Two patients, or one?

Dr. Darrell Cass recently led a successful pre-birth surgery on a child at 23 weeks:

Cleveland Clinic has successfully performed its first in utero fetal surgery to repair a spina bifida birth defect in a nearly 23-week-old fetus.

A multispecialty team of clinicians performed the surgery in February, and the baby, a girl, was later delivered by caesarean section near full term June 3, making it northern Ohio’s first surgery of its kind. Mother and daughter are doing well. …

Spina bifida is a birth defect that is most often discovered during the routine anatomy scan typically performed when a fetus is around 18 weeks old. The condition affects the lowest part of the spine and occurs when the neural tube does not fully close, causing the backbone that protects the spinal cord not to form as it should. This often results in damage to the spinal cord and nerves and can even lead to brain damage.

Spina bifida can affect a child’s lower leg strength and their ability to walk and run, as well as their ability to go to the bathroom and urinate adequately. According to the CDC, approximately 1,645 babies are born with spina bifida each year in the United States.

During the fetal repair surgery, a caesarean section-like incision is made and the mother’s uterus is exposed. An ultrasound is then used to locate the placenta and fetus. The uterus is opened 4.5 cm and the back of the fetus is exposed, showing the spina bifida lesion. The surgeons then carefully suture several individual layers of tissue (myofascia, dura and skin) in order to cover the defect. After the uterus is closed back up, the fetus remains in the womb for the remainder of the pregnancy and is ultimately born by caesarean section.

“By successfully repairing the defect before birth, we’re allowing this child to have the best possible outcome and significantly improve her quality of life,” said Dr. Cass.

When a member of the human family, like this child, is wanted by her mother, we call this child a patient—and our physicians care for the child as a patient whose worth is equal to mother and father. But when a member of the human family is unwelcome, we call that child a fetus—and sometimes even a parasite—and our physicians do not care for the child as a patient, but instead intentionally kill in order to enforce the demands of the comparatively powerful over the comparatively weak. This describes not a humane or compassionate society, but rather one wherein violence has come to be seen as acceptance and even ethical.

If we only have worth because we are wanted, then none of us possess any inherent value. And if this is true, there is no coherent basis for such a thing as human rights.

There are always two patients in the case of a mother pregnant with her child. What varies is not the reality or unreality of the second patient; what varies is our interest in acting as if human rights were either real, on the one hand, or merely a sometimes convenient fiction, on the other.

Noa Pothoven’s suicide

Ross Douthat writes on the suicide of 17 year-old Noa Pothoven:

In the Netherlands, a depressed teenager … committed suicide at home, starving herself while parents and doctors offered palliative care. …

It remains shocking that a young woman’s parents and doctors would give up on treating her at seventeen and let her kill herself. And it remains shocking that Western nations are normalizing euthanasia for mental illness among otherwise healthy adults. …

When such a system emerges as a seemingly organic feature of the liberal order, what then should be your attitude toward liberalism itself? …

Liberalism has never done as well as it thinks at resolving its own crises. America’s gravest moral evil, chattel slavery, was defeated by an authoritarian president in a religious civil war, not by proceduralism or constitutional debate. The crisis of the 1930s ended happily for liberalism because a reactionary imperialist withstood Adolf Hitler and a revolutionary Bolshevik crushed him. The liberal peace that followed may depend on fear of the atomic bomb.

All of which hints that a genuinely post-liberal politics might, indeed, someday be required — to save liberal civilization from dystopia or disaster. The post-liberalisms presently on offer are not as serious as either their advocates hope or their critics fear. But if you cannot imagine ever being a post-liberal, left or right, you are not being serious either.

It couldn’t be clearer to me that the logic behind pro-suicide laws in the United States, which claim to be interested only in permitting suicide for those near death and with a terminal illness, will in time result in lawful suicide for practically anyone, in any condition. When a teenager’s suicide is affirmed and facilitated by both her family and the state, that’s a good indicator that the society has lost its ability to distinguish justice from injustice.

