The Bioethical Dilemma Of The Mother’s DNR Revisited, And More Fetal Rights Ethics Confusion [UPDATED]

In Part 2 of the New York Times editorial board’s examination of the ethical and legal complexities of conflicting laws protecting the right to kill a fetus, the rights a fetus does have, and the mother’s rights, the question is posed:

Katherin Shuffield was five months pregnant when she was shot in 2008. She survived, but she lost the twins she was carrying. The gunman, Brian Kendrick, was charged with murdering them. Bei Bei Shuai was eight months pregnant and depressed when she tried to kill herself in 2010. She was rushed to the hospital and survived, but her baby died a few days later. Ms. Shuai was charged with murder.

Both cases are tragedies. But are Ms. Shuai and the man who shot Ms. Shuffield really both murderers?

It is an ethical question, a legal one and a logical one. Unfortunately, and typical of the entire series, the Times cannot play straight, or begin with basic principles. No, the questions is asked with an assumption in hand: the right to abortion must trump everything, even logic and justice The editors go on:

“Ms. Shuai is one of several hundred pregnant women who have faced criminal charges since 1973 for acts seen as endangering their pregnancies, according to National Advocates for Pregnant Women, which has completed the only peer-reviewed study of arrests and forced interventions on pregnant women in the United States. In many cases, the laws under which these women were charged were ostensibly written to protect them. Ms. Shuai, for instance, was charged under a law that was stiffened after the attack on Ms. Shuffield.

These criminal statutes are results of a tried-and-true playbook, part of a strategic campaign to establish fetal rights, reverse Roe v. Wade and recriminalize abortion. The sequence begins with anti-abortion groups seizing upon a tragic case in which a woman loses her pregnancy because of someone else’s actions. Public outcry then helps to strengthen a state feticide law that recognizes such lost pregnancies as murder or manslaughter. It’s a backdoor way of legally defining when life begins.”

In other words, the Times relies on ideology to duck an ethics conflict that points in a direction that radical abortion advocates don’t like, and thus refuse to acknowledge, because they don’t have a good answer for it. Here’s my answer: Yes, they are both murderers. If a mother who is gestating a child that she and her husband intend to have, and the child is killed by the act of a third party, a human being has been murdered, and charges are just. In the Sheffield case, her twins were within the protection of abortion limitations, though I would hold that this doesn’t matter, if they were both going to be delivered. If you don’t call this a murder, then a manic could perform an involuntary abortion on a 9 month’s  pregnant women, ripping her fetus out of her with murderous intent, and still face no murder charges as long as the mother recovered. Were it not that all obstacles to abortion must fall, even logical ones, no woman, no human being would call such an act anything but murder. Once any rights are assigned to the unborn at all, however, such logic is impolitic.

A law cannot reasonably make the same act on the part of one individual murder that is not even considered homicide when performed by another. The woman who killed her viable fetus in a failed suicide attempt is a murderer for the same reason the twin killer is.

In the6th and  latest installment of the series, the Times returns to a real ethical mess, one that is akin to the suicidal mother problem. I discussed the case extensively in 2014. What happens when a pregnant woman’s legal end of life decision will result in the death of her unborn child? More important for Ethics Alarms, what should happen? In twelve states, pregnancy-exclusion laws prohibit doctors from following a pregnant woman’s wishes to remove life support from her own body.. In 19 others,  laws limit women’s  rights  to dictate their own end-of-life decisions if it will kill or risk killing a viable fetus.

Again, the Times writes with its pre-baked viewpoint obvious and unyielding. Of course a viable unborn child’s life should be rendered inferior and disposable by the mother’s right to, for example, avoid pain. But saying the solution to an ethical conflict is obvious doesn’t make it so.

In the fall of 2013, Marlise Muñoz was 14 weeks pregnant with her second child when she collapsed in her North Texas home. She had suffered a pulmonary embolism from a blood clot, and it was essentially fatal. Brain scans showed no activity. She was clinically dead, being kept alive by artificial means. Marlise Muñoz was  a paramedic, and had seen what being kept alive on life-support meant. Her mother said that she had once told her, “Under no circumstance do I ever want to be on life-support.” (Was she thinking about the situation where life support would allow her child to live?) Muñoz also had a bright orange D.N.R. sticker on her paramedic name badge—but resuscitating her wasn’t the issue now.  She hsdn’t thought of having a “Don’t let my child be born”  sticker on her badge. How do we know she would have wanted one?

The Times writes, misleadingly and manipulatively,

“So when Ms. Muñoz’s heart would not keep beating on its own in Fort Worth’s John Peter Smith Hospital that November day, it was obvious to everyone — her relatives and her medical team — what the patient’s wishes were.”

