Friday, October 29, 2010

"You are swine and infidels" - A multicultural blessing

When you hire someone to give a blessing at your special event--or at least before you post it on YouTube--make sure you know what they are saying!

What to make of this incident, so fraught with contradictory meanings on so many levels? A cultural Rorschach inkblot test. More to follow.

The couple chose an idyllic resort in the Maldives as the perfect place to renew their marriage vows and pledge everlasting love.

But their happiness has turned to humiliation after the wedding video was posted on YouTube and subtitles disclosed that their "Islamic blessing", which was conducted by a hotel employee in the native Dhivehi language, was in fact a stream of insults.

"You are swine. The children that you bear from this marriage will all be bastard swine. Your marriage is not a valid one," he intoned as the couple held up their hands in prayer, blissfully unaware of what was being said.

Dismissing them as pork-eating "infidels", the employee went on: "You are not the kind of people who can have a valid marriage. One of you is an infidel. The other too is an infidel and, we have reason to believe, an atheist who does not even believe in an infidel religion.

"You fornicate and make a lot of children. You drink and you eat pork. Most of the children that you have are marked with spots and blemishes."

Several other staff members were present at the ceremony but said nothing. One appeared to be stifling a laugh.

The "celebrant", identified as Hussein Didi, made reference to bestiality and "frequent fornication by homosexuals". Close inspection of the official-looking document in front of him reveals it to be a copy of the staff employment regulations.

The video was shot by hotel employees who can be heard sniggering in the background and debating whether or not the bride is wearing a bra. "Don't look at the breasts!" says one as the bride leans over in her white wedding gown to plant a coconut palm. "My beard has gone grey watching those things. I have seen so many of them now that I don't even want to look any more when I see them."

The ceremony took place at the Vilu Reef Beach and Spa Resort, which charges £820 for the privilege. The hotel's website claims that the sunset ceremony is the perfect way "to mark a milestone in your amazing journey together".

Although the couple's identity was undisclosed, they were thought to have been Swiss.

The video has caused uproar in the Maldives, a nation heavily dependent on tourism, and the government ordered a police investigation. Ismail Yasir, the deputy tourism minister, said he was "very concerned".

"We have asked the resort to inform us what action they have taken," he said. "We are embarrassed and outraged. We would like to assure everyone who would like to come to the Maldives that we will take such incidents seriously and will take action."

The staff involved have been suspended. A spokesman for the Vilu Reef apologised for their "unforgivable conduct" and said: "The management of the resort is deeply saddened by this humiliating event."

Retrieved October 29, 2010 from

The word 'fetus' is offensive, dehumanizing and manipulative

John Finnis | Friday, 29 October 2010
The word ‘fetus’ is offensive, dehumanizing and manipulative

A law professor at Oxford University argues that use of the word 'fetus' obscures our perception of moral reality.

In this extract from a debate on "The Moral Status of the Fetus" with Peter Singer and Maggie Little at Princeton University, Professor John Finnis, argues that moral status is not a matter of choice or grant or convention, but of recognition of someone who matters as an equal whether we happen to like it or not. It has been republished with permission from Public Discourse.

The last time I had the opportunity of discoursing with Peter Singer was in May 1998 in the Philosophy Society at Oxford, right behind the College where we were colleagues for a while in the 1970s. The topic in 1998 was "Brain Death," and we had a fair measure of agreement that the contemporary tests and criteria for brain death are an unsatisfactory guide to determining when death has occurred. But we disagreed about some things. One was the ethical question whether it's sometimes right to choose to kill living human beings, as Peter thinks, and I deny, because I believe that everyone equally has the right not to be deliberately killed precisely as a means to someone else's well-being. Another was that Peter wanted (and I'm sure still wants) to treat the question whether someone is dead as an "ethical question" -- or in this afternoon's jargon, a question of the moral status of anencephalic babies, people in persistent vegetative states (PVS), and so forth. I consider that it is a question of fact -- of understanding, if you like philosophically and biologically, what it is for an organism of a certain substantial kind to have ceased to be an organism of that substantial kind (which is essentially what happens at that organism's death).

The last time I had the opportunity of discoursing on today's topic was at the American Political Science Association, in 2000, in a debate with the Rawlsian political philosopher Jeffrey Reiman. Reiman is a liberal, but he too, like Peter Singer, doesn't believe in human equality. Peter must speak for himself, but in his publications around 2000 he agrees, I think, with Reiman that birth has little or no real moral significance. Reiman's position is clear enough: the baby has no more rights, is no more entitled to respect, in the minutes or hours or days, or weeks, after birth than in the minutes or hours or days, or weeks, before birth. So far he and Peter agree. But then they split; for Reiman the child doesn't acquire the equal moral status of having rights of its own for several years, when it has started to "consciously care about the continuation of its life" -- whereas for Peter the moral status of equality and right to life is to be affirmed (I'm not sure why) a month after birth. (In the debate following this presentation, Singer made clear that his "one month" proposal dates back to 1984 and was intended just as a pragmatic legislative line, and that his basic and present view approximates to Reiman's.)

So, on Reiman's view (and I suppose Peter's), if there is to be a law against infanticide from birth, it certainly doesn't rest on the moral rights, or moral status, of the young infant -- it has none -- but only on the feelings and dispositions of adults. And Reiman is keen to add this: since the unborn child, like the born child for quite a while, has no right to life, the mother's right to an abortion is not a right simply to be relieved of the presence of what is growing in her body, but a right to ensure that it is killed, whether or not it was delivered or expelled alive.

All parts of this view are rejected by our law, and, I want to say, by our civilisation. In 2002 both houses of Congress unanimously passed the Born Alive Infants Protection Act, with the stated objective: "to repudiate the flawed notion that the right to an abortion means the right to a dead baby, regardless of where the killing takes place." This was in response to the Farmer decision of the Court of Appeals of the Third Circuit in 2000 which seemed to mean that even a fully delivered baby could be lawfully killed if the reason for its delivery was abortion. At that time the Supreme Court had declared that if the baby is two-thirds outside and one-third inside, its mother has the right to employ someone to kill it. The doctor who developed this procedure, Martin Haskell, testified to Congress that in his standard version of the procedure (outlawed in 30 states but upheld by the Supreme Court) it would be possible to deliver the baby fully, in perfect health and without injury, if one treated the woman with dilating drugs for longer, but one doesn't do that, because "the point here is you're attempting to do an abortion ... [The point is not] to see how do I manipulate the situation so that I get a live birth instead."

