Suffer the children

During the past few days, there has been much discussion of philosophy professor Gary Comstock’s spirited defense of infanticide, in the case of a severely handicapped newborn baby who is likely to die (New York Times, July 12, 2017). Such an infant, argues Comstock, lacks “the things that make a life: thoughts, wants, desires, interests, memories, a future.” And if did have thoughts, its dominant thought about being kept alive on a respirator would surely be: “This hurts. Can’t someone help it stop?”

Bioethicist Wesley Smith has pointed out that the case described by Comstock (who is not a doctor), of an infant suffering excruciating pain as its life is needlessly prolonged, is totally fictitious: “When life support is removed, doctors do not just let patients twist choking in the wind. They palliate — as necessary to alleviate pain and agitation.” The testimony of palliative care physician Ira Byock (whom Smith mentions in his article) is well worth citing: “In more than 35 years of practice I have never once had to kill a patient to alleviate the person’s suffering. When other measures fail, palliative sedation for alleviation of physical suffering is reliably effective. Alleviating suffering is different than eliminating the sufferer.” (Maryland Medicine vol. 17, no. 4; January 2017.) And Dr. Michael Egnor, commenting on Comstock’s article for Evolution News and Views, writes: “The notion that handicapped children intractably suffer is a lie. I’ve treated thousands of these kids. Most of the conditions that cause severe neurological impairment aren’t painful and don’t inherently cause physical suffering. Spina bifida, holoprosencephaly, various trisomies and anencephaly don’t ‘hurt,’ and in fact the children afflicted are often quite content babies. They are loved by their families, and they can enjoy life in accordance with their physical limitations.”

Wesley Smith and Michael Egnor point out that infanticide is a crime against humanity, for which doctors were hanged at Nuremberg. Some of these doctors had euthanized handicapped children. Both authors make a telling point; nevertheless, the question needs to be addressed: exactly why is infanticide wrong?

“Humans have spiritual souls” – why I think this is a bad answer

Professor Jerry Coyne, in a recent article over at Why Evolution Is True, suggests that the opposition to euthanasia of severely handicapped newborns is primarily religious: “The reason we don’t allow euthanasia of newborns is because humans are seen as special, and I think this comes from religion — in particular, the view that humans, unlike animals, are endowed with a soul. It’s the same mindset that, in many places, won’t allow abortion of fetuses that have severe deformities. When religion vanishes, as it will, so will much of the opposition to both adult and newborn euthanasia.” Sadly, Dr. Egnor, in his reply to Coyne’s article, adopts a stridently religious defense of the legal prohibition of infanticide, arguing that there is something unique about the human soul, as opposed to the animal soul, whose operations are entirely physical: “Humans have spiritual souls, created in God’s image, which distinguishes them from animals.” I don’t think this defense is legally or philosophically adequate, however.

The beliefs that humans have a spiritual soul, made in God’s image, is a metaphysical belief, as well as being a religious belief. While there are some metaphysical beliefs which are fundamental to our legal system (e.g. the belief that there is an external world, that there are other minds besides my own, and that rational individuals possess libertarian free will), they at least relate to things which we can directly experience. The belief in an immaterial soul which is made in the image of its immaterial Creator is a belief of an altogether different kind. You can’t see a soul, any more than you can see God. If Dr. Egnor is right, then an atheist could have no good reason to oppose infanticide as a matter of principle. On this point, I think Egnor is gravely mistaken.

A purely secular argument for the immorality of infanticide and abortion

Several years ago, I wrote an online book titled, Embryo and Einstein – Why They’re Equal. In my e-book, I endeavored to provide a purely secular argument, free of any controversial metaphysical premises, showing why the intentional destruction of a human being at any stage of development is morally wrong. After citing passages from the writings of atheist feminists who are staunchly pro-life, I went on to argue that any satisfactory defense of the notion that the intentional killing of a human individual is intrinsically wrong has to be grounded in its actual (as opposed to potential) qualities, and should eschew all talk of a spiritual soul:

What distinguishes this essay from other essays written in defense of unborn human life is that I shall endeavor to explain precisely why a human embryo is every bit as valuable as you or I. Moreover, my explanation makes no appeal to the merely potential qualities of the embryo; instead, I only invoke actual properties. Thus my argument is invulnerable to the philosopher Peter Singer’s criticism that a potential X does not necessarily have the rights of an actual X – for instance, a prince (who is a potential king) does not possess the same rights and privileges as an actual king. And unlike the philosopher Don Marquis, who argues that an embryo/fetus matters just as much as we do because it has a future like ours, my account of why a human embryo matters is based principally on its present characteristics. Finally, my explanation makes no appeal to the existence of an immaterial soul, although it is perfectly compatible with belief in one.

