Tuesday, January 17, 2012

Life unworthy of life?

I read this story just a little while ago; the mother of a disabled child was told the child did not qualify for a kidney transplant because of mental retardation:

He says about three more sentences when something sparks in my brain. First it is hazy, foggy, like I am swimming under water. I actually shake my head a little to clear it. And then my brain focuses on what he just said.

I put my hand up. “Stop talking for a minute. Did you just say that Amelia shouldn’t have the transplant done because she is mentally retarded. I am confused. Did you really just say that?”

The tears. Oh, the damn tears. Where did they come from? Niagara Falls. All at once. There was no warning. I couldn’t stop them. There were no tissues in conference room so I use my sleeve and my hands and I keep wiping telling myself to stop it.

I point to the paper and he lets me rant a minute. I can’t stop pointing to the paper. “This phrase. This word. This is why she can’t have the transplant done.”

“Yes.”

I begin to shake. My whole body trembles and he begins to tell me how she will never be able to get on the waiting list because she is mentally retarded.

Fortunately, this story is attracting national attention:

Amelia "Mia" Rivera has Wolf-Hirschhorn syndrome, a complex genetic disorder that causes mental and physical impairments, and her family said that the 3-year-old will die if she does not get a kidney in the next six months to a year.

Mia's mother Chrissy Rivera has said the family is willing to donate a live organ, but Children's Hospital of Philadelphia has reportedly told her that they will not recommend transplantation for the toddler because of her disabilities.

Rivera blogged about her daughter's plight last Friday, and now more than 20,000 online supporters from 15 states are petitioning the hospital to give the toddler the kidney they say she needs to survive.

"I didn't think it was going to be an issue," said Rivera, a 35-year-old high school English teacher from southern New Jersey who has two other children, aged 11 and 6.

When the family went to CHOP last week to discuss the transplant, Rivera said she "thought we were just finding out how transplant works and how we could be a donor."

"But then, I was told we couldn't because she was mentally retarded," she said. "Those were the exact words on a piece of paper."

The hospital says it can't comment on patient cases.

I know there are sometimes situations in which a patient doesn't qualify for a transplant--but those situations are usually based on the patient's own needs and interests. If a patient is unlikely to survive transplant surgery or can't tolerate immunosuppressive medications, for instance, it is quite likely that the patient's doctor will tell him or her that a transplant is not an option.

But in this case--if you read Mrs. Rivera's blog--you will see that the child's nephrology doctor told the Riveras that they had six months to a year before their daughter would need a kidney transplant. Apparently, no one said anything about little Amelia having some underlying health condition that would make a transplant impossible until the parents met with the transplant team, at which point they were told that her mental retardation made her ineligible--not, according to Mrs. Rivera, that there was some physical impairment that would hinder the surgery or make it unlikely to be successful.

To be perfectly honest, I'm not all that surprised by this. Angered, yes, but not all that surprised.

I've heard stories time and time again from parents of children who are disabled about how callously, negatively, unkindly and coldly they are treated by medical professionals--not all, certainly, but enough to place a barrier of distrust between parents of children with disabilities and their doctors. A certain percentage of American doctors seem to have absorbed the phrase that originated in Nazi Germany: Lebensunwertes Leben, or "Life unworthy of life." They see no merit at all in the life of a child who will probably die young, who is physically and/or mentally impaired, who may never reach--in that ugly phrase--his or her "full human potential" (and I'd like anyone to demonstrate who, exactly, has done so?). They may start out by counseling parents somewhat kindly, especially if the child's condition is diagnosed in utero--but let the parents show a bias for life for their child, and they will often grow increasingly hostile. Once the child is actually born, the attitude is often: well, you selfishly chose for this child to experience suffering and a less-than-perfect life, so don't come running to us when he or she is ill or needs help; the sooner he or she dies of some natural cause or progression of the disability, the better for everyone.

Like I said, there are heroic doctors and nurses who reject this attitude with horror, but that doesn't mitigate the suffering inflicted upon the families of the disabled by those who display this attitude--and, sometimes, open contempt--to the parents. In addition to the ordinary difficulties and struggles of raising and caring for a child with disabilities is added this crushing weight of derision, this tendency to view the child as being somehow unworthy of life, of medical resources, and of transplants that should go to "normal" kids--even if, as in the Rivera's case, the family is offering to find a donor kidney from among Amelia's own relatives.

