Anencephaly and right-wing moralizers

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There's an important phenomenon in development called neurulation. This is a process that starts with a flat sheet of ectodermal cells, folds them into a tube, and creates our dorsal nervous system. Here's a simple cross-section of the process in a salamander, but in general outline we humans do pretty much the same thing. Cells move up and inward, and then zipper together along the length of the animal to produce a closed tube.

It's a seemingly simple event with a great deal of underlying complexity. It requires coordinated changes in the shape of ectodermal cells to drive the changes in tissue shape, and invisible in simple diagrams to the right are all the inductive interactions going on that trigger the differentiation of the tube into a nervous system.

This is also a relatively early event in humans. It begins about 18 days after fertilization, with a thickening of the ectoderm to form the initial sheet, called the neural plate. By day 19, the edges of the plate thicken and rise, and the whole thing folds at the midline and looks something like an open hot dog bun. The photo below is of a pair of 20 day old human embryos; the midline seam is open and clearly visible.

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By day 23, the edges have all fused together along the length of the embryo, leaving openings call neuropores at the rostral and caudal ends; the picture to the left is of a 23 day old human embryo, looking at its head end, and you can see right into its prospective brain. By days 26-28, both neuropores will close.

This is a crucial event that occurs very early, in the first month, of a pregnancy. What happens if the zipper gets stuck, and the tube fails to close completely?

It happens, and unfortunately it happens fairly frequently. About 0.1% of births in America have a serious neural tube defect caused by a stuck neural tube zipper.

The outcome is myelomeningocele—portions of the neural tube are left exposed, fail to develop properly, and are damaged and degenerate. It's variable in its consequences; when the posterior neuropore fails to close completely, it can result in nearly undetectable defects in the caudal spine to lower body paralysis and perturbations of cerebrospinal fluid flow that if untreated, can lead to hydrocephalus and severe brain damage.

Failure of the anterior neuropore to close is even more serious. The brain fails to form. This condition is called anencephaly, and it is untreatable and lethal. If they aren't dead at birth, they might last a few days before succumbing. They have no brain. At best, they have a mass of dying, relatively undifferentiated neural tissue smeared across the floor of their incompletely formed skulls. They can't think, they can't feel, they can't respond. The real tragedy is that development can proceed surprisingly far without a brain, and these fetuses are recognizably human (here is a photo for the strong of stomach), and they can be carried fully to term.

I can't imagine a clearer case to illustrate that humanity involves more than just the fusion of two gametes. We aren't defined by our complement of genes or a single instant of genetic combination, but are the result of many genetic and epigenetic processes working progressively through embryogenesis to assemble a functioning human being. When moral absolutists try to apply simple-minded, black-and-white reasoning to a complex situation (and defining a human being is certainly a complex problem), you get criminal travesties like this one:

A sailor's wife was pregnant with an anencephalic child, whose probability of surviving or of ever being conscious was zero. She, reasonably, wanted an abortion.

But the Congress had decided -- that no federal funds should be used to pay for abortions except where the life of the mother was at stake. As a result, Tricare (formerly CHAMPUS) the agency that covers military families, refused to pay the $3000 the abortion would cost.

The family sued, and a federal court ordered Tricare to pay, and the abortion went forward.

Then the Justice Department (with John Ashcroft as Attorney General) sued the family to recover the $3000, out of the sailor's pay of less than $20,000 a year.

The Justice Department just won. A panel of the Ninth Circuit ruled that, under a 1980 Supreme Court precedent upholding the Hyde Amendment -- a parallel provision to the one in question, but applying to Medicaid recipients rather than to military families -- the law was valid and the government didn't have to pay for the abortion. Consequently, the family has to pay the money back.

Our guardians of purity have magnified the pain of this family and willfully and vindictively punished them for the 'crime' of a biological imperfection. I call that evil, pure and simple. There should have been no question in this case that an abortion was necessary.

There are much more difficult cases. What if the fetus was diagnosed with 'merely' a case of myelomeningocele that meant it would be paralyzed, require extensive surgeries, and would be a crippling financial burden? The average cost per year of maintaining a child with myelomeningocele is approximately $70,000, and that drain never ends. People with severe spina bifida can be intellectually and socially capable, fully human, but a young family with limited resources ought to have the privilege of making a choice about whether to shoulder the responsibility before the fetus has acquired those mental capacities. I presume we now have a government that will force families to take on that burden, but will refuse to pay any part of the price.


Cohen MM (2002) Malformations of the craniofacial region: Evolutionary, embryonic, genetic, and clinical perspectives. American Journal of Medical Genetics 115(4):245-268.

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Thought-provoking point: life isn't as discreet as brain vs. no brain, or even DNA vs. RNA. This is something I've thought about a lot lately. As primates, we deal with the world as a series of distinct objects, and this way of thinking has also defined the way we deal with abstract concepts, like "alive" or "human." Political implications aside, organic chemistry just isn't that simple.

Anencephaly and right-wing moralizers

I thought you were going to say that the first condition is the cause of the second. ;)

By Steve LaBonne (not verified) on 10 Jan 2007 #permalink

Poseidon, it's even tougher than you suggest. The world of biology is full of fine gradations, gradual developments, small differences barely detectable that later loom large, and all the messiness of reality. Inevitably, human societies have to draw lines around parts of biological reality, in the moral and legal spheres, if nowhere else. That means there inevitably is some judgment and choice and even arbitrariness in how we draw those lines. The right-wing moralizers don't want to admit that reality. More than anything, they want to believe that the correct location of those lines is somehow predetermined, somehow not a matter of human decision, somehow instead is soemthing Out There, if only we could find it. Their core understanding of morality is based on fantasy. They have no way to address hard issues except by retreat into fantasy. And because it is fantasy, they can't even address the questions that logically arise from it.

There are all sorts of wacky results that fall out of "life (ensoulment) begins at conception". What about chimeras; are they really two people? What about a parasitic twin? I noticed a distinct lack of pro-lifers picketing the hospital where the "pregnant man" had his twin removed (and presumably not placed on life support). What about identical twins; do they each get half a soul? Remember, any dithering about brains or minds or bodies is tantamount to admitting that a just-fertilized zygote doesn't have a soul!

It's pretty damned amazing that anyone can claim these things with a straight face.

I wouldn't say it's evil of them - rather, economically sound. And gals and boys in DC are just tagging along. I hear it's called capitalism.

I am an obstetrician and a veteran. If the government or any insurer were required to cover the cost of abortions for malformations, there would be endless legalizing about the definition of "malformation." If the fetal karyotype is trisomy 21 or Down syndrome, is that mandated to be covered? How about Turner syndrome (45 chromosomes, missing one X chromosome, compatible with a normal but generally infertile female existence)? How about a 47XXX karyotype in the fetus (normal female life, generally fertile, but a stastically significant but maybe not clinically meaningful lowering of IQ compared to the normal 46XX female)? One could go on and on with these types of examples. Anencephaly is a horrible diagnosis to tell a pregnant woman. The insurer, in this case the taxpayers, in deciding to not cover any abortions has decided to not make judgements about the value of any particular fetus' life. In my opinion this is a wise decision. $3000 is a lot of money for a presumably 2nd trimester abortion. It is still much cheaper than the cost of raising a normal child, for which this couple was hoping and maybe even planning. I know I will get hate mail for my supposed insensitivity, but the clearest policy is not to cover abortion at all, rather than deal with the subjective worth of human life with all its variable phenotypes in deciding whether one woman deserves her abortion to be paid for and another woman doesn't.

Joe

There should have been no question in this case that an abortion was necessary.

The definition of "necessary" for the purposes of this law was whether the life of the mother was threatened. The family really had no case and the lower court badly screwed up IMO.

Doe claims that in her particular circumstances there is
no rational relationship between an interest in potential life and § 1093(a)'s funding restrictions because of her fetus' terminal condition. Rational basis review, however, "is not a license for courts to judge the wisdom, fairness, or logic of legislative choices."

Congress has a right to encourage people to have babies by means of refusing payment of abortions of choice -- which this was. Lower court seemed to buy the idea that because this abortion only technically breached the wishes of Congress but didn't really prevent a baby being born (because of it's terminal condition) that it was legal to pay for the abortion. Lower court also goofed in other areas. A poor ruling generally. Appeals court continues:

A statute "does not fail rational-basis review
because it is not made with mathematical nicety or because in practice it results in some inequality." Rather, the constitutional test requires only that the statute, as a general matter, serve a legitimate governmental purpose. Just as in Russell, Doe's contention that "we must consider [her] personal circumstances when judging the reasonableness of [1093(a)'s funding restrictions] is an impermissible attempt to ratchet up our standard of review from rational basis toward strict scrutiny." Id. Because the statute is rationally related to a legitimate government purpose, and because an "imperfect fit" does not render a statute invalid, we reject Doe's equal protection challenge under rational basis review.

Otherwise you have judges second guessing law makers too much. Since congress is the most democratic and the courts the least democratic part of a government that makes sense.