In a nutshell, my argument was that anything possessing and running a program for making itself into a rational human adult, has the same intrinsic value as that adult:

In brief, the essence of my argument is that a human embryo is a person, because it is a complete organism, embodying a developmental program by which it directs and controls its own development into a rational human adult, and in addition, it has already started assembling itself into a rational human adult. A human adult is not merely something the embryo/fetus is capable of becoming, in a passive sense; rather, it is the mature form of the organism that the embryo/fetus is currently assembling itself into, by executing the instructions contained in its developmental program, which has already started running. (In this respect, the embryo/fetus differs vitally from a potential king, who is legally incapable of doing anything to make himself king, and who has none of the rights that properly belong to a king.) I shall argue that it is reasonable to regard any biological organism which is currently assembling itself into a rational human adult through a process which is under its control, as being just as valuable as the adult it will become, and as therefore having the same right to life as an adult. I shall also contend that nothing is acquired by an embryo, fetus, newborn baby or child in the course of its development which would add to its inherent moral value in any way; hence a one-cell embryo must be just as valuable as you or I. Finally, I shall argue that a severely defective embryo, which has no hope of developing into a rational human adult, has the same right to life as a normal embryo, because the correction of its defects does not require the addition of any new instructions to its developmental program; all it requires is the repair of program flaws, and that this correction would in no way alter its identity as a human individual, or add to its inherent value. Given that a normal embryo has the same right to life as a rational human adult, it follows that a severely defective embryo (which is just as valuable as a normal one) has the same right to life as well…

All that matters, for the purposes of my argument, is that:

(a) the development of an embryo/fetus is directed by instructions contained within the embryo;
(b) although external stimuli also have a considerable impact on the embryo’s development, no new developmental instructions are added to the embryo/fetus from outside as it matures; and
(c) the instructions in the embryo’s developmental program are extremely complex and contain a high degree of functional information… [I used this term in its standard scientific sense, in my e-book.]

How the embryo builds itself

To support my claim that a one-cell embryo is a true organism, with its own developmental program, I cited an online paper by Maureen Condic, Associate Professor of Neurobiology and Anatomy at the University of Utah School of Medicine, titled, When Does Human Life Begin? A Scientific Perspective (White Paper, Volume 1, Number 1, October 2008, published by The Westchester Institute for Ethics and the Human Person):

The embryo is not something that is being passively built by the process of development, with some unspecified, external “builder” controlling the assembly of embryonic components. Rather, the embryo is manufacturing itself. The organized pattern of development doesn’t produce the embryo; it is produced by the embryo as a consequence of the zygote’s internal, self-organizing power. Indeed, this “totipotency,” or the power of the zygote both to generate all the cells of the body and simultaneously to organize those cells into coherent, interacting bodily structures, is the defining feature of the embryo. (p. 11)

From the moment of sperm-egg fusion, a human zygote acts as a complete whole, with all the parts of the zygote interacting in an orchestrated fashion to generate the structures and relationships required for the zygote to continue developing towards its mature state. Everything the sperm and egg do prior to their fusion is uniquely ordered towards promoting the binding of these two cells. Everything the zygote does from the point of sperm-egg fusion onward is uniquely ordered to prevent further binding of sperm and to promote the preservation and development of the zygote itself. The zygote acts immediately and decisively to initiate a program of development that will, if uninterrupted by accident, disease, or external intervention, proceed seamlessly through formation of the definitive body, birth, childhood, adolescence, maturity, and aging, ending with death. This coordinated behavior is the very hallmark of an organism. (p. 7) [Emphases mine – VJT.]

There are, of course, many objections to the view that a one-cell embryo is a human being with a right to life. I’ll discuss a few of them here; I answer these and many more objections in my e-book.

Are skin cells people, too?

The philosopher Sam Harris sarcastically quips that if embryos are people, then so are the skin cells you scrape from your nose when you scratch it: “Every time you scratch your nose, you have committed a Holocaust of potential human beings.” However, a human skin cell does not qualify as an organism. Its epigenetic switches, unlike an embryo’s, are not fully activated. As Dr. Condic puts it:

A human skin cell removed from a mature body and maintained in the laboratory will continue to live and will divide many times to produce a large mass of cells, but it will not re-establish the whole organism from which it was removed; it will not regenerate an entire human body in culture. Although embryogenesis begins with a single-cell zygote, the complex, integrated process of embryogenesis is the activity of an organism, not the activity of a cell.

I also mentioned that a skin cell can be artificially converted into a human embryo, by “rewinding” its epigenetic switches back to an embryonic state, essentially turning it back into an embryo again. I then argued that if a scientist were to do that and if the adult skin cell were rewound back to a totipotent stage, then he/she would indeed have created a new human being. However, until the switches are reset back to “embryonic mode”, an adult stem cell is not a human being.

The twinning argument

The “twinning argument” is also cited as a supposedly unanswerable objection to the view that embryos are people, but all it proves is that humans have two modes of reproduction: sexual and asexual. Strictly, the parents of a monozygotic twin are actually its grandparents. The parent is the one-cell embryo that cleaved to form two new human individuals.

