This is precisely how the Culture of Death permeates our society. A bioethical practice once almost universally condemned is promoted at the fringes. The initial response is resistance. But soon, the non judgmentalism arrives, usually in professional journals and among “progressive” pundits, asserting that these issues are “complex,” or “difficult,” or “gray,” or “complicated.” Once this non judgmentalism softens the ground, the issue shifts to one of mere “choice” (as with dehydration of PVS patients), and finally the decision of bioethicists (as in Futile Care Theory).
“The Groningen Protocol: What Is It, How Do the Dutch Use It, and Do We Use It Here?,” (Pediatric Nursing/May-June 2008/Vol. 34/No. 30) by Anita Catlin and Renee Novakovich, is a case in point. (The Groningen Protocol is an infanticide “guideline” used in the Netherlands, discussed often here at SHS.) The article does a very good job of dispassionately describing infanticide practices in the Netherlands and Belgium, and contrasts it with American practices of palliative support, noting that euthanasia is unethical for nurses to participate in at the present time. It also gives both sides of the arguments about the Protocol, with yours truly the quoted opponent.
Issues related to suffering infants, their families, and the nurses and doctors who care for them have been debated for many years. These issues have been examined medically(Carter & Levetown, 2004), ethically (Cassell, 2004), morally(Romesberg, 2003), and legally (Hurst, 2005). In the U.S.,with the desire for beneficence (doing good), the lives of extremely premature infants are frequently supported at the estimated cost of nearly one million dollars per hospitalization. The principles of social justice (care for all children) and non-maleficence (allowing no harm) are seen as less important. However, in countries with socialized medicine, the principles of social justice and non-maleficence (avoiding doing “good,” which causes suffering) have been seen as more important. As long as the U.S. health care system supports the use of extensive technology for infants with life-limiting conditions and provides reimbursement for extremely long hospital stays, the dilemma over what some might consider miracles and others view as suffering will continue
Beware! What we don’t condemn, what we claim to be mere “dilemmas,” we eventually are urged to allow. Infanticide is moving into the mainstream of bioethics and the medical intelligentsia.
(Can provide copy for those who e-mail me privately.)