Long ago, I took a class at a Catholic college in which we discussed life issues, and I recall the teacher saying that the "choice" of abortion would quickly become an obligation for some women, from society's viewpoint. I thought at the time that this was a bit farfetched, as pro-life as I was and still am. How could the pro-abortion side, so enamored of "a woman's right to choose" to have her child slaughtered in utero, stand idly by should women be pressured or coerced to do so? But the subtle coercion that is out there takes many forms, from the daughter who is told she'll be thrown out of the house to the woman with disabilities ordered by a judge to abort to the pervasive attitude out there that children with disabilities don't deserve to be born and should die as quickly as possible. All it takes is the belief that there is such a thing as "life unworthy of life" for these things to happen, and we are much further along that path now than I ever thought we would be in my lifetime.

UPDATE: It appears that the hospital is reconsidering (hat tip: Mark Shea). Good! If no parent ever has to hear again that their child isn't a candidate for surgery or transplant solely because of a mental disability or cognitive impairment, then little Amelia and her parents have done a great thing for those with disabilities by raising awareness of these sorts of policies.

23 comments:

Geoff G. said...

The complicating factor in an organ transplant is the need for a compatible organ. And that depends on the availability of donors, who are always in short supply.

And that means that we have to make choices about who receives organs first. It's mostly first-come-first-served, with long waiting lists of people, many of whom die while waiting for their name to rise to the top of the list. There's controversy about providing liver transplants to alcoholics, for instance.

As for this case, since there does seem to be a kidney available, it comes down to a matter of how to pay for the procedure. Is the hospital working pro bono? If they are, they have the right to determine who is the recipient of their charity. Is insurance or the family paying for it? Then the hospital should take the money and do the procedure, just as they would for anyone else.

Your medical care is in your own hands (or in the hands of your guardians, like in this case). Doctors can recommend and advise, but ultimately the decision for whether to proceed with a particular medication or procedure is yours. That's a pretty bedrock principle of medical care, and it's one that this hospital seems to be violating.

Red Cardigan said...

Well, sure, Geoff--but this family was not being told "You understand your daughter will have to go on a list and she may not be at the top," they were allegedly being told, "We're not putting your daughter on the list, period, because she's mentally retarded."

I think most families of seriously ill children understand how donor lists work, and while I'm sure it's agonizing to have to wait and hope that your child *will* make it to the top of the list and there *will* be an organ available, it's not the same thing as being shut out of the process completely. And even that would be acceptable, though heartbreaking, if the doctor said, "Your child can't receive a transplant because she's deathly allergic to the immune-suppressing drugs and wouldn't survive the transplant process," or some such thing. This is so, so different.

rdcobb said...

The family actually said they had donors willing to be tested and the doctor told her that they would not perform the surgery even if they found a matching donor within their own family....under any circumstances at all.

freddy said...

Who, exactly has lived up to his "full human potential?"

Christ. And He was killed for it.

Little Amelia and children like her ARE and DO live up to their full human potential every day. And that frightens some people. I think they can't help but see their own shortcomings in light of the beautiful way these people live their lives, and that enrages them.

Anonymous said...

Our culture only values you if you make a lot of money, or have "potential" to make a lot of money (beware the word potential).

~ Ann Marie

Annie said...

I work in the dialysis industry and it is not uncommon for patients to be rejected from the transplant lists. The concern is that the patient will not be able to be compliant with the anti-rejection medications that will required for the rest of the patient's life. Patients are denied because of mental illnesses, because they don't demonstrate that they will be able to afford the anti-rejection meds after their Medicare eligibility ends, drug use and other co-morbidities, history of non-compliance, etc.

It not murder to not list a patient on the transplant list. It not murder to decide that a patient is not a good candidate for a specific procedure. I don't see any evidence here that the physicians refused to do the transplant because they didn't think she had a right to live because of her disabilities. Rather they believed she wasn't a good candidate for a transplant. Reasonably her disabilities are a factor they should consider when determining whether she was a good candidate.

Siarlys Jenkins said...

I'm attempting, rather late in the game, to reconstruct some thoughts that Blogger appears to have lost -- they were not censored and they were not in spam either.

It is generally true, although not universally, that when a baby is born with severe cognitive disabilities, they also have severe physical disabilities, which shorten their likely lifespan. Perhaps God intended it this way. If God specially made provision for these "special children," perhaps he ordained for them a special span of life -- possibly because it is truly painful to navigate life with such disabilities.

I see a reasonable case for providing such persons with routine care, but NOT invasive procedures, major surgery, or expensive life-long therapies that give them a few extra years.