In the calculus of power

Archbishop Charles J. Chaput offers his perspective on Joe Biden’s unfortunate embrace of public funding of optional, non-medically necessary abortion:

Speaking at the University of Notre Dame in October 2016, just a few weeks before a national election that seemed sure to put a second Clinton in the White House, I noted that:

[Q]uite a few of us American Catholics have worked our way into a leadership class that the rest of the country both envies and resents.  And the price of our entry has been the transfer of our real loyalties and convictions from the old Church of our baptism to the new “Church” of our ambitions and appetites.  People like Nancy Pelosi, Anthony Kennedy, Joe Biden and Tim Kaine are not anomalies.  They’re part of a very large crowd that cuts across all professions and both major political parties.

During his years as bishop of Rome, Benedict XVI had the talent of being very frank about naming sin and calling people back to fidelity.  Yet at the same time he modeled that fidelity with a kind of personal warmth that revealed its beauty and disarmed the people who heard him.  He spoke several times about the “silent apostasy” of so many Catholic laypeople today and even many priests; and his words have stayed with me over the years because he said them in a spirit of compassion and love, not rebuke. 

Apostasy is an interesting word.  It comes from the Greek verb apostanai – which means to revolt or desert; literally “to stand away from.”  For Benedict, laypeople and priests don’t need to publicly renounce their baptism to be apostates.  They simply need to be silent when their Catholic faith demands that they speak out; to be cowards when Jesus asks them to have courage; to “stand away” from the truth when they need to work for it and fight for it. 

It’s a word to keep in mind in examining our own hearts and the hearts of our people.  And while we do that, we might reflect on what assimilating has actually gained for us when Vice President Biden conducts a gay marriage, and Senator Kaine lectures us all on how the Church needs to change and what kind of new creature she needs to become.

Those words displeased some who see Mr. Biden as a veteran public servant and a well-intentioned, decent man trying honestly to balance his religious faith with the demands of a complicated political terrain.  On the complicated nature of today’s politics, there can be no dispute.  But complexity is never an all-purpose excuse, especially on matters of principle, and most especially when the innocent and voiceless stand to pay the price for a bad choice.

In defending Mr. Biden, his advocates have typically pointed to his long-standing support for the Hyde Amendment banning federal funds for abortion; his support for Catholic teaching on various other social issues; and his resistance to late term abortion, all admirable positions.  In today’s Democratic Party, these things marked him as a “centrist” and set him apart from the pack of other Democratic presidential hopefuls — nearly all of them hard to his left.

That was before last week.

On June 6, the Wall Street Journal reported (“Biden’s Abortion Views Irk the Left”) that Biden faced growing criticism from abortion activists and his party’s leadership for his Hyde Amendment track record.  Exactly 24 hours later, on June 7, the same paper noted that Biden had sharply changed his thinking (“Biden, in Reversal, Backs Abortion Funding”).  Translation:  The unborn child means exactly zero in the calculus of power for Democratic Party leaders, and the right to an abortion,  once described as a tragic necessity, is now a perverse kind of “sacrament most holy.”  It will have a candidate’s allegiance and full-throated reverence . . . or else.

There’s a remark by Thomas More in the film A Man for All Seasons that’s worth remembering in the months ahead: “When statesmen forsake their own private conscience for the sake of their own public duties, they lead their country by a short route to chaos.”

I’m particularly disappointed with Joe Biden because he had a chance to stand for a somewhat older, less extremist sort of American politics in what I expect will be another corrosive national election. Joe Biden’s forfeiting his moderate reputation is both strategically and tactically incomprehensible to me—he signals that in his ambition he is willing to jettison principle, and he will likely obtain a smaller share of the vote as a result.

Ambition and politics

I don’t plan to write much about the next presidential election, and as an example of why I’ll try to avoid writing about it I’ll use Joe Biden’s unfortunate endorsement of public funding for non-medically necessary abortion as an example.

On June 5th, Joe Biden voiced support for the Hyde Amendment, which prohibits federal taxpayer funding of optional abortions. Joe Biden has supported this policy for nearly fifty years. Here’s what I said on June 5th, as Biden’s opponents were criticizing him for his willingness to strive for being a centrist:

“It should not be a controversial stance to oppose public funding of optional procedures, and in fact it should be a common American value that, because abortion is always the deliberate, intentional, and forcible ending of a human life, it should be unthinkable,” Tom Shakely, a spokesperson for Americans United for Life, said in a statement.