By DavidByron (not verified) on 10 Jan 2007 #permalink

While I see the procedure in the OP as justifiable, I don't quite agree with 'necessary'. As stated, the fetus could be carried to term. At such time as the health of the mother is threatened, then the insurance should kick in. Were I faced with such a situation, I'd find the 3K$ somehow. Thanks Joe for your enlightening comments.

As also noted above, one can be inclined to wonder if some of the right wing moralizers might not have some defect of biology themselves. They appear to be able to lead a normal life, but are subject to oversimplifying complex issues into simple white/black ones.

The black and white morality mentioned isn't so much a morality, in my opinion, as the avoidance of a morality.

Morality is a tool to help us make choices, and is part of the society we live in. Choices are not easy - but they have to be made. Any morality that avoids dealing with hard issues is, at best, useless.

By DragonScholar (not verified) on 10 Jan 2007 #permalink

Joe writes, "If the government or any insurer were required to cover the cost of abortions for malformations, there would be endless legalizing about the definition of "malformation."

The rather obvious alternative is for the insurer to cover the cost of any abortion. That removes the insurer completely from making any "judgements about the value of any particular fetus' life." It leaves such judgments entirely up to the woman, and simply has the insurer paying for a medical procedure.

I remember the first time this story came up, and it definitely made me think.

I have a devout Catholic friend. He's so anti-abortion that he would never even think of voting for any candidate who is not totally opposed to it. I can tell he even thinks bad of me because I support abortion rights. So I was kind of surprised when I asked him about anencephaly (I explained it first) and he said he didn't think abortion was really out of the question. Apparently, he doesn't think human beings without brains really do have souls. Somehow intelligence is related to having a soul.

I asked him a question regarding how anencephaly develops later than the embryo stage, and if he would support abortions before the period in which the brain even starts to develop, but he never made that logical leap.

Trying to use biology as an ethical foundation for determining the moral status of abortion leads one ask many utimately irrelevant questions. When is a conceptus 'viable'? What constitutes 'serious impairment' of either the conceptus or the health of the imparata? The important question is when does a conceptus become suffienctly a 'person' (a legal/political (theological?), not biological, status) that its right to survival trumps the imparta's competing right to autonomy? However determined, it must be recognized that equitably arbitrating the competing rights does not necessarily mean minimizing the aggregate harm. Sometimes even the best choice sucks.

DavidByron makes some excellent points of law above. I don't see this as a matter that should be decided by law though. I think that this should fall under a criticism of 'prosecutorial discretion'. I agree that "There should have been no question in this case that an abortion was necessary", I can hardly begin to imagine the trauma of carrying such a child to term in order to give birth to a corpse.

However, Tricare/CHAMPUS should have clearly given an exception to policy, and John Ashcroft clearly should have excercised prosecutorial discretion in declining to prosecute. I think this is why the 'reasonable man' standard has fallen into disuse - we are seriously lacking in reasonable men.

Friends of ours adopted a baby. When she didn't hit some milestones she was tested and they decided she was deaf. When more milestones were missed they did a CAT scan and found that she had only enough brain to drive certain automatic functions like eating, heart, breathing, etc. To add to the family's pain their church keeps telling them that if their faith is strong enough God will give that baby a brain. So when that didn't happen they were left with the unspoken message that something is wrong with them. There is no telling how many years the child will live. She has lived three years so far which is longer than expected. If God does give the child a brain I will be sure to let you all know. Right after I get up off the floor.

I think this is why the 'reasonable man' standard has fallen into disuse - we are seriously lacking in reasonable men.

I think Ambrose Bierce covered this one a while ago:

ARISTOCRACY, n.
Government by the best men. (In this sense the word is obsolete; so is that kind of government.)

The rather obvious alternative is for the insurer to cover the cost of any abortion. That removes the insurer completely from making any "judgements about the value of any particular fetus' life." It leaves such judgments entirely up to the woman, and simply has the insurer paying for a medical procedure.

Well said, Russell.

Consider the reverse situation: Women who choose to continue their pregnancies, as these Pals of the Unborn claim to want, but lose their babies anyway.

As most Americans are vaguely aware, our infant mortality rate is a national disgrace. Our Black and Indian babies, no hyperbole, die so commonly it's as if they were born in some third-world country.

So exactly how much effort have you ever seen Ashcroft or any of those other anti-abortion dicks throw into helping these babies make it? (In particular, take a gander at the white-vs-black numbers in DC, and consider how much local control Congress has over the health delivery system there. Apparently the "right to life" only applies to white babies.)

By Molly, NYC (not verified) on 10 Jan 2007 #permalink

Although I'm a long time supporter of the right of women to choose abortion, I also support the right of those who think abortion is immoral not to pay for abortions through taxes. I also think that whether an abortion is medically indicated is a relevant consideration, and I think "medical indications" should encompass a good deal more than "protecting the life of the pregnant woman."

In short, I think the issues, medical, moral and political, are a good deal more complicated that most people want to acknowledge.

By bob koepp (not verified) on 10 Jan 2007 #permalink

Molly: Is it possible you're making this into an issue of race when it really isn't one? It seems to me it's more of an issue of economics. Especially in DC.

The family doesn't have to cover the cost if friends pay it for them. Is there a place I can donate to become one of those friends?

I think the problem is that people hew towards their subjective notions ("but is it human?") for moral decisions and responsibilities rather than objective realities, like suffering and sentience.

This lends itself to a wild tapestry of competing realities and moralities that are generally mutually incompatible and ignore objective real-world problems. The end result is inhumane, arbitrarily punitive outcomes as noted in the blog.

By Loren Michael (not verified) on 10 Jan 2007 #permalink

I also support the right of those who think abortion is immoral not to pay for abortions through taxes.

I consider the killing of hundreds of thousands of people to stoke a leader's ego to be immoral. Can I refuse to pay for Bush's war? I consider subsidizing tobacco farming immoral (although I support the right of any adult to be a dumbass and smoke if they want to). Can I refuse to pay the part of my taxes that goes to tobacco farmers? And so on. We're talking about taxes, not charitable contributions. You can't pick and chose what you want to pay taxes on. Anyone who considers abortion so immoral that they'd rather a woman die under tortuous conditions (and if you think I'm exaggerating it's only because you haven't ever seen a death in pregnancy or labor) than let their taxes pay for an abortion then they can move to Saudi Arabia where they'll be very happy with the morality.

Jud: I totally agree about friends paying for this. Wouldn't it be nice if atheists could show they have more morals than the Ashcroft types by helping to pay for this procedure.
If there is a donation place, let me know, I would be happy to help them.

When a woman desires an abortion, that abortion is necessary. End of story.

Although I'm a long time supporter of the right of women to choose abortion, I also support the right of those who think abortion is immoral not to pay for abortions through taxes.

bob koepp - What makes these this view so special? My taxes pay for Bush's war and it's neurochemically impossible to view anything as more immoral than I feel this war is. And I'm not alone.

Moreover, they're lying about their motives. It's obvious that the vast majority of anti-abortioners couldn't care less about the welfare of fetuses; what they care about, and all they care about, is giving women a hard time about having sex. You may see that as a reasonable basis for public policy; I sure don't. And neither would they, or they wouldn't lie about it.

By Molly, NYC (not verified) on 10 Jan 2007 #permalink

Both Mooser and Molly deserveth thine accolades, for yea they be-eth correct.

Cyde Weys wrote:

Molly: Is it possible you're making this into an issue of race when it really isn't one? It seems to me it's more of an issue of economics. Especially in DC.

That, of course, raises the much broader question (totally unrelated to the thread at hand) of the extent to which one can separate issues of race and class in this country (and especially in DC). But, suppose one can, and that this is an issue of poverty rather than of race: if you make the appropriate substitutions in Molly's comment, does the end result suddenly become morally tolerable?

For those interested in helping women have access to abortion, consider the National Network of Abortion Funds (http://www.nnaf.org/); they provide information for more local organizations that help women gain access. Planned Parenthood is also a good way to help women have access to birth control and abortion services.

Molly: Is it possible you're making this into an issue of race when it really isn't one? It seems to me it's more of an issue of economics. Especially in DC.

Cyde Weys - That's a fair statement, and absolutely, fixing the IMR is complicated, and it's going to cost. And it's going to cost more, and be more complicated for people with worse IMRs. But:

1. If the anti-abortion crowd were actually concerned about life, why would the cost or the difficulty be an issue? They should be on this like white on rice. But it's not even a blip on their radar, because frankly, they couldn't care less about babies. They care about hassling pregnant women.

2. If you ever wanted a textbook example of institutionalized racism, this is it.

By Molly, NYC (not verified) on 10 Jan 2007 #permalink

Congress has a right to encourage people to have babies by means of refusing payment of abortions of choice -- which this was.

How does making it harder to abort fetuses with severe deformities encourage people to have babies?

But, suppose one can, and that this is an issue of poverty rather than of race: if you make the appropriate substitutions in Molly's comment, does the end result suddenly become morally tolerable?

To libertarians I think it does, which is one reason I left the libertarian camp decades ago.

