus is healthy, if the moral status of the newborn is the same as that of the infant and if neither has any moral value by virtue of being a potential person, then the same reasons which justify abortion should also justify the killing of the potential person when it is at the stage of a newborn.

Two considerations need to be added.

First, we do not put forward any claim about the moment at which after-birth abortion would no longer be permissible, and we do not think that in fact more than a few days would be necessary for doctors to detect any abnormality in the child. In cases where the after-birth abortion were requested for non-medical reasons, we do not suggest any threshold, as it depends on the neurological development of newborns, which is something neurologists and psychologists would be able to assess.

Second, we do not claim that after-birth abortions are good alternatives to abortion. Abortions at an early stage are the best option, for both psychological and physical reasons. However, if a disease has not been detected during the pregnancy, if something went wrong during the delivery, or if economical, social or psychological circumstances change such that taking care of the offspring becomes an unbearable burden on someone, then people should be given the chance of not being forced to do something they cannot afford.
Acknowledgments

We would like to thank Professor Sergio Bartolommei, University of Pisa, who read an early draft of this paper and gave us very helpful comments. The responsibility for the content remains with the authors.

After-birth abortion: why should the baby live? -- Giubilini and Minerva -- Journal of Medical Ethics

[nillapoet]

I read about this a couple days ago.

How long until you can "terminate" your toddler? I mean they don't develop memory until around 3, so they're not really a person right?

/sarcasm

[followerofjesus]

I am beginning to see why the Amish want nothing to do with anything. I feel like doing the same thing most of the time now....

They may be on to something...

[JAyres]

Kill your newborn baby? Sure, not a problem. Try justifying the killing of newborn puppies, and see how many leftist heads explode. Animals have more rights in this country than humans.

[AndyM]

There are many in this world who do not have the fear of God for one day He will pour his wrath upon the earth and then they shall see and fear Him the creator. I am so thankful my folks taught us to fear God for He is our creator, Thank you Jesus for this.