“However, in today’s partisan and polarized climate, we’re grateful for Mr. Biden’s continuing support of the Hyde Amendment, even as we express skepticism of his ability to maintain this position in the face his radical and extremist fellow contenders in the Democratic presidential race,” Shakely said.

One day later, Joe Biden reversed himself and abandoned his principled and moderate position, embracing the same support for public/taxpayer funding of abortion. I offered this in response:

“Joe Biden, like so many of his Democratic peers, supported the Hyde Amendment for decades, because he recognized that compelling American taxpayers to fund optional, non-medically necessary abortion procedures would be both morally outrageous and fiscally irresponsible. Joe Biden’s embrace of today’s extremism in the Democratic Party will only serve to depress millions of Democratic voters across the country who support more life-affirming law.”

David Harsanyi put Joe Biden’s reversal after nearly fifty years in context:

In 1976, Biden voted for the Hyde Amendment, a law banning federal funds to pay for abortion. In 1981, the “Biden amendment” to the Foreign Assistance Act banned any American aid from being used in research related to abortions. In 1984, Biden supported the “Mexico City policy,” which bans federal funding for private organizations that provide abortion, advocate to decriminalize abortion, or expand abortion services. 1993: Biden votes to save the Hyde Amendment. In 1995 and 1997, Biden voted for partial-birth abortion bans that would be vetoed by Bill Clinton. June 5th, 2019, Joe Biden continues his 40+ year support for the Hyde Amendment. June 6th, night, Joe Biden caves and drops a 40+-year position to appease progs. Now supports taxpayer-funded abortion, from conception to crowning. But no, the Dem party isn’t moving hard left, not at all. And Biden is a real rock-ribbed leader. If you take a position 46 years, you change your mind one afternoon, you should probably have a pretty good explanation for why. Biden will make the argument that his experience matters. But if he was wrong about everything, and admits it, then what does that experience mean?

Ambition and politics are corrosive things.

‘Incompatible with life’

Pope Francis recently witnessed to the importance of a humane attitude toward human life:

No human being can ever be incompatible with life, not due to his age, his health conditions, or the quality of his existence. Every child that enters a woman’s womb is a gift, which changes the story of a family: of a father and a mother, of grandparents and siblings. And this baby is in need of being received, loved and taken care of….

Yet, there is something that medicine knows well: children, who from the maternal womb show pathological conditions, are little patientswho not rarely can be cured with pharmacologic, surgical and extraordinary care interventions, now capable of reducing that terrible gap between diagnostic and therapeutic possibilities, which for years constituted one of the causes of voluntary abortion and abandonment of care at birth of so many children with serious pathologies. Fetal therapies on one hand and perinatal hospices on the other obtain surprising results in terms of clinical-assistance and provide essential support to families that accept the birth of a sick child….

Therefore, it’s indispensable that doctors have very clear not only the objective of the cure but the sacred value of human life, whose protection, in the end, rests on medical practice….

At the social level, the fear and hostility in meeting disabilities often induce to the choice of abortion, configuring it as a practice of “prevention.” However, the teaching of the Church on this point is clear: human life is sacred and inviolable and the use of prenatal diagnosis for selective ends is energetically discouraged, as an expression of an inhuman eugenic mentality, which removes from the family the possibility to receive, embrace and love their weakest children. Sometimes we hear it said: “You, Catholics, don’t accept abortion, it’s the problem of your faith.” No, it’s a pre-religious problem. Let us not charge faith with something that has not been its responsibility since the beginning.  It’s a human problem….

Abortion is never the answer that women and families seek. Rather, it’s fear of the sickness and loneliness that makes parents hesitate. The difficulties of a practical order, both human and spiritual are undeniable, but precisely because of this the most incisive pastoral actions are urgent and necessary to support those that accept their sick children.

“No human being can ever be incompatible with life, not due to his age, his health conditions, or the quality of his existence.”