[blockquote]I know I will get hate mail for my supposed insensitivity, but the clearest policy is not to cover abortion at all, rather than deal with the subjective worth of human life with all its variable phenotypes in deciding whether one woman deserves her abortion to be paid for and another woman doesn't.[/blockquote]
Bullshit. By that critieria, the clearest policy is to cover ALL abortions. Then you're not dealing with the subjective value of anyone's life - the embryo's or the mom's.

But hey, I'm Canadian, and we don't even have abortion laws. It's just another medical procedure here (from a medical and legal perspective, anyway).

Covering all abortions or covering no abortions would be equally nonambiguous policies to me. I have no problem with either one.

The insurance coverage for any patient is a business contract between the patient and insurer or employer and insurer. The contract in this case was that this abortion would not be paid for. The courts decided that this contract was valid and legal. The courts enforced the contract. End of story as far as who pays for what.

I think you have to separate out the right to abortion and the right to have it paid for. An employer has the right to negotiate covered benefits with an insurer. A mutual insurance company has the right to determine within legal bounds what is and isn't covered. A significant percentage of Americans seem not to want their tax dollars used to fund abortions. The legislature, recognizing this significant minority, has decided to not allow military employees or dependents to have this procedure covered. They can have the abortion (the Supreme Court has already narrowly affirmed that right), but the taxpayers don't have to pay for it. If anyone doesn't like the legislative decision, work for change through lobbying and voting. This also applies to tobacco subsidies and military fiascos.

Joe

Sparrow,

While I see the procedure in the OP as justifiable, I don't quite agree with 'necessary'. As stated, the fetus could be carried to term. At such time as the health of the mother is threatened, then the insurance should kick in.

You seem to be using a rather narrow definition of "health" here. There may be no physical threat to the mother (I wouldn't know), but I suspect that the majority of women would find the prospect of carrying such a fetus to term very distressing.

By Andrew Wade (not verified) on 10 Jan 2007 #permalink

I know I will get hate mail for my supposed insensitivity, but the clearest policy is not to cover abortion at all, rather than deal with the subjective worth of human life with all its variable phenotypes in deciding whether one woman deserves her abortion to be paid for and another woman doesn't.

The clearest policy is not to cover any medical procedures whatsoever. That doesn't make it a good policy. Likewise for abortion. Avoiding complication is all well and good, but it shouldn't be the first goal of legislation.

By Andrew Wade (not verified) on 10 Jan 2007 #permalink

Joe,

A significant percentage of Americans seem not to want their tax dollars used to fund abortions.

That doesn't make them right.

... If anyone doesn't like the legislative decision, work for change through lobbying and voting. ...

Agreed. Despite the fraud in the last election, the U.S. is still a democracy, and that should not be thrown out. But not just lobbying politicians; speaking out in public too. Public debate and criticism is very important too; and it's a shame that the media has confused commentators, journalists, and shills; they're not the same.

By Andrew Wade (not verified) on 10 Jan 2007 #permalink

The insurance coverage for any patient is a business contract between the patient and insurer or employer and insurer. The contract in this case was that this abortion would not be paid for. The courts decided that this contract was valid and legal. The courts enforced the contract. End of story as far as who pays for what.

So if the contract was made to not cover cardiac bypass surgery that would also be legally okay, as long as the patient had the 'choice' to pay for it themselves should they find themselves in need of it.

Or maybe chemotherapy, or physical therapy, or vaccinations, that list COULD be made endless. I think the poster who commented on the lack of 'reasonable people' being in short supply was quite correct.

As for what our tax dollars go for - we get no say in it for the most part, so why should a few overly vocal, superstitious, god bothering idiots get a say in anyones medical care? Who do you want deciding what procedure you and your family can choose from and/or have paid for by the insurance company (who you are paying). The priest or the MD.

People with severe spina bifida can be intellectually and socially capable, fully human, but a young family with limited resources ought to have the privilege of making a choice about whether to shoulder the responsibility before the fetus has acquired those mental capacities.

The distinction between fetuses and people is not hard to make, but the world is full of idiots. I don't think people with severe spina bifida would be entirely unreasonable to fear that they might be next when fetuses are selectively aborted. But I don't think banning abortion would do anything to discourage bigotted idiots from being bigotted idiots.

By Andrew Wade (not verified) on 10 Jan 2007 #permalink

I agree with what Bulman said: "I can hardly begin to imagine the trauma of carrying such a child to term in order to give birth to a corpse."

Forcing a mother to continue with a pregnancy (which remains medically risky, even in this country) in order to give birth to a maimed, terminal vegetable is not reasonable or rational, much less compassionate.

I see why the circuit court ruled as they did, when forced to it. The blame should be on those who approved the regulation, which appears to specifically exclude cases of anencephaly, to be implemented in the first place. It wasn't an oversight - someone writing the regulation really wanted women in exactly this position to experience exactly this nightmare! How incomprehensible.

Andrew says:

"The clearest policy is not to cover any medical procedures whatsoever. That doesn't make it a good policy. Likewise for abortion. Avoiding complication is all well and good, but it shouldn't be the first goal of legislation."

Some employers do decide to provide no health insurance benefits. That's fine by me. Some provide some coverage but exclude physical therapy, some chiropractic care, some prenatal care. Potential employees should look at medical coverage when applying for a job to see if the policy of the employer suits their needs. In this case, the employer's policy didn't cover the cost of abortion.

Who is "right" or who is "wrong" in the abortion and abortion funding debate is never going to be solved. The reality is that a significant percentage of the population equates abortion with murder, and therefore finds abhorent the thought of the their tax dollars funding such an activity. The policy of non-coverage for abortion for the military antedates all the characters central to the above court case. John Ashcroft as attorney general is a lawyer advocate for the Federal Government's interest, which here was in having the health care coverage policy honored. He is a total asshole, but he was doing his job. The woman received tragic news, had her abortion, ending up paying $3000, and ran up I suspect $20000 in court costs. Not a pretty picture all around.

Joe

John Ashcroft clearly should have excercised prosecutorial discretion in declining to prosecute.

Agreed. Much lower ranking DOJ attorneys exercise such discretion. This wasn't a criminal matter, it was an employee benefit matter and the district court decision would not have been binding precedent for future cases.

Andrew says:

You seem to be using a rather narrow definition of "health" here. There may be no physical threat to the mother (I wouldn't know), but I suspect that the majority of women would find the prospect of carrying such a fetus to term very distressing.

I don't think I specified a definition of 'health'. Physical, mental, emotional all qualify in my view. As someone said above, if the woman feels it necessary, it should be done. I only meant is was not medically necessary from the point of view that it is possible to carry such a fetus full term.

In a similar vein, my wife and I had friends in NYC 15 years ago faced with a similar problem. Their first pregnancy was found about 24 weeks in with a baby with only two chambers to its heart. I've at least forced a few righteous wingnuts to face the fact that abortion is not just a procrastinator's contraception through this personal story.

The reality is that a significant percentage of the population equates abortion with murder . . .

No. A significant percentage of the population pretends to equate abortion with murder.

But if you look at their behaviour, it's never been consistant with a concern for the welfare of pregnant women, neonates, toddlers, older kids or anyone else. (Clearly, any supporter of this war who claims to value human life is full of crap.)

What it has been consistant with is a really punitive view of sex, and a desire to stick their big fat noses into everyone's bedroom.

By Molly, NYC (not verified) on 10 Jan 2007 #permalink

You wrote:
"There should have been no question in this case that an abortion was necessary."

I carried an anencephalic infant to term because I wanted to. Emily was my daughter and I was her mother, and that was that.

I was reassured by many doctors that an abortion was not "necessary" because there was no harm to me. In fact, the potential complications of an immediate delivery at 23 weeks were greater than the potential complications of a delivery at term. At the time, and possibly still, studies showed that anencephalic pregnancies had less risk of gestational diabetes, preeclampsia, and c-section.

Please do not refer to "desirable" procedures as "necessary." Some mothers do not desire the procedure and do just fine without it.

Emily was, we were told, blind and deaf. Yet not only did she respond to sound (she jumped at sudden loud noises) but she actually responded to *specific sounds* and after birth consistently turned toward the sound of my voice. She reacted to light.

Emily only lived for two hours, but I would not trade those two hours.

I run a website for parents who have already decided to go to term, and I moderate an anencephaly support forum for mothers who have decided to go to term. We have 400 members on the online group; I have helped hundreds of parents with the online guide for parents going full-term. I have never, after helping all these parents, encountered parents who regretted going to term. I have unfortunately encountered parents who regretted abortions their doctors pushed them into by saying they were "necessary" only to find out afterward that they, the parents, had a choice.

Emotional recovery tends to be faster for moms who went full-term because we have grieved ahead of the loss and are able to deal with the questions before the shock and can be fully prepared for the time we spend with our babies. We also don't have the questions about our own culpability in our child's (inevitable) death. Perinatal hospice programs are on the rise for exactly this kind of situation, and more parents are being helped every year.

