The Journal of Medical Ethics (JME), which describes itself as ‘an international peer-reviewed journal for health professionals and researchers in medical ethics’, has published an article which takes pro-choice arguments to their logical conclusion and advocates post-birth abortion. The journal is published by the BMJ Group, which is wholly owned by the British Medical Association, itself the professional organization representing the interests of British doctors.
In the article, entitled After-birth abortion: why should the baby live?, ethicists Alberto Giubilini of Monash University, Australia, and Francesca Minerva of the University of Melbourne, argue that fetuses and newborn babies share the same ‘moral status’, and that the arguments in favour of abortion therefore apply equally to newborns. They conclude:
If criteria such as the costs (social, psychological, economic) for the potential parents are good enough reasons for having an abortion even when the fetus is healthy, if the moral status of the newborn is the same as that of the infant and if neither has any moral value by virtue of being a potential person, then the same reasons which justify abortion should also justify the killing of the potential person when it is at the stage of a newborn. After-birth abortion: why should the baby live?
The equivalent status of pre and postnatal children has long been a key argument of pro-life advocates. Anthony Ozimic from the Society for the Protection of Unborn Children told The Huffington Post:
The paper proves what pro-lifers have long been arguing: that the common arguments for abortion also justify infanticide. There is no difference in moral status between a child one day before birth and a child one day after birth. Birth is merely a change of location, not a change from non-personhood to personhood. Killing Newborn Babies No Different To Abortion, Say Medical Ethicists
Some see the JME paper as potentially helping the pro-life cause by showing the inconsistency of the pro-choice position. Writing for the National Catholic Register, Matthew Archbold gave his reaction to the JME paper:
Here’s the thing – they’re right. If you accept their premises, they’re absolutely right.
The second we allow ourselves to become the arbiters of who is human and who isn’t, this is the calamitous yet inevitable end. Once you say all human life is not sacred, the rest is just drawing random lines in the sand.
An ethicist’s job is like a magician’s. The main job of both is to distract you from the obvious. The magician uses sleight of hand to pretend to make people disappear. But when ethicists do it, people disappear for real.
It’s almost a pro-life argument in that it highlights the absurdity of the pro-abortion argument.
Giubilini and Minerva argue from the premise that unborn children and infants are merely potential persons, and so their intentional killing is permissible. This assumption is based upon the argument that sentience is a requisite attribute of personhood. The authors write:
In spite of the oxymoron in the expression, we propose to call this practice ‘after-birth abortion’, rather than ‘infanticide’, to emphasise that the moral status of the individual killed is comparable with that of a fetus (on which ‘abortions’ in the traditional sense are performed) rather than to that of a child. Therefore, we claim that killing a newborn could be ethically permissible in all the circumstances where abortion would be. Such circumstances include cases where the newborn has the potential to have an (at least) acceptable life, but the well-being of the family is at risk. Accordingly, a second terminological specification is that we call such a practice ‘after-birth abortion’ rather than ‘euthanasia’ because the best interest of the one who dies is not necessarily the primary criterion for the choice, contrary to what happens in the case of euthanasia.
The moral status of an infant is equivalent to that of a fetus in the sense that both lack those properties that justify the attribution of a right to life to an individual.
Both a fetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’. We take ‘person’ to mean an individual who is capable of attributing to her own existence some (at least) basic value such that being deprived of this existence represents a loss to her. This means that many non-human animals and mentally retarded human individuals are persons, but that all the individuals who are not in the condition of attributing any value to their own existence are not persons. Merely being human is not in itself a reason for ascribing someone a right to life. Indeed, many humans are not considered subjects of a right to life: spare embryos where research on embryo stem cells is permitted, fetuses where abortion is permitted, criminals where capital punishment is legal.
After-birth abortion: why should the baby live?
This argument is not new. As Matthew Flannagan wrote in an article published in the Summer 2009 edition of Ethics and Medicine – An International Journal of Bioethics:
Common in the literature on feticide is the argument that killing an organism is not homicide unless the organism’s brain has developed enough for it to acquire sentience, the capacity for consciousness and the ability to perceive pleasure and pain.