The helplessness of human fetuses and infants: information vs. meta-information

Finally, many of my readers have pointed out that an embryo / fetus / infant will never grow into a rational human adult without lots of external assistance: babies need to be nourished, nurtured and taught to talk and think, before they can reason as adults do. This is perfectly true, but what it overlooks is the distinction between information (which a human individual receives from other people in the course of its development) and meta-information (i.e. the genetic and neurological instructions in that individual’s brain and body, which enable him/her to process the information it receives, and make sense of it all). What makes us inherently valuable, I would suggest, is not information as such, but the meta-information which enables us to process that information.

There’s a lot more in my e-book for those who are interested. At any rate, the point I wanted to make is that you don’t have to be religious in order to oppose infanticide. The practice of killing newborn babies, even severely disabled ones, has no place in any human society.

The slippery slope is real

The slippery slope is all too real, and if we legalize the practice of euthanizing severely handicapped newborn babies, it will warp our attitudes towards children, causing us to view them as less than fully human. Abuses will inevitably creep in if euthanasia is legalized, as Dr. Byock warns us, citing the example of the Netherlands:

One need only look at Belgium and the Netherlands to glimpse the future. In both countries suicide by self-administration of life-ending drugs and euthanasia by doctor-administered lethal injections have been available for several decades and are increasingly prevalent. According to the annual report from the Dutch Euthanasia Review Committees 3.9% of all deaths in the Netherlands were intentionally hastened, including 5,277 people who were euthanized by physicians. [4] Dutch people are being euthanized at their request by their public health system for non-terminal conditions which include chronic pain, tinnitus or blindness. In excess of 50 of those euthanized in 2015 suffered from psychiatric disorders. Many mentally ill patients who request euthanasia suffer from personality disorders and socially isolation; depression, anxiety, post-traumatic stress disorders are common. [5 – Olie E, Courtet P. The Controversial Issue of Euthanasia in Patients With Psychiatric Illness. JAMA. 2016;316(6):656-657.]

Dr. Byock is writing about the elderly here, but the same potential for abuse exists with the very young, who are also helpless and vulnerable.

To sum up: euthanizing newborn babies who are severely disabled might sound “compassionate,” but it is a barbarous practice that will not relieve any suffering, and will serve only to dehumanize us all, by deadening us to the horror of destroying a human being.

What do readers think? Over to you.

Recommended reading: Deliberate termination of life of newborns with spina bifida, a critical reappraisal by T. H. Rob de Jong. (Child’s Nervous System, 2008 Jan; 24(1): 13–28. Published online 2007 Oct 10. doi: 10.1007/s00381-007-0478-3.)

131 thoughts on “Suffer the children

  1. VJ, I stopped reading this when you mentioned Egnor. This is a guy who gives even the Christian Right a bad name. A guy who has repeatedly claimed that all spree shootings in the US are conducted by Democrats. Sorry, but anyone who references this hate filled bigot to support any argument loses all credibility.

  2. Acartia:
    VJ, I stopped reading this when you mentioned Egnor. This is a guy who gives even the Christian Right a bad name. A guy who has repeatedly claimed that all spree shootings in the US are conducted by Democrats. Sorry, but anyone who references this hate filled bigot to support any argument loses all credibility.

    It’s great, then, that VJ doesn’t reference Egnor to actually support his argument. As I understood it VJ, while he agrees with Egnor on abortion, thinks Egnors reasons for opposing it are bad, and instead gives reasons he thinsk are better.

  3. Vincent said:
    […] Gary Comstock’s spirited defense of infanticide, […]
    Please call it euthanasia, Vincent.

  4. One need only look at Belgium and the Netherlands to glimpse the future.

    Funny, how you are using my country as some kind of dreadful example of what is to come. I actually think the situation in the Netherlands is to be preferred to that in the US, so let me clarify what prerequisites need to fulfilled before euthanasia will be considered here.

    First of all, euthanasia is ONLY administered AT THE REQUEST OF THE PATIENT. To make such a request the patient has to be mentally competent. A request can also be written beforehand, in case that the patient is no longer capable of making his will known at some point.

    To make things crystal clear: Euthanasia, even at request of the patient, is punishable by law, UNLESS a physician follows the “zorgvuldigheidseisen” (prerequisites of care) that have been prescribed by law. Euthanasia can only be administered by a physician, if he/she is convinced that the patient is suffering unbearably with no prospect of improvement and if the patient has submitted a voluntary and well considered request. Both physician and patient should be convinced that there is no reasonable alternative. At least one other independent physician is required to reach the same conclusion.

    So Vincent, is offering people a chance of a dignified ending, when there is only unbearable suffering left with no prospect of any improvement, really an example of abuse, as you call it? Does it dehumanize those people or is it a sign of respect for the dignity and the right to decide about one’s own life?

    If this is supposed to be an example of a “slippery slope”, I would be all for it.

  5. In every country or state that outlaws abortion, abortion-rates increase, and the number of people who die to abortion-related health-complications from the (then illegally performed) procedure also increases subtantially. Often times, both the mother and the foetus dies.

    There’s nothing pro-life about the actual effects of so-called “pro-life” legislation. They invariably lead to more deaths than they’re purported to prevent.

