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[ JBEM Index / Volume 2 / Number 1 ]

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Editor's Note

This past fall the American Life League's publication, A.L.L. About Issues, contained an encouraging testimony of a mother who discovered during her pregnancy that her baby was anencephalic. She carried him to term, knowing that the absence of the upper portions of the brain and skull was always lethal and that there was no treatment known. He lived only a day after birth - a day spent holding and loving him, singing to him, and passing him back and forth between the parents. There was occasion for the parents to share their faith with the doctors and nurses. He was given the name Adam.

In my medical niche I seldom have to think about anencephaly. The essay on Adam, however, was one of several items about anencephaly to come to my attention in a short span of time. The November issue of the Journal of Family Practice published an analysis of the risks and "benefits" of screening a hypothetical population of 10,000 women for anencephaly and other neural tube defects. The author concluded that the economic cost in a screening program approximately equaled the savings to society if the infants are aborted. In one sentence he attempted to dispense with the core issue of the humanity of the anencephalic infant by stating that he was not going to consider in his analysis the benefits and risks to the unborn infant. By including the possibility that abortion could be a benefit to the aborted baby the author, by implication, must believe that a life can be too burdensome to live, so that the baby would kill himself if he could.

Yet another item on anencephaly was a report in the April 23, 1987, New England Journal of Medicine that in Germany anencephalics may be legally declared never to have been alive. this decision would clear the way for their organs to be used by aborting them at a convenient time. Waiting for birth is wasteful, you see, since some die in the process making their organs useless.

The most thought-provoking of all my encounters, however, was the revelation by a conscientious Christian obstetrician that he will abort an anencephalic fetus, the only case in which he will do an abortion. I did not have sufficient time to hear all of his reasoning. I believe some components of it were the reliability of pre-natal diagnosis (no false positives), the uniformly and rapidly fatal nature of anencephaly, and the suffering the parents must endure during the final months of pregnancy, followed by the stillbirth or death of the baby. The highly creditable testimony of that physician's life caused me to reexamine my thoughts about anencephaly. Is he correct? May Christian physicians search out and abort anencephalic babies because the search and predictability of death are so accurate? Does this not relieve the parents of extra months of suffering?

He and I will surely have further discussions on the matter in the future. Meanwhile, I cannot imagine a way to sustain such a practice biblically. Absence of the top of the skull would not be a reason to deny status as a human being. Absence of the "higher" brain and, thus, "higher" brain function might entice some to decide that the being in utero was not human. Such cannot be the case with my Christian obstetrician friend. He will not insert IUD's for a variety of reasons, foremost among them the fact that they are abortifacients. Implantation of the fertilized ovum is prevented by IUD's before the brain is formed at all. If no upper brain = no humanity, why not abort anyone at will before the brain is formed? If the distinction is the fact that anencephalic has no potential for higher brain function whereas the average fertilized ovum does, what about the potential to be used the way Adam was used in the case cited above? Must one live a long time to be used by a sovereign God?

Perhaps simple compassion for the suffering of a couple who are facing the birth of a fatally flawed baby is the reason. If I had to face the issue as often as a compassionate obstetrician perhaps I, too, would be encouraged to seek ways for the suffering to be relieved. Yet compassion as a reason to abort an anencephalic would be the most disturbing of all the reasons I can imagine. Whereas my niche exempts me from routine contact with anencephaly, it seems to specialize in exposing me to the suffering of people caused by other inconveniently flawed people. Countless times I have watched adults suffer for years over the disease, dependency and ultimate death of a family member. The care-giving family members did not even have the assured endpoint of a defined gestation period. Should we simply put to death these flawed people? Shall we at one stroke eliminate both their suffering and that of their compassionate care-giving family? The way is clear. We have but to declare them not human. Define humanity in terms of the functioning or malfunctioning of one organ or one part of one organ, and we are free to treat those humanoid items as sources for organs to help the really human among us. What is the difference between such an approach and aborting an anencephalic?

All the arguments about the image of God in man notwithstanding, one excellent definition of a human being is: Adam and all his descendants. The Adam in the story above was certainly so descended. The unlawful taking of his life at any stage because he lacked part of his brain is a violation of the sixth commandment until biblically proven otherwise.

[ JBEM Index / Volume 2 / Number 1 ]

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