[This is a revised version of the Editorial which appears on the JME home page. It will replace that version.]
I am personally opposed to the legalisation of infanticide. However, as the Editor of the Journal I would like to explain why the Journal would publish an article defending infanticide.
The ethical discussion of infanticide dates back several thousand years. At least 100 articles have been published on infanticide in the Journal over its history, with articles both for and many against it. Some of the world’s most famous living philosophers have written about its merits and justification over the last 40 years, including Michael Tooley,[1] Jonathan Glover,[2] Peter Singer,[3] [4] Jeff McMahan,[5,6] and John Harris,[7] some in this Journal. McMahan argues that the permissibility of infanticide is not only implied by certain theories, but by beliefs that are widely held and difficult to reject [5].
Infanticide is currently legal in the Netherlands. The “Groningen Protocol” allows doctors to kill neonates at the request of their parents if they are experiencing unbearable suffering.
The active withdrawal of medical care (an intentional act that kills) is a standard part of care of newborns with severe disability and suffering in the UK, US, rest of Europe and nearly all of the world. This is sometimes called passive euthanasia.1
Over the last 40 years, there has been an active debate on the ethics of killing or allowing severely ill or disabled newborns to die. Jonathan Glover’s landmark Causing Death and Saving Lives notes that “Dr Francis Crick [the Nobel Laureate who discovered DNA with Jim Watson in 1956] once proposed a two-day period for detecting abnormalities, after which infanticide would not be permissible” [2] (p.168).
In the case of abortion, termination of pregnancy is permissible in most countries not only for severe disability but also for reasons of maternal welfare (or other reasons). Giubilini and Minerva extend the long running debate on infanticide to ask: if abortion is permissible both for social as well as medical reasons, why is infanticide permissible only for medical reasons? They ask: what is the moral difference between a fetus and a neonate? They point out that both have similar capacities and if one is permissible, why not the other?
This extension of the existing debate around infanticide from medical indications to social indications is relatively novel. I don’t personally agree with it. But their arguments – based on the similar moral status of the fetus and neonate – call for rebuttal.
This paper was scrutinised by 3 peer reviewers and revised in light of their comments. The Journal does not publish or not publish articles because of the controversial nature of their conclusion, but rather on the quality of the argument. If an argument was based on clearly and obviously mistaken premises, then we would reject it. But in this case, there has been a long and ongoing debate on the moral status of early human life – embryos, fetuses and neonates, as the above literature attests.
The Journal is publishing opposing views to accompany this controversial article.
Julian Savulescu
Editor
Journal of Medical Ethics
FOOTNOTE
1. Young argues that the reason it is not classified as murder in England is because of a technical legal judgement in the case of Tony Bland that redefined the act of withdrawing a life-prolonging medical treatment as an “omission.” If the act of withdrawing a life-preserving feeding tube (or other medical treatment) had been properly described as an act, then it would constitute intentional killing and would have been murder. Young argues this was a convenient legal redescription to protect doctors from charges of murder [8].
REFERENCES
1. Tooley M. Abortion and Infanticide. Philos Public Aff 1972;2:37-65.
2. Glover J. Causing Death and Saving Lives. Harmondsworth: Penguin. 1977.
3. Singer P. Practical Ethics. Cambridge: Cambridge University Press. 1979.
4. Kuhse H, Singer P. Should the Baby live? The Problem of Handicapped Infants. Oxford: Oxford University Press, 1985.
5. McMahan J. Infanticide. Utilitas 2007;19:131-159.
6. McMahan J. The Ethics of Killing. Oxford: OUP. 2002.
7. Harris J. Ethical problems in the management of some severely handicapped children. J Med Ethics 1981;7:117-124.
8. Young R. Medically Assisted Death. Cambridge: Cambridge University Press. 2007.
I think most topics you raise were already clear for researchers with some experience in the field, but it is indeed good to find everything in a single place.
It troubles me, however, that this matter has been handled unilaterally all around the world, by people who have no idea of what is going on, or who haven't even read the article.