Human remains, abortion, and eugenics

This week, the U.S. Supreme Court decided Box v. Planned Parenthood, ruling 7-2 that Indiana’s human fetal remains law is constitutional. Americans United for Life had filed a brief in support of Indiana’s law, which went to the U.S. Supreme Court because the Seventh Circuit had struck it down as unconstitutional:

Americans United for Life filed a “friend of the court” brief in support of Indiana on behalf of AUL and the Charlotte Lozier Institute, asking the Supreme Court to take the case to address this nationally important question. The brief explains that human fetuses are human beings, and as such, it was constitutional for Indiana to require the humane and dignified disposition of human fetal remains—especially in light of reports of an Indiana waste company dumping human fetal remains in landfills. 

“AUL is delighted that the Court agreed to address this important issue,” said AUL’s Litigation Counsel Rachel Morrison. “Without laws like Indiana’s fetal remains law, medical providers are free to dispose of human fetal remains by incineration with medical waste, by dumping in landfills, and even by burning the remains to generate energy. Indiana’s law recognizes the simple biological fact that human fetuses are human beings and, as such, should be treated with humanity and dignity whether in life or in death.”

Box v. Planned Parenthood is a major victory for life-affirming law and policy, because it is a de facto acknowledgement by the U.S. Supreme Court of the basic humanity of those once-living human beings whose lives were terminated through abortion. Where do human fetal remains comes from, but from human beings?

Justice Clarence Thomas’s concurrence is highly significant, because he uses Box v. Planned Parenthood to speak authoritatively on an aspect of the case that the Supreme Court has punted on, namely whether eugenic abortions (abortions for reasons of race, gender, disability, etc.) are permissible. Thomas writes powerfully on the history of eugenics and abortion, and concludes by getting to the heart of the matter, which is that abortion will continue to haunt the Supreme Court because it is the Supreme Court itself created the right to abortion and therefore will need to continue to legislate its boundaries so long as it continues to promote abortion as a legitimate human practice:

“This case highlights the fact that abortion is an act rife with the potential for eugenic manipulation. From the beginning, birth control and abortion were promoted as means of effectuating eugenics. Planned Parenthood founder Margaret Sanger was particularly open about the fact that birth control could be used for eugenic purposes. These arguments about the eugenic potential for birth control apply with even greater force to abortion, which can be used to target specific children with unwanted characteristics. …

Today, nonwithstanding Sanger’s views on abortion, respondent Planned Parenthood promotes both birth control and abortion as ‘reproductive health services’ that can be used for family planning. And with today’s prenatal screening tests and other technologies, abortion can easily be used to eliminate children with unwanted characteristics.

“Indiana’s Legislature, on the 100th anniversary of its 1907 sterilization law, adopted a concurrent resolution formally ‘express[ing] its regret over Indiana’s role in the eugenics movement in this country and the injustices done under eugenic laws.’ Recognizing that laws implementing eugenic goals ‘targeted the most vulnerable among us, including the poor and racial minorities, … for the claimed purpose of public health and the good of the people,’ the General Assembly ‘urge[d] the citizens of Indiana to become familiar with the history of the eugenics movement’ and ‘repudiate the many laws passed in the name of eugenics and reject any such laws in the future.’

“In March 2016, the Indiana Legislature passed by wide margins the Sex-Selective and Disability Abortion Ban at issue here. Respondent Planned Parenthood promptly filed a lawsuit to block the law from going into effect, arguing that the Constitution categorically protects a woman’s right to abort her child based solely on the child’s race, sex, or disability. The District Court agreed, granting a preliminary injunction on the eve of the law’s effective date, followed by a permanent injunction. A panel of the Seventh Circuit affirmed. …

“Enshrining a constitutional right to an abortion based solely on race, sex, or disability of an unborn child, as Planned Parenthood advocates, would constitutionalize the vies of the 20th-century eugenics movement. In other contexts, the [U.S. Supreme] Court has been zealous in vindicating the rights of people even potentially subjected to race, sex, and disability discrimination. … Although the Court declines to wade into these issues today, we cannot avoid them forever. Having created the constitutional right to an abortion, this Court is dutybound to address its scope. In that regard, it is easy to understand why the District Court and the Seventh Circuit looked to Casey to resolve a question it did not address. Where else could they turn? The Constitution itself is silent on abortion.”

