HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Tuesday, November 16, 2004

Bioethics Class Visits NICU.

They're not law students, but the 13 members of Peter Singer's freshmen seminar, "Ethical Choices," nonetheless recently had an opportunity to view first-hand the excruciating choices typically debated in "Bioethics and Law" classes around the country.  As described in an article in the Nov. 15 Daily Princetonian, "Singer had brought his students to the ward to show them the living faces of a medical debate featured prominently in his scholarship and his seminar: whether it is ethical to end an infant's life when medical data predict she has a low chance of surviving."  Actually, Singer's claims go considerably beyond this statement, and the article eventually gets to the argument that has made Singer's views so controversial:

     Born 14 weeks premature, the 2-hour-old infant the class had come upon had a slim chance of surviving, let alone growing up without mental and physical impairments. Because of these defects, Singer argues the infant's parents should be able to decide whether to shut off her life-support machines and end her life. That claim, based on a belief that a young baby is not self-aware, has generated widespread controversy across the world. (emphasis added)

The class had the opportunity to get both sides of the argument from Singer and from the medical director of the NICU, Mark Hiatt:

   "We [at St. Peter's] don't want to do all this aggressive, heroic intervention unless there's a good possibility that this will be an intact, healthy child," he said. "[But] I could never do anything to terminate a [healthy] life. I became a doctor for the opposite reason."

    Hiatt said he would not allow a baby to die by any means except withdrawing care, called passive euthanasia.

    "As a society, I don't think we want our doctors to [perform active euthanasia, where the doctor directly ends someone's life]," he added. "I wouldn't do it. I couldn't do it. . . . I'm not an executioner."

    Not all students, however, accepted Hiatt's reasoning.

    In discussion on the bus ride home, class member Nic Poulos '08 called Hiatt's distinction between active and passive euthanasia "semantics."

    "He's enabling the child's death, period," Poulos said. "He didn't say, 'Yes, [my position is] based on guilt, but he did say, 'No, I couldn't do that.'"

    Singer played his usual Socratic role in the discussion, speaking up only to inject questions or ask for clarification. When pressed, he agreed with Poulos.

    "I don't think there's a distinction between deciding to withdraw life and deciding to actively end it," Singer said. "[Hiatt] also has an attitude that you should try to save every life you can, regardless of circumstances. In the case of the grad student [who asked Hiatt to withdraw care from his baby] . . . it's still a human life, but it's a life that's barely begun. I would have been prepared to agree with the parents."

This is a discussion I'd have been pleased to hear my law students develop, and the annual trip we take the PICU at Children's Medical Center Dallas often provides just such an opportunity.

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