The parents definitely have a choice to make. But then let them make it, and don't call it "necessary" the way you did in your post. Thank you.

Joe:

The policy of non-coverage for abortion for the military antedates all the characters central to the above court case.

I think most of the comments above were more directed at the policy, rather than at the players involved in this particular court case, after the policy had been set. Certainly for all I know, the judge was correct, most of those involved were just doing their job. That doesn't obviate the policy discussion.

I see an irony in this story that many of you probably wouldn't. I was serving in the US Air Force when Roe v Wade legalized abortion. (Prior to that it was legal in only a few states, as I recall.) Before Roe v Wade it was a not very well kept secret that women in the military were among the select few in the country who could actually get an abortion -- and Uncle Sam paid for it. Not sure whether "dependent wives" had the same access.

Sparrow,

I don't think I specified a definition of 'health'. Physical, mental, emotional all qualify in my view. As someone said above, if the woman feels it necessary, it should be done. I only meant is was not medically necessary from the point of view that it is possible to carry such a fetus full term.

My apologies; I misunderstood.

By Andrew Wade (not verified) on 10 Jan 2007 #permalink

Please do not refer to "desirable" procedures as "necessary." Some mothers do not desire the procedure and do just fine without it.

as is often common in these debates, Jane forgets that there are more than somatic processes involved in the term "necessary".

As another in this thread brought up, just because the idea brought you no significant mental stress, does NOT mean that such stress is not to be found in others.

You are overgeneralizing your own experience by a long ways, to be sure.

Have you considered yet another possibility?

Maybe the parents in question would prefer to get on with their lives more quickly; give themselves another chance at having a child that would survive as quickly as possible.

Your gross generalizations about "emotional recovery" don't necessarily apply to others.

Some employers do decide to provide no health insurance benefits. That's fine by me. Some provide some coverage but exclude physical therapy, some chiropractic care, some prenatal care. Potential employees should look at medical coverage when applying for a job to see if the policy of the employer suits their needs. In this case, the employer's policy didn't cover the cost of abortion.

You live on a different planet than I do. A good percentage of the population doesn't have the luxury of "seeing if the policy of the employer suits their needs." I am barely able to keep from adding expletives to that sentence, by the way. The breathtaking smugness and arrogance is beyond me.

By Shell Goddamnit (not verified) on 10 Jan 2007 #permalink

Yo Joe,

News flash, I, (granted I do not represent a significant portion of the population), find the thought of my tax dollars funding the war in Iraq which has caused the deaths (murders) of thousands of innocent fully formed human beings, to be abhorent.

Would you please tell me where on my income tax return forms I can check off those items that I find abhorent so I can can make sure that my tax dollars are not used for those purposes.

BTW, This statement totally shattered my irony meter,

"The policy of non-coverage for abortion for the military antedates all the characters central to the above court case. John Ashcroft as attorney general is a lawyer advocate for the Federal Government's interest, which here was in having the health care coverage policy honored."

Wasn't this the same guy who had the bare breasts of the statue of justice covered for indecent exposure, I'm sure he was just doing his job then as well.

On January 28, 2002, Attorney General John Ashcroft, announced that he spent $8000 of taxpayer's money for drapes to cover up the exposed breast of The Spirit of Justice, an 18ft aluminum statue of a woman that stands in the Hall of Justice.

Just curious, Joe, was that taxpayer money well spent?

You may want to read, if you haven't already, the poem written by Claire Braz-Valentine with regards this particular incident.

Joe, you may be right but I think you probably deserve any hate mail you might get because your point of view is indefensible.

By Fernando Magyar (not verified) on 10 Jan 2007 #permalink

Shell Doddamnit says:

"You live on a different planet than I do. A good percentage of the population doesn't have the luxury of "seeing if the policy of the employer suits their needs." I am barely able to keep from adding expletives to that sentence, by the way. The breathtaking smugness and arrogance is beyond me"

Boy oy boy, this is my first time commenting on this blog. I had thought it was read by open minded critical thinking types. God (sorry), Thor, forbid we deviate from the party line of the open minded. News flash, Shell, it's an all volunteer army. There are loads of $20000 a year jobs out there, and some where you don't have to be launching Tomahawk missiles onto civilians.

I think there are going to be many ideas beyond you, Shell. If my smugness and arrogance took your breath away, keep reading, but please, only until you pass out.

Joe

Fernando,

I believe I said John Ashcroft was an asshole. I believe I said that we can vote out of office those with whom we disagree. And by the way, name the Senators and Representatives that had the gonads to vote against the megalomaniacal president on his way to this war? Difficult task?

Exactly what part of what I have said is indefensible?

Joe

Poseidon, most primates are a little smarter than homo sapiens sapiens. We are well aware that the world is not a bewildering collection of disjoint objects. You tie your own selves in knots with your psychotic hallucinations.

Get yourselves some treatment. You can come home when you are no longer a danger to yourselves and others.

By Primate indeed! (not verified) on 10 Jan 2007 #permalink

News flash, Shell, it's an all volunteer army. There are loads of $20000 a year jobs out there, and some where you don't have to be launching Tomahawk missiles onto civilians.

And the number of $20,000/year jobs that offer health insurance the way the armed forces do is probably pretty close to zero. That's less than $11.00 an hour.

I think I'm starting to recognize Joe from when he was Joe Schmoe over at Kevin Drum's place. Same smug insistence that libertarianism really does work, same conviction that the people currently working at Wal-Mart have only to walk through the door of a Fortune 500 company to be offered a $100,000/year salary.

By Mnemosyne (not verified) on 10 Jan 2007 #permalink

Personally, if it had been me, I might have said, "Fine, don't pay teh $3,000 for the abortion, you can pay the $20,000 it will cost for me to bring this fetus to term and have it die within a couple of hours." But I'm a bitch that way.

By Mnemosyne (not verified) on 10 Jan 2007 #permalink

Joe,

You said "The insurer, in this case the taxpayers, in deciding to not cover any abortions has decided to not make judgements about the value of any particular fetus' life. In my opinion this is a wise decision. $3000 is a lot of money for a presumably 2nd trimester abortion. It is still much cheaper than the cost of raising a normal child, for which this couple was hoping and maybe even planning."

Unless I missed something this couple was seeking an abortion because the woman was pregnant with an anencephalic child, that had no chance of survival. They already had that knowledge.

It was Ashcroft's job to defend the interest of his client, The Federal Government, and asshole or not he had to do his job, no argument here. However I do expect that the Attorney General of the United States of America should have the wisdom to exercise his powers of discretion in certain cases.

What I find very hard to defend is your viewpoint that not making a value judgement about a fetus without a brain can be considered a "WISE" decision. More importantly I as a taxpayer don't remember having been asked to make that decision one way or another. Maybe I missed that memo.

My apologies if I have I possibly misunderstood your viewpoint.

"Although I'm a long time supporter of the right of women to choose abortion, I also support the right of those who think abortion is immoral not to pay for abortions through taxes."

What if I don't want to have to pay for cancer treatment for people who chose to smoke? What if I don't want to pay for surgery to staple someone's stomach? What if I thought black people shouldn't be able to get treatment?
Can I choose not pay taxes to support war? Choose not to pay taxes to support national ID cards? Government subsidies of tobacco farmers? Choose not to pay for oil subsidies rather than mass transit subsidies? No taxes to go to the D.E.A.?

There are an infinite number of things government does that some person could consider immoral. There are an infinite number of things a person could see as immoral NOT to do that government doesn't do.

Of all of those things, why is abortion the only one that its "reasonable" to allow people to opt out of paying taxes for?

Add me to the list of those willing to help the Does meet this unforeseen expense. If anyone knows of a way to do so, please let me know.

This is where the European countries are well ahead.

Here, an abortion is given if the mother wants it.

Yes, there are christian goups (RC & Evangelical) making LOTS of noise, and occasionally protesting.
We've even had a couple of cases of doctors/pharmacists trying to stop it, but the bad publicity shuts them down, except among their own little faith-groups.

But, that's what they want - they WANT to be hated by the "irreligious", because it makes them feel so good and smug.
You have the same problem, except these creeps are still in charge.

Oh dear.

By G. Tingey (not verified) on 10 Jan 2007 #permalink

Fusion of the two sides of the invaginated neural plate cannot occur without properly orchestrated apoptosis (programmed cell death). Too much, or too little, apoptosis during neurulation results in a failure of the tube to close properly. If this happens at the caudal (tail) end of the neural tube, the spina bifida occurs as a result.

An example of what Dawkins calls "the tyranny of the discontinuous mind".

Thanks ben, re: neurophilosopher's deep insight, I was just about to ask for the punch line.

By Fernando Magyar (not verified) on 11 Jan 2007 #permalink

Jane, thank you for sharing your story. You obviously are much stronger mentally that I, because I would have had an abortion if any of my children had been found to be anencephalic. There's no way I could hold it together mentally if I had to prepare for both a birth and a death at the same time.