Of course, a devoted mother who wants to save her child won't see it that way. There is no reason she should. A cold, callous, "well, we're just not going to consider it," is rather pompous and could be vastly improved upon.

Some years ago, an older woman distantly related to me by two intervening marriages obtained a liver transplant KNOWING she had an infectious illness which would destroy the new liver as it had the old. She might have gained six months extension of life. Family members much closer to her than I have privately expressed doubt that this was appropriate, particularly with long waiting lists.

Some triage in these matters is appropriate and necessary. Triage is almost always abused -- any allocation of scarce resources is abused. That is human nature. Absence of triage also promotes abuse, often more egregious abuse.

The willingness of family (if they are a good match -- not always guaranteed) to donate the necessary kidny, removes the question of allocation of scarce resources. The remaining question is how much expense are we, as a nation, or a local community, going to go to for this procedure. It is not a question to be summarily over-ridden by saying "how could you put a price on this little girl's life."

There IS a price on saving her life. What if the procedure cost 10% of annual GDP? It doesn't of course, but "modern medicine" is tending in that direction. If 100 people a year need an operation that costs one percent of the revenue of a relevant branch or level of government, or ten percent of the resources of a relevant charity...

Perhaps we should cancel organ transplants, across the board, for everyone? We will rely on what God gave us, and when that runs out, we will accept that God has called us home? I'm not fully committed to that either. But did anyone see the episode of "Grey's Anatomy" where one doctor is gleefully celebrating the availability of an organ for her patient, when another doctor sternly asks her to step down the hall and observe the grieving spouse of the suddenly dead and now available donor?

This are of medicine raises almost the same moral quandaries as in vitro fertilization for sterile parents who sincerely want a baby...

A willing live kidney donor can, of course, live on without one kidney, but severely impaired, and running some risk of infection, blood poisoning, permanent tissue damage. If I were a potential donor, just what level of functioning the recipient possesses would be a significant consideration. On the other hand, I know if it was my wife (or the woman I hope to marry) I would not hesitate at all. No doubt the family feels the same about this child.

John Henry said...

Re: your professor's prediction that abortion would become mandatory for certain women: We're already starting to see why a live-and-let-live approach to controversial issues like this just isn't working. I am reminded of the Fugitive Slave Act of 1850 that ultimately resulted in the creation of the Republican Party, the Civil War, and the Emancipation Proclamation, and I wonder whether religious liberty issues won't be at the center of the next big American conflict.

Siarlys Jenkins said...

There is nothing more pathetic than a contemporary cause trying to wrap itself in the mantle of a long-settled controversy, now that everyone agrees, with 20/20 hindsight, that the eventual winners were right. PETA is not the civil rights movement, nor is gay marriage, and pro-life is not the abolitionist cause.

You also have it backward as to abortion becoming mandatory. No doubt, there are among our fellow citizens the sort of prying nanny-state manipulators who would like to move in that direction, "for the woman's own good" etc. etc. etc.

But if they work up the political moxie to try it on any large scale, they will find that the immovable obstacle in their path is none other than Roe v. Wade. Justice Blackmun wrote nary a word about abortion being good, or right or just, he applied extensive and well-established constitutional principles to find that an individual woman has the right to make that decision without interference from the police powers of the state.

Should anyone attempt to mandate, that is no less an exercise of the police powers of the state than prohibition. It will be struck down. Justice Scalia will cackle gleefully as he writes his concurring opinion -- and he will be right.

One of the sloppiest tendencies in the media today -- left, right and center -- is to conflate the crass interest of the contending litigants, with the constitutional principles on which courts actually make decisions. Sure, each party wants what it wants -- but it only gets what it wants if there is a broad constitutional foundation.

Roe v. Wade wasn't pro-abortion, it was pro individual liberty and privacy. The constitution is not a policy document, it is a jurisdictional document. The state lacks jurisdiction, period. The state may not set ANY policy binding on individuals in this decision.

Red Cardigan said...

So, Siarlys, a law permitting people to euthanize their elderly, dependent relatives would also be pro individual liberty and privacy. After all, shouldn't the decision whether or not to off grandma be a private personal decision between a grandchild and her doctor? Why should the grandchild have to be inconvenienced by a comatose elderly person sucking money from her inheritance?

You just think it's fine to kill a class of people based on their size, age, and level of dependency. Which makes you pretty small, in my opinion.

Siarlys Jenkins said...

