Customer Reviews

Should the Baby Live?: The Problem of Handicapped Infants (Studies in Bioethics)

5 star:		(3)
4 star:		(0)
3 star:		(0)
2 star:		(0)
1 star:		(1)

 

 

Peter Singer is brilliant when it comes to reasonably arguing for what prima facie seem highly implausible ideas starting with "Animal Liberation" in which he fathered the modern animal rights movement. By the end of that book I was convinced of its argument and must say the same of this book. First a word of warning: proponents of the "sanctity of life" view should not buy this book if that is what they are looking for. If you're a sanctity of life proponent and you want a clear argument and statement from proponents of the opposing "quality of life" view, then by all means, buy this book.

There is a central theme connecting Singer's works such that if you did not enjoy "Animal Liberation," you probably will not enjoy this (although there will certainly be others that DID enjoy "Animal Liberation" that will not enjoy this. Agreeing with "Animal Liberation" seems at least a reasonable prerequisite.) Connecting these two books, as well as all his others, is a disdain for speciesism and deep wish to minimize suffering in the world. So, the first and most obvious question is, "How is infanticide supposed to minimize suffering?" According to Singer and Kuhse, the first thing one needs to realize is that quality of life decisions are made all the time in hospitals. If an anencephalic baby is born, doctors immediately see that it has no prospect at living a normal life and usually let the baby die which may take a minute or it may take a day. What Singer and Kuhse suggest is that if the anencephalic has the capacity to suffer and is going to be left to die anyway, we should be able to minimize its suffering by euthanizing it swiftly and painlessly.

The argument is generalized to many cases of babies born with various cognitive disabilities. The argument can also be generalized to babies born with physical disabilities whose parents do not want them. Singer and Kuhse do not say that we SHOULD kill disabled infants, only that it should be PERMISSIBLE to if the parents and the doctors wish. It is very important to note that the argument CANNOT be generalized to apply to physically disabled adults with normal cognitive abilities although it can be generalized to apply to severely cognitively disabled adults such as those in irreversible coma or with severe Alzheimer's disease IF the family wishes.

The arguments presented in this book, along with the relevant caveats prove extremely stimulating if not completely persuasive.

When you read reviews of this book, its easy to tell the difference between someone who has read this book, and someone who has not. The people who have not read this book will mischaracterize Kuhse and Singer as evil individuals who want to gas everyone participating in the special olympics; people who have read this book find it fascinating from cover to cover.

As the title suggests, the book is a discussion of how severely handicapped infants fit into our current picture of the ethical universe. By 'severely handicapped infants', the authors are referring to a very tiny category of infants born with abnormalities that prevent an infant from ever gaining consciousness, or worse, cause the infant to suffer intensely for the first few months of its life before eventually expiring. Such infants include:

- anencephalics, or infants born without a brain, and infants with intra-cranial hemorrhaging, who have no capacity to experience consciousness, feeling, emotion, pain, pleasure, or have any mental life whatsoever.

- spina bifida, where the portion of the spinal column is split and exposed, rather than formed in a tube and covered with skin. Even with the best treatment, three-fourths of these infants die in the first year; 90% of long-term survivors have 30 to 40 surgeries before the age of five. Nearly all long-term survivors of this disease suffer from acute degrees of paralysis and severe mental retardation.

- infants born without intestines, where it is not possible for infants to gain nourishment from food taken in orally.

Singer and Kuhse focus on several well-known cases of infants born with severe abnormalities, and discuss how these cases cannot be reconciled with an ethic that normally holds human life as sacrosanct. In particular, Singer and Kuhse argue persuasively that human life is not sacred (in fact, they state that 'sanctity of human life' ethical systems are philosophically unsound); nearly all decisions to preserve or terminate life are based on underlying quality-of-life judgements.

The book contains a fascinating discussion of the moral distinction between actively euthanizing an individual and 'letting nature take its course' (i.e. why is active euthanasia illegal, but a lingering death by starvation and dehydration legal?), how we draw the line between infants with severe disabilities like spina bifida and relatively minor disabilities like hemophilia, and who should make life and death decisions about severely disabled infants.

To a certain extent, it is admirable how Singer and Kuhse take this quality-of-life ethic to its logical (and shocking) ends. This philsophical foundation forms the thesis of Singer and Kuhse's book: it is simply a fact that some infants will be born so severely disabled that they have no chance of a happy existence. It is cruel and of no benefit to these unfortunate infants to bring them into existence and prolong their misery for months and months without an end to the suffering, especially when these infants will never recover or live long enough to see their first birthday. In these cases, humane euthanasia is justifiable.

Contrary to the misconceptions of uninformed critics, the authors of this book are neither heartless nor cruel. The authors opinions follow naturally from their immense compassion and respect for the lives of feeling beings.

The authors draw upon the wisdom of pediatricians, modern ethical philosophers, and families who have had to make these kinds of decisions. They present compelling arguments that lift away the veil of self-deception people have regarding how they value quality of life. Considerations for the quality of life of the infant are especially well-considered, especially when making the argument that allowing doomed newborns to suffer and linger is inhumane at best, and moral waffling at worst.

They make a very good case for the idea that to withdraw treatment and only give palliative care is not more ethical than direct euthanasia, and clearly prove that those who think otherwise are in denial of their actions (or lack of them).

They are NOT saying that all disabled babies should be killed upon birth. They ARE making a very good case for considering whether the most profoundly disabled would have a quality of life worth the suffering their lives would entail. This is not the same as an adult becoming disabled, and then deciding to give up on life; the idea is that it is humane to make this decision before the newborn becomes self-aware enough to understand its situation.

While this subject may be very difficult for some to swallow, denying its importance does not make it disappear. Pointing out that you know some disabled people that are totally awesome also does not make it disappear. This is about families and doctors being able to make a difficult decision without interference from life-at-all-costs zealots. This is a careful and well-constructed discussion of humane treatment of human infants. To dismiss and condemn it as "oh noez, they want to kill the babiez!1!!" is to be intellectually dishonest--or at least reveals that someone cast a judgment without even bothering to read the book.

The author recommends that parents may kill infants who are born with different abilities than is typical in the first 28 days after they are born. I wonder if he has ever had a friend who is handicapped, if he has ever been to the Special Olympics, or even had his groceries bagged by someone with different than typical abilities. People with different abilities are everywhere working, relating, and giving us all a glimpse into what is really important (love) and what is less important (achievement). His assumption that their lives are subject to more suffering than "normal" is of course totally false and misguided. He is so blinded by superficial appearances, he cannot grasp that their lives can be filled with joy and meaning.And paradoxically, they have much to teach all of us. It is unfortunate for Mr. Singer that he has been unable to grasp the lessons they might teach him. Perhaps he is the disabled one. But I certainly would not suggest that in hindsight his own mother should have released him from his utterly blind life, as much as I strongly oppose his views. Each life is valuable in miraculous and often temporarily hidden ways.