Our Utilitarian Medical Elite

Original Article

Jeffrey Drazen, the editor of the New England Journal of Medicine, recently penned a scathing editorial about Planned Parenthood’s harvesting of fetal tissues. No, Drazen and his two coauthors (one a volunteer for Planned Parenthood) didn’t criticize the abortionists for killing fetuses in a “less crunchy manner” to obtain intact organs. Rather, deploying the highly emotive language of ideological pro-abortion activism, the doctor-advocates attacked the messengers as “radical anti-choice” and supposedly engaging in a “campaign of misinformation” by vividly revealing the cruel practices and attitudes of top Planned Parenthood executives.

The NEJM is supposed to be an evidence-based journal. But the editorialists didn’t even try to grapple with the actual content of the videos released by the Center for Medical Progress. Instead, they resorted to the usual bromide that fetal tissue research could lead to cures, and they simply asserted that Planned Parenthood follows proper ethical guidelines—without offering any rebuttal of all the evidence to the contrary on the tapes. Their conclusion:

We thank the women who made the choice to help improve the human condition through their tissue donation; we applaud the people who make this work possible and those who use these materials to advance human health. We are outraged by those who debase these women, this work, and Planned Parenthood by distorting the facts for political ends.

Technical point: The “tissue” isn’t that of the woman: It is—was—the fetus’s. Whatever one thinks of fetal tissue research, obtaining the specimens isn’t the same as creating a cell line from an excised tumor. Moreover, utility doesn’t justify all things. Good ethics and respect for the intrinsic value of human life are integral to a science sector supported widely by the public.

Drazen’s editorial is one small example of how highly ideological our medical intelligentsia has become—and how increasingly enthusiastic about morally questionable practices. To understand why this might be—why venerable journals like the NEJM are supportive of controversial policy agendas such as assisted suicide and medical rationing—we have only to grasp the ideas that now animate bioethics, the field that presumes to determine what is right and wrong in medicine and public policy.

Most bioethicists are reluctant to define the boundaries that designate when human life becomes morally relevant. That leaves some of the most extreme voices in the driver’s seat. Thus, the field’s predominant view endorses a discriminatory approach to valuing life (human or animal) based on each individual’s cognitive capacities. In this view, those who are demonstrably self-aware or able to value their own lives are deemed “persons.” Those insufficiently mature—embryos, fetuses, infants—or who have lost their mental capacities owing to illness or injury (such as Terri Schiavo or Alzheimer’s patients) are effectively “nonpersons,” deemed to have lesser moral worth than the rest of us.

This isn’t like arguing about heads of pins and the size of angels. Under the dominant strain of bioethics, nonpersons have no right to life. Access to abortion is not just about protecting a woman’s right to do what she pleases with her own body, although that is part of it. Abortion is also morally acceptable because the fetus is not deemed to be a person. For many in the field, this means that infanticide should also be permitted—and for the same reasons as abortion.

Princeton’s Peter Singer is the foremost proponent of this view, but he is far from alone. A few years ago, an article published in the Journal of Medical Ethics caused a public furor when it advocated “after-birth abortion.” The authors inflate what is often blandly called the “right to choose” into a putative right not to be personally inconvenienced by an infant. Thus, since an abortion can be obtained for convenience purposes, and since newborns have no greater self-awareness than fetuses, babies should also be killable (and, one presumes, harvestable by Planned Parenthood), just as the unborn are abortable. The authors write:

By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call “after-birth abortion” (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled.

It’s not just fetuses and babies that are viewed broadly in bioethics as killable and harvestable. There is increasing advocacy—although it is important to emphasize that this isn’t yet happening—for killing those with profound cognitive impairments for their organs. Here is one typical example—published, as it happens, in the New England Journal of Medicine:

Many will object that transplantation surgeons cannot legally or ethically remove vital organs from patients before death, since doing so will cause their death. . . . Whether death occurs as the result of ventilator withdrawal or organ procurement, the ethically relevant precondition is valid consent by the patient or surrogate. With such consent, there is no harm or wrong done in retrieving vital organs before death, provided that anesthesia is administered.

Now we can see why those who presume to possess the greatest ethical expertise in the biomedical fields are not leading the charge against Planned Parenthood’s crass attitudes toward the dismemberment of fetuses to obtain sellable parts. It is a very short journey from considering babies—whether unborn or born—to be an inferior stage of human life to believing they have no rights that fully developed persons are bound to respect.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.