This was your choice, though. No one forced you to carry Emily to term. The problem with our current "pro-life" lunatics is that they want to force women to "pay" for having sex. Getting rid of abortion rights is just the first step. The real goal of groups like Operation Rescue and the men at Concerned Women for America is making birth control illegal. In their world sex has to have "consequences", and if that means bringing more unwanted babies into the world so be it. They don't care what happens to these babies after they're born, only that they get born.

Oh, this is my first comment ever on this blog, in the spirit of Delurking Week :)

How brainless can Emily really have been, if she really reacted to light? The eyes, and even the optic lobes, are rather far away from the brainstem... ~:-| For movements other than reflexes, the region on top of the head is needed... and so on... can someone explain all that?

And the two-chambered heart: What would that lead to? A baby with the metabolism of a toad? Or was there no connection to the lungs or something?

Now to neoliberal politics ( = a lack of both knowledge and empathy at the same time):

Potential employees should look at medical coverage when applying for a job to see if the policy of the employer suits their needs.

Bullshit. The USA should at long last become a First World country, or at least a Second World country. It's about time. Healthcare by an inefficient bureaucracy is vastly preferable over healthcare by employers, especially in a world where there aren't any jobs anymore except maybe in Malaysia.

About the US "volunteer army"... that's a draft on the poor, pure and simple. I propose the following experiment: Raise the minimum wage to First World levels (10 $ per hour upwards), stop rewarding immigrants with the citizenship if they serve and survive, and watch where all the volunteers go.

By David Marjanović (not verified) on 11 Jan 2007 #permalink

David,

I agree whole-heartedly that there should be universal single payer medical care. I also agree that the present volunteer army is especially attractive to the disadvantaged (no John Kerry references here please!). I personally favor universal conscription with everyone serving 2 years in national service. This would decrease the chance of silly military actions like Iraq. The wealthy and privileged congresspersons will think twice about military action when their kids might be put in harm's way. However, we can't make an "ought" out of an "is." I was addressing the present realities in the discussion at hand.

So far I have been called "neoliberal," whatever that might mean, and "libertarian." I personally consider myself a non-evangelical rationalist. I'm non-evangelical because I want to continue to remain an optimist.

Joe

Joe

I rarely post here, but I think I'm entitled this time. My son was born in 2002 and appeared to develop normally at first, but started showing obvious delays after about 6 months. It took until he was 16 months old for him to be diagnosed with porencephaly. He is missing most of the right hemisphere of his brain. Moreover, I'm no expert, but I believe it is visible on his 20-wk ultrasound. However, when I investigated the possibility of a malpractice suit, I was told by attorneys that my case would involve arguing that I would have chosen an abortion had I known what was wrong, and they were unwilling to make this argument in a Florida court! Now, please do not get me wrong. I love my son with all my heart, but if I had to do it all over again, and I had known, I would have had an abortion. In fact, when I was pregnant again, 3 years later, I had ultrasounds done every 2 weeks, scheduling on at exactly 23 weeks, to have the option of a legal abortion before 24 weeks. Afer that, even with severe brain malformations, no legal abortion would have been possible.
My son is a sweet kid, and he laughs, and appears to have some level of consiousness, but he is and always will be severely disabled. It is unfair to him, it is unfair to us, and frankly, it is unfair to society, which bears most of the costs of his medical care.
How inhumane that the mother should have gone on and have a full-term pregnancy, knowing full well that the child would have died. Would the birth, the funeral, and everything else not have cost more than $3000? Not to mention the heartache and suffering of the family. How cruel!

Mooser said:
When a woman desires an abortion, that abortion is necessary. End of story.

It doesn't get any more right than that!

Makita your story moves me, and it highlights the outrageous nature of the system that is currently in place. A group of middle aged men and women who from behind their desks in the state legislature have the pleasure of seeing their values practiced by everyone without bearing much or any of the tremendous emotional and financial costs of that values system.

I have never seen a convincing argument for why abortion is an issue that justifies collective rulesmaking - why the decision cannot simply be left up to the mother according to her own values. Any cogent argument from the right on the matter is rare.

P Z Myers wrote:

We aren't defined by our complement of genes or a single instant of genetic combination, but are the result of many genetic and epigenetic processes working progressively through embryogenesis to assemble a functioning human being.

From the perspective of Dawkins's "selfish gene" no doubt human beings would be viewed as temporary vehicles which convey genetic lineages forward through time, but from my perspective as one of those temporary vehicles I most certainly believe I have a beginning and an end.

An individual human being is not just a three-dimensional object in space, he or she is also an event that stretches out - if they are lucky - through decades of space and time. Just as those individuals have spatial boundaries so they are bounded in time. The fact that there is disagreement about where to set those boundaries for the purposes of legal rights does not alter that fact.

My parents eggs and sperm had the potential to produce many children. Most probably there were many instances where the two fused that led to nothing. But around nine months before I was born, a specific fusion of egg and sperm occured which led to me and no one else.

Like every other individual human being on this planet, I occupy and absolutely unique position in space and time. Just as with the rest of you, there has been and never will be another me. That unique individual object/event that is me or you began with the union of egg and sperm and it is simply absurd obfuscation to argue otherwise.

The questions of whether that uniqueness has any value or whether - or at what stage of development - concepta acquire a property called "humanity" are separate issues.

As an agnostic, I do not recognise so-called God-given or natural rights. I hold that what we call rights spring from a mutual recognition that we all have an interest in personal survival and development. Rights are what we have agreed are necessary to that survival and development within the context of human society. When embodied as laws, they are intended to regulate, not some nebulous concept of society, but individual human behaviour.

Most if not all societies acknowledge a right to life and have laws against murder. They agree that it is wrong to take the life of another human being except under certain extreme and carefully-defined circumstances. The question at issue is at what stage of development does - or, rather, should - a human being become entitled to the right to his or her own life.

PZ and others argue that there is a vast difference between a blastocyst, for example, and an adult human being and of course that is true. But does that have any bearing on the right to life? The fact is that we were all blastocysts once. The various stages of development are contiguous not discrete and form a single event through time.

If rights are, as I believe, effectively social conventions then we can, of course, set the boundary to the right to life at any point we choose. But does it make any sense to quibble over arbitrary points months into that process of development when the obvious solution is simply to extend the right to the point at which the development of the individual begins?

As far as I can see, the strongest opposition to this comes from women who, for various reasons, do not wish to be burdened with pregnancy or children and those who see in opposition to abortion an attempt by men to reassert control over women.

My opposition to abortion is based entirely on my belief that the right to life should be extended to the point of conception. That means that a woman has no more right to end that life - by virtue of being a woman - than anyone else does. There should, of course, be a medical exemption. Where the mother's health or life are threatened by a pregnancy then it should be terminated.

Having said that, I do not think that anti-abortion legislation is the best route to the desired result since it will simply drive women into the hands of backstreet abortionists. Far better to press on with debate, education and support, preferably not from religious groups, though, whose ulterior motives are suspect.

By Ian H Spedding FCD (not verified) on 11 Jan 2007 #permalink

Ian H Speeding FCD,

That unique individual object/event that is me or you began with the union of egg and sperm and it is simply absurd obfuscation to argue otherwise.

So you think identical twins are two copies of a single unique human being, rather than two unique human beings, do you? And that people who arose from an embryo formed from the fusion of two embryos are actually two unique human beings packaged in a single body, do you?

As I think I commented the first time this post went up, my identical twin died at birth (fairly common with twin births). Obviously this caused my atheism, because under the loony fundie ensoulment-at-conception doctrine I'm half-soulless.

Speeding presumably agrees, which means that he thinks I have half a soul more than I think I have. (Forget souls; I'm not even convinced consciousness exists, or is more than a mindless tag saying `I exist' which things like Cotard's syndrome can remove. Go on, prove that it's not just a convincing illusion.)

"My opposition to abortion is based entirely on my belief that the right to life should be extended to the point of conception. That means that a woman has no more right to end that life - by virtue of being a woman - than anyone else does." -Ian H Spedding

Helminth parasites have more consciousness and sentience than a human blastocyst, yet you would not hesitate to rid your body of said parasite were one found occupying your intestine, for example. No human being alive has the right to parasitize another without his or her consent.

I do not have the right to take your organs without your explicit will, even if I were on death's doorstep and you were the only match to me. Tapeworms don't have the right to deplete your body of nourishment, unless you get off on that for some odd reason. Likewise, an adult woman should never have to carry a human fetus, which is technically a parasite that has hijacked her body, and that potentially can cause a large deal of health problems and even death, against her will.

Unless you're a vegetarian, the steak that you may be so fond of eating from time to time came from an animal that was more sentient and individualistic than any human embryo. Spare me. The precious diploid zygotes don't really care about much of anything, and they certainly aren't individuals. They're balls of undifferentiated cells.

For the person who wondered how Jane's anencephalic baby could react to light - there are different levels of severity of anencephaly - strictly speaking, the link in PZ's post shows an "atelencephaly" - no cerebral cortex, but you can see the eyes have formed, and there is some sensory development including, possibly, the hearing.