Haskell was doing this skull-emptying of a living healthy baby almost fully delivered from a physically healthy mother at 22, 23, 24, 25 or 26 weeks of gestation or pregnancy. My pediatrician daughter treats premature babies of some of these ages. While there can be agonising problems about the futility or medical benefit of treatment, no one involved in her practice -- mothers, nurses, doctors -- has the slightest doubt about the nature of the baby as a human person or, consequently, about its moral status as a bearer of interests and rights, unconscious though it often is for days or weeks. So there are babies born, babies half-born, and babies soon to be born. Since 1973, U.S. constitutional law allows abortion virtually completely freely for a further 11-15 weeks beyond the stage I have just been mentioning.
The first time I debated the rights and wrongs of abortion (which I'm not here to do today, as I am to limit my remarks to the "moral status" of the "fetus") was in print with Judith Jarvis Thomson, author of the justly famous article about the kidnapped violinist, the first philosophical article to articulate a woman's right to an abortion, an article whose thesis about the significance of the intimate intertwinement of the mother and the unborn child has been elaborated and extended by Margaret Little. Of course, this was 1971, so Thomson, while most strenuously arguing for this moral right, denied that it includes a right to get the baby dead. (Since then, hearts have hardened.) She had this to say about our topic this afternoon: "I am inclined to think also that we shall probably have to agree that the fetus has already become a human person well before birth. Indeed it comes as a surprise when one first learns how early in its life it begins to acquire human characteristics. By the tenth week, for example, it already has a face, arms and legs, fingers and toes; it has internal organs and brain activity is detectable."

That was 1971 and since then ultrasound makes all this much less surprising. And once Roe v. Wade and even more importantly Doe v. Bolton came along in January 1973, people became more resolute than Judith Jarvis Thomson in denying that what they could see is a human baby, is a human person, or has moral status.

All sorts of stages have been proposed for "becoming a person" or "acquiring moral status": implantation, development of the primitive streak, brain life, sentience, quickening, viability outside the womb, actual birth, actual birth unless it was an induced abortion, formation of desires, formation of concepts, formation of self-consciousness, valuing your own existence -- but these all cancel each other out, and anyway, with the talk of the threshold being desires, or self-consciousness, or conscious concern to stay alive, we are now deep, deep into infanticide territory with Peter Singer and Jeffrey Reiman. These are positions that willy-nilly are incompatible with non-arbitrarily affirming the personhood of adults who are in even temporary unconsciousness. And what is wrong in principle with their positions is that they deny human equality, elevating various subrational animals of their choice above healthy young babies weeks, months, and years after birth, and above the deeply disabled mentally or physically.

The thing about moral status is, if you believe in morality at all, that it is not a matter of choice or grant or convention, but of recognition. If you hear anyone talk about conferring or granting moral status, you know they are deeply confused about what morality and moral status are. The very idea of human rights and status is of someone who matters whether we like it or not, and even when no one is thinking about them; and matters, whether we like it or not, as at bottom an equal, because like us in nature as a substantial kind of being.

This mattering is the immediate basis for respect, including self-respect, and for guilt or remorse when one betrays another. It goes with the territory we call meaning, which transcends times and places, and forces us to speak about mind or spirit, and freedom of choice. If we are thinking alertly to the realities of the realm of sharable interiority, we know what it is to be a developed and conscious person: a being who finds himself or herself to have a rational nature, capacities that combine intelligibility with intelligence. A nature to be recognized and acknowledged, not conferred.

If one asks oneself about one's own personal origins, one can go back to one's earliest memories, and then to the earliest photographs, earlier than one's surviving memories but showing one as a center of personal life; and then to the life before birth that was scarcely or not at all conscious, but is recorded perhaps in those ultrasound photos which show you as you, a white male thumb-sucker, or a vigorous female Chinese thrower of punches, or whatever. Now we are only a couple of months from our conception. But it is certain that we began before.

Unless we are one of the 1 percent identical twins, we began as Louise Brown the first IVF baby began in the discriminating care of Professor Robert Edwards who got the Nobel Prize for it last week: "She was beautiful then" he said at her birth, showing a photo of her at one cell, "and she's beautiful now." Edwards gives a lucid account of the dynamic self-directing unity of the embryonic being who even at one cell smaller than a pin-head has scores of millions of molecular components all organized, then and there, to make him or her, well, him, or her, and brown, yellow, black or white, and clever or not so clever, and clumsy or not so clumsy, and much else, by nature.

The key concept here is radical capacity. The early human embryo has the radical capacity to think and laugh and pun; all it (he or she) needs is time and nourishment, no more: the actual and active second-order or radical capacity, written into its molecular and cellular constitution, to develop first-order, promptly usable capacities such as to learn a language here and now.

In the discussion, I put to Singer the following hypothesis, which I owe to Patrick Lee. Suppose that on my return home I am diagnosed with a rare and lethal brain tumor which can be cured only by excision of a part of my brain such that all my memories of life, people, languages, etc. before the operation will be irreversibly expunged, though I will retain the capacity, after nine months of unconsciousness following the operation, to rebuild a new stock of memories, language, skills, affections, etc. Right after this operation, would not my "moral status" or, more relevantly, my reality as a person, be essentially that of the newborn baby and indeed of the early embryo? (Unfortunately, Singer was never called upon to answer my question.) The chairman of the panel, Prof. Arthur Caplan intervened to say that I would not be me (JMF). But of course I denied that completely; I would be JMF before, during, and after the operation, someone who suffered grievous loss in and as a result of the operation, but retained like the embryo and newborn baby the radical capacity for continued life as the one and only person I already am.

But I wasn't asked to discuss the moral status of the embryo, but of the fetus. You ceased to be conventionally called an embryo 56 days into your life and became in medical parlance -- but it's just a conventional boundary -- a fetus, which you remain, for purposes of discourse between doctors: a fetus until delivered. But of course, a website describing ultrasound for expectant mothers doesn't talk about her fetus but her baby, and so do her doctors unless they're her abortionists or think she has been or is interested in abortion. So there's the topic of the moral status of the fetus, and there's the topic of the moral status of the phrase "the fetus."

About the moral status of the fetus, it's clear, I suggest, beyond doubt, after forty years of intense philosophical discussion, that there's no credible halfway house between, on the one hand, acknowledging that whether we like it or not the fetus -- indeed the embryonic baby from the outset -- has the same radical equality of nature that we all have despite myriad differences, and on the other hand joining Peter and Jeffrey in denying two things: (1) denying that the primary question is one of fact -- shared nature as beings all having or capable of developing (given only food and protection) rational characteristics and activities, and (2) denying equality or ethical or moral entitlement to rights such as life until some time after birth (and here I think Reiman's position will prove more stably defensible than Peter's in making that years after birth; but of course neither of them can limit their denial of human equality to conditions of infancy; the denial extends to various sorts of disablement and decay). And each of them goes wrong from the outset in making "moral status" the fundamental predicate in the discussion, instead of predicates of the form "person," "rational nature," "kind of being."

About the moral status of the phrase "the fetus," I will just say this. As used in the conference program and website, which are not medical contexts, it is offensive, dehumanizing, prejudicial, manipulative. Used in this context, exclusively and in preference to the alternatives, it is an F-word, to go with the J-word, and other such words we know of, which have or had an acceptable meaning in a proper context but became in wider use the symbol of subjection to the prejudices and preferences of the more powerful. It's not a fair word, and it does not suggest an open heart. Those of you who have an open mind or a fair heart may wish to listen to every speaker at this conference, and see whether they are willing to speak, at least sometimes, of the unborn child or unborn baby, and to do so without scare quotes or irony.