    Stop giving me irrelevant philosophical arguments about how bad it is in theory, and stick to the empirical facts: If what you want to do is save lives, make abortion legal, make contraceptives free or at the very least easily available, promote comprehensive sex-ed, and make abortion a legal part of women’s health care without a million idiotic and counterproductive synthetic hurdles, and make it be performed by professionals, aka actual medical doctors.

    Time and time again, this has been proven, as in it is a concrete real world fact only denied by religious lunatics, that this will reduce the number of abortions and the number of deaths related to abortions.

    And it’s obvious why. When people get comprehensive sex ed, they learn what causes pregnancy, so then they can avoid it when they don’t want it.

    When they have easy access to contraceptives, same thing. They can avoid an unwanted pregnancy.

    And last but not least, when abortions are performed legally by professionals who know what they’re doing, instead of by backalley quacks, complications from the procedure is minimized.

    All of these things have been PROVEN in the ACTUAL REAL WORLD to save lives. There will be less abortions, and those that happen cause less death.

    If you’re actually for SAVING lives, if you’re actually PRO-LIFE, you will be for the things that have been proven to work.

  6. Corneel: Funny, how you are using my country as some kind of dreadful example of what is to come. I actually think the situation in the Netherlands is to be preferred to that in the US, so let me clarify what prerequisites need to fulfilled before euthanasia will be considered here.

    First of all, euthanasia is ONLY administered AT THE REQUEST OF THE PATIENT. To make such a request the patient has to be mentally competent. A request can also be written beforehand, in case that the patient is no longer capable of making his will known at some point.

    To make things crystal clear: Euthanasia, even at request of the patient, is punishable by law, UNLESS a physician follows the “zorgvuldigheidseisen” (prerequisites of care) that have been prescribed by law. Euthanasia can only be administered by a physician, if he/she is convinced that the patient is suffering unbearably with no prospect of improvement and if the patient has submitted a voluntary and well considered request. Both physician and patient should be convinced that there is no reasonable alternative. At least one other independent physician is required to reach the same conclusion.

    So Vincent, is offering people a change of a dignified ending, when there is only unbearable suffering left with no prospect of any improvement, really an example of abuse, as you call it? Does it dehumanize those people or is it a sign of respect for the dignity and the right to decide about one’s own life?

    If this is supposed to be an example of a “slippery slope”, I would be all for it.

    I completely agree.

    In fact I think there’s nothing wrong with it, and if you can refer me to some moral system in which this is somehow a bad thing, then all you will have succeeded in doing is convincing me that said moral system is a bad moral system.

  7. Rumraket: It’s great, then, that VJ doesn’t reference Egnor to actually support his argument. As I understood it VJ, while he agrees with Egnor on abortion, thinks Egnors reasons for opposing it are bad, and instead gives reasons he thinsk are better.

    That’s what I get for trying to read when I am tired.

  8. Rumraket: Stop giving me irrelevant philosophical arguments about how bad it is in theory, and stick to the empirical facts: If what you want to do is save lives, make abortion legal, make contraceptives free or at the very least easily available, promote comprehensive sex-ed, and make abortion a legal part of women’s health care without a million idiotic and counterproductive synthetic hurdles, and make it be performed by professionals, aka actual medical doctors.

    The problem about selling this argument to most of those who oppose abortion is that they also oppose comprehensive sex education at an early age and the availability of contraceptives. And, sadly, they don’t see the irrationality of it.

  9. This is a surprise. It seems that this discussion is over a decade old, and was started in the very same hospital that I am currently employed. It has resulted in the Groningen Protocol, a set of guidelines to inform end-of-life decisions in newborns (euthanasia on newborns is illegal in the Netherlands, as they cannot give their consent, and a request by the parents is invalid, so physicians face the risk of criminal prosecution). The paper under the link gives some information I believe is vital to this discussion:

    1) That the “infant suffering excruciating pain as its life is needlessly prolonged, is totally fictitious” line is false, and that cases of newborns with extremely poor quality of life are real:

    Twenty-two cases of euthanasia in newborns have been reported to district attorneys’ offices in the Netherlands during the past seven years. Recently, we were allowed to review these cases. They all involved infants with very severe forms of spina bifida. In most cases (17 of the 22), a multidisciplinary spina bifida team was consulted. In the remaining five cases, at least two other independent medical experts were consulted. The physicians based their decisions on the presence of severe suffering without hope of improvement (see Table 1). The decisions were always made in collaboration with, and were fully approved by, both parents. The prosecutor used four criteria to assess each case: the presence of hopeless and unbearable suffering and a very poor quality of life, parental consent, consultation with an independent physician and his or her agreement with the treating physicians, and the carrying out of the procedure in accordance with the accepted medical standard.

    2) That end-of-life decision are already being taken by neonatologists worldwide, and that there are cases that are so severe that withdrawing life-prolonging treatment is acceptable, not just by European but also by US physicians.

    Deciding not to initiate or to withdraw life-prolonging treatment in newborns with no chance of survival is considered good practice for physicians in Europe and is acceptable for physicians in the United States. Most such infants die immediately after treatment has been discontinued.

