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Culture War Roundup for the week of January 1, 2024

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I don't know about the US, but in the UK the surgery would not be done unless the parents wanted it to be, and there if anything the system would encourage the parents not to go ahead on the basis that people underestimate how hard it is to raise a severely disabled child.

The doctors involved have the outright ability to deny the parent's wishes here, if they consider it to be against the best interests of the child. This goes the other way too, they have the legal ability and duty to forcibly provide care in situations where the parents might vehemently disagree, if they think it's in the child's best interests.

Source: I've studied enough of UK medical ethics for my exams that I'm now more familiar with it than the laws in India.

Source: I've studied enough of UK medical ethics for my exams that I'm now more familiar with it than the laws in India.

You are of course, correct, but the reported legal cases where doctors have refused treatment that parents wanted on "best interests of the child" grounds (e.g. Charlie Gard) involve more severe disability than spina bifida - mostly cases where the treating doctors thought it was unlikely that the child would ever breathe unaided. If doctors were deciding to withold treatment based on a judgement that parents who claimed to be willing should not in fact be allowed to parent a child who could have a "normal disabled" life then there would be parents suing and the cases would be showing up in the law reports.

The reason why the ethics textbook I hurled across the room in my youth used spina bifida as a case study is that the surgery is sufficiently simple that refusing it is clearly infanticide-by-omission, and was therefore a live controversy at the time (example discussion from a quick google) with the Reagan administration treating it as a right-to-life issue in the US and repeatedly being overruled by the courts, leaving it as in issue of de facto parental discretion.

As far as I can see, that specific issue is no longer live in the UK because modern imaging means that spina bifida is diagnosed in utero and the standard response outside pro-life culture is an abortion (although fetal surgery which seals the spinal cord and prevents damage before it happens is now an increasingly available option). I don't think this affects the ethics much - I genuinely struggle to see how the morality of unaliving a likely-to-be-disabled child depends on which side of the birth canal it is on.

The point I am trying to make is that nobody (except parts of the US pro-life movement) treats infanticide-by-omission in this type of case as "monstrous" - everyone understands that it is a practically and morally difficult decision. And utilitarians (or any other form of consequentialist ethics) think that infanticide-by-omission and infanticide-by-deliberate-act are approximately morally equivalent. So when I see "Singer is a monster who promotes infanticide of disabled kids" I assume I am seeing either an ill-thought-out emotional response similar to my 18-year-old self, or a religiously motivated pro-lifer (who secular philosophers have already written out of the conversation because "God says so" is not a valid argument unless both sides acknowledge that God is real).

I don't really have a longer response to make because I happen to agree with you here haha. Yes, a few centimeters of flesh and fluid doesn't change the moral valence as far as I'm concerned (and thus I see no difference of note between abortion or infanticide, at least for identical periods of gestation), and knee-jerk emotional responses attract at best my bemusement, at worst my disdain.