Flannagan goes on to show the problem of using the non-sentience of the unborn child as justification for abortion:
Despite its pervasive appeal, there are some prima facie problems with such an account. In chapter 3 of A Defense of Abortion, Boonin reviews various accounts and notes that they all fail for similar reasons. Boonin notes that those who attempt to ground humanity in the amount of brain development an organism has undergone face a dilemma: “Any appeal to what a brain can do at various stages of development would seem to have to appeal to what the brain can already do. Or to what the brain has the potential to do in the future.”
Either option leads to problems for a defender of the permissibility of feticide who does not also want to endorse infanticide. This is because “by any plausible measure dogs, and cats, cows and pigs, chickens and ducks are more intellectually developed than a new born infant.” Suppose, then, one takes the first horn and appeals to what the brain can already do. However, unless one wishes to affirm that cats, dogs and chickens are human beings, “appeals to what the brain can already do” will “be unable to account for the presumed wrongness of killing toddlers or infants.”
Suppose, then, one takes up the second horn of the dilemma and appeals to “what the brain has the potential to do in the future.” Boonin notes that this will entail that feticide is homicide. “If [such an account] allows appeals to what the brain has the potential to do in the future, then it will have to include fetuses as soon as their brains begin to emerge, during the first few weeks of gestation.”
In the face of fierce criticism, Julian Savulescu, Editor of the JME, vigorously defended the article’s publication:
As Editor of the Journal, I would like to defend its publication. The arguments presented, in fact, are largely not new and have been presented repeatedly in the academic literature and public fora by the most eminent philosophers and bioethicists in the world, including Peter Singer, Michael Tooley and John Harris in defence of infanticide, which the authors call after-birth abortion.
The novel contribution of this paper is not an argument in favour of infanticide – the paper repeats the arguments made famous by Tooley and Singer – but rather their application in consideration of maternal and family interests. The paper also draws attention to the fact that infanticide is practised in the Netherlands.
Many people will and have disagreed with these arguments. However, the goal of the Journal of Medical Ethics is not to present the Truth or promote some one moral view. It is to present well reasoned argument based on widely accepted premises. The authors provocatively argue that there is no moral difference between a fetus and a newborn. Their capacities are relevantly similar. If abortion is permissible, infanticide should be permissible. The authors proceed logically from premises which many people accept to a conclusion that many of those people would reject.
Of course, many people will argue that on this basis abortion should be recriminalised. Those arguments can be well made and the Journal would publish a paper than made such a case coherently, originally and with application to issues of public or medical concern. The Journal does not specifically support substantive moral views, ideologies, theories, dogmas or moral outlooks, over others. It supports sound rational argument. Moreover, it supports freedom of ethical expression. The Journal welcomes reasoned coherent responses to After-Birth Abortion. Or indeed on any topic relevant to medical ethics.
What is disturbing is not the arguments in this paper nor its publication in an ethics journal. It is the hostile, abusive, threatening responses that it has elicited. More than ever, proper academic discussion and freedom are under threat from fanatics opposed to the very values of a liberal society.
Writing for the Telegraph newspaper, Will Heaven observes that it is unsurprising that there is reaction when supporting ‘freedom of ethical expression’ includes the provision of a platform for the overt advocacy of infanticide:
Now Julian Savulescu, the Editor of the Journal of Medical Ethics, is complaining that the authors – both leading ethicists – have received “personally abusive correspondence”, most of which is anonymous, “threatening their lives and personal safety”.
Which doesn’t surprise me, not that I approve of such harassment. You can’t be unashamedly pro killing babies and not expect controversy.
Kenneth Boyd, Associate Editor of the JME, was as unapologetic as Savulescu:
Coming up to me at a meeting the other day, an ethics colleague waved a paper at me. “Have you seen this ?” she asked, “It’s unbelievable!” The paper was “After-birth abortion: why should the baby live?” by two philosophers writing from Australia, Alberto Giubilini and Francesca Minerva.