There is an equation in your presentation that I don't follow, and we both know what it is: during at least some portions of pregnancy, what is growing inside the mother is not, in my view, a person with rights equal to the mothers, or, indeed, a person at all.

That, of course, makes all the difference in the world. I wax very caustic when someone who claims to be pro-life offers a logical argument for offing five year olds, as if it somehow burnishes how pro-life they are.

Grandma is not growing inside the body of the grandchild -- and that makes all the difference in the world. If, at a certain point in the human life cycle, an elderly person's continued life depended upon being able to curl up in the womb of a grand-daughter, I might conceivably say it is the grand-daughter's option to accept them, or let them die for lack of the biological shelter she could provide.

However, that question does not arise in our biology. You may be answering my earlier post, but you have not at all undermined that Roe v. Wade would ban mandating abortion just as surely as it bans criminal penalties for abortion in the first two trimesters.

John Henry said...

History repeats itself from time to time, Siarlys. There are many parallels between the abolitionist cause and the anti-abortion cause: lousy jurisprudence, questions about the personhood of the victims, and opposition that focuses exclusively on the personal rights of the perpetrators. You call it "trying to wrap itself in the mantle of a long-settled controversy;" I call it recognizing patterns and similarities.

No doubt, there are among our fellow citizens the sort of prying nanny-state manipulators who would like to move in that direction, "for the woman's own good" etc. etc. etc.

Yes, I have lived most of my life surrounded by people whose support for compulsory sterilization is wholehearted and completely serious. While I have not heard as much support for forced abortion (I have heard some) there is little or no real difference between the two positions, given the assumption that an unborn baby is not a person.

But if they work up the political moxie to try it on any large scale, they will find that the immovable obstacle in their path is none other than Roe v. Wade. Justice Blackmun wrote nary a word about abortion being good, or right or just, he applied extensive and well-established constitutional principles to find that an individual woman has the right to make that decision without interference from the police powers of the state.

Oh, nonsense. Not only are such cases already happening, the logic behind such orders was already laid by the Roe and Casey decisions. If babies in utero are not persons and abortion is a personal matter for a competent woman to make for herself, it stands to reason that if she is deemed incompetent of making her own decisions, that decision should be handed over to competent authorities.

Roe v. Wade wasn't pro-abortion, it was pro individual liberty and privacy. The constitution is not a policy document, it is a jurisdictional document. The state lacks jurisdiction, period. The state may not set ANY policy binding on individuals in this decision.

Really? In a political environment where the DHHS has the jurisdiction to order religious institutions to cover contraceptives in their health plans you're telling me the government has no authority to compel mothers one way or the other on abortion? As an example, given the assumption that "during at least some portions of pregnancy, what is growing inside the mother is not, in my view, a person with rights equal to the mothers, or, indeed, a person at all," and assuming you agree that suicide should be illegal, what would be your argument for not compelling a woman to have an abortion against her wishes if it would save her life?

[The belief that a baby in the womb is not a person with rights] of course, makes all the difference in the world.

Yes. Given this difference in... opinion... I almost think all further discussion is a waste of time.

I wax very caustic when someone who claims to be pro-life offers a logical argument for offing five year olds, as if it somehow burnishes how pro-life they are.

My reasons for opposing abortion are the same as my reasons for opposing the murder of a 5-year-old: it prevents the victim from living out the rest of his or her natural life, it deprives the world of the contributions the victim might have made, and it disfigures the souls of its perpetrators.

Siarlys Jenkins said...

Let me start with your newest, and weakest, point of argument: requiring that contraception be covered in health plans. The "religious liberty" argument is extremely tenuous, and the stronger argument is the rights of employees to make their own choices, without undue coercion by their employers.

Many churches have become large-scale employers of employees who are there, not out of commitment to the canon or mission of the church, but because they need a job, and this one was available. For such employees, it is no different than being employed by General Motors, or Safeway stores, or a local construction company.

There was a time when all employment was "at will," so an employer could set any conditions they wanted, and a person who sought autonomy could darn well open their own business. Our laws have long since recognized that in an economy based on mass production, where an overwhelming majority of citizens rely on "finding a job" in order to be self-supporting, employers' infringement upon employees must be curtailed. Thus, we have a variety of laws protecting the rights of employees.

This provision is one. Nobody is asking the Roman Catholic Church, the Wisconsin Evangelical Lutheran Synod, or any other church, to issue contraceptives, endorse contraceptives, or refer people for contraceptives. All the law and regulations say is, if you hire people as employees, don't try to parade your internal church canon as an excuse to infringe upon your employees' medical options, in a manner no other employer would be allowed to do.