I want to highlight something from a footnote from Justice Ginsburg in Box v. Planned Parenthood, because it’s something that will only look worse with time. In responding to Justice Thomas’s concurrence, Justice Ginsburg asserts that pregnant women who choose to abort their children are not mothers: “a woman who exercises her constitutionally protected right to terminate a pregnancy is not a ‘mother’”. While this might be causally accurate—in the sense that women whose children have died are no longer mothers—it’s neither intellectually nor scientifically coherent. Despite his rejection of her, Steve Jobs was the father of his daughter Lisa from the very first moment of her existence—and it’s no different for mothers, despite Justice Ginsburg’s tortured philosophy.

A child’s first home

I’m heading to Dallas this morning, and as I’m leaving home for two days I want to share Haley Stewart’s recent reflection on our first home:

As my fourth baby has learned to crawl over the past few weeks, I watch her launch out across the living room to grab toys and explore. After scurrying several feet away, she will turn her head back to where I sit cross-legged on the floor and return to me, climbing into my lap to rest her head on my chest or pat my cheek with her chubby palm before going on her next tiny adventure across the room.

My five-year-old, for so many years the baby of the family, still asks to sit in my lap each day. While we eat lunch, while she does schoolwork, while we read books at bedtime, her little girl limbs find a way to curl up into the space where she found comfort for so long.

My seven-year-old wraps her arms around me many times a day for a huge hug. She touches my hair or shoulders as she walks past me. She runs into my embrace when she scrapes her knee.

My ten-year-old still snuggles up as we look over math problems and read together. He still wants a hug to comfort him when he is distressed or needs to resolve a disagreement.

While my children’s need for physical touch can be exhausting, it reminds me of a beautiful truth: my body will always be my children’s first home. My body is the space where they were woven together, where their tiny baby arms and legs kicked and swam, their first cradle that rocked them to sleep.

When I was 23 and my mom was diagnosed with breast cancer, I was struck by this truth. Already married and a new mother myself, I was in the process of creating my own home and family. And yet, the prospect of losing my mom made me feel unmoored and lost. Praise God, she has been cancer free for almost 10 years. But no matter how old I am, losing my mother someday will be the loss of home—my first home. In both an emotional and physical reality. The loss of her presence will take away from the comfort of visiting my hometown. It will not feel like home, because my first home, her very body, will not be there.

We know now that some of a baby’s cells to stay in the body of her mother (fetal microchimerism). Part of each of my children will be with me forever and they each have a piece of me. We are physically connected for our whole lives. But a mother’s connection to her child transcends DNA. We will find home in those who have been a mother to us. Our birth mothers, our adoptive mothers, our foster mothers, women who have stepped in to mother us when our own mothers may be separated from us by death, illness, addiction, or abuse.

Our need for a mother, a presence of home, is part of God’s design for human souls.

I think part of the reason I found this so moving is that it’s a way of thinking and speaking that’s presently lacking in both our politics and our conversations on life issues. It’s both tender and humane, and through it we discover a truth about where we can trace our material origins that doesn’t require argument or analysis, but simply a willingness to listen and consider. It reframes life issues from their extreme focus on rights and duties, to one of hospitality and love. And through this reframing, we might consider Roger Scruton’s belief that ours is largely “a loveless culture, which is afraid of beauty because it is disturbed by love.”

Rally Against Bullying

I was in Center City, Philadelphia yesterday for the Rally Against Bullying, organized in response to Pennsylvania State Representative Brian Sims’s live-streamed verbal abuse and harassment of a grandmother, mother, and three teenaged girls who were praying outside of Center City Philadelphia’s abortion center:

The “Pro-Life Rally Against Bullying” took place in front of a downtown Philadelphia Planned Parenthood facility. On May 2, state Rep. Brian Sims livestreamed video from the same location, posting two videos in which he denounced two women, three teenagers and a man.

Sims called for donations to Planned Parenthood while offering money to viewers who could provide the identities and addresses of the witnesses.

Shortly after the videos emerged on social media, the national organization Live Action organized the rally. It featured representatives from a number of local and national groups…

Several speakers directly addressed Sims’ claims that the pro-life advocates he had filmed were racist.

Richara Krajewski of the Pro-Life Union of Greater Philadelphia said she stood before the crowd “as a pro-life black woman.”

Noting that “it’s so popular now to call out racism,” Krajewski wished to clarify that application of the term, particularly “in the context of pro-abortion politics.”

