Adam J. MacLeod

Judging human worth

Adam J. MacLeod
By Adam MacLeod
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May 24, 2012 (thePublicDiscourse.com) - Some of the great civil rights battles of our day are being waged in Massachusetts, Vermont, Hawaii, and Montana this year. If you do not recognize those states as civil rights battlegrounds, you are not alone. While advocates for assisted suicide have targeted those states with legalization campaigns, residents may not fully appreciate what is at stake.

The connection between assisted suicide and the civil rights struggles of previous centuries is foundational. To claim that some human lives are not worth living is to deny the intrinsic and equal worth of every human being. It is, in other words, to deny the principle from which we derived our prohibitions against slavery and racial segregation. Pro-life scholars and activists would do well to make this clear, and may be assisted in their efforts by consulting the arguments of Emily Jackson and John Keown in their new book, Debating Euthanasia. Jackson, a law professor at the London School of Economics, marshals the arguments for legalization of physician-assisted suicide and voluntary euthanasia, and Keown, the Rose F. Kennedy Chair in Christian Ethics at Georgetown University, defends their continued prohibition by law on both practical and principled grounds.

Central to Keown’s case is concern for the equal and intrinsic worth of all human beings. The “cardinal ethical principle” of the inviolability of human life prohibits the intentional killing of an innocent person, and it is precisely this principle that grounds the “equal and inalienable rights” that we enjoy “in virtue of our common membership in the human family.” The authors of the Declaration of Independence thought this principle self-evident. Keown points out that the principle also finds expression in the Preamble to the Universal Declaration of Human Rights, the European Convention on Human Rights, and a 1994 report of the House of Lords Select Committee on Medical Ethics. Neither anachronistic nor novel, this idea explains the law’s insistence on protecting the lives of all, irrespective of age, stage of development, or condition of dependency. No one is better off dead, Keown maintains, “even if some patients lose sight of their worth.”

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It is precisely the failure to grasp the implications of intrinsic human worth that plagues arguments for decriminalization of physician-assisted suicide and voluntary euthanasia, including Jackson’s. Jackson quite candidly rejects the inviolability of human life. “There is nothing independently valuable about being alive, other than that it enables me to live a life.” But to claim, as Jackson does, that the value of life is merely instrumental is to reject the immutably inherent and equal value of all human persons. On Jackson’s terms, any particular human life is more or less valuable, and thus variably worthy of legal protection, according to some standard of instrumental usefulness. But this raises the questions of how the value will be measured and whom the state will authorize to make the valuation.

Jackson recognizes this problem but seems unable to resolve it coherently. She insists that we should not accept the judgment of the lovesick teenager that her life has no worth, and yet we should accept the same judgment from the elderly or terminally ill person for whom “life has become an intolerable burden.” Jackson discounts outright the lives of persons in persistent vegetative states because of the “important difference between simply being alive, and having a life which is worth living.” But here, again, we are no closer to understanding what a worthy life consists of.

Jackson tries to resist the full implications of her own argument. She protests that “accepting that someone’s life has ceased to benefit them is not the same as saying they have no worth.” Family and friends of a suffering patient, she claims, can assent to the request for death without assenting to the judgment that the patient’s life is worthless. Presumably, the operative principle here is one of deference to the personal autonomy of the patient, but Jackson does not explain why deference is necessary. Given the high correlation between terminal illness and depression, deference would seem especially inappropriate in such cases.

Jackson’s conception of human worth becomes clearer in light of her analogy to animal euthanasia. “When it comes to animals,” Jackson observes, “most people accept that euthanasia is not only justifiable, but also often the right thing to do.” For at least some humans, she argues, the experience of dying is no different than a cat’s. Even allowing for differences between humans and cats, such as the practice of making wills and other provisions for resolution at the end of life, these differences do not “justify forcing someone to suffer intolerably.”

That Jackson considers this argument persuasive indicates that she has not fully confronted the claim that human beings have intrinsic and equal worth. Keown is quite clear that we should not force anyone to suffer, nor should we preserve life at all costs. “That would be ‘vitalism,’” Keown explains, “and morally indefensible.” The right to life is a “right not to be intentionally killed” (Keown’s italics). Animals enjoy no such right precisely because they are merely animals, and not humans. Acting with a purpose to bring about the death of a fellow human being is fundamentally unlike acting with a purpose to bring about the death of an animal.