Does that mean that a bit of church money may be subsidizing an individual employee's decision to use a service that the church condemns? Yes it does. If you don't want to be in that position, don't run subsidiary institutions that hire employees on a non-religious basis; staff your operations entirely with members of your own religious orders. (Then there would be no conflict).

That is a far cry from the government compelling an individual to submit to an invasive medical procedure the individual does not desire, and may even be repulsed by. In both cases, the right of an individual to make their own decisions is the proper issue.

I'm not opposed to sterilization, or even abortion, being prescribed in situations where a woman is truly incompetent, but, my libertarian soul is highly skeptical of broad application of the concept "incompetent." Eccentric isn't good enough. Congenitally incapable of understanding what pregnancy is, or how to care for a child, if substantiated by a well-documented organic condition, maybe. Nothing less.

Siarlys Jenkins said...

I can't read the cases ALREADY HAPPENING link just yet, because my browser would lose this connection, but there is ALWAYS some judge, or administrator, or something, somewhere, who will take it upon themselves to order something without legal basis, because they want to... e.g., the state judge in Nebraska who ORDERED a woman not to have an abortion while he pondered the putative father's whining that "it's my baby too." (I've said at much greater length, a man who wants a say in such decisions should marry the woman before sleeping with her, and make sure he and his bride are of one accord). BUT, these individual actions are generally over-ruled by a competent appellate court... it's what gets UPHELD on appeal that you have to worry about being THE LAW.

I have written at length on the difficult of having a civil discussion between people with such diametrically opposite premises. Look here:

http://www.aleksandreia.com/2010/01/12/seeking-agreement-is-futile-but-we-must-try-anyway-after-all-it-is-the-meaning-of-life/

http://www.aleksandreia.com/2010/04/27/embryo-3-whats-in-a-name-or-any-other-name/

http://www.aleksandreia.com/2010/03/03/its-time-to-turn-off-the-lights-and-go-home-nobody-cares-except-the-talking-heads-on-the-stage/

The alternatives are that we ignore each other, scream at each other until we are blue in the faith, attempt to exterminate each other... or keep talking.

You can see all the patterns you want... but if I don't see the same pattern, you aren't strengthening your argument any. Analogies can be good for purposes of illustration, but they are not evidence. Again, we begin from different premises, therefore we will see different patterns.

I could, for example, suggest that those who seek to require a woman to carry a pregnancy to term, against her will, shows the same pattern repeating itself as slave owners breeding their females slaves to produce profitable offspring... you no doubt would find the illustration unconvincing.

John Henry said...

Wow. This is some serious sophistry. If my employer doesn't pay for my vasectomy, I'm being unduly coerced? If said employer doesn't pay for it as part of my employee benefits, that means they're "parad[ing] [their] internal church canon as an excuse to infringe upon [my] medical options?" Those religious people - always looking for excuses to infringe.

Part of the problem with these kinds of statutes is that they often accomplish exactly what you're hoping they will accomplish. When a church can't act as an employer without formally cooperating in evil, it is very likely that the end result will not be freedom and equality for their employees (many of whom, no doubt, signed on without any objections to a pay-for-your-own-vasectomy-style health insurance policy) but rather pink slips. We're seeing similar problems in the area of adoption: rather than allowing the Church to assist in placing babies with parents - just not same sex couples - the states forced them to either condone sin or shut down their operations altogether. Guess what the Church chooses to do?

We've been playing the slippery slope game for decades, and at each turn we're told that the envelope goes so far and no farther. "Contraception is a matter of individual liberty that won't lead to widespread infidelity or to legalized abortion." "Dalliances between consenting adults are private matters that won't lead to widespread divorce and out-of-wedlock pregnancies." "Divorce and single parenthood are private matters that won't have social impacts; kids are pretty resilient, after all." "Legalizing abortion won't increase the frequency of abortions - in fact, the more we fund Planned Parenthood, the more abortion will be safe, legal, and rare."