“Real racism,” she said, “is co-opting the language of liberation to advocate for the destruction of the lives of the most vulnerable. Real racism is a so-called white ally telling black and brown women that they need to choose between their dreams and their babies.”

Kevin D. Williamson writes on Brian Sims’s decision to stream himself harassing members of the public:

The times being what they are, perhaps we should classify political fanaticism of the social-media performance-art variety as a kind of insanity. Political fanatics such as Sims live in the shadows between the idée fixe and outright monomania. The inferior kind — and Sims is the inferior kind — fixate on terminology as a substitute for ideas, and for them buzzwords are a necessary intellectual crutch. Hence, Sims’s shouty accusations of “white privilege” in the face of a young woman who, as she pointed out with a smile, is not white. Intersectionality — it is a bitch.

Rep. Sims had offered $100 to anyone who would reveal the names and home addresses of the women he filmed himself harassing. Thankfully, that resulted in Philadelphians instead crowdfunding more than $125,000 to benefit the Pro-Life Union of Greater Philadelphia and Guiding Star home for women and children.

Women Speak

Americans United for Life hosted “Women Speak 2019: A Symposium on Life Without Roe” this morning at The Heritage Foundation in Washington, DC:

Women Speak 2019 brings together leaders in law, medicine, economics, and culture, to explore the current cultural and political paradigm that falsely argues abortion is necessary for women’s advancement in society.

“Women Speak” addresses itself to the heart of the presumption underlying the U.S. Supreme Court’s Roe and Casey abortion jurisprudence—that is, the idea that American women have a “reliance interest” in abortion.  A few scenes from the symposium:

Paul Strand was there and reports:

Americans United for Life organized the event, with its leader Catherine Glenn Foster arguing women would no longer need to kill their unborn children if society was more accepting of motherhood.

She asserted, “It is not women who need to change, but a nation that would discriminate against pregnant and parenting women.”

Because of that prejudice, many women feel they’ll threaten their careers, their opportunities if they embrace motherhood.

Writer Alexandra DeSanctis of National Review answered, “It’s actually deeply disempowering to women to tell them that they need the right to kill their own child in order to be flourishing, in order to be happy.”

Foster told CBN News, “The Supreme Court has this mistaken assumption that women rely on abortion to succeed in society. They say that we can’t make it on our own, that we’re not enough, that we have to have abortion, legalized abortion on demand, all nine months of pregnancy, in order to succeed. And that is simply false.”

She suggests as women fill up more and more positions in the working world, businesses and the women will both be better off if institutions learn to positively accommodate motherhood. If they won’t, it sends a deadly message. …

“Since Roe v Wade, 61 million Americans are not here because they’ve been aborted,” said Rep. Vicki Hartzler (R-MO)…

Women Speak was a great symposium and is available in its entirety on Facebook and YouTube streams:

8:30 a.m. – Registration
9:00 a.m. – Welcoming Remarks by Melanie Israel
9:10 a.m. – Opening Remarks by Catherine Glenn Foster
9:20-9:35 a.m. – Congressional Address by Rep. Vicky Hartzler
9:40-9:55 a.m. – Congressional Address by Rep. Debbie Lesko
10:00-10:30 a.m. – Law & Policy Panel
10:35-11:05 a.m. – Women’s Health Panel
11:05 a.m. – Break
11:15 a.m. – Presentation of “Defender of Life in the Media” Award
11:30 a.m. – Culture Panel
12:05 p.m. – Closing Remarks
12:15 p.m. – Lunch

Care, not suicide

I spoke this morning on Fox & Friends in response to Gov. Andrew Cuomo’s recent advocacy of suicide by physician for New Yorkers:

I spoke alongside Kristen Hanson, Community Relations Advocate for the Patients’ Rights Action Fund, as well as Dennis Vacco, former New York State Attorney General. Dennis Vacco successfully argued the landmark 1997 U.S. Supreme Court case Vacco v. Quill, wherein the Supreme Court ruled 9-0 that no constitutional right to physician-assisted suicide exists.

Suicide by physician was made lawful in New Jersey over the weekend, which is apparently what prompted Gov. Cuomo to suggest making it legal in the Empire State, too. We’re living through a time when we think we’re cleverer than we are. Suicide is suicide.