November 27, 2022

Should severely disabled infants be euthanased?

Two of the leading voices in bioethics go head-to-head.

Two of the leading voices in bioethics have a fascinating head-to-head confrontation on the euthanasia of severely disabled infants in an upcoming issue of the Journal of Thoracic and Cardiovascular Surgery. Udo Schuklenk, of  Queen’s University, in Canada, the  co-editor of the journal Bioethics, and Gilbert Meilaender, of Valparaiso University, in Indiana, discuss the ethics of, in Schuklenk’s words, “what would amount to postnatal abortion”.

The arguments of both men are familiar, but succinct and quotable.

Arguing from a quality-of-life standpoint, Schuklenk writes that “Once we have concluded that death is what is in the best interest of the infant, it is unreasonable not to bring about this death as painlessly and as much controlled in terms of timing by the parents as is feasible.”

After dismissing arguments drawn from human dignity, sanctity-of-life, and the principle of double effect, Schuklenk still has to explain why a suffering infant could not be simply sedated so that it would not suffer, thus avoiding the need for euthanasia. The answer he says, is that parents and doctors and nurses would suffer unnecessarily.

The unnecessarily prolonged dying of their infant son would extend a severely distressing situation for the parents. They would have to witness the deterioration of their infant son over a period of days, possibly weeks. Some of the attending health care professionals would undoubtedly also find it psychologically difficult to watch the child die foreseeably an unnecessarily slow death. …. Given that a terminally sedated infant would have no surviving interests to speak of, the interests of these other parties matter. If his prolonged dying is harmful to them, a further quality-of-life based argument in favor of terminating the infant’s life is established.

Meilaender’s argument is less closely argued in academic terms. First he appeals to compassion, the traditional duty of a physician to accompany a patient in his suffering, “ neither abandoning them by imposing treatments that are useless or excessively burdensome, nor abandoning them by deliberately aiming at their death”.

His second argument is more political than bioethical. He appeals to the liberal tradition of human equality:

If I seek to give ultimate authority over my life to others, I become something less than their equal. I join what John Locke called the “inferior ranks of Creatures,” and I make my person an object to be possessed and controlled by others. And the same is true when I give such authority over this child’s life to others. Likewise, the person who carries out the euthanizing deed pulls rank and, in effect, exercises a more-than-human authority over the life of one who is, in fact, his moral and political equal. For us to try to exercise such authority is to pretend to be what we in truth are not: something other than beings of equal dignity. And that would be to lose one of the greatest achievements of our political tradition: an affirmation of equal dignity laboriously gained at great cost over centuries.

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Creative commons
euthanasia
infant euthanasia
Udo Schuklenk