[I am tired, having engaged in a knockdown, drag-out session on legal ethics with a lively group of Federal bar practitioners. This was not the issue I wanted to come home to for the last post of the day. In fact, I gave up and am posting it this morning. Funny, the issue isn’t any easier now than it was yesterday.]
A pregnant woman who was a Jehovah’s Witness checked into a Sydney, Australia hospital suffering from leukemia. She directed the staff that her treatment could not include blood transfusions, as her religious beliefs forbade them. She suffered from acute promyelocytic leukemia (APL), which is treatable, and often successfully. According to The American Cancer Society, “more than 90% of patients with APL go into remission with standard induction treatment.” Pregnant women with the cancer have an 83 percent remission rate, and their babies have a high rate of survival when their mothers are diagnosed in their second or third trimesters.
In the end, the fetus and the mother died for want of proper treatment. “Staff were distressed, grappling with what was perceived as two ‘avoidable’ deaths,” doctors at the Prince of Wales Hospital in Australia wrote in a letter published this month in the Internal Medicine Journal.
Well, they should be distressed: they aided and abetted negligent homicide.
The Australian doctors wrote that not giving the woman any blood products “undoubtedly contributed” to the deaths of the woman and her fetus, but that they didn’t give her any blood transfusions because “maternal autonomy was respected.” That’s maternal autonomy to get her own baby killed. This is not a case in which the mother, following current pro-abortion cant, had decided that her fetus was the equivalence of an annoying, career or convenience-obstructing wart or cyst, and thus should be excised as part of her sacred dominion over her own body. For the purposes of this issue, I’ll accept that intellectually dishonest construct, but that isn’t how this mother saw her unborn child.
She wanted it to live; she believed it was (as in fact it is) a living human being and not a wart or cyst. Under that set of facts, the hospital could not ethically do otherwise than pursue a course that maximized the chances of the child’s survival. The women, being in the thrall of a toxic, dangerous, reality-denying religion, may not have understood or believed that she was placing her child at mortal risk by insisting that he be left “in God’s hands” (ignoring the wise maxim “God helps those who let medical professionals help them”), but that was what was occurring, and the doctors knew it. Unfortunately for the fetus, they talked themselves into non-action.
“Refusal of a lifesaving intervention by an informed patient is generally well-respected, but the rights of a mother to refuse such interventions on behalf of her fetus is more controversial,” the doctors wrote. “A doctor indeed has moral obligations to both the pregnant woman, and perhaps with differing priority to the unborn fetus.”
This is self-serving blather. There’s no “perhaps” about it. The unborn baby isn’t a Jehovah’s Witness; the child requires protection from a deluded mother whose blind faith will kill him unless someone sane, responsible and zombified by an eccentric cult takes charge. In the U.S., that would almost certainly have occurred. The issue was settled, if not conclusively (states vary in their approaches), in the Supreme Court case of Prince v Massachusetts, where in another Jehovah’s Witnesses case, the majority stated…
The family itself is not beyond regulation in the public interest, as against a claim of religious liberty. And neither the rights of religion nor the rights of parenthood are beyond limitation…The right to practice religion freely does not include the right to expose the community or the child to communicable disease or the latter to ill-health or death…
Parents may be free to become martyrs themselves. But it does not follow they are free, in identical circumstances, to make martyrs of their children before they have reached the age of full and legal discretion when they can make that choice for themselves. Massachusetts has determined that an absolute prohibition, though one limited to streets and public places and to the incidental uses proscribed, is necessary to accomplish its legitimate objectives. Its power to attain them is broad enough to reach these peripheral instances in which the parent’s supervision may reduce but cannot eliminate entirely the ill effects of the prohibited conduct. We think that with reference to the public proclaiming of religion, upon the streets and in other similar public places, the power of the state to control the conduct of children reaches beyond the scope of its authority over adults, as is true in the case of other freedoms, and the rightful boundary of its power has not been crossed in this case.
It would be interesting to see if the fervent conservative advocates of the new religious freedom protection laws would want them to block government measures designed to protect the unborn when a religiously-addled mother regards her fetus as a human life and wants the child to be born, but by her actions is ensuring that it will not be. My guess is that we would see yet another hypocritical flip-flop on the Right.
There is no ethical basis by which the child should have been allowed to die because the mother refused treatment. Doctors are required to render medical aid to save lives, heal the sick, and to do so in a beneficent manner that “does no harm.” Allowing a baby who didn’t have to die to perish because of inadequate treatment is harm.
Providing excuses and cover for the Australian doctors is Columbia University Medical Center’s Cynthia Gyamfi, an associate professor of obstetrics and gynecology, who is quoted by the Washington Post as saying,
“[T]here’s “another ethical principle that comes into play in the management of a Jehovah’s Witness is nonmaleficence, or ‘do no harm.” Although a provider may believe that allowing a bleeding patient to die by not transfusing her with blood is clearly causing harm, a devout Jehovah’s Witness may perceive far more harm in the belief that eternal damnation will ensue from such a transfusion.”
If “do no harm” only means “do no harm including imaginary harm that the patient believes due to ignorance, indoctrination or insanity,” the medical profession’s bedrock ethics principle is nearly worthless.
The Australian doctors’ ethical judgment was warped by an excessive reverence for a woman’s right to choose stupidly, unreasonable submissiveness to demonstrably absurd religious requirements, and insufficient respect for human life and their own ethical standards.
The doctors allowed an unborn child to die, and that is indefensible.
[More on the issue here]
Facts: Washington Post