As my late good friend Richard John Neuhaus once wrote, “for the most part, bioethicists are in the business of issuing permission slips for whatever the technicians want to do.”
A less charitable friend of his put it more bluntly: “a bioethicist is to ethics what a [prostitute] is to sex.” A recent article in the New York Times shows why one could be so harsh.
The story is about the rising number of what are euphemistically called “twin reductions”: Women who are carrying twins decide to kill one of their unborn children while allowing its sibling to live.
This demonic procedure was the unintended but not unforeseeable consequence of reproductive technologies such as in-vitro fertilization. Women undergoing IVF often found themselves carrying four, five, and even six children at a time.
The medical response was to “reduce” the number of fetuses to a more “manageable number.” “Reducing” in that case meant a shot of potassium chloride to the heart of one of the three-month old fetuses.
And do I have to tell you that the definition of what’s “manageable” has shrunk over the years? In a blink of an eye, reducing meant from going from whatever number of children there were to twins.
At this point, bioethicists became uneasy: Dr. Mark Evans, a pioneer of the “reduction” procedure, helped draft guidelines for the industry. According to the guidelines, “most reductions below twins violated ethical principles.” Evans wrote that performing these reductions turned doctors into “technicians to our patients’ desires.”
Do I have to tell you that Evans himself now performs twin reductions? He justified his reversal by saying that he understood why “women didn’t want to be in their 60s worrying about two tempestuous teenagers or two college-tuition bills.”
In other words, as New YorkTimes columnist Ross Douthat noted, Evans had become a technician to his patients’ desires.
Douthat spelled out why none of us should be surprised at either Evans’ reversal or the growth of “twin reduction.” What he calls “liberal bioethics” is always “adapting” to meet patients’ desires. What was unacceptable yesterday will be “understandable” tomorrow. Bioethicists acknowledge our concerns and promise that they will draw the line tomorrow. But, as Douthat says, “tomorrow never comes.”
That’s because, outside the Christian view that all human life is sacred, they have no real basis on which to draw that line. For all the talk about “human dignity,” this brings to mind a joke told by Winston Churchill: a woman asked if she would sleep with a man for 5 million pounds, replies “yes.” When asked if she would do it for 5 pounds, she replies, “What kind of woman do you think I am?” to which the man replies, “we’ve already established that, now we're just haggling over price.”
Bioethicists have already conceded that killing an unborn child for reasons that have nothing to do with saving the mother’s life or even her health is acceptable. They’ve given their sanction to medical procedures that make this procedure inevitable. Now they are haggling over details: how patients’ desires should be worded before they write the permission slip.