False. How could they possibly know her wishes regarding a horrible choice that she may never  have considered. My guess, and it is a guess only, would be that Muñoz, like most mothers, would be willing to suffer great pain to allow her child to live. To painlessly allow her child life—the mother was dead, after all, and not even being inconvenienced—would be an obvious choice, would it not? A real no-brainer. (Sorry.) It seems to me that the father and the family didn’t want the burden of a motherless child.

A lawyer for the hospital, , however, maintained that the state’s end-of-life law applied, noting that the Texas Penal Code’s definition of a human being had been updated in 2003 to include an “unborn child at every stage of gestation” and the hospital could be charged with criminal homicide if it caused the death of a fetus. Muñoz’s life support remained connected to allow the fetus to continue gestating.

The family sued the hospital to cut off life-support, and in late January 2014, a judge ordered the hospital to discontinue life-sustaining measures, and his orders were carried out, killing the five month old fetus.

I am not at all sure this was an ethical decision (I have no opinion whether it was a legal one.) The Times editors, however, rig the argument and prevent fair consideration of the issues involved. They note that it was ultimately determined that the fetus was not viable. That’s moral luck, and irrelevant to the ethical issue. They tell us that demonstrators outside the hospital harassed the family, and that the family received death threats. What does that have to do with whether the unborn child’s life should be accorded higher priority than the condition of the mother’s corpse or the uncertain wishes of the deceased?

“People would say, ‘How could you pull the plug on your daughter?’” the Times quotes the woman’s mother as saying. “You weren’t walking in my shoes. And we knew her wishes.” Again, no, they really didn’t and the issue wasn’t killing the daughter, who was dead. The issue was, if the Times pro-abortion advocates posing as journalists would allow it printed, pulling the plug on another life, the unborn child’s. The Times concludes,

“The Muñoz case illustrates what’s at stake when the distilled ideology of the anti-abortion movement makes its way into the laws of the land. Statutes that give fetuses more rights than the women who carry them are bound to lead to heartbreaking outcomes when applied in the real world, however infrequently.”

Again, this false, and dishonest analysis to preserve a desired position. The editors are the ones distorting the issue with a “distilled ideology.” Apparently an unborn child dying in the womb when it could be born and allowed to have a life isn’t heartbreaking, because, you see, it doesn’t matter. It can’t be allowed to matter, because once we start thinking of it as a human being, the ethics get complicated.

14 Comments

Filed under Bioethics, Childhood and children, Ethics Alarms Award Nominee, Government & Politics, Health and Medicine, Journalism & Media, Law & Law Enforcement

14 responses to “The Bioethical Dilemma Of The Mother’s DNR Revisited, And More Fetal Rights Ethics Confusion [UPDATED]

  1. Glenn Logan

    “The Muñoz case illustrates what’s at stake when the distilled ideology of the anti-abortion movement makes its way into the laws of the land. Statutes that give fetuses more rights than the women who carry them are bound to lead to heartbreaking outcomes when applied in the real world, however infrequently.” [my emphasis]

    How about statutes that give unborn children the same rights to life as the mother then? I get that this is a transparent appeal to emotion, but if we are to value life at all during the continuum of gestation, don’t we have to decide at what point we value it?

    Suppose the mother had been 9 months pregnant. Would the parents still have sued for the discontinuation of life support? If so, an undelivered baby would still have perished.

    My point is, is there any place along the gestation timeline in hypothetically similar cases where the editors of the Times would say, “We have to try to save the child at this point, because it’s the right thing to do”?

    I’m guessing not, as gruesome and inhuman as that sounds. All of which makes the Times view of the right to abortion look, for all the world, as a right to murder.

    Which of course, it is. It cannot be otherwise, logically.

  2. If you do not value human life from the moment of conception, such problems will always exist.

    The old ‘blob of cells’ argument continually lost ground as medical science advanced during the 1970s and 1980s. As ultrasound and, later, photography, began to show normal Americans what the child looked like, how they acted, and (most importantly) how the child acted when aborted, fewer and fewer believed that a baby magically became human, endowed with rights and protections, at the moment of birth. This swing in much of the general population’s perceptions threatened Democrat political power, and caused the left to dig deeper into the hill they are willing to die upon.

    As it became possible to care for a child outside the womb earlier in gestation, the question of when the blob of cells became human became even more problematic from an debater’s point of view. Where once we debated opinion and the left cited scientific ‘fact,’ the right slowly gained the scientific fact, and the left decided to no longer debate at all.

    In the early 1990s the worshipers of Moloch- I mean ‘selfish political hacks -I mean ‘pro-abortion advocates’ – went from science believers to science deniers: it no longer mattered how science refuted their arguments: supporting abortion on demand became absolute. Thus abortion became a holy sacrament, a litmus test, in the religion of socialism. Progressive politicians either accept the pronouncement or were removed from power. This dogma cannot be questioned, and anyone who disagrees has progressed from ‘deplorable’ to ‘evil’ to ‘Nazi’ in the progressive lexicon.

