I remember the case vividly.

One of my patients showed up in the Emergency room complaining of “something hanging out down there”. A quick exam showed what I feared.

The uterus had opened, and the umbillical cord of the baby was hanging out.

Standard procedure with these things is to get a nurse to put her hand up and push the baby’s head away from the cord so that the cord did not get squeezed shut, while we docs arranged an Emergency Caesarian section.

But the problem with this patient was that she was only half way through her pregnancy. In those days, we had no ultrasound at our 30 bed hospital, but she had gone to the nearby 70 bed hospital for one the week before. Since the baby could die at any moment, we went ahead and operated.

Alas, the child was not 28 weeks, as we had guessed, but less than one pound, probably 25 weeks, and very sick. the little boy barely had a pulse, and was not breathing. In those days, the Universities saved about 30 percent of these babies, but the nearest Intensive care Nursery was 250 miles away, two hours by air ambulance…

So we stopped the resusitation after five minutes. Prolonging the resusitation when the child was not responding was cruel. So we gave the boy to his mom and he died peacefully in her arms five minutes later.

Yet, if the child was born two weeks later, or at a large hospital, where the survival rate was higher, my decision would have been different. When extraordinary care is available, and the treatment has a good chance of succeeding (i.e. over 5-10%) then you treat.

Wesley Smith has written several articles about the debate on Infant Euthanasia that was started by the Royal College of Obstetrics/Gynecology in the U.K.

Essentially they said if the child was very sick and had poor chance at a normal life, doctors should be able to kill the child in Britain, just as is being done legally in the Netherlands.

Two days later, the UKTimes reported that the Church of England essentially said the same thing…yet a closer look at what the Church actually said was the same thing that the Catholic church has always said: That when the chance of life was small, one did not have to use extraordinary treatment to keep a very premature child or malformed child alive.

In the Catholic church’s teachings, a person has to use ordinary means to stay alive, but if a treatment is extraordinary, or is burdensome to the patient, you can refuse it. There is no moral reason to prolong dying. Indeed, the Catholic and Anglican churches have been at the forefront of the Hospice Movement.

Not using every treatment for a person is not the same as “killing”. Iin some cases, both in infants and in the elderly who we give comfort care instead of a cold and confusing Intensive Care Unit the person actually does well with minimal care and lives. But when they die, they die with family around them, not with five tubes and three beeping monitors and a person pounding on their chest.

Similarly, if a child has Myelomeningocele, a sac on their back from an unformed spinal column, we fix it…even though the kid will need surgery later to drain fluid from the brain and to fix the paralyzed bladder, and the child will probably need a wheel chair. The US is a rich country. There’s a lot of suffering for these children, but nowadays most docs have a couple adults in their practice who were treated as children, often with health problems but often holding down jobs and married.

But in Africa, surgery is not even considered. Even if we do surgery, the child will die of bladder infection, or bedsores, or malnutrition, or from hydrocephalus, or from treatment by the local traditional healer. The nearest University is 200 miles away, but the bus fare is equal to a months’ salary…and even if the care is free, the mother may not be able to care for the child’s many complications, and it is doubtful the child would live long.

In both these incidents, the decision is made on how best to help the child live, but in one surgery is a moderate burden that will result in a decent life, and in the second, chances of living beyond a few months is small even with surgery, so we didn’t treat.

In both cases, the decision was complex, but in both cases, we tried to do the best we could, because we respect the child as a human being.

The REAL danger is that of seeing a person or child as not quite a person, or the idea that if your “quality of life” does not meet a certain criteria, you are better off dead.

That is the real danger. Abortion has made some people callus toward unborn life. The women I saw seeking abortion were in terrible emotional distress, and often needed emotional and often financial help. Yet as a society, in America, too often the only “assistance” for these women is to counsel them that nothing is wrong with abortion, and to teach them the “correct” answers to assuage their consciences in their stress.

So it is not surprising that the Royal College of Obstetricians (who deliver babies) NOT the Royal College of Pediatrics are the doctors is proposing to “discuss” infant euthanasia.

Oh, it’s only about the very tiny and very sick babies…not.

You see, infanticide is performed in the Netherlands, and most of those killed  are not 24 week premature babies, but retarded children or children with the myelomeningocele who would be crippled…but who could be fixed in any large Medical Center.

Given these two facts, one suspects all the talk of “compassion” is really because they see it as compassionate to end the life of a retarded or handicapped infant.
One doesn’t have to go the Europe to see this type of “ethics” being applied to infants. The public would be shocked at how many ethicists have proposed medical rationing according to their own “quality of life” criteria, or that some ethicists even propose certain people, including infants, lack a “criteria for personhood” and shouldn’t be treated at all.

One infamous case occured in the late 1980’s,LINK
“… There were cases at Yale-New Haven, at Johns Hopkins, University of Oklahoma, which is depriving handicapped children for surgery for spina bifida based on the formula Q equals NE times H plus S, quality of life equals natural endowment times contribution from home and society.

Children were denied treatment not only because they were expected to be mentally retarded, but simply because they were poor and black. And that led to a court case that was settled out of court….”


So Infanticide is the next taboo to be stalked and killed….

The way to destroy a moral rule is the same.

You start with a taboo: Something that everyone agrees is wrong.

First, a professor or philosopher argues the rule should not hold in hard cases.

The next step is we need as a society to discuss the moral problem, and consider the problem “rationally”, not just automatically follow outmoded moral traditions.

The next step is that some people actually do it. They are frowned upon, but then the press writes up the action as actually moral, and starts pointing to those condemning the action as bigots.

Soon the law changes, often by courts, not by social consensus.

The next step is that those who still oppose the activity and condemn it are now labled as immoral, and we are told they are the ones who should be social outcasts.

This has happened over and over again. First it was premarital sex, then abortion, then living together, then drug use, then homosexuality, then partial birth abortion, then starving the handicapped…

So for infanticide, we are now at step two.

———-Nancy Reyes is a retired physician who lives in the rural Philippines with her husband, eight dogs, three cats, and a large extended family.

Her blog is Finest Kind Clinic and Fishmarket

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