POC Blog

The random technotheolosophical blogging of Reid S. Monaghan

Living or Dying in the "Gray Zone"

Peter Singer, the famed (or infamous) "ethicist" from Princeton University has another wonderful meditation out on life and death.  Singer is somewhat of a hero to some and a demon to others for his views on the termination of babies who have severe problems at birth and perhaps up to two years of age...only if the parents "want to" of course.  Singer is a utilitarian at heart and in his thinking. By that I mean he is a consequentialist in terms of his ethical reasoning.  He makes decision about right and wrong based on his understanding of whether suffering will be limited and happiness extended.  Now you may ask "how does one know the future and what a decision will or will not bring?"  Welcome to the wonderful world of consequentialism.  Let me give you some examples in a dialogue:

Lifescape 1

Doctor No: Your baby's chromosomes are abnormal, you will have a child with down's syndrome.  What would you like to do?

Parent Happy Me: [thoughts] this means lots of trouble for us, lots of money we will have to spend to care and raise this child - that will quell our happiness and quality of life.

Doctor No: Most children with downs life very painful lives and die very young.  What would you like to do?

Parent Happy Me: [thoughts] Well, that child will suffer, will not be very happy...after he will not be "normal" and bullies will pick on him.  He will not have high self-esteem because people are mean.  I think we want a do-over.

Lifescape 2

Doctor No: You baby is severely deformed and mentally retarded.  He will probably only life a few years and will need constant medical attention from the highest of professionals.  We are not sure if he will be in pain or not, but his quality of life will not be anything like a normal human being.  What would you like us to do?

Parent Happy Me: [thoughts] This is very hard, what will our lives be like with this child.  But what is the right thing to do?  We need some expert advice

Captain Singer Ethical Crusader: Well, it may be ethical to "end the suffering" of severely challenged human like creatures if it will alleviate suffering and promote the welfare of the parents, and not burden society's resources.

Parent Unhappy Now: Do you mean kill the baby?

Doctor No:
Well, kill is a very loaded term, we like to say alleviate suffering for the common good.  To help society with unwanted burdens and make everyone's life better.  In reality, this is a very good thing you are doing for all involved.

Parent Sick to Their Stomach: We just don't know what to do...

Now Dr. Singer is weighing in on another potential problem we are seeing due to the advance of neonatal care and intensive units.  The survival of babies severely premature.  It is coming more common that children are surviving birth into the lower twenty week range (the range where abortions often take place).  Dr. Singer has written an op/ed piece over at the Council for Secular Humanism about one such astounding case (which people this is good by the way) of a girl named Amillia:

In February, newspapers hailed “miracle baby”Amillia, claiming that she is the earliest-born surviving premature baby ever recorded. Born in October at a gestational age of just twenty-one weeks and six days, she weighed only 280 grams, or ten ounces, at birth. Doctors did not expect Amillia to live, as previously no baby born at less than twenty-three weeks had been known to survive. But, after nearly four months in a Miami hospital’s neonatal intensive-care unit, and having grown to a weight of 1,800 grams, or four pounds, doctors judged her ready to go home.

These cases are problematic for Singer and like minded utilitarians.  You see, the care just to attempt and save one of these little ones is: 1) very expensive to society 2) will be very hard on parents and their happiness 3) should many not even be attempted in Singer's opinion.  So Singer's solution to this "problem" we face is to highlight research from out of the land of Australia which proposes a "gray zone" where doctors (see Doctor No above) should consult the parents on their "options" whether to treat the baby or not.  Now, we in no way can save every child - of course some will die with or without this care.  But what is troubling is Singer's disdain for the sentiment in America, that we ought to try and save everyone, despite the cost.  Some revealing portions of his essay.


In the United States, although the American Academy of Pediatrics states that babies born at less than twenty-three weeks and weighing less than 400 grams (14.2 ounces) are not considered viable, it can be difficult to challenge the prevailing rhetoric that every possible effort must be made to save every human life.

Emphasis added

So trying to save even the most hopeless cases is based only on rhetoric (empty, vacuous thinking, that has no basis in Singer world).  The essence of his reasoning is found in this paragraph.  I will highlight much of the sloppy thinking and crystal ball future predicting nonsense of some utilitarian reasoning:

In these circumstances, what should doctors—and society—do? Should they treat all children as best they can? Should they draw a line, say at twenty-four weeks, and say that no child born prior to that cut-off should be treated? A policy of not treating babies born earlier than twenty-four weeks would save the considerable expense of medical treatment that is likely to prove futile, as well as the need to support severely disabled children who do survive. But it would also be harsh on couples who have had difficulty in conceiving and whose premature infant represents perhaps their last chance at having a child. Amillia’s parents may have been in that category. If the parents understand the situation, and are ready to welcome a severely disabled child into their family and give that child all the love and care they can, should a comparatively wealthy, industrialized country simply say, “No, your child was born too early”? Bearing these possibilities in mind, instead of trying to set a rigid cut-off line, the workshop defined a “gray zone” within which treatment might or might not be given, depending on the wishes of the parents.

So here we are again - in the gray zone of life and death decisions which Singer says lands "on the wishes of the parents."  However, this is not very accurate.  We spent a week in the Neonatal Intensive care with our son Thomas in August, and I saw these very children. Tiny, precious, human persons.  In these scenarios the parents listen to the doctors. The parents are at one of the most vulnerable and most influenced places in their lives.  Saying it is "up to the parents" is a bit misleading as the parents will very much be influenced by the counsel from doctors and ethicists on these situations.  The question is which worldview will be brought to bear? The one who sees that all life is of equal value and dignity and worthy of our time and effort to love an nurture?  Or the one who thinks certain humans should survive based on their mathematical "good for society" calculations.  Some are amazed when they read of the eugenics movement which was common among intellectual elite less than 100 years ago in western culture.  We should not be surprised, as the seeds of that same thinking are alive and well today. It is found in the gray zone - a world created by people who desire to determine what kinds of persons shall live or die.  

(HT - thanks to Tim Dees for pointing me to the essay)