Posted by: bridget | 26 January 2007

Not A “Sophie’s Choice”

In recent news, a couple from Australia had their daughter undergo several radical surgeries. Ashley has static encephalopathy; she is currently nine years old but has the mental age of a three-month old. She is bedridden, cannot talk, and may not be able to recognise her family. When she showed signs of puberty, her parents – with the approval of a hospital’s ethics committe – had Ashley undergo a complete hysterectomy, removal of her breast buds, and an appendectomy. She is being treated with high levels of oestrogen in order to prevent growth; her parents believe that a smaller Ashley will be less likely to develop bed sores and will be more mobile.

An appendecomy is understandable: Ashley lacks the means to communicate the symptoms of appendicitis. Her parents concern about developing heavy breasts is understandable, but the surgery to remove her breast buds is reprehensible. Many women with large breasts undergo reduction surgery, which would certainly be an option for Ashley. A hysterectomy will prevent menstrual cramps; so will the Pill. Criticisms of these surgeries do not rest on their motivations, but rather on their methods. In our technologically-advanced society, there are other ways of ensuring that their goals are met. Ashley’s parents could have opted for other methods to keep her healthy, but seemed to choose the most extreme and dehumanising of all options. Is it any wonder that ethicists cry foul?

Finally, Ashley is only nine and had these surgeries at age six. Stem cells show great promise for treating people in her position; it is not impossible that advances in medicine can help Ashley to grow mentally. At that point, she will still be a prisoner in her body – this time, a body designed for someone younger than she.

Peter Singer has defended the parents on “ethical” grounds. Essentially, he claims that a three-month old child is not worthy of human dignity – that efforts to maintain Ashley’s dignity are misguided. He believes that dignified is different from adorable, and that humans are not worthy of respect without intellectual development. Singer conflates knowledge with personhood; his own inability to understand why humans are different from animals – the development of civilisation not being quite obvious enough for him – leads him to conclude that a person who lacks the reasoning capacity even of an animal is unworthy of treatment with decency.

Singer is not a bioethicist, for ethics implies some norm of moral belief. Rather, he is a biophilosopher – one who reasons without moral grounding. While Ashley may never develop intellectual capacity, she is undoubtably human. Her life does not only have meaning because her parents love her; if such were the case, it would be legal and moral to murder the homeless and the unloved.  Expecting mothers and neonatal nurses know what Mr. Singer chooses to ignore: babies who are barely viable outside of the womb have distinct personalities.   That gives her life both meaning and dignity.

It is not an overly sentimental or squeamish society that complains about Ashley’s treatment, but a society that recognises that a human being, regardless of development, is amazing and rare.  Such has prompted every known civilisation to believe in a god; our exploration of the universe does nothing but underscore the rarity of human intellect.

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