    3) And most importantly, that these decisions are NOT dehumanizing, but are taken with much consideration and respect and out of a deep compassion with the newborn.

    All possible measures must be taken to alleviate severe pain and discomfort. There are, however, circumstances in which, despite all measures taken, suffering cannot be relieved and no improvement can be expected. When both the parents and the physicians are convinced that there is an extremely poor prognosis, they may concur that death would be more humane than continued life.

  10. I recently had a discussion about abortion with KF over at UD, if you can call any communication with KF a discussion. I pointed him to evidence that the abortion rates today are lower than they were before abortion was made legal. That countries that have comprehensive sex education at an early age and unrestricted access to birth control have the lowest rate of unwanted pregnancies and, therefore, abortions. But he would have none of it. He simply marched out his parade of cliches (greatest holocaust of all times, blood guilt, etc.). He simply would not accept that a significant reduction in abortion is a step in the right direction. He would not be happy with anything other than an outright ban on abortion.

    The main argument that he and others use is that a fetus from conception onward is human and has the same right to life as any child or adult. I then pointed out that if they truly believed this that they must support charging women who have illegal abortions with first degree murder. KF, WJM and others twisted themselves in knots to rationalize why, given their assertions that a fetus has the same right to life as an adult, it is not logically inconsistent to charge a person who plans and executes the killing of a child or adult with first degree murder but not to charge a woman who plans and makes arrangements to have an abortion of her fetus with the same crime.

    WJM continued to dig deeper and argued that there are charges other than first degree murder that are often used for the killing of another human. When I pointed out that charges such as manslaughter, second degree murder, etc. are never used in cases where there is clear evidence that a person went out of their way to plan and execute the killing of another human, he fell back on diminished capacity. I then pointed out that diminished capacity/insanity/temporary insanity are not charges, they are defences. I then explained how none of these defences could work, except in rare instances, because of the clear an evident premeditation of the act. Unless, of course, he was arguing that all pregnant women had diminished capacity.

    Needless to say, none of them could see the inconsistency of their argument. And, as is par for the course, KF banned me (again) from UD. Something he routinely does when he gets backed into a corner.

  11. Hi Corneel,

    In my OP, I wrote:

    During the past few days, there has been much discussion of philosophy professor Gary Comstock’s spirited defense of infanticide, in the case of a severely handicapped newborn baby who is likely to die…

    You responded:

    Please call it euthanasia, Vincent.

    Here’s how Wikipedia defines infanticide: “Infanticide (or infant homicide) is the intentional killing of infants.”

    In his article, after describing the hypothetical case of a severely disabled infant whose life is ended by removing its respirator, Gary Comstock concludes:

    You should not have let your baby die. You should have killed him.

    That certainly sounds like infanticide to me.

  12. vjtorley: That certainly sounds like infanticide to me.

    Ah OK, we’re playing the dictionary game. Suit yourself. I just wanted to point out that using loaded terms with strongly negative connotations may not help an open discussion.

  13. Vincent wrote: To sum up: euthanizing newborn babies who are severely disabled might sound “compassionate,” but it is a barbarous practice that will not relieve any suffering, and will serve only to dehumanize us all, by deadening us to the horror of destroying a human being.

    I totally agree. Infanticide and abortions carried out just for the convenience of the people who are making the decisions is inhumane. It doesn’t matter if legalising these procedures is considered the lesser of two evils, either way it is wrong.

    The late Dr Bernard Nathanson who was instrumental in making abortion legal in the USA after changing his views on abortion said the following

    We aroused enough sympathy to sell our program of permissive abortion by fabricating the number of illegal abortions done annually in the United States.

    Repeating the big lie often enough convinces the public. The number of women dying from illegal abortions was around 200-250 annually. The figure we constantly fed to the media was 10,000. Those false figures took root in the consciousness of Americans, convincing many that we needed to crack the abortion law.

    Should we just uncritically accept without doubt the figures in relation to abortion induced fatality rates in various countries with differing abortion laws. What about China at the time when the one child rule was in force and abortions were not only legal but quite often enforced?

    Luckily my daughter has two healthy children but I was very proud of her when during both pregnancies when asked if she wanted the test for Down’s Syndrome replied “There is no point, I am going to have and care for this baby either way”.

    She does not consider Down’s Syndrome a condition that justifies killing an innocent life and does not see why a child with the condition cannot lead a happy and fulfilled life..

  14. Hi Corneel,

    You write:

    Funny, how you are using my country as some kind of dreadful example of what is to come. I actually think the situation in the Netherlands is to be preferred to that in the US, so let me clarify what prerequisites need to fulfilled before euthanasia will be considered here.

    I presume you’re Dutch. However, what Dr. Byock said, in the article I quote from, was: “One need only look at Belgium and the Netherlands to glimpse the future.” So let’s talk about what’s happening in Belgium, shall we?

