Deliberate termination of life of newborns with spina bifida, a critical reappraisal

Objects: Deliberate termination of life of newborns (involuntary euthanasia) with meningomyelocele (MMC) is practiced openly only in the Netherlands. 'Unbearable and hopeless suffering' is the single most cited criterion for this termination, together with the notion that 'there are no other proper medical means to alleviate this suffering'. In this paper, both (and other) statements are questioned, also by putting them in a broader perspective. Methods: First, a historical overview of the treatment of newborns with MMC is presented, concentrating on the question of selection for treatment. Second, a thorough analysis is made of the criteria used for life termination. Third, a case of a newborn with a very severe MMC is presented as a 'reference case'. Conclusion: 'Unbearable and hopeless suffering' cannot be applied to newborns with MMC. They are not 'terminally ill' and do have 'prospects of a future'. In these end-of-life decisions, 'quality of life judgments' should not be applied. When such a newborn is not treated, modern palliative care always will suffice in eliminating possible discomfort. There is no reason whatsoever for active life-termination of these newborns

Children: an inheritance from the Lord. Infanticide and the value of life

Arguing from preference utilitarianism, contemporary moral philosopher Peter Singer considers infanticide permissible because infants lack the cognitive capacity to prefer life over death. Christian theologians object that Singer’s general theory offers too thin a conception of ‘the good’, fails to recognise the dependence of value on purpose and abstracts moral value from common humanity. Few confront him directly on infanticide. Singer’s empirical claims are unconvincing, but scientific evidence alone cannot refute his judgement that the properties which normatively distinguish infants from adults (‘childness’) offer no inherent value. I argue that a Christian moral anthropology, too, privileges adultness over childness if it holds imagehood to represent properties such as rationality that adults have in common with God, but not with infants. I set out an alternative anthropology that draws on scripture, Christian eudaimonism, neuropsychological research, and the theology and philosophy of childhood. I suggest the value of present moral action in respect of any human is the extent to which it facilitates her vocation. I describe modes in which childness enables humans to flourish at any age, thus extending the range of cognitive properties that can confer personal value on the eudaimonist account beyond rationality to include many that infants possess. I conclude that, even while infants, humans have a vocation and are equipped both to flourish and contribute to the flourishing of others. Killing humans during infancy imperils human flourishing as decisively as during adulthood and is usually wrong, irrespective of individual capacity to prefer to live.</p