Bioethics class visits neonatal facility (Culture of Death Alert!)

Princetonian ^ | November 15, 2004 | Elyse Graham

[NYer]

    Inside the neonatal intensive care unit of a Metuchen hospital, a jungle of machines surrounded a two-hour old baby gasping shallowly. Tubes from one machine sent a steady stream of air pressure down her nasal passages, preventing her tiny airways from collapsing. Intravenous pumps and catheter tubes entered through her belly button, delivering nutrients to her bloodstream and energy pulses to her heart. A screen nearby showed continuous readings of her cardiac function, respiration and oxygen saturation level.

    Around her at Saint Peters University Hospital on Friday were 13 Princeton students, members of bioethics professor Peter Singer's "Ethical Choices" freshman seminar.

    Singer had brought his students to the ward to show them the living faces of a medical debate featured prominently in his scholarship and his seminar: whether it is ethical to end an infant's life when medical data predict she has a low chance of surviving.

    The students, excited as they entered the hospital, turned somber as they walked through the ward. Other infants were similarly surrounded by life support machines, and the philosophical debates previously held in class had become a stunning reality.

    "Everyone came in very bouncy and energetic, and I thought, 'Wow, these people have no idea what they're getting into,'" said Jennifer Calise, a young mother cradling her one-year-old daughter, a former ward patient who had come for a checkup. "Now they all look a little shell-shocked."

    Born 14 weeks premature, the 2-hour-old infant the class had come upon had a slim chance of surviving, let alone growing up without mental and physical impairments. Because of these defects, Singer argues the infant's parents should be able to decide whether to shut off her life-support machines and end her life. That claim, based on a belief that a young baby is not self-aware, has generated widespread controversy across the world.

    Division of Neonatal Medicine Director Dr. Mark Hiatt had led the class to this tiny red infant. Up close, the class could see her small forehead muscles contracted, eyes squeezed shut. As she breathed, her abdomen sucked in and out ferociously.

    "This is one of the smallest babies we've ever had," Hiatt said. At nine inches and 365 grams, she could easily fit in the palm of an adult's hand. (A baby in the 50th percentile of births would weigh 960 grams.)

    Though he said the infant's fate was dependent on "literally minute-to-minute, hour-to-hour" reevaluations, Hiatt maintained that she was fully human and rejected Singer's view of what makes a baby's life worthy of continuance.

    "This is a child. Somebody's daughter," Hiatt said. "Hopefully she'll be with us for many weeks and eventually go home with her mother and father."

    But the presence of Singer and his class made things less clear.

    "Is it ethical to keep a baby alive without the chances of it being healthy and able to go to public school, whether a special school or not, or whether it would hurt the baby and everyone involved?" Courtney Mazo '08 said on the bus ride to the hospital. "Who makes the decisions to keep going with care, and what do you do if the parents and doctors conflict? And when is it better to refuse care instead of doing everything you can?"

    But, she noted, with medical advances, premature infants can live longer. Other questions — such as cost of treatment and quality of life — nevertheless remain.

    Hiatt described his struggles with the issue for the class. Once, he said, a family asked him to withhold care for their premature baby because of financial reasons. The father was in graduate school and had a young family already. Hiatt asked them to seek another hospital.

    "We [at St. Peter's] don't want to do all this aggressive, heroic intervention unless there's a good possibility that this will be an intact, healthy child," he said. "[But] I could never do anything to terminate a [healthy] life. I became a doctor for the opposite reason."

    Hiatt said he would not allow a baby to die by any means except withdrawing care, called passive euthanasia.

    "As a society, I don't think we want our doctors to [perform active euthanasia, where the doctor directly ends someone's life]," he added. "I wouldn't do it. I couldn't do it. . . . I'm not an executioner."

    Not all students, however, accepted Hiatt's reasoning.

    In discussion on the bus ride home, class member Nic Poulos '08 called Hiatt's distinction between active and passive euthanasia "semantics."

    "He's enabling the child's death, period," Poulos said. "He didn't say, 'Yes, [my position is] based on guilt, but he did say, 'No, I couldn't do that.'"