I also am dismayed at the high cost of abortion for medical reasons in the U.S. Is part of that cost paying for the insurance of the obstetrician who will deliver the aborted fetus, to protect him/her and the clinic from home-grown extremists and terrorists?

Hindsight is clearest. I agree with those who state that the pregnant woman should have the choice to interrupt or retain a pregnancy for any reason during the consensus first trimester, and for any medical reason thereafter, provided that the consulting doctor can document having discussed all possible outcomes during multiple consultations with the pregnant woman. If, after making her decision to keep or abort the baby, she or her family comes to regret it - it's not our affair, is it? And it's not like you can turn back the clock and try the other option, either way. Many people, given hard decisions, convince themselves consciously or not that they made the *best* one because it's the one they came to terms with and have appropriated. The unknown is always more frightening. I both admire and pity those who, like one commentator above, are able to imagine having taken the other road and have enough distance from the branchpoint to allow themselves realistic regrets.

As far as I can see, the strongest opposition to this comes from women who, for various reasons, do not wish to be burdened with pregnancy or children and those who see in opposition to abortion an attempt by men to reassert control over women.

It sure sounds like you have myopia then.

I suggest actually talking to a woman once in a while to find out if your assumptions have any basis in reality, 'cause based on my experiences, they don't.

rights are an entirely artificial concept. Not being relgious, you must surely agree with this.

that being so, biology has nothing to do with the assignment of rights, really, and the only time rights should come into question should be determined by the society at large, and rightly could (and has) vary along with societal norms.

so, I'm surprised to hear you argue for something that by your own stated background, seems pretty illogical.

by the same logic, I assume then that you would prefer to see those deemed "brain dead" to be preserved on life support indefinetly as well, if possible (just to be on the safe side).

correct?

can't you see the flaw in that line of reasoning?

"My opposition to abortion is based entirely on my belief that the right to life should be extended to the point of conception. That means that a woman has no more right to end that life - by virtue of being a woman - than anyone else does." -Ian H Spedding

Cool. Then she can remove herself from around the embryo/fetus/what-have-you (or rather, remove it from herself, as that's more convenient and serves the same purpose), as obviously a fetus has no more right than any other person - by virtue of being a fetus - to access another person's body and body parts against the other person's will, and it can have its "right to life," same as everyone else, until it dies.

Everybody's happy.

Jane Lebak"

Please do not refer to "desirable" procedures as "necessary." Some mothers do not desire the procedure and do just fine without it.

And for some women it is in fact necessary. Ir is necessary because the alternative of carrying a doomed, brain-dead fetus to term is extremely traumatic for them, to the point where the option of abortion goes beyond "desireable," and becomes a necessity.

You obviously don't feel bothered much by having a doomed fetus inside you, or carrying and giving birth to it only to watch it die. But another woman might be horrified by it, or devastated---just as much as you might be horrified or devastated at being forced to abort a perfectly healthy pregnancy. I'd imagine you'd consider the right to continue a pregnancy---especially a healthy one---a necessity. Why, then, do you dismiss another woman's ability to avoid a similarly traumatizing experience of weeks or months of intimacy with a corpse (which it is, from some of their perspectives) as mere "desire?"

Now I, personally, don't want to ever be pregnant at all. I don't like the idea, even. For me, a legal compulsion to abort wouldn't be a problem at all, and I would have no desire for anything that would allow me to avoid an abortion and give birth. Should I then say "Please do not refer to such 'desireable' procedures as the right to give birth as a 'necessity?'"

Does that above sentence sound acceptable to you? It's the exact position you stated, altered to fit another woman's feelings. Doesn't sound so nice, now, does it? Maybe it sounds insulting, sickening, vicious, callous, cruel? But it's the same logic, the same argument.

Just because the idea of carrying and giving birth to a terminally-damaged baby doesn't bother you, and even means a great deal to you, doesn't mean it can't be very traumatic for many other women---and it is excessively callous and disrespectful of you to dismiss their experiences and the effects of such an event on them.

Jane Lebak,
I agree with other poster that what may have been right for you is not right for others. My son is not nearly as severe as anencephaly, and if we can keep his seizures under control he is expected to have a normal lifespan. When I got pregnant, my husband and I had already agreed that we would abort a fetus with genetic or other defects. I wasn't given that choice, because I was not informed about my son's defects. He is now almost 5 years old, and I have not changed my mind yet. I still would have aborted if given the choice. If I'd had a child with anencephaly I would abort it as soon as possible. That may sound cruel to you, to me it seems more cruel to continue unnecessary suffering. That does not mean, I think the abortion is desirable. Under the circumstances (even circumstances much less severe than anencephaly), I would state the abortion was medically necessary.

Jason wrote:

So you think identical twins are two copies of a single unique human being, rather than two unique human beings, do you? And that people who arose from an embryo formed from the fusion of two embryos are actually two unique human beings packaged in a single body, do you?

Identical twins are two unique individuals who have sprung from the same 'seed'.

And an individual that has emerged from the fusion of two embryos is still a single individual.

Bear in mind that these definitions are only being drawn in the context of deciding whether prenatal forms of a human being are entitled to the right to life - a right which only exists to regulate human behaviour. Just as in adults, a death from natural causes is not a breach of the right to life whereas a death that is the result of human intervention might be.

By Ian H Spedding FCD (not verified) on 12 Jan 2007 #permalink

Nix wrote:

Speeding presumably agrees, which means that he thinks I have half a soul more than I think I have. (Forget souls; I'm not even convinced consciousness exists, or is more than a mindless tag saying `I exist' which things like Cotard's syndrome can remove. Go on, prove that it's not just a convincing illusion.)

As I mentioned before, I am agnostic on the question of God or souls. I see no evidence for their existence and assume, for all practical purposes, that they do not exist while bearing in mind that absence of evidence is not necessarily evidence of absence.

By Ian H Spedding FCD (not verified) on 12 Jan 2007 #permalink

Shigella wrote:

Helminth parasites have more consciousness and sentience than a human blastocyst, yet you would not hesitate to rid your body of said parasite were one found occupying your intestine, for example. No human being alive has the right to parasitize another without his or her consent.

Correct me if I am wrong, but I understand parasitism to be a symbiotic relationship between to phylogenetically unrelated organisms. It seems to me that trying to defend elective abortion by comparing the offspring of human sexual reproduction to infestation by members of an entirely different species is stretching the analogy pretty thin. The fact that both a fetus and a liver fluke both draw resources from a human host does not mean they are the same in all ways, especially not for the purposes of deciding whether or not we are entitled to kill them.

Tapeworms don't have the right to deplete your body of nourishment, unless you get off on that for some odd reason.

Rights do not apply to tapeworms, only to human beings.

The precious diploid zygotes don't really care about much of anything, and they certainly aren't individuals. They're balls of undifferentiated cells.

We were all balls of undifferentiated cells once. Kill that ball of undifferentiated cells and you prevent the development of someone like you or me. Do we have that right? I say only where there is a threat to the host for that cluster of cells.

By Ian H Spedding FCD (not verified) on 12 Jan 2007 #permalink

Ichthyic wrote:

It sure sounds like you have myopia then.

Actually, I do.

I suggest actually talking to a woman once in a while to find out if your assumptions have any basis in reality, 'cause based on my experiences, they don't.

YMMV

rights are an entirely artificial concept. Not being relgious, you must surely agree with this.

I thought I said that...

that being so, biology has nothing to do with the assignment of rights, really, and the only time rights should come into question should be determined by the society at large, and rightly could (and has) vary along with societal norms.

By and large, yes...

so, I'm surprised to hear you argue for something that by your own stated background, seems pretty illogical.

We can agree that the definition and assignment of rights is an arbitrary process but that does not prevent us from trying to be as consistent as possible in the arguments we use to support our views.

by the same logic, I assume then that you would prefer to see those deemed "brain dead" to be preserved on life support indefinetly as well, if possible (just to be on the safe side).

Those are very difficult cases. I would say that if the consensus of medical opinion is that there is no possibility of recovery then life support should be withdrawn. However, if the family want life support to continue and have the resources to pay for continuing care then they should be allowed to do so.

By Ian H Spedding FCD (not verified) on 12 Jan 2007 #permalink

"Kill that ball of undifferentiated cells and you prevent the development of someone like you or me. Do we have that right?"

And use a condom, or even abstain from sex while ovulating, and you prevent the development of whoever could have developed from that egg (and potential sperm). I have no doubt that a number of lovely and wonderful people could have resulted from the eggs that my body has released over the course of my lifetime. By not getting pregnant, I have prevented those people from developing just as effectively as if I had gotten pregnant and then had an abortion. This is why the whole argument that abortion is wrong because it prevents a person from developing just doesn't make sense to me. Who's to say that I have the right to allow an egg to pass through my body unfertilized, when it could develop into someone like you or me? And how is that different from abortion of a group of undifferentiated cells?

Ian H Spedding FCD,

Identical twins are two unique individuals who have sprung from the same 'seed'.

How can an embryo be both a single unique human being, and also merely a "seed" from which two unique human beings subequently "spring?"

