Legal Personhood and the Beginning of Life in Northern Ireland: Can the coroner inquire into the death of someone who was never born?

This is a guest post by Nathan Emmerich. Nathan Emmerich is a Visiting Research Fellow at Queen’s University Belfast where he has been working on Bioethical Expertise. He took his PhD from Queen’s and this was recently published as a book entitled ‘Medical Ethics Education.’

On Thursday the 21st of November the Court of Appeal in Northern Ireland (NI) gave its judgement in a case between the Attorney General for NI, John Larkin, and the Senior Coroner for Northern Ireland. The case concerned whether the Attourney General could compel the coroner to convene an inquest into a still-birth. The coroner had declined to do so, arguing that it did not fall within the remit of his office. Briefly, as the role of the coroner is to investigate deaths there had to be an individual who was, legally speaking, alive and had subsequently died. Thus coroners in NI and, for that matter, the UK have not historically held inquests into still-births. A lower court had previously upheld the position of the coroner and that judgement alluded to some of the concerns I raise here.

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The question of when life and, in particular, human life begins and ends has been persistent and contentious in biology, philosophy, theology and law. In bioethical thought there are a number of different accounts where it is common to distinguish between the start of life and the point at which a human organism attracts moral importance. Furthermore we might think that the human organism has different moral weights depending on the state of its development or, for that matter, demise. Such consdierations lead in a variety of directions, not least to the provocative argument that neonates might not meet the requirements for ‘personhood’ and therefore should not be considered (full) members of the moral community. It is not easy to resolve these ethical conundra and they will continue to trouble bioethical scholarship for the foreseeable future. However, the law cannot afford the luxury of uncertainty. Whilst we might recognise some degree of complexity and attempt to mediate between competing demands, ultimately the law has to adopt a position on when the ‘human organism’ becomes an individual, recognised by law and, therefore, a (legal) person.

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Pregnant Women

Readers may be interested to learn that the initiative to include pregnant women in biomedical research is gaining steam.  To follow this progress, please check the following website:  http://secondwaveinitiative.org/ And–just as the movement to lift severe restrictions on abortion is … Continue reading

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Adrienne Asch

This post originally appeared on the Medical College of Wisconsin Bioethics Listserv. It is posted here with permission from the author. I have known Adrienne since the mid-1980s, when she approached me after I had given a talk for the … Continue reading

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Private Imaging in Alberta

Canada’s single-payer health system is the envy of some Americans. Under Canadian Medicare, every province runs a single public health insurance plan with very low administrative overhead: in this sense, the system is efficient. It is also a natural fit for the goal of health equity: everyone is in the same plan; everyone has the same benefits.

A single-payer system is no panacea, however. Much rides on what the single payer covers and does not cover. For example, Canada scores poorly on international comparisons of health equity. This is largely, but not entirely, the result of what we exclude from Medicare: prescription drugs, as well as non-physician care (physical therapy, dental care, speech language pathology, etc.—any function not performed by physicians), in the community. As a result of these exclusions, Canada has a high rate of private health insurance for extended benefits, and one of the highest levels of private expenditure among universal health care systems. If you need rehab, or have on-going prescription drug costs, moving to Canada might or might not save you from American-style inequities in access to care.

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Embryo Sex Selection Shouldn’t Be Illegal

This commentary was initially posted on August 16, 2013 on the Impact Ethics blog and is reposted here with permission of the authors. Visit impactethics.ca

Stephen Wilkinson and Eve Garrard respond to Alana Cattapan’s blog post calling for the continuing prohibition on embryo sex selection.

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Alana Cattapan raises many important questions about our objections to the current legal prohibition on embryo sex selection within IVF (not sex-selective abortion), in the UK and other relevantly similar countries. We are grateful for this opportunity to comment.

Law and Morality: Our report, Eugenics and the Ethics of Selective reproduction, isn’t about the ethics of IVF sex selection per se, but about the defensibility of a legal prohibition on IVF sex selection.  We hold that, while some instances of sex selection are morally problematic, the case in favour of a ban is insufficiently strong.  Using the powers of the state to impose legal restrictions on people’s reproductive behaviour is a serious, and potentially dangerous, business and something to be done cautiously and only for compelling reasons.  Sometimes there are such reasons – we don’t support an entirely laissez-faire position – but, in the case of sex selection, a conclusive case hasn’t been made.  We don’t claim that sex selection is desirable, or even that most cases of it are morally acceptable.  Our conclusion is just that the case for legal prohibition is insufficiently strong to overturn the presumption of reproductive freedom.

