How to reframe beginning-of-life issues
Last week’s parliamentary debate on whether to have a committee examine the issue of when life begins illustrates the need to reframe how we in Canada approach “beginning of life” issues.
The proponent of the parliamentary motion, and cabinet ministers such as Jason Kenney and Rona Ambrose who supported it, insisted that its aim was to address a more fundamental issue than abortion. But the opposition and most of the media insisted on debating it within the historical abortion-focused framework – still polarized between pro-choice and pro-life positions developed in the 1970s and 1980s.
The result was not only divisive but also embarrassingly unproductive – confirming once again in the public mind that our Parliament seems to be the last place in the country where we can have a forward-looking discussion of a substantive issue.
The reframing of beginning-of-life issues for productive discussion in the public arena involves taking more fully into account the latest findings of genetic science and new advances in medical practice.
Parliament and the courts continue to adhere to the “born alive” rule – the position, rooted in the rudimentary medical knowledge of the 19th century, that a fetus acquires no actionable rights in law, nor should any aspect of its humanness or “personhood” be recognized in law, until it is “born alive.”
But as Supreme Court justices John Major and John Sopinka wrote in dissent more than 15 years ago, in a case requiring the balancing of fetal and maternal rights, “present medical knowledge renders the ‘born alive’ rule outdated and indefensible … when technologies like real time ultrasound, fetal heart monitors, and fetoscopy can clearly show that a fetus is alive and has been or will be injured by conduct of another.”
Many parliamentarians and editorialists take the position that the law must recognize either maternal rights or fetal rights. Feeling obliged to choose, they then refuse to recognize any fetal rights or claims at all. But doctors and nurses on the front lines of advanced medical procedures such as in utero surgeries to correct medical problems in the fetus before birth are obliged by their ethics and duty of care to recognize both.
The reframing of beginning-of-life-issues for productive discussion in the public square also means exploring beyond the attitudes and positions of the baby boom generation as well as finding more solid ethical foundations for decisions that have the potential to fundamentally alter the genetic foundations of the human race.
The assertion that our generation – the baby boomers – has had the last word on abortion or any other beginning-of-life issue and that no “reopening the discussion” should be allowed is not only arrogant but simply unacceptable to a younger generation that will insist on making its own decisions regarding public policy in these areas – decisions that, we hope, will be better informed than ours by new knowledge and deeper ethical reflection.
In particular, public policy on such beginning-of-life issues as the regulation of reproductive technologies, germ line alteration and cloning requires reconsideration of the ethical foundations on which such policies are to be based.
Are pragmatic, utilitarian ethics (the ethics of contemporary politics and the marketplace) sufficient? If so, then these ethics say that, if the promised benefits outweigh the visible costs, we should proceed.
But when we’re dealing with something as fundamental as mankind’s potential to alter the genetic foundations of our species, is it not what the ethicists call “deontological ethics” that need to be brought into play? If so, these ethics say that, when it comes to the preservation or alteration of human life, certain actions and decisions are either inherently right or inherently wrong, regardless of other considerations, and we ought not to do that which is inherently wrong.
I’m confident that, 20 years from now, the ethical, scientific, medical and political context within which Canada deals with beginning-of-life issues will have been reframed. Respect for women will be even more firmly entrenched than it is today, and a new appreciation of what’s required to implement that respect in law and practice will have emerged.
But significant progress will also have been made toward respect for unborn humans, attaching certain rights to them, such as the right not to be deliberately harmed if a woman has chosen to bring a fetus to term or to be aborted solely for sex-selection purposes. And the legal and public-policy framework within which a woman, her partner and her doctor make beginning-of-life decisions will require each to give due consideration to such rights.
The challenge for society and some future Parliament will then be to debate not when life begins but at what point before birth our law should begin to recognize and respect certain aspects of “personhood” in the unborn or, at the very least, that they are human beings. And most difficult of all – the issue with which we should have been wrestling all along – how should we reconcile the rights of the fetus and the rights of the mother on those occasions when they conflict?
This column was published by the Globe and Mail on October 5, 2012