For about 12 weeks after viability some of these little beings are on the outside being tended by the pediatrician and everyone as babies, and some of them are on the inside still intertwined with their mothers, and being cared for, in some cases, by gynecologists who recognise they have two patients, and in some cases, as the mother decides (in America, or the party official in China) being threatened with destruction by her (or the state's) abortionist as a mere fetus. However extensive the rights in all fairness of the mother, and they are extensive, they are no basis at all for denying to the child she's bearing during those twelve weeks its proper human name, her baby or child -- what an important article of Margaret Little's calls at one point "being connected to the child in one's belly." So, I suggest, listen; this is a litmus test, in words, of this conference's motto.

John Finnis is Professor of Law and Legal Philosophy in the University of Oxford and the Biolchini Family Professor of Law at the University of Notre Dame. This piece is adapted from his remarks delivered at the conference “Open Hearts, Open Minds, and Fair-Minded Words,” held on the campus of Princeton University on October 15 and 16.

Retrieved October 28, 2010 from

Tuesday, October 26, 2010

Binge drinking and hooking up as policy problems

Binge drinking and hooking up as policy problems
Paul Adams | 25 Oct 2010 |

One challenge of teaching social policy is that students—social work students anyway—too often mistake advocacy for analysis, opinion for fact. It makes it hard to conduct a serious analysis of a problem and the best ways to address it if you smuggle your preferred solution into the way you define the problem. The problem is lack of resources or services, the intervention is to provide more, and the criterion for evaluating success is whether more were provided—omitting the rather key question of whether the resources or services made any difference to whatever social problem they were supposed to address. Too often the inquiry becomes pro forma because the “analyst” has decided on the preferred policy approach before doing any analysis. (This problem, unfortunately is by no means limited to students.)

Elizabeth Marquardt’s essay on “Bacchanalia Unbound” in the current issue of First Things is refreshing in this respect. Not that she lacks opinions on the toxicity of the environment that many young college students enter when they start their undergraduate education. She addresses problems like binge drinking and hooking up that many students and progressive faculty do not even see as a problem, or at least not different from universal and timeless student behavior. But though the essay is far from being a formal policy analysis, Marquardt entertains real alternatives, some of which are compelling but counter-intuitive.

On the problem of binge drinking of college students, for example, the problem of how to reduce it elicits two opposed strategies. One is from a group of college presidents, under the name of the Amethyst Initiative, which wants to lower the drinking age on the grounds that the current high minimum age of 21 encourages binge drinking (as happened in England and Australia when they had strictly limited pub hours). Here we have college presidents taking the view associated with leftist academic sociologists of deviancy of past decades who saw the roots of deviant behavior in social control. (If people didn’t condemn it, it wouldn’t be deviant. The way to reduce the incidence of drug-related crime is to decriminalize drug use.)

As Marquardt suggests, there is much to commend this approach, but also a big obstacle in this context—boys and cars. The other policy approach, favoring the high minimum drinking age and supported by Mothers Against Drunk Driving (MADD), fiercely opposes the college presidents on the grounds that the present high minimum age reduces traffic fatalities.

And then there is the stricter college rules and enforcement approach--no alcohol at fraternity or sorority parties at which freshmen are present.

The other topic is the (linked but distinct) practice of "hooking up," which is arguably much more harmful than commonly recognized--disproportionately harming young women; encouraging male irresponsibility, selfishness, and lack of empathy or love; degrading human sexuality into a less than fully human activity that engages the whole person; and undermining marriage and family by detaching love and commitment from sex; and so forth.

Again, there are interestingly different approaches to addressing the problem, from denying that it is a problem at all; to tightening up on university rules for underage drinking, dorm room visiting, social events, and so on; to encouraging a return to earlier marriage (and so to dating as a more serious matter involving a potential spouse rather than casual sex for the next ten years as a substitute for dating). As Marquardt observes, this last approach would be a hard sell to parents, who themselves want to see their kids’ ever more expensive college education completed without being sidetracked by marriage. But for a case for earlier marriage, see this link.

Both would be interesting and less well-trodden paths for a policy analysis paper than more common, but not unimportant social welfare topics such as how to reduce homelessness among people with severe and persistent mental illness. Both student binge drinking and hooking up elicit intriguing and non-obvious options, and can be adapted to other populations of young people. Both begin in high school. Leonard Sax's book, Why Gender Matters, has a very depressing chapter on hooking up in high school. And then there's Tom Wolfe's powerful novel, I Am Charlotte Simmons.

Retrieved October 25, 2010 from

Sunday, October 24, 2010

Multiculturalism and Moral Decay

Archbishop Chaput's powerful address to a tri-diocesan catechetical congress held in Victoria, British Columbia on Friday and Saturday, Oct. 15 and 16, 2010.

Describing a teacher's experience of student responses to the short story, The Lottery,how they changed from shock and indignation in the 1970s to multicultural sensitivity and understanding in the 1990s, Chaput notes that
Our culture is doing catechesis every day. It works like water dripping on a stone, eroding people’s moral and religious sensibilities, and leaving a hole where their convictions used to be.
Without a strong confident Catholic catechesis to enable young people to swim against the stream, they lose their moral bearings. Speaking of the teacher, Kay Haugaard, who wrote an essay on her experience of teaching The Lottery over decades, Chaput says,
Haugaard’s experience teaches us that it took less than a generation for this catechesis to produce a group of young adults who were unable to take a moral stand against the ritual murder of a young woman. Not because they were cowards. But because they lost their moral vocabulary.

Haugaard’s students seemingly grew up in a culture shaped by practical atheism and moral relativism. In other words, they grew up in an environment that teaches, in many different ways, that God is irrelevant, and that good and evil, right and wrong, truth and falsehood can’t exist in any absolute sense.
The problem, he argues, lies with the adults--parents and teachers--who fell into easy accommodation with the new barbarism, surrounding, increasingly amoral culture, were embarrassed by their faith, and so unable to teach or model it convincingly.
Instead of changing the culture around us, we Christians have allowed ourselves to be changed by the culture. We’ve compromised too cheaply. We’ve hungered after assimilating and fitting in. And in the process, we’ve been bleached out and absorbed by the culture we were sent to make holy.
His remarks are a call to courage, humility, obedience, and zeal.
We need to stop calling ourselves “Catholic” if we don’t stand with the Church in her teachings – all of them. But if we really are Catholic, or at least if we want to be, then we need to act like it with obedience and zeal and a fire for Jesus Christ in our hearts. God gave us the faith in order to share it. This takes courage. It takes a deliberate dismantling of our own vanity. When we do that, the Church is strong. When we don’t, she grows weak. It’s that simple.

Here is the full address:
ARCHBISHOP CHAPUT: Repentance and renewal in the mission of catechesis

Friday, October 22, 2010

A Cure for Curmudgeons

As The Anchoress ( puts it, "Watch this 3 year old conducting Beethoven. Ponder his astounding musicality and stick around to the end, when the music overwhelms him into belly-laughing joy!"