Now I'm being told that acceptance of abortion plus government mandates about what constitutes healthcare will not add up to forced abortions. Well, I'm skeptical, and not only because there have already been such orders issued by judges, or because government officials such as the Director of the White House Office of Science and Technology Policy are on record supporting compulsory population control, including forced abortion. I'm also skeptical because I think that at some point, healthcare is going to be seen (rightly) as a shared expense. And when I'm paying for your healthcare, I have the right to make certain health decisions for you. For instance, I have the right to insist you stop smoking so I won't have to pay all your emphysema and lung cancer bills in twenty years when you start getting sick. It'll start with smoking, but abortion won't be far behind, because, after all, the rest of us have to pay the social costs for the babies poor women have.

I can see a lot of support for this, both from the "right" and from the "left." The rightists would get to tell those on welfare or Medicare to abort that expensive baby, or get thrown off the rolls. And the leftists would get to feel warm and fuzzy inside because for every human baby they forcibly abort, that's one less set of carbon footprints tracked across the land. It sounds abhorrent to us now, but so did things like gay marriage and legalized abortion to our grandparents. Things change, and what we do now affects what happens down the road.

John Henry said...

I've said at much greater length, a man who wants a say in such decisions should marry the woman before sleeping with her, and make sure he and his bride are of one accord.

By that logic, a woman who wants financial support for a child, should she conceive, should marry the man before sleeping with him, and make sure she and her husband are of one accord. And yet I imagine you would agree that it's right and just to demand a man pay child support even if he refuses to stick around and fulfill his other fatherly obligations.

While it's possible to have a civil discussion about abortion without agreeing as to the "personhood" of the child, I don't know that any such discussion is very productive. I suspect it would be much more productive to debate the premise using axiomata we can agree on, and move on from there.

Siarlys Jenkins said...

Well John Henry, the main reason I keep suggesting that we need to have a civil dialog is we have to share the planet, the body politic of our nation, we may even have to live next door to each other. We can try to exterminate or subjugate each other, we can ignore each other and let the world go its merry way, or we can continue the dialog.

The fact that you open your mouth and offer your opinion means that you are entering into a dialog, or, it means you are talking to yourself. The fact that we don't come to a rapid consensus is secondary. I take more flak from pro-choice people, who are sufficiently self-righteous they don't see any point in talking to the pro-life crowd, than I have from you.

My own preference, which I know is unacceptable to you, is that Roe v. Wade should remain the law of the land, pro-life people should, without physically blocking or assaulting anyone, be available to talk to women considering abortion anywhere they can find them, and the individual woman should make her individual choice. Short of kidnapping, murder, and resort to criminal penalties, I think your voice is an important one which should be heard.

Since I am constitutionally incapable of pregnancy, it doesn't matter whether I accept what you offer. Any woman who will listen to you is one abortion less, and probably an abortion that should not happen.

As for financial support, life isn't always fair. It so happens that women can conceive and give birth, but men cannot. IF a child is born, it requires support. If would be unfair to the child to excuse the father from providing support. The more work mom has to do to support the child, the less time she can spend raising the child. Of course if daddy wants to provide child care... but that's not usually how it works out.

Men have to exercise care whether women do or not. That's just the way God made us. IF the fetus could be seamlessly transferred to the father's abdomen, I would give him the legal right to exercise that option in lieu of abortion. But its not possible. As long as the fetus can only grow inside the mother's body, it is HER choice, not his. Once it is born, I fully support the right of the biological father to claim the child rather than the mother putting it up for adoption.

John Henry said...

We can try to exterminate or subjugate each other, we can ignore each other and let the world go its merry way, or we can continue the dialog.

Yeah, those are pretty much the options when you disagree with someone: fight, run, or talk. There's a time and a place for each. I think most civilized folks prefer talking. Still, I wonder what point there is in discussing an issue the nature of which we can't even agree on. First you agree on axiomata, then you move on to proofs. Right?

And believe it or not, it's not the Roe decision I find unacceptable; it's the practice of abortion. The one encourages the other, which is the primary reason I object to it. I would prefer abortion be legal and rare than illegal and common, if that were the way the world worked.

As for financial support, life isn't always fair. It so happens that women can conceive and give birth, but men cannot. IF a child is born, it requires support. If would be unfair to the child to excuse the father from providing support.

Let's tweak that phrasing just a tad, shall we? "As for biological support, life isn't always fair. It so happens that women can conceive and give birth, but men cannot. IF a child is conceived, it requires a womb. If would be unfair to the child to excuse the mother from providing biological support." The difference is that any stranger can pick up the tab for a baby; a deadbeat dad doesn't generally mean a dead kid.

Siarlys Jenkins said...

Once we agree that we cannot find common ground as to the relevant axioms, if we are not prepared to kill each other, we must coexist.