    J. Pereira, MBChB MSc, in an article titled, Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls (Current Oncology, 2011 Apr; 18(2): e38–e45), wrote:

    In Belgium, the rate of involuntary and non-voluntary euthanasia deaths (that is, without explicit consent) is 3 times higher than it is in the Netherlands. (“Involuntary euthanasia” refers to a situation in which a person possesses the capacity but has not provided consent, and “non-voluntary euthanasia,” to a situation in which a person is unable to provide consent for reasons such as severe dementia or coma). A recent study found that in the Flemish part of Belgium, 66 of 208 cases of “euthanasia” (32%) occurred in the absence of request or consent 10. The reasons for not discussing the decision to end the person’s life and not obtaining consent were that patients were comatose (70% of cases) or had dementia (21% of cases). In 17% of cases, the physicians proceeded without consent because they felt that euthanasia was “clearly in the patient’s best interest” and, in 8% of cases, that discussing it with the patient would have been harmful to that patient…

    In Belgium, some critical care specialists have opted to ignore the requirement that, in the case of non-terminally-ill patients, an interval of 1 month is required from the time of a first request until the time that euthanasia is performed. One specialist reported that, in his unit, the average time from admission until euthanasia was performed for patients that seemed to be in a “hopeless” situation was about 3.5 days…

    Requests by the Belgian palliative care community to include an obligatory palliative care consultation (“palliative filter”) were denied. From 2002 to 2007 in Belgium, a palliative care physician was consulted (second opinion) in only 12% of all cases of euthanasia. Palliative care physicians and teams were not involved in the care of more than 65% of cases receiving euthanasia. Moreover, the rates of palliative care involvement have been decreasing…

  15. Hi Corneel,

    Now let’s look at the Netherlands. Euthanasia advocate Boudewijn Chabot has written an article titled, “Worrisome Culture Shift in the Context of Self-Selected Death” (NRC Handelsblad June 16, 2017).

    He writes that while the increase in euthanasia cases every year does not trouble him, “what does worry me is the increase in the number of times euthanasia was performed on dementia patients, from 12 in 2009 to 141 in 2016, and on chronic psychiatric patients, from 0 to 60.”

    LifeNews reports:

    He recounts some of the horrific cases of patients of advanced dementia being euthanized without consent, such as one woman whose coffee was drugged, and who when she tried to struggle was held down by her family, and another where a husband mixed sleep medication in the porridge of his demented wife before the GP arrived with his deadly syringe. He describes both of these cases as “executions”.

    Dr. Chabot concludes:

    Where did the Euthanasia Law go off the tracks? The euthanasia practice is running amok because the legal requirements which doctors can reasonably apply in the context of physically ill people, are being declared equally applicable without limitation in the context of vulnerable patients with incurable brain diseases. In psychiatry, an essential limitation disappeared when the existence of a treatment relationship was no longer required. In the case of dementia, such a restriction disappeared by making the written advance request equivalent to an actual oral request. And lastly, it really went off the tracks when the review committee concealed that incapacitated people were surreptitiously killed.

    Doesn’t sound too encouraging, does it?

  16. Read this:

    Corneel: First of all, euthanasia is ONLY administered AT THE REQUEST OF THE PATIENT. To make such a request the patient has to be mentally competent.

    Then read this:

    Corneel: Please call it euthanasia, Vincent.

    Only in the Netherlands I guess.

    ETA:

    Corneel: Ah OK, we’re playing the dictionary game. Suit yourself. I just wanted to point out that using loaded terms with strongly negative connotations may not help an open discussion.

    LoL! By your own definition it’s not euthanasia! God help us.

  17. vjtorley: Doesn’t sound too encouraging, does it?

    What’s your proposal? Everyone must suffer until the very last moment possible? Or find a better way?

  18. vjtorley: Doesn’t sound too encouraging, does it?

    To be honest, I’m not sure what the problem is. All the people discussed had serious problems, dementia and similar. All that’s happened here is that they’ve been freed to join Christ the Saviour in Heaven with a new body and all their earthly cares washed away.

    Behold! I tell you a mystery. We shall not all sleep, but we shall all be changed, in a moment, in the twinkling of an eye, at the last trumpet. For the trumpet will sound, and the dead will be raised imperishable, and we shall be changed. For this perishable body must put on the imperishable, and this mortal body must put on immortality. When the perishable puts on the imperishable, and the mortal puts on immortality, then shall come to pass the saying that is written: “Death is swallowed up in victory.” “O death, where is your victory? O death, where is your sting?”

    So what’s the problem here, exactly? They’ve been freed from this moral coil and they’ve gone to a better place. Sure, some of them might have gone a little earlier then they otherwise would have, but no big deal right given where they are going….

  19. CharlieM: Should we just uncritically accept without doubt the figures in relation to abortion induced fatality rates in various countries with differing abortion laws.

    One woman dead from an illegal abortion is sufficient.

  20. vjtorley: Doesn’t sound too encouraging, does it?

    It sounds like everyone should clearly indicate their wishes concerning end of life.

  21. CharlieM: Infanticide and abortions carried out just for the convenience of the people who are making the decisions is inhumane.

    Will you look after an unwanted child then? How many?