Sunday, October 17, 2010

When the workers of the world unite

The second collection of readers' letters sent to but unpublished by the Daily Telegraph (UK) has just been published under the title, I Could Go On by Iain Hollingshead (Aurum Press, UK). The paper receives 700 letters a day and publishes 20, so there are gems to be found among the rejects.

Some are delightfully eccentric in a Colonel Blimp kind of way and most complain of something (but wittily). The letters reflect the readers' average age, which is something over 50, perhaps well over.

In English custom and practice, you can be as rude as you like as long as you are witty enough with it. I recall a good friend in graduate school at Oxford who was incensed by the way his wife's boss had treated her. When my friend next met the man at a party, he went up to him and started the conversation with the observation, "I hear you are the rudest man in Oxford." The man replied to my friend with admirable brevity: "I was."

One Daily Telegraph correspondence of the past year brought to mind the tradition of English schoolmasters in my day who were expert in using disparaging wit as a mechanism of classroom control and socialization. I recall comments like, "When I want your opinion, Jones, I'll send you a telegram," or to a boy staring in silence at a Latin passage he had been asked to translate for the class, "No mistakes so far."

The comments that schoolmasters were expected to write on end-of-term reports (report cards) offered a particular opportunity for sarcasm which, I suppose, concerns about self-esteem, strengths-based feedback, and fear of litigation have now rendered obsolete.

Three exquisite gems I read with nostalgic pleasure: “When the workers of the world unite it would be presumptuous of Dewhurst to include himself among their number”; “Unlike the poor, Graham is seldom with us”; and my personal favorite, “The improvement in his handwriting has revealed his inability to spell”.

Friday, October 15, 2010

Nobel award: misconceived

There is or ought to be something deeply disturbing about the award of a Nobel prize to Dr. Robert Edwards for his development of in vitro fertilization (IVF). It is disturbing that fetuses are killed in large numbers to create new life in the petri dish. It is disturbing that women delay childbearing until they are well past the age when they are able to conceive "as nature intended." Both contraception and IVF "gave birth to a new and arrogant attitude to human beings at the very beginning of their lives and in their dependent years," Carolyn Moynihan argues below.

IVF does not cure infertility but contributes indirectly to the leading cause of it, delayed childbearing. Babies become objects of adult desire, to be manipulated according to adult agenda and wishes, without regard to what they may feel about the matter as they grow to realize that they were "designed" to adults' specifications--think of the case of the lesbian partners who, deaf themselves, went to great lengths to ensure that one of them would give birth to a baby who was also deaf.

No less disturbing is the blank moral incomprehension, as it seems, of the Nobel committee that awarded the prize. As Bioedge editor Michael Cook put it,
But I listened in astonishment to a representative of the committee who selected Professor Edwards as he blandly declared that the ethical issues surrounding IVF itself were "resolved" decades ago. I am not quite sure what "resolved" means. Is there another field of medicine which regularly gives rise to such knotty ethical issues, ranging from the exploitation of impoverished Indian women as surrogate mothers to the thousands of children of anonymous sperm donors who will never know their fathers?

Moynihan's essay below, from the excellent dignitarian blog MercatorNet, helps troubled readers like me sort out the issues in a clear, thoughtful way.

Nobel award: misconceived
Carolyn Moynihan | Friday, 8 October 2010

Robert Edwards' IVF technique devalued the human embryo and contributed to infertility.

There is something quite ironic in this week’s award of the Nobel Prize to Robert Edwards for the development of human in vitro fertilisation. During decades in which the whole thrust of reproductive medicine was to render fertile women infertile for 99 per cent of the time, Dr Edwards and later his colleague Patrick Steptoe were perfecting techniques for turning infertile women into mothers.

And yet these two grand projects are only apparently contradictory. Both pushed medicine away from its basic curative function and towards a social engineering role: efficient contraception would suppress bodily rhythms to make every child a wanted child; IVF would make wanted children appear even when the body was not fit to conceive.

In pursuing this path, both contraception and IVF gave birth to a new and arrogant attitude to human beings at the very beginning of their lives and in their dependent years.

Up until the 1960s it was generally considered a crime and a personal tragedy to put an end to the life of an unborn child, but with the advent of the contraceptive pill, abortion had to be excused or legalised to get rid of “mistakes” by individuals who did not use the new technology correctly, or neglected to use it at all. This was the first modern blow against new human life.
Then came fertilisation outside the body. What belonged by nature and culture to an act of love between spouses -- the generation of a new person -- was broken down into its components and manufactured in the laboratory, but no moral authority apart from the Catholic Church could see what was wrong with this. Today, most Catholics do not understand why the church teaches that the marital embrace is “the only cradle worthy of a human being”.

Cradle this being in a petri dish, however, and it turned out that everything was permitted.

If you could treat a foetus with a heartbeat, fingers and toes as a mis-timed product of conception, how much more the human embryo of only a few days who really did look like a “clump of cells” under the microscope. By the time a live baby was born from IVF in 1978, Dr Edwards had been fertilising human eggs for nearly 10 years, and the wastage of new human lives continues to be a necessary part of the technology. Those that do develop but are flawed are discarded.

Before long, embryos who passed muster but were surplus to requirements at the time were being stored in freezers, “waiting to be transferred in utero or, more likely, be used for research or to die, abandoned and forgotten by all,” as the head of the Pontifical Council for Life forthrightly commented on Monday, referring amongst other things to embryonic stem cell research. Monsignor Ignacio Carrasco de Paula also noted the “market for eggs” that IVF has spawned.

Donor eggs, donor sperm and IVF together have turned the “wanted child” into the “must-have” child wanted by anyone at all: sixty-year-old women, single women, same-sex partners. And, increasingly, it has to be exactly the “product” desired: the right sex, or the right genetic make-up. The rights and welfare of the child are no longer paramount; adult desires trump all other considerations.

For anyone who cares about the sanctity of human life, about children and the future of the family, all the above makes a damning list. Is there not something positive we can say about Dr Edwards’ work? Even the Vatican official said that he “has inaugurated a new and important chapter in the field of human reproduction, whose best results are evident to all.”

Certainly we have to rejoice that four million people have been born as a result of IVF, even though they represent only 20-30 per cent of the embryos brought into being. One also has to acknowledge the happiness that these children have brought their parents; infertility is undoubtedly the greatest sorrow that can afflict spouses, and, at a time when abortion was reducing the number of babies available for adoption, IVF offered hope, and sometimes a real baby.

But here we run into another deep irony: the hope IVF held out of a technical solution began to function as a reason to delay childbearing and thus became another cause of infertility.

The reproductive revolution unleashed by the contraceptive pill encouraged delayed marriage and child-bearing. Indeed, that was the whole point of it in the minds of those who produced the pill out of concern about the mid-twentieth century “population explosion”. Over the last four decades that delay has steadily increased, so that the median age of mothers giving birth (married or not) has risen from the mid-twenties to around 30 in some developed countries.

