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ss nucleus - summer 2005,  Ethical Enigma 12

Ethical Enigma 12

Response to enigma 12: You are working for a consultant obstetrician who is very keen on his patients undergoing as much antenatal screening as possible. He is not in favour of abortion for social reasons but justifies them entirely for fetal abnormality, saying, ‘Don’t you believe it’s a parental right to have a normal baby?’ How would you defend your unborn neighbour in such a discussion?

There are two important keys to handling this situation. First, you must think carefully about how to respond – what angle is this doctor coming from? Second, you are working for him so this could be an ongoing discussion that does not require you to demolish all his arguments in one sitting.

Keep in mind also that 99% of abortions are carried out for social reasons, so, by refusing to be involved in them, this obstetrician is most of the way there.

Eugenics by the back door

In a politically correct society, a safe starting point for debate is the issue of discrimination. Verbally or physically abusing a fellow human being on the grounds of gender, race, sexuality or beliefs is illegal. However, in the clean, sanitised precincts of the antenatal clinic (ANC), worse thoughts and actions are encouraged.

Mothers-to-be are commenced on a conveyor belt of blood tests, scans and sometimes amniocentesis (which itself carries a 1% miscarriage risk!) to check that ‘baby is OK’. But do these women really understand the implications? Consent forms for operations run to three pages, but is truly informed consent obtained for this screening process, where abortion is often the only ‘therapy’? Only the boldest couples will actually refuse the tests on the basis that they’ve thought it through and will unconditionally accept whatever child is born to them.

The complex and expensive tests that are offered, and often presumed to be wanted, in the ANC amount to one of the most expensive eugenics projects the world has ever seen. The government does not spend millions of pounds of taxpayers’ money on tests for Down’s syndrome just so mothers can be ‘prepared before the child is born’. There is a strong drive to reduce the ‘financial burden’ on society of caring for these people by aborting them.

Protecting the weak

But, wait a minute! Isn’t the medical profession supposed to be a caring profession? Or are we free to decide when caring comes at too high a price? The law exists to protect the rights of the weak. Doctors are trained to look after the vulnerable. Parents have a duty to care for their children. The 1967 Abortion Act turned these three historic guiding principles on their head and made the womb a pretty dangerous place to be.

Social abortion supports a woman’s choice over the baby’s right to be cared for. The process is indiscriminate unless a GP or gynaecologist challenges their wishes. Abortion for fetal abnormality is, because of the discrimination involved, in some senses a worse act. You could suggest to your boss that either all or none of these babies have a right to prenatal protection. Why will he not do an abortion for the reason that the mother doesn’t want it? And why is he prepared to do it if the mother doesn’t want her baby because it is abnormal in some way? And how does he cope when the scan results turn out to be false and a perfectly developed baby is aborted?

A right to be ‘normal’?

If he should continue to take the line that the parents have the ‘right to a normal baby’ then you have two more options to discuss. Firstly, what constitutes a normal baby and in what circumstances does he consider there to be a substantial risk of serious handicap justifying abortion (section 1(1)(d) of the Abortion Act)? This is a very grey area but he must have some standards that he lives by, which may give you further opportunity for discussion.

Next, how does he balance his obstetric responsibility to protect and deliver a baby safely with a parental right to a normal baby? Does he believe the Darwinian principle that only the fittest should survive? That surely is a flawed argument given that Darwin suggested a theory for evolution; he was not recommending that humans forcibly remove the weaker members from society. If we argue that a normal baby is a parental right, how long before we decide normal is an IQ of >130, blue eyes, blonde hair and a physique to die for? The Brave New World is upon us.

Where do we stop?

A more frightening extrapolation of this ‘parental right’ is the view of Professor John Harris (Manchester University bioethicist) that, as no magical change occurs in the birth canal, one could justify infanticide if the baby’s condition was unsatisfactory to the parents! The best way to counter this is to agree that there is no magical change that occurs in the birth canal, but that as infanticide is abhorrent, and clearly murder, so is selective abortion. Even if I can’t see them both, when I have a pregnant mother in front of me, I have two patients, but one of them has no voice.

Loving my neighbour

Finally, it may turn out that your boss claims to share your faith. You could then add arguments from Genesis 1:26,27 that all humans are made in God’s image and worthy of the utmost respect. Loving my neighbour should be an important drive for a Christian medic - God does not look kindly on humans who engender the suffering of innocents. In all this, though, don’t forget that God offers forgiveness to all who turn away from wrongdoing.

Enigma 13

You discover that one of your most anxious patients has a serious debt problem. How as a Christian GP can you help her?

Please email responses to CMF

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