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Women, politics and feminism: we need to watch our backs

The times are tough, both for women in politics, and regarding political decisions affecting women. Three recent events are particularly noteworthy. The first was the overthrow last week of the first female Australian Prime Minister, Julia Gillard. While I was scouring news sites for comment and analysis on that sorry affair, I noticed the extraordinary effort of Texan senator Wendy Davis to filibister a Senate Bill that aimed to introduce regulations with the potential to close 37 of the 42 clinics that provide abortions in Texas and to ban abortion after 20 weeks gestation. Her courage and tenacity have proved to be a lightening rod, attracting swelling support in the aftermath of her marathon speech. The contrast could not be greater between this event and the actions of Ohio’s governor in signing into law major restrictions on women’s reproductive rights in that state a few days later. As Steve Benen reports, Governor Kasich was surrounded by middle-aged white men as at the stroke of a pen, he introduced wide-ranging and draconian measures that will make seeking abortion, for women including those pregnant following rape, a far more onerous, expensive and difficult event than it needs to be.

How are these events linked?

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LET HER SPEAK

Tuesday night, Senator Wendy Davis, a very vocal supporting crowd at the Texas capitol, and very engaged online communities fought for women’s reproductive rights in Texas.

And won.

The issue, if you haven’t heard — and you may not have, as mainstream media ignored this yesterday (most hilariously on CNN, where the caloric value of blueberry muffins were discussed during the climax in the TX Senate) — the issue was Texas Senate Bill 5. This bill would make illegal any abortions “at or later than 20 weeks post-fertilization” on the basis that “substantial medical evidence recognizes that an unborn child is capable of experiencing pain by not later than 20 weeks after fertilization” (SB5). This, along with other restrictions about meeting ambulatory care facility standards, would restrict the number of abortion providers in the state of Texas by 80-90%, leaving just five. FIVE PROVIDERS. For the entire state of Texas.

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Money Talks

The Supreme Court of the United States (handily referred to in short as SCOTUS) heard arguments on April 22, 2013, weighing speech rights of grant-receiving non-profit organizations against the rights of the U.S. government to put restrictive conditions on the grants which they give.  At issue is whether the U.S. government, through the U.S. Agency for International Development (USAID) can require groups doing anti-HIV work supported by USAID to take a stance against prostitution.

 

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Tasmania Proposes Bill to Decriminalise Termination of Pregnancy

Whether or not women have access to safe termination of pregnancy is a critical issue for women’s health. In Australia, access to termination of pregnancy is governed by a patchwork of state laws. Many states still have abortion listed under nineteenth crimes act, creating the situation in which abortion is illegal unless certain conditions are met. These conditions may be specified in the various acts, or have been determined through case law. They usually relate to the likelihood that continuing the pregnancy will pose a grave threat to the health of the woman, and require certification from two doctors before the woman can legally be offered the procedure.

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Necessary Restrictions? I don’t think so.

A commentary by Art Caplan alerted me to the recent case of a “surrogate” offered $10,000 to abort the fetus she was carrying, “Baby S.” After meeting with a couple through an agency, Surrogacy International, Crystal Kelley signed on to gestate their frozen embryos, one of which survived. Unfortunately, at five months, a sonogram showed that the fetus had serious abnormalities, abnormalities that led the contracting couple to ask Kelley to terminate the pregnancy, as their contract specified—although it included no details about what abnormalities could trigger that clause. Kelley initially refused, even though she was notified that the contracting couple was unwilling to assume legal responsibility for the resulting child. She was then offered $10,000 to abort the pregnancy. Although Kelley was opposed to abortion, she made a counter-offer for $15,000. The contracting couple refused, but by then Kelley had apparently decided that she would not have an abortion no matter what.  The contracting couple responded that they would take legal custody of the child, then abandon her to the state of Connecticut. In response, Kelley fled to Michigan, where she would be recognized as the child’s mother when it was born, and where she could get topnotch care for it. Because Kelley recognized that her circumstances precluded her caring for the child herself, she sought—and found—a family eager to nurture such a child. In the meantime, the contracting couple took steps to be named legal parents. In the end, the man relinquished his legal standing in exchange for the couple’s right to some social connection with the child.

What a mess…

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