Many factors come into play in this cultural change, not least the increasing participation of women in the workforce and the boost that has given to the material aspirations of couples, who often desire not only an elegant home in which to begin family life, but also a hugely extravagant wedding as a prelude. They must have some inkling that their fertility will run out, but the idea that men in white coats will provide a baby if all else fails has taken such a hold that IVF experts themselves have begun issuing warnings against it.

Just a few days ago the leading practitioner in New Zealand said plainly that the leading cause of infertility now is delayed childbearing. In 20 years the number of women in the country having babies between their mid-30s and mid-40s has risen from around 5000 to more than 13,600, and Dr Richard Fisher said that one-third of women receiving IVF treatment were over 40 (when their chances of conceiving naturally are between 6 per cent and zero).

"And we treat most of them because they are over 40, not because of an underlying medical condition. The longer you delay, the less your chances of conceiving. If you have the opportunity to conceive younger you should take it."

For all their misgivings, IVF doctors find it hard to say no to anybody.

A few years ago Dr Alan Pacey of the British Fertility Society went so far as to admit: “Nature designed women to have children in probably their late teens and early twenties, and many women are now waiting until they are over 35.”

Delay can reduce fertility in other ways as well. The flip side of the reproductive revolution is the sexual revolution -- the increase in sexual partners during the uncommitted twenties that raises the risk for sexually transmitted diseases, which in turn can lead to infertility from pelvic inflammatory disease and blocked fallopian tubes. Indirectly, IVF contributes to such lifestyle-related risks in a culture where marriage and child-bearing are delayed.

On balance, Dr Edwards’ great invention may have contributed more to infertility than it has appeared to solve. Strictly speaking it has not cured any type of infertility, it has only circumvented it, and in doing so has failed both medically and socially.

His was a clever scientific breakthrough which, however, was fundamentally unethical and a massive distraction from the quest for real solutions to infertility. That the Nobel Prize committee cannot see it devalues the prize and sends a misleading message to young adults, who already have more than enough incentives to squander their fertility in the -- largely vain -- hope that technology will rescue them.

Carolyn Moynihan is deputy editor of MercatorNet.

Retrieved October 15, 2010 from

Thursday, October 14, 2010

The slippery euthanasia slope: From right to die to duty to kill

Bill Muehlenberg | Monday, 4 October 2010

A slippery slope to forced euthanasia?
Pressure for legalising euthanasia has been stepped up in Australia by the pro-euthanasia Greens.

It appears that the party of death never sleeps. Already the Greens have introduced their pro-death bill into Australia’s Federal Parliament. The party's leader, Bob Brown, argued that most Australians support voluntary euthanasia. But I suspect most Australians in fact may not have a clear understanding of just what the euthanasia agenda is all about.

They are certainly not getting the full story from the pro-death lobby. There are many misconceptions and myths out there that need to be dispelled. One is that this will in fact be entirely voluntary, with no pressure or coercion. But this is just wishful thinking.

The truth is the right to die implies a duty to kill. Let me explain. We live in a rights-mad culture. Everyone is demanding a right for this or that. But there are no rights without corresponding duties. An officially sanctioned right must be backed up by the legally enforced means to ensure those rights can be carried out. Thus if society goes down the path of legalised euthanasia, this right to die will lead to its necessary corollary, the duty to kill.

Indeed, once a society has said that its citizens have the right to die, it will be forced to provide the means to do so. If a state says there is a legal right to die, logically, anyone can bring suit to ensure that governments comply. Just as today society tells us a woman has a right to abort her own child, so it provides, via medical aid and tax-payer funding, the means to carry out this activity.

In fact, once legalised, it is possible that doctors may one day face lawsuits if they violate someone’s rights by not killing them. As commentator John Leo puts it: “Imagine doctors purchasing malpractice insurance that covers ‘denial of death’ suits. That day may not be far away.”

And as ethicist Leon Kass reminds us, the “vast majority of candidates who merit mercy killing cannot request it for themselves.” But we can count on the fact that the “lawyers and the doctors (and the cost-containers) will soon rectify this injustice. . . Why, it will be argued, should the comatose or the demented be denied the right to such a ‘dignified death’ or such a ‘treatment’ just because they cannot claim it for themselves?”

For all the talk about choice, about freedom to choose, about giving people options, the legal and social legitimisation for assisted suicide will effectively eliminate one option, namely, staying alive without having to justify one’s existence. With legalised euthanasia, the burden will be upon people to justify being alive - we will have to prove that we ought to be allowed to live.

Lest that sound too far out, consider the words spoken in 1984 by the then Colorado Governor Richard Lamm who said, “Elderly people who are terminally ill have a duty to die and get out of the way.” Or recall the comments made in Australia by the country’s then Australian Governor-General Bill Hayden who, thinking of his own advancement in years, spoke of “unproductive burdens” which we need to be “disencumbered” of via euthanasia.

But as Simon Leys (Pierre Ryckmans) has noted, why is Bill Hayden as a senile, incoherent old man in a wheel chair (one day) any less of value and worth than Bill Hayden was as Governor-General? A society that allows such distinctions is one that has “simply forsaken the very principle of civilisation and crossed the threshold of barbarity”.

Moreover, would Hayden set up a test whereby we determine who is an unproductive burden? Will people be forced to give written evidence as to why they should be allowed to remain alive? After all, in a world of scarcity, such proposals are not all that far off. Indeed, some people are calling for such measures already.

Some people, concerned by what they see as a crisis in over-population, have called for a drastic reduction in population levels.

The tone of debate seems to be becoming increasingly shrill. Many formerly uncommitted public figures and organisations are now speaking out in favour of cutting population levels. In recent times, the Anglican Church of Australia has warned of “catastrophic” consequences of global overpopulation. Sir David Attenborough has pushed for lower population in his documentary: “How many people can live on planet Earth?”. And the previously non-aligned Australian businessman, Dick Smith, produced his own documentary, “Population Puzzle”. Smith commented “This is the most important issue I have ever undertaken in my life. I won’t rest until we have a proper plan in place that informs Australians just how many people we can sustainably support in this country.”
It is clear where such passionate “concern” can lead. In the past a number of Australian commentators have argued for draconian measures to cull population, with some claiming that Australia’s population it should be reduced to less than half its present level. Going back as far as the 1990s, the then Leader of the Australian Democrats John Coulter argued that no Australian family should have more than two children. One city councillor even argued that people who choose to have three children should be compulsorily sterilised and forced to pay the government $200 per fortnight.

It does not take much imagination to see that euthanasia will be enlisted to support such population-reduction goals.

Again, this is not far-fetched. In the past Australia’s Economic Planning Advisory Commission (EPAC) has discussed the rising costs of health care for the elderly and in one publication EPAC actually looked at the issue of euthanasia as one option in the whole discussion. There was no talk about alleviating suffering or being compassionate -- the whole proposal centered on cost-cutting measures.

