Saturday, April 14, 2018
Mahatma Ghandi reputedly said, “A nation’s greatness is measured by how it treats its weakest members.” We could paraphrase this in a contemporary context: a nation’s right-to-die laws are measured by how it treats the disabled.
Our lead story this week deals with the euthanasia of patients with an intellectual disability or autism in the Netherlands. Four bioethicists suggest that the necessary safeguards are lacking in these cases.
That is bad enough. But they go on to point out that the disabled have to deal with nigh-intolerable suffering for their whole lives. How does legal euthanasia make them feel? In the words of another author, “If society endorses the right of a person to seek physician assistance to end his or her life because of increasing loss of functional autonomy, what does that say about how our society values the lives of people who live with comparable limitations every day of their lives for years on end?”
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Commercial surrogacy contains inherent contradictions about the status of the mother, according to an article in the Journal of Medical Ethics. Jennifer Parks and Timothy Murphy, two American bioethicists, focus on times when the person or persons who commissioned the pregnancy abandon the child. This has happened in a number of widely-publicised cases overseas and in the US. Most of the time, the mother is left with responsibility for the baby, even if it is disabled.
They argue that “Treating commercial surrogates as presumptively responsible for children abandoned by commissioning parents, ... rest[s] on highly gendered assumptions about women and altruism.” Furthermore, “current commercial surrogacy practices face an internal conflict: dematernalising commercial surrogates while sometimes holding in reserve that maternal status as a safety net for unwanted children.”
There are no tidy solutions, they acknowledge. However, they suggest that preimplantation genetic diagnosis should be included in the contract and that the commissioning parent or parents discuss the possibility of birth defects with the mother. Another strategy would be to assess commissioning parents to see if they would make good parents. “While these strategies may not altogether prevent the abandonment of children born via commercial surrogacy,” they conclude, “they would at least make abandonment less likely, which would work not only to protect the resulting children’s welfare but also that of the surrogates who might otherwise face expectations of care for surrogacy orphans.”