    Where are we to ethically draw the line? As it has become clear that science will keep progressing with the ability to nurture a child outside the womb at earlier and earlier gestational dates, the only ethical stance can be that a baby is human from the moment egg and sperm combine.

    Any other stance depends upon state of the art medical status quo which changes every year, or upon an arbitrary stance for political convenience.

    • Glenn Logan

      Where are we to ethically draw the line? As it has become clear that science will keep progressing with the ability to nurture a child outside the womb at earlier and earlier gestational dates, the only ethical stance can be that a baby is human from the moment egg and sperm combine.

      This is a tough one for me. The ability to gestate a human in a test tube from a fertilized egg does not necessarily mean the fertilized egg is what we would colloquially call a “human.” Scientifically, it indisputably is because of the genetic composition, but when we discuss “human” in the common meaning, I don’t know if a group of largely undifferentiated cells qualify.

      My religious upbringing would bring me to your conclusion, but my scientific training is in conflict. It is a conflict that I have been unable to resolve.

      • Glenn,

        The very fact that you think about it places you miles above anyone on the left at all. There is no conflict for them at all, simply because it is an article of faith.

  3. I have very strong opinions about a D.N.R..

    Marlise Muñoz was quoted as saying, “Under no circumstance do I ever want to be on life-support.”

    Jack asked, “Was she thinking about the situation where life support would allow her child to live?”

    The answer is ethically, morally, and legally clear to me; the question is not relevant, a D.N.R. is 100% clear. The language she used was unambiguous. She made her choice when she was of sound mind and body, her wishes were 100% consistent across her personal and professional life and there is no evidence that she changed her opinion because she was pregnant, “under no circumstances” in conjunction with the D.N.R. makes everything absolutely clear. They should have followed the mothers wishes and pulled the plug.

    Just because we have the technology to keep people alive well beyond the natural life capabilities of any particular human body doesn’t mean that it’s ethically or morally sound for us to force that unnatural life sustaining technology upon others; we are not God.

    I’ve had a D.N.R. for over 30 years and I too have used the phrase “under no circumstances” and I expect my wishes to be honored. I’ve stipulated to allow my wife and children that are in close enough physical proximity (within an hour or two – no more) to have physical closure then allow me to go in peace. I’ve had a good life and they all know I love them.

    • Glenn Logan

      I think you make some fair points, although I do have an issue with the term, “under no circumstances.”

      As Gandalf related to Frodo Baggins in the Lord of the Rings, “Even the very wise cannot see all ends.” When we foreclose possibilities without the ability to see the consequences, I think that has ethical repercussions. This is such a case.

      Whenever we drop into absolutism, as fallible human beings we open ourselves up to unintentional, unethical and even evil consequences. Such declarations exceed our wisdom, and I think we’d do well to recognize that.

      • Glenn Logan wrote, “When we foreclose possibilities without the ability to see the consequences, I think that has ethical repercussions.”

        Using that argument no one should have a D.N.R. and they should just be satisfied with whatever consequences they might be stuck with by someone else making life choices for them when they are in a possible end of life situation.

        There are ethical repercussions of creating a will too; in fact there are repercussions to almost every choice we make in life but we still must make choices.

        No one can foresee all possibilities, that’s why we choose to make life choices based on our own knowledge, our own personal opinions, our own morals, our own ethics, and our own perception while we are of sound mind and body.

        We should respect and honor D.N.R.’s.

        • Glenn Logan

          Using that argument no one should have a D.N.R. and they should just be satisfied with whatever consequences they might be stuck with by someone else making life choices for them when they are in a possible end of life situation.

          I’m certain I wouldn’t go that far. I do think unequivocal language, like “under no circumstances” should be … thought out more. Surely a more nuanced DNR would be possible to accommodate unforeseen but important developments on the way to end of life. I have a DNR, but “under no circumstances” is not present in the declaration. That may need rethinking, as it may be implicit.

          There are ethical repercussions of creating a will too…

          Indeed, I can’t disagree there. Choices must be made, for sure, and no effort is going to cover all circumstances. We just have to do the best we can.

          I agree with you that we should respect and honor DNR’s, but I don’t think I can agree that we should do it at the cost of another life. Perhaps that should be the only exclusion I would accept, I don’t know, and even then, I’m not sure the first months of a pregnancy would trigger such a modification.

          It’s a difficult ethical problem.

  4. Mrs. Q

    “Suppose the mother had been 9 months pregnant. Would the parents still have sued for the discontinuation of life support?”

    Here in Oregon a mother can abort a 9 month fetus for no other reason than not liking the sex of the baby, so I guess it would just depend on the state you lived in.

  5. Isaac

    When you set up a “peculiar institution,” you end up with peculiar legal and ethical quandaries

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