Indeed, it is estimated that around half of all health care dollars are spent on people in their last six months of life. Thus cost considerations are increasingly becoming a major part of the decision-making process. In a recent case of a brain-dead man on life support, a Monash University medical ethicist said that there would be a high cost involved in maintaining the man, so the economic factor would have to be considered in deciding his fate.

American human rights lawyer Wesley J. Smith drives this point home: “If assisted suicide were ever permitted to become a legitimate and legal part of medical practice, in the end it would be less about ‘choice’ than about profits in the health care system and cutting the costs of health care to government and families. The drugs for assisted suicide only cost about $35 to $40, while it might cost $35,000 to $40,000 (or more) to treat the patient properly. The math is compelling, and contains a warning we dare not ignore.”

In a culture where worth and value tends to be measured by the bottom line, the call for legalised euthanasia will likely also be assessed in those terms. Financial considerations will tend to trump other concerns, including the right to life. All the more reason to never allow euthanasia to be legalized.

Retrieved October 8, 2010 from

Wednesday, October 13, 2010

Legislating against Use of Cost-Effectiveness Information

New England Journal of Medicine
Legislating against Use of Cost-Effectiveness Information
NEJM | October 13, 2010
Peter J. Neumann, Sc.D., and Milton C. Weinstein, Ph.D.

The Patient-Centered Outcomes Research Institute . . . shall not develop or employ a dollars per quality adjusted life year (or similar measure that discounts the value of a life because of an individual’s disability) as a threshold to establish what type of health care is cost effective or recommended. The Secretary shall not utilize such an adjusted life year (or such a similar measure) as a threshold to determine coverage, reimbursement, or incentive programs under title XVIII.

— The Patient Protection and Affordable Care Act1

In 1996, after 2 years of deliberation, the U.S. Panel on Cost-Effectiveness in Health and Medicine, composed of physicians, health economists, ethicists, and other health policy experts, recommended that cost-effectiveness analyses should use quality-adjusted life-years (QALYs) as a standard metric for identifying and assigning value to health outcomes.2 The recently enacted Patient Protection and Affordable Care Act (ACA) created a Patient-Centered Outcomes Research Institute (PCORI) to conduct comparative-effectiveness research (CER) but prohibited this institute from developing or using cost-per-QALY thresholds. The two events serve as revealing bookends to a long-standing debate over the role and shape of cost-effectiveness analysis in U.S. health care.

QALYs provide a convenient yardstick for measuring and comparing health effects of varied interventions across diverse diseases and conditions. They represent the effects of a health intervention in terms of the gains or losses in time spent in a series of “quality-weighted” health states. QALYs are used in cost-effectiveness analyses (termed “cost-utility analyses” when QALYs are included) to inform resource-allocation decisions: the cost-per-QALY ratios of different interventions are compared in order to determine the most efficient ways of furnishing health benefits. In contrast, other health outcomes are generally expressed in disease-specific terms, such as incidence of cardiovascular events, cancer progression, intensity of pain, or loss of function. Though useful for measuring the effects of particular treatments, these outcomes do not permit comparisons among diseases and conditions or between treatment and prevention.3

Researchers have published thousands of cost-utility studies in leading medical and health policy journals. Health policymakers around the world have used such analyses to inform clinical guidelines and reimbursement decisions. The U.S. government, through agencies such as the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, and the National Institutes of Health, has sponsored cost-utility analyses. Medical specialty societies have cited cost-utility studies in support of clinical guidelines.

The ACA specifically forbids the use of cost per QALY “as a threshold.” The precise intent and consequences of this language are unclear. One might interpret it to mean that the PCORI, or its contractors or grantees, can still calculate cost-per-QALY ratios as long as they are not compared with a threshold (e.g., $100,000 per QALY) or used to make a recommendation based on such a threshold. Comparisons of cost-per-QALY ratios across interventions could still be useful to decision makers even without the invocation of an explicit threshold. However, the ACA suggests a broader ban on the use of cost-utility analyses — and this could have a chilling effect on the field.

The ACA’s language might be seen as symptomatic of the legislation’s aversion to policies that critics might see as enacting “big-government” health care or “death panels.” It may reflect a certain xenophobia toward the kinds of approaches used in Britain, where the National Institute of Health and Clinical Excellence makes recommendations about technologies and services on the basis of cost-per-QALY thresholds. Reflecting this sentiment, the ACA creates a new CER institute that it labels “patient-centered” and states that the findings of PCORI-sponsored research cannot be construed as mandates for practice guidelines, coverage recommendations, payment, or policy recommendations.

The ban on using cost-per-QALY thresholds also seems to reflect long-standing concerns that the approach would discriminate on the basis of age and disability. The worry is that the metric unfairly favors younger and healthier populations that have more potential QALYs to gain.

To be sure, there are legitimate debates about the role of QALYs as the sole benchmark of health gains for purposes of allocating society’s resources. However, acknowledging the measure’s limitations, panels in the United States and Britain and at the World Health Organization have found QALYs preferable to alternative measures of health improvement.

QALYs simply give priority to interventions that offer the most health benefit in terms of measures people care about — more time spent in good health. In fact, populations with more impairment typically fare better in cost-effectiveness analyses, because they have more to gain from interventions; for example, it is generally less cost-effective to screen or treat healthier persons than persons who have poorer health at baseline or who are at greater risk for complications.

Moreover, a ban on valuing life extension presents its own ethical dilemmas. Taken literally, it means that spending resources to extend by a month the life of a 100-year-old person who is in a vegetative state cannot be valued differently from spending resources to extend the life of a child by many healthy years. Though the ACA may be seeking to avert discrimination, it instead helps to perpetuate the current system of implicit rationing and hidden biases.

The antagonism toward cost-per-QALY comparisons also suggests a bit of magical thinking — the notion that the country can avoid the difficult trade-offs that cost-utility analysis helps to illuminate. It pretends that we can avert our eyes from such choices, and it kicks the can of cost-consciousness farther down the road. It represents another example of our country’s avoidance of unpleasant truths about our resource constraints. Although opportunities undoubtedly exist to eliminate health care waste, the best way to improve health and save money at the same time is often to redirect patient care resources from interventions with a high cost per QALY to those with a lower cost per QALY.4 At a time when health care costs loom as the greatest challenge facing our country’s fiscal well-being, legislating against the use of the standard metric in the field of cost-effectiveness analysis is regrettable.

The ACA states that the PCORI is intended to assist patients, clinicians, purchasers, and policymakers. Yet a ban on cost-utility analysis would leave decision makers with less information with which to compare the relative effects of interventions across diseases. The ACA states that PCORI-produced CER is intended to inform, not mandate, decisions. Why, then, be so prescriptive about costs per QALY? Better to simply develop and disseminate the information and let decision makers choose whether or not to use it and in what settings. Decision makers could consider cost-per-QALY ratios alongside other criteria, such as the priority of an intervention for vulnerable populations and concerns about equity and fairness. How can our market-driven health system work efficiently if participants lack information about the relationship between the costs and benefits of health interventions?