Jackson fails to appreciate her interlocutor’s arguments in other respects, as well. An important corollary of the inviolability of human life is the principle of double effect, according to which it is sometimes permissible knowingly to bring about harms (as foreseen side-effects) that may never be intended directly. Jackson attacks this principle with a hypothetical:

If I visit my doctor complaining of mild stomach cramps, it would not be acceptable for him to give me a life-threatening injection of diamorphine, and he could not escape responsibility for my death by pointing to the doctrine of double effect. My doctor could not claim that his intention was merely to relieve my pain, and that my death was a foreseen but unintended side-effect.

It apparently does not occur to Jackson that the doctor’s disproportionate response to the pain would in fact supply a significant, perhaps conclusive, reason to infer that his intentions were not pure. She ignores what Keown expressly states, namely, that one of the conditions of the operation of double effect requires a “proportionate reason for allowing the bad effect to occur.” Far from excusing the disproportionate conduct that Jackson rightly condemns, the principle of double effect would rule out the doctor’s actions.

By contrast, Keown takes Jackson’s arguments seriously. (In one instance, he makes the effort to strengthen one of her arguments before refuting it.) Indeed, the book’s most glaring weakness is its asymmetry. The rules of engagement required each author to submit his and her contribution blindly, unable to predict precisely what arguments the other would deploy. Nevertheless, Keown and others have developed many of the pro-life arguments over a period of many years. If Jackson wanted to understand the arguments she was trying to refute, then she could have found robust statements of those arguments with little effort.

Despite this asymmetry, Jackson’s contribution to the book is well worth reading. She is often refreshingly candid, as when she acknowledges the limits of personal autonomy. She remarks that the choice of suicidal patients to end their lives requires the cooperation of others: “they are crucially dependent upon other people, namely healthcare professionals, to comply with their wishes.”

Jackson’s contribution also contains important reminders for opponents of decriminalization. Legalization proponents, like many citizens who are open to legalization, are motivated not by bias against the disabled but rather by compassion and respect. “It seems cruel to force someone to endure suffering they find intolerable,” Jackson’s argument goes, “and condescending to disbelieve them when they claim to be suffering so much.” Such advocates, therefore, tend to be unpersuaded by the common pro-life argument drawing analogies between contemporary legalization and Nazi euthanasia practices. As Jackson notes, the Nazis operated on social Darwinist theories of racial hygiene; their “motivation was never a compassionate response to individual suffering.”

Similarly, Jackson offers some insight into the relative inefficacy of “slippery slope” arguments. Accepting assisted suicide and voluntary euthanasia does not, in her view, obviously set one on a course toward “the involuntary extermination of disabled people,” and therefore, a blanket prohibition seems to her “a peculiarly blunt approach to regulation.” Why not give carefully regulated legalization a try?

There are, of course, many good reasons not to try. Keown discusses the failures of regulatory efforts in Oregon and the Netherlands. Despite the prevalence of depression among those who request assisted suicide and euthanasia, fewer than 10 percent are referred for psychiatric evaluation. Oregon’s meager reporting requirements prevent any comprehensive study of abuse, but anecdotal evidence suggests that coercion by family members is sometimes a factor in the decision to commit suicide. And the speed with which the Dutch have moved from voluntary euthanasia of adults to non-voluntary euthanasia of infants should trouble even those who are unmoved by slippery-slope arguments. But for legalization proponents, these failures are insufficient reasons not to proceed with legalization, albeit with more rigorous regulations. Jackson herself criticizes the Swiss regulatory scheme for its lack of safeguards. For example, she favors rules that would require “thorough investigation of the person’s circumstances.” One has the impression that, no matter how many of these safeguards might fail in practice, Jackson will always be prepared to propose more, until reasonable concerns about abuse are satisfied.

Most importantly, Jackson has no answer to the moral argument against physician-assisted suicide and euthanasia. And herein lies a lesson for pro-life advocates as they fight legalization efforts around the country this year: they should resist the temptation to avoid making moral arguments. They are our strongest resources. To skirt the fundamental moral question would be both unnecessary and, it seems, a strategic blunder. Pro-life activists should not give offense or recall images of swastikas. It is enough to point out that a nation committed to racial equality should, for the same reason, be committed to the intrinsic worth of the sick and the disabled.

Adam MacLeod is an associate professor at Faulkner University’s Thomas Goode Jones School of Law. This article reprinted with permission from thePublicDiscourse.com.