On that level, I would suggest that as long as two thirds, or even forty percent, of the population does not accept your axiom, you should not even try to pass criminal statutes. If ninety percent of the population accepts your axiom that the fetus has rights equal to the mother from the moment of conception, that it is a person fully entitled to the same legal protection as a 35 year old, then you probably could succeed at enforcing a law on the recalcitrant few who disagree.

Also, you could secure respect for the law from women who agree in principle, but opportunistically want an abortion when it is their own situation that is at issue, not someone else's. Until then, work on it one woman at a time.

Do you want to compare THAT to the issue of slavery? As long as a majority of human beings, including a large portion of those enslaved, considered slavery a natural condition and an normal part of life, it was not in fact threatened as an institution. What was unique in America, and then in the British world, is that it became counterposed to emerging conceptions of "liberty." Until a sufficient critical mass of citizens were willing to overtly opposed slavery as an institution, there was in fact not much to be done about it, except to aid individuals with the initiative to run, to get away.

You, unfortunately, don't have the option to spirit a fetus out of the womb and run off to Canada with it. In fact, there are not enough willing homes offering to adopt newborns to handle all the babies who would have been born if none of the abortions of the past fifty years had been performed.

As for your tweaking, it is perfectly logical, but as long as we are talking about what a woman must keep inside her own body, well, that's a bit too personal for anyone to FORCE upon her.

There have been times, places, and cultures where a woman had a DUTY to marry, to marry whomever her father told her to marry, to accept that this man would perform marital acts deep inside her person... and now we accept, at least in principle, that no man belongs there unless she accepts and invites him. Yet you insist that you can dictate what she will keep inside her. Yes, I know, she had to invite the man, unless its a case of rape, but you are dictating that because of a thoughtless moment, which she may regret, she must keep the result inside her for nine months. I don't buy it.

Siarlys Jenkins said...

John Henry, I missed your "serious sophistry." There is no reason in principle that an employer should pay for your vasectomy. (As a devout Catholic, I doubt you intend to have one anyway). In fact, if we had moved to public options instead of jury-rigging the existing system of employer-financed medical insurance, the issue might not arise.

AS LONG AS individuals are dependent upon a relatively small pool of insurers, and premiums paid by employers, it is reasonable for the government to protect the choices available to consumers and employees.

A more sensible approach would be an array of public and private options, funded by a combination of individually paid premiums, employer contributions, and public subsidies, in which each individual can make their own choices. Properly organized, this would allow both the individual and other contributors to benefit from cost savings, including "I don't need contraception to leave that off my policy." If it were an individual choice, not employer negotiation for a group plan for the employees of the employer, it would be a totally different question.

Personally, having had medical coverage for three of my 58 years, and run up a lot of hard-nosed correspondence with the insurance administrators, I would prefer a plan where I pay low premiums, have a high deductible, and pay money into a Health Savings Account (the kind that roll over, not the FSA that vanishes at the end of the year). But that's not for everyone.

John Henry said...

Once we agree that we cannot find common ground as to the relevant axioms, if we are not prepared to kill each other, we must coexist.

Well, yes. But I don't think that this issue is, ultimately, one where you can serenely tell people like me to simply live and let live. From my perspective, those who promote and procure abortions are not doing the "let live" part themselves, and when I'm told "If you don't like abortion, don't have one," it rings very, very hollow.



On that level, I would suggest that as long as two thirds, or even forty percent, of the population does not accept your axiom, you should not even try to pass criminal statutes... Until then, work on it one woman at a time.

While I appreciate your concern, I don't take advice on evangelization from atheists, and I'll not take advice on opposing abortion from someone who supports it. I think the widespread acceptance of abortion we've seen in the last few decades is largely the result of legalized abortion. Making it illegal is, as far as I can see, part of the recipe for making it rare. Perhaps not even the main ingredient, but an important one nevertheless.

Do you want to compare THAT to the issue of slavery? As long as a majority of human beings, including a large portion of those enslaved, considered slavery a natural condition and an normal part of life, it was not in fact threatened as an institution. What was unique in America, and then in the British world, is that it became counterposed to emerging conceptions of "liberty." Until a sufficient critical mass of citizens were willing to overtly opposed slavery as an institution, there was in fact not much to be done about it, except to aid individuals with the initiative to run, to get away.

True. Remember that a large part of what led to slavery becoming unacceptable was the enforcement of the Emancipation Proclamation and the 14th Amendment over time. The law and public sentiment have a back-and-forth relationship.