As the country searches for ways to curb health care spending, consideration of the cost-effectiveness of health interventions will unavoidably be part of the health care debate, alongside considerations of possible payment- and delivery-system reforms. The use of explicit, standard metrics such as cost-per-QALY ratios has the advantage of transparency and can help direct our resources toward the greatest health gains. These kinds of analyses will therefore endure as a rough benchmark of value and as a normative guide to resource-allocation decisions. It would be unfortunate if the ACA created a barrier to their development and use.

Disclosure forms provided by the authors are available with the full text of this article at

Source Information
From the Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center (P.J.N.), and the Department of Health Policy and Management, Harvard School of Public Health (M.C.W.) — both in Boston.


1.The Patient Protection and Affordable Care Act. PL 111-148. 3-23-2010.

2.Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB. Recommenda-tions of the Panel on Cost-effectiveness in Health and Medicine. JAMA 1996;276:1253-1258
CrossRef | Web of Science | Medline

3.Neumann PJ, Greenberg D. Is the United States ready for QALYs? Health Aff (Millwood) 2009;28:1366-1371
CrossRef | Web of Science | Medline

4.Weinstein MC, Skinner JA. Comparative effectiveness and health care spending — implications for reform. N Engl J Med 2010;362:460-465
Full Text | Web of Science | Medline

Retrieved October 13, 2010 from
Legislating against Use of Cost-Effectiveness Information

If you vote for my opponent, puppies will die

From the Illinois Governor's race

Gov. Pat Quinn may be a supporter of the right to abort humans, but when it comes to the killing of puppies he’s adamantly pro-life. And that’s what really counts, right?

Via Outside the Beltway ( and First Things (

Wednesday, October 6, 2010

Intellectual rigor and reasoned loyalty

A beautiful reflection on reason, dissent, assent, and loyalty by First Things/The Anchoress blogger Elizabeth Scalia, author of Caring for the Dying With the Help of Your Catholic Faith. I love the expression about intellectualism pickled in its own ego!

The Reasoned Loyalty of Catholicism
Oct 5, 2010
Elizabeth Scalia

In the weeks leading up to the beatification of John Henry Newman, more than one writer asked whether the Anglican convert might be embraced by some, particularly by progressives, as “the patron saint of dissenters.” Newman’s willingness to launch his spacious intellect into debate within the church was so glamorous to contemplate that some writers lost sight of the fact that what is now called his dissent, honed by his openness, was always exercised in full conformity with the church's teaching. Loyalty, as it were, not only won out, it was the ground of this dissent.

Intellectual rigor and loyalty are not mutually exclusive, as some progressives are prone to insist. What Newman models is, perhaps, a willingness to apply one’s own intellect to any question with enough openness as to leave room to be surprised at one’s own conclusions.

In that sense, Newman is hardly the first prominent Catholic to wonder “yes, but . . .” and then prostrate. Dorothy Day was able to reason with such openness, and she self-identified as “an obedient daughter of the church.”

Reasonable Catholicism is reasoned loyalty, or sometimes even loyalty with gritted teeth; it is loyalty that insists upon the application of reason lest its value be questioned. By the same token, intellectualism that is not tempered with loyalty ends up pickling itself in its own ego. Either one, by itself, is incomplete. Both are required.

This openness is the difference between reading Paul’s words to Timothy that women “will be saved in childbearing, provided [they continue] in faith, love and holiness” and either rejecting them as the discriminatory and archaic utterances of a misogynist, or grimly trying to conform to the stricture without question, which may also mean without understanding, and possibly without charity.

Believing that nothing in Scripture is accidental, Catholics are obliged not to sneer, but to wonder about the theology behind Paul’s words and to discern what in that surprising verse is worth pondering, in an era where human life is held cheap. Can we discern within the verse a notion that women are, in God’s sublime and mysterious mercy, privileged in their ability to assist God in his continual re-entering into our world, disguised as he is within that helpless, vulnerable, and unconditional love that instantly forms between mother and child, father and child, siblings, and grandparents and child?

If we can openly allow ourselves to reason upon the foundational stipulation that God wants only our Good, we can surprise ourselves with our conclusions. Suddenly “misogyny” looks like an expedient and human explanation, and blind obedience looks so unsatisfyingly empty; the whole verse is suddenly fraught with a deeper, holier and ultimately more idealistic meaning than either the intellectualist or the unquestioning loyalist could have imagined.

The church is egalitarian in whom it regards as holy; the canon of saints includes the highly educated Augustine and the loyal little bourgeoisie known as Therese and calls both of them Doctors of the Church. She recognizes that intellectual gifts are only remarkable because they are, in fact, gifts, conferred over a lifetime, as with Newman, or spontaneously bestowed, as upon Catherine of Siena.

When intellectualism and loyalty are open each other, all understanding is enlarged. The first without the second breeds cynicism, and the second without the first tempts it. And both breed complacency and self-satisfaction, and close us off from the mystery.

Sometimes, the commingling of faith and reason is a neat and natty thing. More often it is a bit messy, but once our intellects have thrashed a matter to its frayed ends, we realize that we have stumbled into mystery and then, if we are open, we (very reasonably) throw our hands up to heaven and submit to it, because we know mystery for a good adventure, and we are loyal to it.

It is a loyalty that peers into a mirror, darkly, but is never wholly blind.

Elizabeth Scalia is a contributing writer for FIRST THINGS. She blogs at The Anchoress.

Retrieved October 5, 2010 from

John Henry Newman An essay in aid of a grammar of assent

Sunday, October 3, 2010

The argument over pregnancy - Tollefsen

The Argument Over Pregnancy – And Why it Matters
by Christopher O. Tollefsen

October 1, 2010

Accepting the “liberal” definition on pregnancy can actually help clarify the morality of contraception, abortion, and embryo adoption.

Liberals and conservatives sometimes spar over the definition of pregnancy. Some liberals define the term as meaning the period from implantation of an embryo in a mother’s womb forward. Conservatives often define it as beginning at the point of conception. Quite a lot can seem to depend on the definition, since it can seem natural to think that a contraceptive, for example, works by preventing pregnancy, and an abortion by disrupting it. Thus, if pregnancy is not initiated until implantation, and an abortion disrupts pregnancy, then drugs that prevent implantation would be considered contraceptive, and not abortifacient. Conservatives rightly resist this claim, and do so by contesting the meaning of pregnancy.

But a better strategy might be to accept the liberal definition of pregnancy, but reject the conclusions that purportedly follow from it. On three issues—contraception, abortion, and embryo-adoption—I’ll argue that the liberal definition of pregnancy can actually help clarify what sound morality demands.

