Saturday, September 6, 2008

Physician, Heal Thyself

During an attempt to criticize a woman because of her political potential, a medical doctor loses his way in a discussion about abortion.



There's something about the dynamic new Republican VP nominee, Sarah Palin, that compels physician and Salon.com blogger Rahul K. Parikh to leave the familiar grounds of medical expertise and traipse, rather clumsily, into the wilder territory of political and ethical commentary.

Parikh's latest concern is that Sarah Palin elected to have a prenatal test to determine whether or not her unborn child, Trig, had Down syndrome, and the doctor's argument is that Palin is a hypocrite because that test provided her with a choice (to abort or not) that—being pro-life—she would deny to others.

The difficulty with the doctor's diagnosis is that he begs a crucial question: namely, what are the unborn? If the unborn are not fully human persons, not bearers of rights as you and I are, then no problem. But if they are fully human persons and subjects of dignity, then his reasoning is dead on arrival. Parikh seems blind to the fact that the validity of his reasoning hangs on such a question, and not seeing it, he repeatedly stumbles, making the same mistake throughout his article.

To take just one example, consider the following commentary from Dr. Parikh:

By knowingly giving birth to a Down syndrome child, Palin represents a minority of women. A 2002 study found that about 90 percent of pregnancies in the United States where the fetus was diagnosed with Down syndrome were terminated.

Rabid anti-choice activists have called that trend eugenics via medicine. But try telling that to a mother who is told early on in her pregnancy that she will be raising a child who will have a host of medical and developmental problems, requiring intense medical and social attention for the rest of his or her life. It can be tragic and nearly impossible news to bear.

Now consider a slightly modified set of paragraphs—penned by me, not Parikh—which will help to make the point:

By knowingly caring for a Down syndrome child, Palin represents a minority of women. A 2002 study found that in about 90 percent of cases in the United States where a toddler was diagnosed with Down syndrome, the child was terminated.

Rabid anti-choice activists have called that trend eugenics via medicine. But try telling that to a mother who is told early on in her life as a parent that she will be raising a child who will have a host of medical and developmental problems, requiring intense medical and social attention for the rest of his or her life. It can be tragic and nearly impossible news to bear.

This may strike the reader as outrageous. And it should. Yet the changes made above boil down to simply substituting a class of individuals outside the womb (young child, toddler) for those inside the womb (the fetus). When that is done, the assumption in the doctor's rhetoric—namely, that the unborn are not fully human persons—is flushed out into the open, and his argument is revealed to be as hollow and unconvincing as the arguments of slave owners in the antebellum South. If there is a real human being at stake, his arguments are pathetic. If he believed that the unborn were fully human, then he couldn't possibly argue the way he does. So the whole thing turns on the question of the nature of the unborn: are they human beings, or not? Yet Dr. Parikh says nothing about that question.

To apply a medical analogy, this oversight is like a physician counseling a patient suffering from terminal cancer, and telling her that she just needs to drink more water, or make a dietary change, perhaps get a little more exercise. If you're engaged in ethical discussion about the situations justifying abortion, you need to deal with the real issue—the humanity of the unborn—before considering peripheral circumstances.

Given this background, is Sarah Palin a hypocrite for having a test that—the doctor admits—would help to prepare her and her family to deal with a child with special needs? What if he had said this: "Sarah is a hypocrite because she had her newborn tested for Down's syndrome, and decided to keep him, but she had the choice whether to kill the toddler or not and would deny that choice to others"? Would it really make any sense to call such a woman a hypocrite under those circumstances? Of course not. And yet that is more akin to the frame of reference that Sarah Palin is operating out of, because abortion, in her view, is the killing of a defenseless human being. Not only that, it is also the loss of a significant blessing to a family and to humanity, generally—in Sarah Palin's words, a "gift" of "unspeakable joy." Whether or not you agree with her, you can't call her a hypocrite.

There are excellent arguments for the full humanity of the unborn (e.g. those marshaled in Francis Beckwith's Defending Life from Cambridge University Press, or Robert George's Embryo, or Patrick Lee's fine work, Abortion and Unborn Human Life), but again, Parikh writes as if he is simply unaware of the question, and ignorant of the scientific and philosophical evidence for the personhood of the unborn.

Even from a medical standpoint, this would seem to reflect extremely poorly on a physician that has commented as Dr. Parikh has. Why? Because physicians are supposed to act in the interest of patients, to heal, and not to harm. But if the physician in question doesn't even raise the relevant questions about who the patients are in a given situation, and who may be in harm's way during a medical procedure, isn't he operating recklessly? Isn't there an element of gross incompetence or malpractice at play, morally if not legally? These are basic questions, after all, certainly basic to the medical profession that must deal with situations at the beginning and end of human life.

All through the article at Salon.com, Dr. Parikh begs these crucial questions, and simply assumes without argument that the unborn are not fully human. He takes pains to criticize a courageous mother of five with a special needs child—precisely for political reasons—but hasn't done his homework on an issue important to both his commentary and his profession. Leave Sarah Palin alone, Doctor. Heal thyself.

HT: Between Two Worlds