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African denounces Western elites pushing population control in his country

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By Ben Johnson

An op-ed in one of the leading publications in Uganda has denounced the promotion of IUD use and other long-acting reversible contraceptives (LARCs) in the nation as a colonialist form of population control.

An article published in New Vision, which bills itself as “Uganda's leading daily,” and which was posted online after being translated into broken English, contradicts the frequent claim that there is a desperate cry from Africans and brown people generally to provide the “unmet need” for contraception in the Third World.

Programs to convince African women to use the IUD or other forms of contraception “are projects of multibillion international agencies distributing them under the guise of helping the poor countries to control birth rates,” Stephen Wabomba wrote.

The use of the IUD leads to an increase in “the spread of STIs/HIV/AIDS, infections or increased rates of Pelvic Infection Diseases (PID),” and other maladies, he said. The IUD, which is inserted into the uterus and may work for years at a time, offers no protection against sexually transmitted diseases and often does not prevent fertilization.

Western governments and NGOs are very much “aware of the side effect[s] but still force them on us through sensational marketing strategies by claiming that there is unmet need” for contraception “in Uganda,” he wrote.

He instead suggested the use of Natural Family Planning methods as the “best alternative” for married couples, as well as increased “funding of chastity and abstinence education in Uganda.”

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He called on every citizen of Uganda “to stand up and be counted as a lover of life” and become a “protector of the voiceless and defenseless unborn children being aborted every day.”

Wabomba is heeding his own advice by acting as director of the Pregnancy Help Center in Jinja, the second largest city in Uganda. The town of 87,000 is perched on the shores of Lake Victoria.


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UN tells Chile and Peru to legalize abortion

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By Guilherme Ferreira Araújo

On July 7 and 8, the United Nations Human Rights Commission (UNHCR) discussed Chile’s abortion laws and issued a report asking for liberalization of those laws.

According to the report, Chile “should establish exceptions to the general prohibition of abortion, contemplating therapeutic abortion and in those cases in which the pregnancy is a consequence of a rape or incest.”

Chile is one of the few countries that prohibits abortion in all cases.  So far, the country has managed to stand against internal and external pressure to legalize abortion.

But during her campaign, President Michele Bachelet promised to make the legalization of abortion a priority.  Indeed, last May she stated that her intention was to reopen the debate so that the government could approve therapeutic abortion before the end of this year.  The U.N. report also said that Chile “should make sure that reproductive health services are accessible to all women and adolescents."

One of the reasons the UN is using to pressure Chile’s government to change their abortion laws is the high number of clandestine abortions allegedly taking place in Chile. The UNHRC points to “official data” showing 150,000 annual clandestine abortions. However, not only is it impossible to corroborate that figure, but other sources show that this number could be exaggerated by a factor of 10.  According to an article published in the Chilean news publication, Chile B, the annual number of clandestine abortions in Chile may vary between 8,270 and 20,675.

Inflating the number of illegal abortions and maternal mortality is a common tactic of the pro-abortion movement’s effort to legalize the deadly practice. Dr. Bernard Nathanson, founder of the National Abortion Rights Action League (NARAL), famously admitted the tactic after becoming pro-life.

“We claimed that between five and ten thousand women a year died of botched abortions,” he said. "The actual figure was closer to 200 to 300 and we also claimed that there were a million illegal abortions a year in the United States and the actual figure was close to 200,000. So, we were guilty of massive deception."

Chile has also been used as a prime example that legalized abortion does not reduce maternal mortality.

A study published in 2012 by Plos One Institute found that since 1989 when Chile banned abortion, there has been an annual decrease in maternal death. That study, and others compiled and published by the Chilean MELISA Institute strongly challenge the myth that abortion is safe or even necessary to increase maternal health.

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Notwithstanding the empirical data, the United Nations is also hard at work to pressure Chile’s neighbor to the North, Peru, to liberalize its own abortion laws.  In the case of Peru it is the Committee on the Elimination of Discrimination Against Women (CEDAW) that has issued the report, not the UNHRC.  CEDAW representatives examined Peru’s case on July 1 and suggested that Peru should legalize abortion in case of rape and severe abnormalities of the unborn child.

The organism suggested that the government eliminate all laws that punish women who abort and asked that Peru “urgently” adopt a law to fight violence against women, a notion often used as a euphemism for legalizing abortion.  