And an individual that has emerged from the fusion of two embryos is still a single individual.

If each of the two embryos that fused was a unique human being before the fusion, which one of them, if either, is the unique human being you claim exists after they have fused? What happened to the other one?

How can an embryo be both a single unique human being, and also merely a "seed" from which two unique human beings subequently "spring?"

Sperm Magic!

If each of the two embryos that fused was a unique human being before the fusion, which one of them, if either, is the unique human being you claim exists after they have fused? What happened to the other one?

This is actually pretty interesting stuff.

First, the individual isn't much of an individual until after several cell divisions. Technically, the Zygote is genetically individualistic (unless parthenogenesis is in play, not common in humans!). But until several cell divisions have taken place, there is nothing sufficiently organized for any of the details to matter.

If active embryonic cells from two zygotes are pushed into each other early enough in the process, the processes that are happening are not interrupted. If the cells are pushed together early, in equal number, etc. then what you get is a chimera that is an individual in every respect in development, organ systems, etc., but where every other cell or so, possibly randomly possibly less randomly, has the genome originally in one of the zygotes, and every otherother cell has the genome of the other zygote.

This is not at all strange or weird or hard to manage. A human and all other diploid organisms already have this, in a way. Every cell that has a nucleus has a haploid genome of a different individual (mom or dad).

I once asked a colleague of mine who studies this stuff (David Haig) how common accidental chimerism was in humans. He said "We don't know, but if you found a human chimera, it is not odd enough to get a publication out of it"

Think of it this way: You are an artist working in oils. You buy a selected number of paints at the supply store and put them away. One day you take a selected set of paints out and put them on a table. Then you take some of those paints and start working up your palette, that big roundish thing with the thumb hole on which an artist will place raw paints and mix them, from which the dabs of paint will be selected. Then you start putting down some background shading and stuff, then details, and then more details and highlights, etc. and eventually you have a unique oil painting.

This unique oil painting is a thing made out of paint. Originally it was jars of paint in the store, now they are all organized on the canvass.

At what point did the individual, special, unique painting exist as such? At each of the stages mentioned above, the artist is increasingly committed to a certain kind of outcome. But anything could happen from the stage of going to the store and buying paint,lots of different things are possible with a nice selection of oils in the cabinet, and a very much narrower range of things are possible from the palette of selected pigments, and so on.

Chimerism or twinning is trivial at the go to the store and buy the paints level. After that, it is problematic. (That's where you get those funny looking moles that just might be your twin brother....)

Anencephaly and the Right-Wing Moralists

The next paragraph is the shortest version I have yet written on this topic; many sub-arguments have been left out.

I have myself used anencephaly as an open and shut example of the general proposition that while our biological characteristics are necessary (for the sake of argument) for an organism to count as a human being, they are not sufficient. That is because, to suppose to the contrary that they are sufficient, then one could be placed in a cage, kept warm, watered, fed and dry, and one's humanity would not be affected in the slightest. But we know that is false; so the premise of sufficiency must be false. In the case of the anencephalic neonate, there is not even the potential for humanity that there is in most live births. In any case, the fetus is only potentially human, it is not actually a human being. That is because it is not doing anything remotely close to being human; it is, by definition, gestating. Since it is not actually a human being, it cannot actually be murdered, so abortion cannot be murder. Therefore, abortion is morally permissible, neither obligatory nor forbidden (and you only get three choices).

Further, the anencephalic is a perfect example that there are cases when infanticide is likewise permissible.

Joe, the obstetrician and veteran, will no doubt disagree, given that he wrote

"The insurer, in this case the taxpayers, in deciding to not cover any abortions, has decided to not make judgements about the value of any particular fetus' life. In my opinion this is a wise decision ... rather than deal with the subjective worth of human life ... "

But it is entirely possible to assign a value to human life (even prior to personhood). To say that we cannot is to say that one must be indifferent to whether a fetus will emerge "normal" (in the usual sense) or abnormal (in the uncontentious sense that trisomy 13, for example, is statistically rare). Now, indifference translates readily into a willingness to accept equally, 50/50, either outcome. That is to say, prospective parents would just as soon have mentally retarded offspring as one with intact capacity for intellectual functioning. But that is obviously not the case; and to recognize that, is ipso facto to recognize that we certainly can put a higher value on some offspring than others, that we do, and that we must.

Some benighted people talk about the fetus being an innocent human being. Well, it is none of those things. OK, it is innocent, in exactly the same way that I am innocent of exceeding the speed limit on the expressway -- on my bicycle! Now, if innocence meant merely an absence of guilt then stones might be saints. But innocence actually means freedom from guilt, and that is possible only if one is capable of acting culpably. Since the fetus is not capable of acting at all, it can't possibly be innocent.

Abortion is a woman's sovereign choice, and neither church, nor state, nor any man, can rightly deny it of her!

Douglas of Beachville (Lurking no more)

By Doug Rozell (not verified) on 12 Jan 2007 #permalink

There's a bigger point that the incidence of human chimeraism brings up, I think...

*If* a person is a full legal person, with full legal rights, from the moment of fertilization, then any adult human who is a chimera is also, by definition, a murderer. In fact, they're guilty of a particularly gross form of murder: cannibalism.

I really don't see any way around this conclusion. Granted, one could argue over how much intent a hundred-celled blastula might have, and whether or not a charge of involuntary manslaughter might be more appropriate than a charge of murder. But if the evidence exists that an independent conceptus became incorporated into the body of the person with whom it shared a womb, then that person displaying the evidence must have killed its sibling. After all, the second that sperm broke through the cell wall of the ovum, that fertilized ovum became a full human being in the eyes of the law, right? And anything that interferes with its right to continue living is a criminal act. Thus, living chimeras are also murderers.

In fact, considering how little we know about the frequency of failed twinning events in early embryonic development (or chimeraism, for that matter), there's really no telling just how many of us are murderers. Any one of you reading this right now might be.

kmarissa wrote:

I have no doubt that a number of lovely and wonderful people could have resulted from the eggs that my body has released over the course of my lifetime. By not getting pregnant, I have prevented those people from developing just as effectively as if I had gotten pregnant and then had an abortion. This is why the whole argument that abortion is wrong because it prevents a person from developing just doesn't make sense to me. Who's to say that I have the right to allow an egg to pass through my body unfertilized, when it could develop into someone like you or me? And how is that different from abortion of a group of undifferentiated cells?

The right to life applies to actual individuals. An unfertilized egg or sperm that have not fuzed with an egg have the potential to become individuals but that potential has net yet been realized. You cannot be charged with murdering a potential person only an actual one.

The question is whether or not an undifferentiated ball of cells or even a fertilized egg qualify as an individual human being - albeit in the very early stages of development.

By Ian H Spedding FCD (not verified) on 14 Jan 2007 #permalink

Jason wrote:

How can an embryo be both a single unique human being, and also merely a "seed" from which two unique human beings subequently "spring?"

For the purposes of the right to life it really doesn't matter. Once the egg is fertilized at least one individual life has begun. If there is a subsequent division into two separate individuals, each is as entitled to the right to life as the preceding single individual.

If each of the two embryos that fused was a unique human being before the fusion, which one of them, if either, is the unique human being you claim exists after they have fused? What happened to the other one?

As I said, for the purposes of the right to life it doesn't matter. Even if one embryo is subsumed into the other the remaining one is still entitled to the right to life.

Posted by: | January 12, 2007 12:09 PM

By Ian H Spedding FCD (not verified) on 14 Jan 2007 #permalink

Doug Rozell wrote:

In any case, the fetus is only potentially human, it is not actually a human being. That is because it is not doing anything remotely close to being human; it is, by definition, gestating. Since it is not actually a human being, it cannot actually be murdered, so abortion cannot be murder. Therefore, abortion is morally permissible, neither obligatory nor forbidden (and you only get three choices).

Since you have failed to define what you mean by "human being" or "humanity" and why a fetus does not to qualify as such, you have failed to demonstrate that abortion is morally permissible.

But it is entirely possible to assign a value to human life (even prior to personhood).

The value - however that might be calclated - of a human life is irrelevant to whether it is entitled to the right to life. Your right to life is not dependent on your 'value'.

Abortion is a woman's sovereign choice, and neither church, nor state, nor any man, can rightly deny it of her!

The choice you are talking about is whether or not to kill something that is by any definition alive. If we decide that "something" has the right to continue living then the woman has no such choice.

By Ian H Spedding FCD (not verified) on 14 Jan 2007 #permalink

Jillian wrote:

*If* a person is a full legal person, with full legal rights, from the moment of fertilization, then any adult human who is a chimera is also, by definition, a murderer. In fact, they're guilty of a particularly gross form of murder: cannibalism.
I really don't see any way around this conclusion.

The crime of murder assumes the capacity to form the intent to kill and an awareness that such an act is unlawful. We have no reason to think that an embryo - let alone a zygote - has such a capability. A new-born baby, for example, is considered human and has the right to life but if, but some feakish mischance, it managed to bring about the death of another person, there is no question of it ever being charged with murder.

