Slaughtering babies, ethically

January 24, 1996|By Katherine Dowling

LOS ANGELES -- In June 1994, the American Medical Association's Council on Ethical and Judiciary Affairs decided that the cannibalization of living babies for their organs was ethically permissible.

The infants put forward as the first lambs to the slaughter were born with a profound neurologic defect, anencephaly, in which the thinking part of their brains failed to develop, though the areas responsible for basic life functions like breathing and cardiac function did work, supporting life for weeks, months or longer.

A chronic shortage of infant parts for babies born with intact brains but bad kidneys or hearts pushed the council to take the pragmatic position that babies with no apparent cognitive ability can't have a life anyway, so their organs were fair game for infants whose defects were not in such a strategic location.

Most physicians could appreciate that taking organs from infants who were not brain -- or any other part -- dead would put a host of other humans at risk for involuntary dismemberment. It took a while, but these doctors finally prevailed on the council to put its cannibalization ethics on hold.

The face-saving reasoning for this ethical reversal? No one could be sure that anencephalic babies really lacked consciousness, and there was some overlap between supposedly anencephalic babies and others with similar neurologic defects.

This controversy within the American Medical Association brought to memory a baby I encountered long ago as a physician-in-training. He was a beautiful child, with perfectly formed features and an ear-splitting high pitched scream. I couldn't get him to look at me as most 2-month-olds would.

Wrapping his delicate little body in a blanket, we took him into a closet and put a flashlight to his head. The light shone clear through. Our little patient had a fluid-filled cyst where his brain should have been.

A new mother myself at the time, I dreaded having to tell his widowed mom what we'd discovered in that closet. This child probably ''lacked consciousness'' in its usually understood form and as such he may have approached the ethics council's criteria for becoming replacement parts.

With the council's ethical flip-flop, anencephalic babies are safe for a time. Not so their sisters and brothers in utero.

Built-in obsolescence

Humans are constructed with a built-in obsolescence that could be the envy of Detroit auto manufacturers. As time goes on, many of us will be affected by neurologic disorders like Alzheimer's and Parkinson's. These cruel diseases rob people of dignity and comfort in their later years, and much medical effort has gone toward finding cause and cure.

Recently, it's been postulated that taking fresh young tissue from fetal brains and transplanting it into the brains of Parkinson's victims may alleviate the involuntary body movements. This approach has actually been tried in humans with some success.

A recent article in Transplantation Proceedings describes the harvesting of spinal tissue from spontaneously aborted human fetuses into rodents with Alzheimer's-like disease. With their new implants, the rats seemed to spruce up considerably.

Another study suggested that one in five women would find it easier to have therapeutic abortions if they thought that their unborn children's tiny brains would help old people.

Does any of this scare you? Or do you concur with the idea of pregnancies created to help Grandpa walk better, of infants dissected because they're going to be retarded anyway, of a decision to terminate a pregnancy made without much thought because if someone will benefit, an abortion can't be all that bad.

Congenital disease is tragic, and neurologic decompensation a terrible burden. But it cannot be dealt with by permitting the smart to take the body parts of the mentally handicapped, the old to steal the brains of the preborn. For the true measure of a civilization is how it respects the rights of its weakest members.

Katherine Dowling is a family physician at the University of Southern California School of Medicine. She wrote this commentary for the Los Angeles Times.

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