u/Connect-Knowledge992

I hadn't planned on making this post, but Last Week Tonight released an episode about fetal personhood that made my blood run hot.

In the episode, John Oliver cites the case of Cherise Doyley, who was mid-delivery when a tablet with containing a Zoom call with a judge was wheeled into her hospital room to make a determination about whether she would be forced to have a c-section.

In my previous post on bodily integrity, I brought up forced c-sections but effectively "punted" on the issue, saying of such cases:

>Discussing all these cases will be impossible in a single post, but it’s important to note that some of these cases actually do legitimize an intrusion into a pregnant woman’s bodily integrity to save the life of her baby. For example, in Jefferson v Griffin Spalding County Hospital Authority, the Georgia Supreme Court upheld the state’s authority to authorize a caesarean section over a mother’s objection to protect the life of a viable unborn child.

>However, there is a massive caveat: in every case I found where courts overrode a pregnant woman’s bodily integrity to protect a fetus, the compelled procedure also significantly benefited the woman’s health. Courts tolerated such intrusions only when they improved maternal outcomes, not when they posed additional risk.

By sticking to the legal facts alone, I refrained in this post from making a statement of support for or against. For the purposes of the post, this was sufficient, and as I'm long-winded generally, I didn't include arguments against forced c-sections.

However, after seeing such an intrusion on video tape, with the judge telling her that she had no right to counsel in this case, I am incensed and realized I should have taken a hard position against this from the start. The indignity of being ambushed and forced to cover up during childbirth so that a panel of strangers can decide your medical care, against your (informed and educated) consent, and telling you that you have no right to representation while they hastily dictate your treatment, is absurd. Beyond absurd; it's a travesty.

This case is a perfect example of this prescient review written more than 15 years ago:

>Court ordered cesarean sections come up infrequently in the courts, but when the situation occurs, it occurs in the worst possible way. The decision making time is often limited and the doctors face a pressing deadline. Parents are unprepared to defend their position and the courts lack the time to analyze the law and issue properly. (Pg. 24)

That the conclusion is still relevant today is a failure of the legal system:

>Court ordered cesarean sections happen infrequently, but they can occur. Because of their infrequency, courts have reached different results on the issue. In these situations, however, courts should honor the woman’s wishes and not use a balancing test. By using a balancing test, the woman becomes nothing more than a shell protecting the fetus until birth. Women have come a long way since the image of a docile, subservient woman and have the same legal rights as men in this country. A balancing test, however, causes the courts to sweep aside the woman’s rights and places her firmly in the Middle Ages, when the cesarean section was a last resort. While doctors face a quandary about who to treat with a pregnant patient, they, as well as the courts, should honor the woman’s decision. By acting contrary to her decision, the woman’s constitutional rights are violated, and she is placed back in the kitchen, barefoot and pregnant. Courts should not presume to know what is best for the woman. Thus, they should abide by the woman’s informed refusal of a cesarean section and not use a balancing test, which could result in a trade off between her rights and the fetus’s rights. (Pg. 25)

This kind of indignity should never occur.

This is a perfect example of how in a culture where fetal rights are given priority over those of their mothers that women are treated as mere incubators, with their desires for their body ignored and their rights trampled. No one should be treated as a vessel for another life that takes priority.

Is there any possible argument that these women should have their competent decisions overridden by rushed judges who paternalistically claim to know better? I do not think there is.

During my time debating abortion, I have found it incredibly difficult to find common ground. The debate often gets stuck on defining words. Even simple concepts like “killing” and “rights” get muddled when having this discussion. This is because, I think, we have shockingly different understandings of these words and take for granted that others must think like us.

This is decidedly not the case.

Take the word “killing”. My previous post assumed a definition of killing oriented around how directly your causal contributions were to the resulting death. While at the time this approach seemed appropriate, it later occurred to me that assuming this definition only addressed a single moral parameter that might define killing. However, even among philosophers, simply defining what counts as “killing” as opposed to “letting die” requires a fair amount of clarification.

Even more complex is the morality of killing. To quote Jeff McMahan, “there is no single, unitary explanation of the wrongness of killing.” In truth, the moral permissibility of killing is determined by a set of interacting variables, such as:

Causation: How directly did the person cause the death? Was it direct or indirect?
Intention: Did the person who caused the death intend for that outcome?
Responsibility: Did the person who caused the death have a responsibility to act to preserve life or to not act to end it? Was the person in some way responsible for the deceased's situation in the first place?
Rights Justification: Did the person who died have a right that was violated by their death?
Normative Justification: Was it morally permissible to cause the death of the individual?
Prior Trajectory: Was the person who died already on a negative health trajectory prior to your involvement, or was your act the beginning of their negative health outcome?
Power Dynamics: Does one party have disproportionate power to dictate terms?
Alternatives: Did you have the ability to act reasonably in a way that would have avoided death?

Given that there is no single element of an act that we use to define “killing”, nor is there a single element by which we morally judge killing, it may be more useful to talk about the moral variables involved rather than appealing to a contested definition.

While I want to try and go through these variables one at a time in a future post, I'd like to dedicate this post on a single variable: prior trajectory. I've seen PLers argue that for situations like Thompson's Violinist, it is morally relevant that the Violinist was vulnerable (or on a "negative health trajectory") prior to your being connected. I'd like to know why.

Per my view, the Violinist argument doesn’t change conclusions if we talk about the Violinist as someone whose trajectory was a healthy one prior to your involvement. If you woke up connected to someone that is otherwise healthy but disconnecting would cause a shock to his system such that it would kill him, I don’t think that creates a substantive difference in the conclusion. I still think you are morally permitted to disconnect.

So, that's my line of questioning for this post: What makes a pathological dependence morally less obligatory than a “healthy” one? This assumes natural biological states generate stronger obligations than pathological ones. This strikes me as a kind of teleological argument. Why is trajectory or nature morally relevant to the discussion?

Forced C-Sections

Health Trajectories