By Ian H Spedding FCD (not verified) on 14 Jan 2007 #permalink

Ian H Spedding FCD

As I said, for the purposes of the right to life it doesn't matter. Even if one embryo is subsumed into the other the remaining one is still entitled to the right to life.

Of course it matters. Your whole argument rests on the proposition that an embryo is an individual human life. But if a single embryo can split to become two individual human lives, and two embryos can merge to become a single individual human life, how can your proposition be valid? In the case of a split, how can the single embryo be both an individual human life and also a package containing two individual human lives? In the case of a merge, how can the two embryos be both two individual human lives, and also two halves of a single individual human life?

Jason wrote:

Of course it matters. Your whole argument rests on the proposition that an embryo is an individual human life. But if a single embryo can split to become two individual human lives, and two embryos can merge to become a single individual human life, how can your proposition be valid? In the case of a split, how can the single embryo be both an individual human life and also a package containing two individual human lives? In the case of a merge, how can the two embryos be both two individual human lives, and also two halves of a single individual human life?

My argument rests on the proposition that rights are the entitlements of individual human beings. If twins emerge ultimately from a single zygote, there are two individuals, each entitled to the right to life. If, at an early stage, one twin is subsumed into the other, there is no reason for the survivor to lose his or her right to life.

The question still remains: given that rights are the entitlement of individual human beings, is it reasonable to extend the right to life to individuals at the earliest stage of development?

Quite plainly, a zygote is different from a blastula which is different from an embryo which is different from a newborn which is different from an adult, but are any of those differences sufficient to disqualify some of those stages from being considered human? Are we entitled to the right to life solely on the grounds of being human or is it narrower than that, being limited to sentient or self-aware humans, for example?

And if you limit it to sentience or self-awareness, for example, do these properties emerge in all individuals at the same stage of development and, if not, how do you test for their presence so that the right to life can be awarded at the proper time?

And if a individual is killed by another person before he or she has been tested for self-awareness, how do we know whether or not a crime has been committed given that we do not know whether or not the victim was entitled to the right to life?

It seems to me that pro-choice advocates put themselves through all sorts of contortions to justify witholding the right to life solely to give women the absolute and unfettered power to decide whether another human being should live or die - a power not granted to individuals in a civilized and democratic society under any other circumstances.

By Ian H Spedding FCD (not verified) on 15 Jan 2007 #permalink

Ian H Spedding FCD,

Your entire point seems to rest upon calling balls of cells "individual human beings" when clearly they are far from individual. They have no capacity to function and survive outside of a host's/mother's body. As a collection of cells living within and feeding off of that body, they should be considered a part of that body in decision-making. When the fetus gains the capacity to survive outside of that body, then it does become an individual in the full sense of the word.

The twisted logic behind asserting that the 'potential' for these cells somehow makes them off-limits to the individual woman's health care decisions, even as they are still physically a part of and a burden on her own body, can lead to other unsavory things. As an example, there is much potential benefit possible by giving someone on dialysis a kidney. By an extension of the reasoning that seems to be in use, if a match is found for a patient on dialysis, the matching "donor" should be forced by the government to give up the kidney no matter the future physical and mental repercussions...

You seem to be putting yourself through contortions to justify controlling the health care options for one-half of the human population by redefining what it means to be an individual, and then trampling on the body integrity rights of actual individuals.

My argument rests on the proposition that rights are the entitlements of individual human beings.

then it appears to be an error in your thinking.

rights are NOT entitlements. They are specifically granted, and created, in all cases. take the US constitution for example: rights are specifically defined and granted in that document, and no real basis is given as to why the authors thought the rights "inalienable". It was more succinct and less confusing than to say they "were agreed upon by the general consesus of the time", I'd wager.
Or did you wish to argue that rights were granted by something... else...?

I thought you agreed with me when I mentioned this earlier (go back to your response to my post), but I can see that you apply your thinking on this matter rather haphazardly, in contrast to your stated goal.

even given the slightest twist to your argument, that of a brain-dead "adult", you quibble.

hmm.

I would instead argue that the most consistent application of rights IS via generally shared agreement at whatever time and place rights are defined and determined. The application of age in the matter is entirely arbitrary, and nonsensical when you look at the actual application of extant rights in any given society.

Ian Spedding wrote: Since you have failed to define what you mean by "human being" or "humanity" and why a fetus does not to qualify as such, you have failed to demonstrate that abortion is morally permissible.

No. There is no need to define "human being" or "humanity" for the sentence to be true that "biology is only necessary, not sufficient, to what it is for something to be a human being". Therefore, the argument still holds, that abortion is deontically permissible, since the only characteristics that are true of the fetus are biological ones.

By Doug Rozell (not verified) on 16 Jan 2007 #permalink

jsc wrote:

Your entire point seems to rest upon calling balls of cells "individual human beings" when clearly they are far from individual. They have no capacity to function and survive outside of a host's/mother's body. As a collection of cells living within and feeding off of that body, they should be considered a part of that body in decision-making. When the fetus gains the capacity to survive outside of that body, then it does become an individual in the full sense of the word.

The problem with that position is that newborn babies are just as dependent on parental support for survival as fetuses, yet they are presumed to have the right to life. The same goes for adult human beings in a persistent vegetative state, for example. Their complete dependency on others does not automatically deprive them of the right to life either.

The twisted logic behind asserting that the 'potential' for these cells somehow makes them off-limits to the individual woman's health care decisions, even as they are still physically a part of and a burden on her own body, can lead to other unsavory things. As an example, there is much potential benefit possible by giving someone on dialysis a kidney. By an extension of the reasoning that seems to be in use, if a match is found for a patient on dialysis, the matching "donor" should be forced by the government to give up the kidney no matter the future physical and mental repercussions...

No, the same rights which I argue should be extended to the unborn would prevent any attempt to forcibly remove organs from an unwilling "donor".

You seem to be putting yourself through contortions to justify controlling the health care options for one-half of the human population by redefining what it means to be an individual, and then trampling on the body integrity rights of actual individuals.

On the contrary, I am all for pregnant women having the best possible healthcare and I have already agreed that there should be a medical exemption to any ban on abortion. If the pregnancy poses a serious threat to the mother's life or long-term health then I accept that it should be terminated on the grounds that it would be the lesser of two evils.

What I am opposed to is elective abortion where the woman can choose to have the fetus killed because she wishes to be relieved of the inconvenience of pregnancy.

By Ian H Spedding FCD (not verified) on 17 Jan 2007 #permalink

Ichthyic wrote:

rights are NOT entitlements. They are specifically granted, and created, in all cases. take the US constitution for example: rights are specifically defined and granted in that document, and no real basis is given as to why the authors thought the rights "inalienable".

I see no difference between us on this. When I wrote that rights are "entitlements" I meant society has agreed that these are what its members are entitled to have as human members of that society.

The application of age in the matter is entirely arbitrary, and nonsensical when you look at the actual application of extant rights in any given society.

I agree it is arbitrary. I just believe that, knowing what we do now, conception is a less arbitrary cut-off point than birth.

By Ian H Spedding (not verified) on 17 Jan 2007 #permalink

Doug Rozell wrote:

No. There is no need to define "human being" or "humanity" for the sentence to be true that "biology is only necessary, not sufficient, to what it is for something to be a human being". Therefore, the argument still holds, that abortion is deontically permissible, since the only characteristics that are true of the fetus are biological ones.

Unless you define this quality of "humanity' which, according to you, distinguishes adult human beings from prenatal forms you might as well say that a fetus lacks 'gwxlkgity'. The word is meaningless and tells us nothing. And even if you assign a meaning to the word you would still have to demonstrate that lack of this property is sufficient to justify denying the unborn the right to life.

By Ian H Spedding FCD (not verified) on 17 Jan 2007 #permalink

The problem with that position is that newborn babies are just as dependent on parental support for survival as fetuses,

I'm no expert, but I'm pretty sure babies can breathe on their own and don't have to actually have access to a particular parent's blood supply 24-7. Fetuses, not so much.

How brainless can Emily really have been, if she really reacted to light? The eyes, and even the optic lobes, are rather far away from the brainstem... ~:-| For movements other than reflexes, the region on top of the head is needed... and so on... can someone explain all that?

And the two-chambered heart: What would that lead to? A baby with the metabolism of a toad? Or was there no connection to the lungs or something?

Now to neoliberal politics ( = a lack of both knowledge and empathy at the same time):

Potential employees should look at medical coverage when applying for a job to see if the policy of the employer suits their needs.

Bullshit. The USA should at long last become a First World country, or at least a Second World country. It's about time. Healthcare by an inefficient bureaucracy is vastly preferable over healthcare by employers, especially in a world where there aren't any jobs anymore except maybe in Malaysia.

About the US "volunteer army"... that's a draft on the poor, pure and simple. I propose the following experiment: Raise the minimum wage to First World levels (10 $ per hour upwards), stop rewarding immigrants with the citizenship if they serve and survive, and watch where all the volunteers go.

By David Marjanović (not verified) on 11 Jan 2007 #permalink