Well yes, I agreed, I had seen it: in fact I had been the editor responsible for deciding that it should be published in the Journal of Medical Ethics; and no, I didn’t think it was unbelievable, since I know that arguing strongly for a position with which many people will disagree and some even find offensive, is something that philosophers are often willing, and may even feel they have a duty, to do, in order that their arguments may be tested in the crucible of debate with other philosophers who are equally willing to argue strongly against them.
Of course for that debate to take place in the Journal of Medical Ethics, many of whose readers, doctors and health care workers as well as philosophers, may well disagree, perhaps strongly, with the paper’s arguments, we needed first to make sure that the paper, like any other submitted to the Journal, was of sufficient academic quality for us to publish; and the normal way in which we determine this is to invite academics in relevant disciplines to review the paper critically for us, so that we can eventually make an informed decision about whether or not to publish it, either in its original or (as in this case) a form revised in the light of the reviewers’ reports.
Whereas the authors of the article advocate for infanticide (though not under that name), and the editors of the JME have readily given them a stage from which to do so, Christians who accept the Bible as God’s Word have no doubt as to the ‘moral status’ of the unborn child as the very creation and work of God:
For You formed my inward parts;
You covered me in my mother’s womb.
I will praise You, for I am fearfully and wonderfully made;
Marvelous are Your works,
And that my soul knows very well.
My frame was not hidden from You,
When I was made in secret,
And skillfully wrought in the lowest parts of the earth.
Your eyes saw my substance, being yet unformed.
And in Your book they all were written,
The days fashioned for me,
When as yet there were none of them.
Psalm 139:13–16, NKJV
Then the word of the LORD came to me, saying:
“Before I formed you in the womb I knew you;
Before you were born I sanctified you;
I ordained you a prophet to the nations.”
Jeremiah 1:4–5, NKJV
Though moral outrage is a natural and proper reaction to the unabashed advocacy of child-murder, the same Bible reveals that all of us are guilty of breaking God’s Law, and therefore deserving of everlasting punishment:
What then? Are we better than they? Not at all. For we have previously charged both Jews and Greeks that they are all under sin. As it is written:
“There is none righteous, no, not one;
There is none who understands;
There is none who seeks after God.
They have all turned aside;
They have together become unprofitable;
There is none who does good, no, not one.”
“Their throat is an open tomb;
With their tongues they have practiced deceit”;
“The poison of asps is under their lips”;
“Whose mouth is full of cursing and bitterness.”
“Their feet are swift to shed blood;
Destruction and misery are in their ways;
And the way of peace they have not known.”
“There is no fear of God before their eyes.”
Now we know that whatever the law says, it says to those who are under the law, that every mouth may be stopped, and all the world may become guilty before God. Therefore by the deeds of the law no flesh will be justified in His sight, for by the law is the knowledge of sin.
Romans 3:9–20, NKJV
It also presents the remedy – the good news of Jesus Christ crucified in the place of sinners, and His perfect righteousness put to the account of all those who trust in Him and His finished work for them:
But now the righteousness of God apart from the law is revealed, being witnessed by the Law and the Prophets, even the righteousness of God, through faith in Jesus Christ, to all and on all who believe. For there is no difference; for all have sinned and fall short of the glory of God, being justified freely by His grace through the redemption that is in Christ Jesus, whom God set forth as a propitiation by His blood, through faith, to demonstrate His righteousness, because in His forbearance God had passed over the sins that were previously committed, to demonstrate at the present time His righteousness, that He might be just and the justifier of the one who has faith in Jesus.
Romans 3:21–26, NKJV
“Therefore let all the house of Israel know assuredly that God has made this Jesus, whom you crucified, both Lord and Christ.”
Now when they heard this, they were cut to the heart, and said to Peter and the rest of the apostles, “Men and brethren, what shall we do?”
“Repent, and let every one of you be baptized in the name of Jesus Christ for the remission of sins; and you shall receive the gift of the Holy Spirit. For the promise is to you and to your children, and to all who are afar off, as many as the Lord our God will call.”
Acts 2:36–39, NKJV
Update 15 March 2012: The paper under discussion appears to have been removed from the JME website.