    Singer played his usual Socratic role in the discussion, speaking up only to inject questions or ask for clarification. When pressed, he agreed with Poulos.

    "I don't think there's a distinction between deciding to withdraw life and deciding to actively end it," Singer said. "[Hiatt] also has an attitude that you should try to save every life you can, regardless of circumstances. In the case of the grad student [who asked Hiatt to withdraw care from his baby] . . . it's still a human life, but it's a life that's barely begun. I would have been prepared to agree with the parents."

    Singer's has stirred much controversy with these views, with some groups labeling him a "baby-killer." Singer responds by saying that societies throughout history have used selective infanticide for the greater good.

    Singer also refuses to equate killing newborns with killing adults, saying newborns are not self-aware and therefore different from adult humans and animals worthy of protection.

    Some of Singer's students disagree with these views.

    Mazo, whose mother works as a neonatologist, said experience tells her it's "better for families" to make the most of even a brief time together.

    Such a time was all too brief for Calise, whom Hiatt introduced to the class as someone "who's been under the anvil."

    Calise was forced to confront the viability-of-life issue abruptly in February 2003, when her water broke early and doctors told her the fetus had a low chance of surviving. When Calise gave birth to her first child several days later, the newborn's prognosis was not good.

    "What we call viability is 24 weeks," said Dr. Denise Hassinger, who oversees Calise's care. "[Calise's first baby] came out at 23 weeks. And she could move, she could breathe and everything, but it was 23 weeks. So is it a person, is it not a person? There's a lot of legal and ethical issues involved."

    Calise had instructed the doctors to resuscitate the baby if it showed any chance of survival, but its premature birth, and a severe prenatal infection, suggested little use in trying to keep the baby alive. The baby, named Simone, died after support was withdrawn.

    "[My husband and I] have seen the miracle babies, and everyday we ask ourselves, did we do the right thing?" Calise said.

    Calise gave birth again in September 2003 to a baby named Ava. Though her second baby was also premature at 25 weeks, it was relatively healthy otherwise and doctors started care immediately. Calise proudly showed the class her cheerful, healthy daughter.

    When Hiatt encouraged students to ask Calise questions, they were hesitant. "I could see with the students, everyone was thinking 'Oh my God, is she going to have a nervous breakdown if I say her first child wasn't a person?'" Calise said later.

    After about 30 seconds, the first question came from Faruk Colakoglu '08.

    "Are [underdeveloped babies] children?" he asked.

    "What makes them a child?" Calise replied. "I mean, is it the fact that they breathe, or is there something else that tells you there's a life?"

[NYer]

First there was abortion, then partial-birth abortion—which is essentially infanticide—and now full-blown infanticide.

[NYer]

Princeton “bioethics” professor Peter Singer

2. Euthanasia

Often disguised by the name "mercy killing," euthanasia also is a form of homicide. No person has a right to take his own life, and no one has the right to take the life of any innocent person.

In euthanasia, the ill or elderly are killed, by action or omission, out of a misplaced sense of compassion, but true compassion cannot include intentionally doing something intrinsically evil to another person (cf. EV 73).
EV John Paul II, Evangelium Vitae (The Gospel of Life)


Voter's Guide for Serious Catholics

Catholic Ping - please freepmail me if you want on/off this list

[NYer]

the first question came from Faruk Colakoglu '08. "Are [underdeveloped babies] children?" he asked.

Class of '08 - a freshman in an Ivy League College and he doesn't "know" whether underdeveloped babies are children!

Pathetic!

[ClearCase_guy]

At multiple points in this article, the students feel sadness or trepidation in dealing with these sick children. Yet (some of the students) can rationalize their way to depersonalizing the children. Nope. Their emotions are correct. They feel sad and hopeless because they see sick children suffering. They know that this is what they see. Yet they try to "get past that" and talk about "ethical decisions" in which the children are either not human or not really living at all. Fools.

[DBeers]

I did not catch it -is this Peter Singer a 'Catholic'?