The CEDAW commission presented the conclusions of the report on July 22 and put special emphasis on the abortion issue. This happens despite the strong opposition to abortion in Peru. A recent survey showed that 79 percent of Peruvians support the Catholic Church’s position on abortion.

The CEDAW pressure on Peru is not new. In 2011, after the UN sanctioned Peru for denying an abortion to a teenager, Carlos Polo, Director of the Population Research Institute’s Latin American office, stated that the UN organism doesn’t have the right to force Peru to approve abortion.


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People ask me all the time, “How do you live with your past?” My answer is silly, but it is a true story. Youtube screenshot
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I helped so many women abort their babies. Now how do I live with that?

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By Abby Johnson
Abby Johnson business card Planned Parenthood

I have many memories of my time with Planned Parenthood. I spent eight years of my life there. Some memories are good, some are not. But they are contained in my mind. It’s easy to forget them. I have forgotten so much about my time there in just four and a half short years. 

I found my old business card the other day. That is a tangible memory for me. It made me think of the day that I heard I had been promoted to direct the clinic. I was so happy…hugging and jumping up and down with my supervisor. She was so proud of me.

I thought about the day I moved everything into my new, big office. I put pro-choice stickers all over my file cabinet. I called my parents to share the news. They were, of course, proud of me, but hated my work. I can’t imagine how conflicted they were in their minds and hearts. Human resources sent me my new paperwork. There was my new title, my new and amazing salary. 

A few days later, my new business cards came. I remember putting them in my new business card holder on my desk. I filled up the business card holder that I kept in my purse. I had already become used to hearing myself say my new title.

I was proud of myself. I was proud of the hard work I had put in to earn that new title. I worked so many hours, sacrificed so much time from my family. But I knew it would be worth it. And now I had the job title to prove it.

I remember proudly passing out my new business cards to anyone that would take one. Being pro-choice was not just a movement to me; it was a lifestyle. I wholeheartedly embraced that lifestyle and loved being a part of it. 

These tangible reminders that I occasionally find are sometimes hard to work through. I remember receiving the records from my medication abortion. That tangible reminder of my past was difficult to manage. I look at my “Employee of the Year” award that I received from Planned Parenthood and think back to the night I received it. I ended up putting that old award on my desk as a reminder of where I came from and how much my life has changed. Seeing that plaque no longer brings back those tangible memories. 

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One of the reasons I was so taken aback when finding my old business card was not just because it was a reminder of how proud I had been to run an abortion clinic…something I find deplorable now. It was because of the things I took part in while I had that big title.

The memories of handing women small monetary checks in order to pay for their silence after we had left them with a serious infection after their abortion. The memories of watching women bleed out on our abortion table and being instructed not to call the ambulance because we didn’t want to let the pro-lifers know that we had a medical emergency. The memories I have of “joking” about the babies that died in our facility by abortion. The memories I have of training our abortion facility employees on the “normalcy” of abortion and how to convince women that abortion is the best choice for them.

Part of being a former abortion clinic worker is learning how to deal with your past sin. It may be the lady who came to your clinic for an abortion that you bump into at the store. It could be standing in front of your former abortion facility and remembering all of the damage your words and actions did to so many women. It could be finding that old business card that reminds you of the pride you felt when you became the director of an abortion facility. 

People ask me all the time, “How do you live with your past?” My answer is silly, but it is a true story. 

One day I was watching the kid’s movie “Kung Fu Panda” with my daughter. In the film there is a wise, old tortoise named Oogway. He is talking to one of his students who is frustrated with his current situation. Oogway asks his student, “Do you know why today is called the present? Because it is a gift.”

That little line by an animated tortoise hit me like a ton of bricks. Today is a gift. There is absolutely nothing we can do with our past. And there is very little we can do to control our future. We live NOW. We serve NOW. We choose to move on from our past NOW. 

I don’t know what your past sins are. And I don’t know how frequently you are reminded of them. But as someone who has to face their past sins on pretty much a daily basis, I can tell you that you can be free from their burden. Being reminded of your past doesn’t mean that you have to live with constant grief. It simply means that you have been given the opportunity to transform your past into something positive…maybe you can help others make different choices than you did, maybe you can help others heal from the same struggles that you lived through. I don’t know what you are being called to do, but as the saying goes, “God can turn our mess into a message.” 

Carrying around past burdens doesn’t help us in any way. Know that you can be forgiven. Accept that forgiveness. Use your life to help others. The present is indeed a gift.

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