    The fact is that unwanted children are significantly worse off then others

    In summary, there is a substantial literature that documents the serious health, social, psychological, and economic consequences of unintended and unwanted childbearing. These consequences can include increased maternal and infant death and illness, unstable marriages, and the restriction of educational and occupational opportunities leading to poverty and limited roles for women. These adverse effects are not shared equally by all segments of society, and in the United States fall more heavily on those who are poor, young, or members of an ethnic minority group. Further, evidence suggests that even in advantageous social and economic circumstances, when a pregnancy is unwanted and the women requests an abortion, to deny it forces her to bear a child at risk for psychological problems that are long lasting.

    Also noted how you conflate abortion, which is typically the removal of a tiny bundle of cells, with murder Charlie. Nicely done.

    Out of interest, is abortion allowable in any circumstance Charlie? Rape, incest? Also, what punishment do you think is appropriate for women who have abortions? Should we charge them with murder? After all, that’s what you say is happening….

  22. newton: It sounds like everyone should clearly indicate their wishes concerning end of life.

    Especially infants.

  23. OMagain: One woman dead from an illegal abortion is sufficient.

    Sufficient for what? Surely not for uncritically accepting figures.

  24. Maybe Charlie, Mung, Phoodoo and VJT can answer the questions that KF and WJM danced around.

    1) Does a fetus have the same right to life as you or I?
    2) If abortion is made illegal, should a woman who has an abortion be charged with first degree murder?

  25. In the United states, for terminally ill people, we have the morphine drip, which allows the patient to control the medication, until they stop breathing.

    Aside from ethical issues, I’m confused about the effects of morphine. I had it in the emergency room some years back. As I recall it didn’t do anything to diminish the pain, but it made me stop crying and complaining. Which made everyone else feel better.

    On the other hand, for eye surgery, I had something like Valium, which erased all my fears (you are awake during eye surgery) and a local anesthetic for the eye itself.

  26. Mung: The topic is infanticide.

    The topic is abortion, infanticide and euthanasia. I’m fine if you choose not to answer my questions. It can be difficult to admit to yourself that your views are not logically consistent.

  27. petrushka,

    I had morphine years ago for back surgery. My memory of it is that I could still feel the pain but that I just didn’t care about it.

  28. This is a difficult topic, there are some grey areas. in particular when it comes to legislation: should the government be allowed to force a decision onto families?

    vjtorley: He writes that while the increase in euthanasia cases every year does not trouble him, “what does worry me is the increase in the number of times euthanasia was performed on dementia patients

    Have you ever been in this situation yourself, Vincent?
    How can you justify prolonging the suffering of a loved one, when you know that all you’ll get is a few more days or weeks of increasingly deteriorating conditions?

    OTOH I would never dare call it torture if someone opts to prolong treatment till the last moment.

    Neither option is murder nor torture, it’s a hard problem.

  29. Acartia: I had morphine years ago for back surgery. My memory of it is that I could still feel the pain but that I just didn’t care about it.

    This.

    Although I did care, I could joke about it. What morphine does best is reduce the stress in the people around you.

  30. vjtorley: Euthanasia advocate Boudewijn Chabot has written an article titled, “Worrisome Culture Shift in the Context of Self-Selected Death” (NRC Handelsblad June 16, 2017).

    Heh, I read that newspaper, and I saw that article. I have also read the reactions to that article, several of them critical of the objections raised by Dr. Chabot.

    Let’s make several thing clear first. Last year 141 patients with dementia and 60 psychiatric patients received euthanasia in the Netherlands. Of the patients with dementia, 138 were in the early stages and could confirm that euthanasia is what they wanted. These people were saved from an undignified end. We are now talking about the patients were the dementia had progressed to the point where they were no longer able to express their will. NEITHER of the women mentioned in the LifeNews article were euthanised without their consent (thus the article is incorrect at this point). Both had issued a written request for euthanasia before their disease made them incapable of expressing their will. Also, both were judged to be suffering unbearably with no prospect of improvement.

    Here is what Jacob Kohnstamm, president of the review committee euthanasia had to say of the matter [translation is mine, hope it carries over well]:

    If a patient is severely demented and has stated in a previous well informed written living will: in that situation I want that the physician helps me die, and if all prerequisites of care have been fulfilled, you might as well say: If you don’t administer sleep medication before the euthanasia, you are letting down your patient.

    and to the objection that the patients were unaware that the sleep medication was administered:

    Everything that happens to deeply demented people happens without them being aware of it. But please note: these people have explicitely stated in a valid living will that they want euthanasia, even if they are no longer competent when the moment comes. If the physician then administers euthanasia, he has to do it in a medically responsible way.

    So I ask again: If the euthanasia is administered at the explicit request of the patient, how is this abuse?

  31. My only thought on the subject is that I hope you never face the situation where someone you disapprove of gets into power.

  32. Mung: By your own definition it’s not euthanasia! God help us.

    I never offered a definition of euthanasia, Mung. Some people call it neonatal euthanasia, to clarify that no expressed consent is possible.
    But if you want to call it infanticide, go ahead. I myself prefer not to polarise the discussion.