In fact, there are not enough willing homes offering to adopt newborns to handle all the babies who would have been born if none of the abortions of the past fifty years had been performed.

Not if they suddenly appeared all at once, no. But the world would be a much different place if they had not been aborted in the first place. Some would have stayed with their parents, others might be fostered, still others would be raising the next generation of unwanted children. Perhaps others might not have been conceived in the first place, or their parents might have had a different sort of relationship.



As for your tweaking, it is perfectly logical, but as long as we are talking about what a woman must keep inside her own body, well, that's a bit too personal for anyone to FORCE upon her.

...unlike, I suppose, half a man's disposable income for the next 18 years of his life.

John Henry said...

... and now we accept, at least in principle, that no man belongs there unless she accepts and invites him. Yet you insist that you can dictate what she will keep inside her. Yes, I know, she had to invite the man, unless its a case of rape, but you are dictating that because of a thoughtless moment, which she may regret, she must keep the result inside her for nine months. I don't buy it.

But a similar "thoughtless moment" on the part of a man means he must either accept the death of his child or accept the support of it for the next couple of decades, as the woman chooses? Sorry, but I'm offended on behalf of women that you hold them in so low a regard. Men must be held accountable for 18 years, but holding a woman accountable for nine months is beyond the pale?

There is no reason in principle that an employer should pay for your vasectomy. (As a devout Catholic, I doubt you intend to have one anyway). In fact, if we had moved to public options instead of jury-rigging the existing system of employer-financed medical insurance, the issue might not arise.

OK, on this we are in complete agreement. Insurance itself might not be an issue if the system weren't rigged.



AS LONG AS individuals are dependent upon a relatively small pool of insurers, and premiums paid by employers, it is reasonable for the government to protect the choices available to consumers and employees.

Protect health care, perhaps. But what makes elective sterilization such an important part of health care coverage that must be protected by the government? Why not my next tattoo? Why is it so important to force Catholic churches to pay for a surgical procedure that stops the body functioning in a natural, healthy fashion (vasectomy) when an elective surgery that restores normal, healthy function (lasik) is not covered by any health plan I've ever heard of? Or why is it so important to force Catholic churches to pay for employees' birth control pills, but not force my secular employer to pay for my choice of herbal supplements?

I can't quite tell whether this kind of legislation is more about love of contraception or contempt of religion, but it's certainly not about love of freedom.

John Henry said...

(Reposting because I believe my last comment got gobbled again.)

... and now we accept, at least in principle, that no man belongs there unless she accepts and invites him. Yet you insist that you can dictate what she will keep inside her. Yes, I know, she had to invite the man, unless its a case of rape, but you are dictating that because of a thoughtless moment, which she may regret, she must keep the result inside her for nine months. I don't buy it.

And I'm not buying the trivialization of sex that leads to the "necessity" of abortion. We have enough regard for men that we hold them accountable for their "thoughtless moments" to the tune of 50% DI for 18 years, but we can't hold a woman accountable for the very life of her child for a mere nine months? But something has occurred to me: you've admitted that we disagree as to the personhood of the child, but you're still advancing the argument that a woman shouldn't be asked to carry a child to term if she doesn't want to. Would you still feel this way if you accepted the premise that a baby in the womb at eight weeks is a person with all the rights thereof?

There is no reason in principle that an employer should pay for your vasectomy. (As a devout Catholic, I doubt you intend to have one anyway). In fact, if we had moved to public options instead of jury-rigging the existing system of employer-financed medical insurance, the issue might not arise.

Full agreement. The health insurance system is rigged. It's ridiculous.



AS LONG AS individuals are dependent upon a relatively small pool of insurers, and premiums paid by employers, it is reasonable for the government to protect the choices available to consumers and employees.

But generally a health insurance plan is allowed to decline coverage for elective items. My health plan doesn't cover lasik, which would restore healthy, normal function to my eyes. Why should it cover my vasectomy, which impairs normal function? Or why should it cover The Pill, but not the herbal supplements I've decided I need? Why is "protecting" this particular "choice" so important? A vasectomy isn't really more expensive than lasik, or The Pill than an herbal supplement. Why is mandating coverage of these things by religious employers so important? It smells more like a symbolic move: making the Church knuckle under to the State's view of sex.

The State has no jurisdiction to protect the life of a child in the womb, but has the jurisdiction to force churches to pay for vasectomies? All this in the name of freedom and choice? Sophistry.