I would suggest you to exercise your right of reply in the main venues in which this kind of criticism can be found, and ask the respective editors to publish the new Editorial, as it is JME's right.
I mention this because what I have seen so far in Italian, German and Brazilian contexts are news that make everything possible to discredit Uehiro Centre and studies in practical ethics as a whole, and this is not acceptable.
Letter to the Editor Julian Savulescu at the Journal of Medical Ethics
Let me go straight to the matter, first dealing with the consequences, after which I will show how the argument was based on clearly and obviously mistaken premises. Dr. Minerva and yourself either simply ignore or eschew responsibility. Dr. Minerva was quoted as saying "This is not a proposal for law. This is pure academic discussion.", that position is naive and can simply be described as living in a bubble. What we say and argue for matters and has consequences. As with Roe v. Wade lawmakers do not form their opinions merely as individuals, they inquire, outside the legal system and precedent, into other realms of society i.e. bio ethicists, doctors, scientists, neurologists, etc. More importantly this inquiry comes in the form of respectable establishments and from people with a Ph.D. in their title and as such their opinions and arguments also carry respectability and more weight which ultimately, though not based solely on those opinions, translates into influencing lawmakers decisions i.e. law.
Now, as to how the argument was based on clearly and obviously mistaken premises, I will attack premise 1.
There are two criterion for demarcation the authors draw;
1. The individual is capable of attributing to her own existence some basic value.
2. The individual is capable of making any aims.
These are the properties the authors allude to; "…properties that justify the attribution of a right to life to an individual."
These two properties are the foundation for premise 1 "both fetuses and newborns do not have the same moral status as actual persons"
Amazingly, the authors even admit that foundation is flawed through ignorance;
"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."
The authors, nor anyone for that matter, knows when a human being is capable of attributing to her own existence some basic value or of making any aims, especially in a free will sense. When do we become self-aware? When do we conceptualize death? Value is also a higher concept, how do we know it outside of the simple pain response our genetics provide us with without learning it? What really establishes a right to life? What justifies rights? What justifies life? These are massive and unsettled questions that are not addressed by the authors and absurdly and hastily forgotten. It is because of this the foundation and justification for premise one crumbles and is clearly and obviously mistaken.
-DiwataMan
"The authors, nor anyone for that matter, knows when a human being is capable of attributing to her own existence some basic value or of making any aims, especially in a free will sense. When do we become self-aware? When do we conceptualize death?"
Could it be:
1) When they are able to gather sensory information, i.e. when their senses are functional and receiving input. Be it light (after birth), hearing and tacticle sensation (for instance, when they can feel pain).
Although not actually proven, it is reasonable to assume that symbolic thought requires sensorial input. If nothing feels, how can a being that has never felt anything ackowledge itself?
Therefore:
2) When their central nervous systems are developed enough (around the 20th-24th week, if I am not mistaken).
3) That said, what *is* argued with enough evidence is that babies up to some months old still cannot differentiate between themselves and their mothers, their toys, or from someone else.
It is also argued that newborn babies can percieve the smell of their mothers milk within a few days of birth.
Hellen Keller is a prime example of sensory depravation not leading to lack of personhood. The thoughts and perceptions were there although her senses were limited, she merely needed someone to teach her language in order to express it. Couldn't the same be argued about an infant with limited sensory abilities, they simply need time to develop such abilities and an adult to provide them with a "vocabulary."
Having worked with people with disabilities in order to help them communicate non-verbally, I have seen first hand that there is usually a great depth of human exisence locked away within a disabled mind, it simply needs the means to express itself.
There is a big difference between having senses and losing them, and never having had them at all. If you could see once, even if you become blind the knowledge of "red", "square" will remain in your mind.
I would also argue for the life of sensory deprived people, mainly because I believe they will live enough for medicine become able to provide them with artificial senses. Besides, I suppose it is at any impossible to be born without tactile perception.
The point, however, was that fully sensory deprived people cannot have a percpetion of themselves, for the sole reason that they have no input and is very unlikely that in this condition they can form conceptions about anything.
*at any rate.
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