  33. Corneel: Let’s make several thing clear first. Last year 141 patients with dementia and 60 psychiatric patients received euthanasia in the Netherlands. Of the patients with dementia, 138 were in the early stages and could confirm that euthanasia is what they wanted. These people were saved from an undignified end.

    I’m so signing this, no doubt in my mind whatsoever… if and when a similar law is passed here too.

    At what stage of dementia is the procedure performed?

  34. dazz: At what stage of dementia is the procedure performed?

    My own thought on living wills is that if I can answer questions, then I will. If I can’t, and there is no hope that I ever will be able to answer, then that is the time.

    As technology advances, there are more avenues for asking and responding.

  35. Acartia: It can be difficult to admit to yourself that your views are not logically consistent.

    I see that you suffer from keiths syndrome. Given that I haven’t expressed my views, it must take some special ability on your part to know what they are and to arrive at the conclusion that they are not logically consistent. Perhaps that’s what got you banned from UD. Being a keiths clone could do that.

  36. dazz: At what stage of dementia is the procedure performed?

    Good question. I had to look that up.

    It appears that the procedure is performed in the early stage. Most physicians (usually general practitioners) are reluctant to administer euthanasia if the dementia has progressed, as the patient is no longer able to voice his/ her consent.

  37. Corneel: I never offered a definition of euthanasia, Mung.

    It’s rather remarkable how you were able to capture the essence of it without defining it.

    But if you want to call it infanticide, go ahead.

    Another mind reader. What I want to call it has nothing to do with it.

    Under Dutch law euthanasia is the termination of life by a doctor at the express wish of a patient. The request to the doctor must be voluntary, explicit and carefully considered and it must have been made repeatedly.

    http://www.medicinenet.com/script/main/art.asp?articlekey=7365

    So you told us what euthanasia is, without defining it. *claps*

  38. Mung: So you told us what euthanasia is, without defining it. *claps*

    Good. Glad to have that cleared up. So long as we understand each other, I guess.

  39. Mung: Given that I haven’t expressed my views, it must take some special ability on your part to know what they are and to arrive at the conclusion that they are not logically consistent.

    I didn’t conclude that your views were not logically consistent. Possibly you are just seeing your self in a generic statement that I made.

  40. Mung: Perhaps that’s what got you banned from UD. Being a keiths clone could do that.

    Nah. I got banned in that instance for repeatedly asking KF how he could claim that abortion was the worst holocaust in history yet not think that women who actively participate in this holocaust should not be charged with crimes against humanity.

    But my favourite KF banning was when he banned me for using the word masturbation in his thread on sexual perversion.

  41. Acartia: I didn’t conclude that your views were not logically consistent.

    And you didn’t write the following either:

    Acartia: I’m fine if you choose not to answer my questions. It can be difficult to admit to yourself that your views are not logically consistent.

    Perhaps you just suck at communicating in the English language.

  42. Acartia: …yet not think that women who actively participate in this holocaust should not be charged with crimes against humanity.

    Maybe he thought it was the doctors that should be charged.

  43. Rumraket writes:

    In every country or state that outlaws abortion, abortion-rates increase, and the number of people who die to abortion-related health-complications from the (then illegally performed) procedure also increases subtantially. Often times, both the mother and the foetus dies.

    There’s nothing pro-life about the actual effects of so-called “pro-life” legislation. They invariably lead to more deaths than they’re purported to prevent.

    I would question that.

    Dr. Bernard Nathanson (1926-2011) was an American medical doctor from New York who supervised 75,000 abortions and who helped to found the National Association for the Repeal of Abortion Laws (N.A.R.A.L., now the National Abortion Rights Action League) in 1968, but who became a pro-life activist in the 1970s. By Dr. Nathanson’s own admission, pro-choice advocates in the 1960s inflated the number of deaths from illegal abortions in the United States by a factor of 25 to 33 (from 200-300 to 5,000-10,000), and inflated the number of illegal abortions in the United States by a factor of five (from 200,000 to 1,000,000). In an article entitled Confessions of an Ex-Abortionist, he writes:

    We persuaded the media that the cause of permissive abortion was a liberal enlightened, sophisticated one. Knowing that if a true poll were taken, we would be soundly defeated, we simply fabricated the results of fictional polls. We announced to the media that we had taken polls and that 60% of Americans were in favour of permissive abortion. This is the tactic of the self-fulfilling lie. Few people care to be in the minority. We aroused enough sympathy to sell our program of permissive abortion by fabricating the number of illegal abortions done annually in the U.S.… Another myth we fed to the public through the media was that legalising abortion would only mean that the abortions taking place illegally would then be done legally. In fact, of course, abortion is now being used as a primary method of birth control in the U.S. and the annual number of abortions has increased by 1500% since legalisation. (Emphases mine – VJT.)

    Dr. Nathanson, who has confessed to inflating statistics relating to maternal deaths from illegal abortions, personally knew Alan Guttmacher (1898-1974), an abortion provider whose institute now disseminates the bogus statistic that 70,000 women around the world die from illegal abortions.

    You can read more about it here, in my online book.

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