[GBA]

I tend to agree with you: their initial reactions and emotions are valid. Philosophy tends to give them the means to rationalize away those emotions and see the situation without the emotions that make us human. To be overly emotional wouldn't be helpful and to be without emotion wouldn't be human. Being able to decide with both one's head and heart should be the result of a philosphy class, imho.

[SilentServiceCPOWife]

Singer also refuses to equate killing newborns with killing adults, saying newborns are not self-aware and therefore different from adult humans and animals worthy of protection.

It's ok to murder human infants, but it's not okay to kill an animal.

[SilentServiceCPOWife]

I also think that part of it is that they feel intimidated by Singer and want to please him. After all, he is THE Peter Singer. (If you could hear me say that, you would hear the scorn in my voice.) It's a shame that they are willing to give up their humanity for a grade.

[Restorer]

In discussion on the bus ride home, class member Nic Poulos '08 called Hiatt's distinction between active and passive euthanasia "semantics."

This is accurate, depending on your definition of "withdrawal of care." I consider not putting a person on intensive life support equipment to be a moral, though tragic, choice in some circumstances.

However, withdrawal of care is often used to mean not giving food or water. In my opinion, this is just plain murder, except that most murderers are decent enough to not kill their victims very, very slowly.

If you are going to kill a baby, at least have the common humanity to do it in a human way. You can go to jail for an extended period for starving a puppy to death.

[Bikers4Bush]

If I had walked in to find ghouls like that around my now 6 year old niece who was born very premature there'd have been a war.

[NYer]

I did not catch it -is this Peter Singer a 'Catholic'?

Not to the best of my knowledge. Just wanted to post his 'mug shot' for all to see. He's been pursuing this path of 'post birth' abortion, for several years now. Didn't realize that he was on the teaching staff at Rutgers.

[NYer]

Ping! (this may interest your list)

[AnAmericanMother]

I am ashamed and embarassed that my alma mater has given this ghoul a professorship and a bully pulpit to preach his gospel of death.

[ClearCase_guy]

Philip K. Dick had a wonderful short story (The Pre-persons) in which the yardstick of "self-awareness" had morphed into "understanding of higher math (algebra)".

If a child were well-behaved, it was safe, of course. But disobedient children could be turned in by their parents. They'd be given a math test, and if they didn't do well, they would be "eliminated".

Eventually, a High School Math Teacher climbs into the Child Collection Van and professes that he doesn't really understand algebra that well and asks them what they will do about it.

The point: all such yardsticks are arbitrary and wrong. Human life is sacred, and it is not hard to identify "human life". Only evil people pretend that it's an intellectual challenge.

[Osage Orange]

bttt...for later reading.

[madprof98]

Singer's has stirred much controversy with these views, with some groups labeling him a "baby-killer."

You mean, just because he wants to see babies killed . . . they're calling him NAMES! That is just so mean! Why, it's hate speech, pure and simple.

[NYer]

It's ok to murder human infants, but it's not okay to kill an animal.

Just did a quick Google search on him ... oh brother! From The International Vegetarian Union web site ...

Peter Singer is now a Professor at Princeton University, USA. He was formerly Professor of Philosophy and Director of the Centre for Human Bioethics at Monash University, Melbourne, Australia. He is the author of Animal Liberation, which can be considered the Bible of the animal rights movement. Recently, he has been instrumental in the formation of the The Great Ape Project, which seeks to extend personhood and legal rights to the Geat Apes.

FULL TEXT

[NYer]

If I had walked in to find ghouls like that around my now 6 year old niece who was born very premature there'd have been a war.

Imagine your niece, as a college student, attending his class! Hope she develops a strong right arm swing!

[kittymyrib]

Are there Christian medical schools whose graduating doctors would not murder "the least of these"? I don't want any of these moral midgets treating me or my family.

[SilentServiceCPOWife]

I often avoid reading things like that because I become so frustrated and angry. I sit and ask myself "How can people think like this?" over and over again and I can never find an answer. The only thing that can explain it is that they have no sense of right and wrong at all.