Regrettably, the topic of infanticide remains stubbornly in the news. Last week, for instance, we had the release of the LiveAction undercover tapes which seemed to indicate that newborns are at least sometimes refused medical treatment and care after a botched abortion in New York and Washington clinics.
Last week also saw the release of the May issue of the Journal of Medical Ethics, a special double issue on infanticide. (All articles are free and open access for the first two months here.) You may recall that last year JME published an an article titled ‘After-Birth Abortion: Why Should the Baby Live?’ which caused international outrage–and even saw death threats leveled at the authors and Julian Savulescu, the journal’s editor. JME has responded with an entire issue specifically devoted to the topic, and has heavy-hitters making contributions: Peter Singer, Michael Tooley, Jeff McMahan, John Finnis, Robert George, Francis Beckwith, and many more. In the issue, George and I continue our exchange about whether we should describe arguments for infanticide as “madness.” Those who are interested can read our (short) arguments by following the link above, but I’ve had an additional thought about this since writing those pieces.
We rightly condemn aiming at the death of newborns by action. This is what Gosnell did in his clinic in Philadelphia and this is for what many argue in the current issue of JME. But what the clinics seem to describe in the LiveAction video is a refusal to treat or offer care. And, quite frankly, the refusal to offer medical treatment and care to newborns in the NICU happens all the time. I speak here not of refusal of extraordinary treatment (which happens even more often and can be morally justified in some circumstances), but rather refusals to feed or resuscitate babies which aim at their deaths. Though sometimes an ethics consult is called, this “aiming at death by omission” goes on routinely without the sound and fury made over infanticide.
So, in this post I’m really trying to frame two questions–and would be particularly interested in feedback. First, is there a case to be made for the moral difference between aiming at death by omission and aiming at death by action? Second, if there is no moral difference, can we say that infanticide is madness without also saying that aiming at death by omission is madness?
And I guess I have a third question. What, if anything, do your answers to these first two questions mean for how we should talk about these issues in public?