There are, after all, plausible reasons to think the liberal definition sound. Pregnancy signifies a relationship between the developing human being and his or her mother, but that relationship is not simply the relationship of being the mother of an embryonic child. Mothers of embryos conceived through in-vitro fertilization (IVF), for example, are not pregnant while their children are in Petri dishes. Nor does it seem to be enough simply for an embryo to exist within some part of a woman for the woman to be pregnant. We are inclined to think that in pregnancy the embryo or fetus isconnected to the mother in a special way. So, plausibly, a mother becomes pregnant, as liberals think, at the time that the embryo implants in the mother’s womb. At that time, in addition to being a mother of a child, the woman also stands in a uniquely intimate biological relationship of nurturing and sustenance to the developing child, a relationship it makes sense to call “pregnancy.”

But why do liberal proponents of this definition think that it has consequences for understanding the difference between contraception and abortion? The answer, it seems, lies primarily in their misunderstanding of the nature of contraception. For contraception is not a practice whose purpose is the prevention of pregnancy, but a practice whose purpose is the prevention of the conception of a new human being. Consider: someone who prevents an embryonic human being from being implanted in a woman after IVF is not reasonably thought to be contracepting. Someone contracepts only if they intend to prevent a human being from coming into existence—they act contra-conception.

So the questions surrounding whether the so-called “week-after pill” Ella—or the contraceptive pill, or an IUD—operates only as a contraceptive really has very little to do with pregnancy. The real question is whether they work exclusively by preventing possible human beings from coming into existence, or whether they ever work by making it impossible for already existing human beings to continue to exist. If they do the latter, they are not exclusively contraceptive.

What about abortion: is it not a disruption of pregnancy? Interfering with the life of a not yet implanted embryo usually takes the life of that embryo, yet it does not, if we accept the liberal definition of pregnancy, terminate a pregnancy. Does this make it difficult to say that drugs or devices that take the life of a pre-implantation embryo are abortifacient? One approach to the question of what abortion is might say yes.

This approach identifies abortion, or direct abortion, precisely as the intentional ending of pregnancy. But even apart from the question of how pregnancy is to be defined, this is a bad definition of abortion. Ending a pregnancy seems neither necessary nor sufficient for a procedure to be an abortion. Not necessary, because an embryo or fetus could be removed from the mother, thus ending the pregnancy, precisely to save the child’s life, if, for example, the mother was incapable of sustaining the child in the womb. Not sufficient because an embryo or fetus could be aborted without the mother’s pregnancy ending. This, sadly, is what happens when mothers undergo “selective reduction” of embryos when they are carrying multiple children. These mothers abort, but remain pregnant.

It seems more plausible to think that abortion causes the death of an unborn child, and that a “direct” abortion is an intentional killing of the unborn child. Not only does such a definition avoid the problem cases just mentioned, it draws attention to what is wrong with abortion in a way that the “ending of a pregnancy” definition does not. For while ending a pregnancy is, just as such, a serious matter—under most circumstances, mothers surely owe it to their unborn children to provide them with a uterine home until birth—the wrong of direct abortion is, more specifically, the wrong of intentionally killing one’s unborn child, not the wrong of expelling it from the womb.

Moreover, the distinction allows one to acknowledge that there might be cases in which only the ending of pregnancy was intended, and not the death of the child. Would this justify ending a pregnancy if the intention was not to kill? In almost every imaginable case, no: For to accept the death of one’s own child as a side effect of ending one’s pregnancy is unjust in every circumstance except when otherwise both the mother and child will certainly die. So while direct abortions are always wrong on this account, indirect abortions—the kind that are a result of ending pregnancy—are also wrong in the overwhelming majority of cases. Moreover, it would seem reasonable to adopt, as a convention, the practice of referring to all procedures that take the life of an unborn human being, whether intentionally, or indirectly but unjustly, simply as “abortions”: it would then be fair to say that all abortions are morally impermissible.

And yet, some problem cases will, arguably, be settled in a different way. Consider the use of methotrexate when used to address a tubal ectopic pregnancy (methotrexate is also used for “elective” abortions). Given where the embryo has implanted, if nothing is done both mother and child could die. Methotrexate works by inhibiting the growth of the trophoblastic tissue that connects child to mother. It also inevitably results in the death of the embryo. Its use seems to fall into the category of “intentionally ending pregnancy,” yet not into the category of “intentionally killing an unborn child.” Thus, if a mother’s life is truly at risk, and there is no possible way to save the child, then deliberately ending a tubal pregnancy by use of methotrexate might not be an instance of “direct abortion,” i.e., not an instance of intentional killing of an unborn child, and might, in fact, be an instance of rightly accepting death as a side effect. But this possibility is likely to be overlooked if abortion is equated with the intentional ending of a pregnancy.

Consider a third case: the question of embryo adoption and rescue, a vexed issue among many conservative bioethicists. Sound moralists acknowledge that one should never separate the unitive and the procreative aspects of the marital act; in other words, marital sexual acts should be open to new life; and new life should not be created outside the performance of marital sexual acts. But neither, the philosopher Mary Geach has argued, should the marital act be imitated in respect to either function. And so the question arises whether, in making a woman pregnant by implanting the biological child of another, the act of transferring an embryo to the womb of a woman imitates the marital act, for, in Geach’s words, in both the marital act, and in embryo transfer, the woman performs an act “of a generative kind.”

Several philosophers have pointed out, however, that the act of transferring an embryo to a womb is not, in fact, an act of a generative kind. It is an act of an impregnating kind, to be sure, but the generation has already been accomplished, and it is the generative significance of conjugal intercourse—the capacity of sexual union to result in a new human being—that is essential to its unitive significance—the capacity of the marital act to make the spouses “one flesh.” It is not, in other words, the “capacity to make pregnant” that makes man and woman one flesh but rather the capacity to generate new life.

In consequence, the transfer of a human embryo to the womb of a woman who is not that child’s biological mother, whether to rescue the child from the absurd fate of cryo-preservation, or as the first step of a process of adoption, does not imitate the marital act in respect of any of its proper functions. The liberal definition of pregnancy helps us see this because it makes clear that generating a child, and being pregnant with a child, are two different realities.

Yet accepting this definition does not result, I have shown, in the false claim that a process that prevents implantation of an embryo is thereby “merely” contraceptive. And this definition can help us see that there are some procedures which end a pregnancy but are not acts which intentionally take the life of an unborn child. Acts of the latter sort are intrinsically wrong and always morally impermissible, but some acts of the former sort may be morally permissible when otherwise both the mother and child will certainly die.

Christopher O. Tollefsen is Professor of Philosophy at the University of South Carolina and a senior fellow of the Witherspoon Institute. His latest book, co-authored with Robert P. George, is Embryo: A Defense of Human Life (Doubleday, 2008). Tollefsen sits on the editorial board of Public Discourse.
Copyright 2010 the Witherspoon Institute. All rights reserved.
Retrieved October 2, 2010 from

Unless you become like little children... Kyrie - Missa de Angelis

From Vol.1 of Gregorian Chant for Kids, designed for teaching children Gregorian Chant. Go to

A most beautiful song - Ave Maria (Schubert) - Andrea Bocelli

Kyrie eleison - Gregorian chant by Benedictine Monks

Deepak Chopra on Beliefs--Other than His Own!