Author:  H. Tristram Engelhardt Jr.

Title:  Ethical Issues in Aiding the Death of Young Children

Publication information:  Beneficent Euthanasia, edited by Marvin Kohl, published by Prometheus Books, Buffalo, N.Y., 1975.

Outline by  Don Berkich,  University of Texas, Corpus Christi (by permission)

Englehardt argues that infants and children are not person's in the full sense of the word and hence decisions about whether or not to use extraordinary measures to save their lives is best left to their parents.  Englehardt goes further and argues that even ordinary care may be withheld in cases where it is clear that the child or infant's continued existence is actually an injury to the child or infant.

Argument

When is (active) infanticide morally permissible?

1. Infanticide is morally permissible when there is little chance for a full human life and a great likelihood of suffering.

2. Infanticide is morally permissible when there is great cost to prolonging life.

Who should decide when to euthanize?

• Since the child is socially considered a person only in virtue of being a member of a family, it follows that the parents have the right to determine when it is appropriate to euthanize their children.

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Summary by Damali Joseph, Queensborough Community College  (2002)

Euthanasia is very common to both adults and children.  But it involves issues that brings out a difference between euthanasia of adults and euthanasia of children.  Children are not seen as equals to adults because children are not independent and need someone to make decisions for them.  On the other hand, adults are independent and need only themselves for decision-making.  When the subject of Euthanasia is brought up it is obvious that children cannot be involved in such things just because they cannot exercise their personal rights, therefore they need adults to pursue the issue of life and death for them.  There are several reasons there are queries about children and these types of subjects question the ranking of the rights of children, the standing of parental rights, the responsibility of adults, and effects on society and people.   

Euthanasia, sometimes known as infanticide among children is described as preservation of unexpected life-prolonging healing.  Death is not intended directly, no extra treatment is pursued on the recipient of care causing in the end, death.  This is one of the reasons that for example, as high as 14 percent of children in one hospital have been acknowledged as dying after a choice was not made not to treat additionally, the belief that the children would have survived longer had treatment been presented.  Had there not been options to treatments, children would have died anyway, but these tribulations seem to be products of medical progress.   

In the passages to come, I will be discussing differences between adult and children euthanasia, the analysis of the issues involving parents and the status of children, then, the perception of the “injury of continued existence”, and finally, an outline of unanswered important questions that relates to the issues.            

The Status of Children 

Drawing the line between persons and other human beings who may not be persons may be as difficult as drawing the line between child and adult.  Adults are rational, lucid, responsible human beings who can form goals and meaningfully pursue them.  Adults are sui juris.  A young person in turn isn’t responsible.  An adult is responsible for making decisions and in turn they depend on no one to help guide their lives and well-being.  As for a child, they can’t depend on themselves.  They are in no way capable of handling adult responsibilities and therefore they need adults to guide them in the right direction.  So, are children persons?  In a social sense, children bear no responsibilities, so they survive and exist through the care of the adult party, mother, father, and so on. 

Therefore, a child and adult must be treated in a different aspect.  An adult and child cannot bear the same respect because an adult is independent and a child is dependent.  An infant and child are important because they in turn are valued because they grow up to be responsible individuals.  Therefore, all decision making is “held in trust” by an older, responsible adult.   

Medical decisions to care for a small child or an infant all depend on what their future life will be.  If a child bears no future achievements because of an illness, withholding medical treatment is justified.  Justified because of the expensive costs and the unnecessary prolonged suffering which not only the child experiences but the parents, too.  Anything having to do with treatment is the responsibility of the parent because they are the ones who have to make sure the child pursues life long fulfillment.  The function of the physician is to make sure that the parents know and understand all aspects of treatments even cost.  Extraordinary and unusual treatment is never an obligation for treatment because of the high cost in 2 cases.  1) Serious compromised future of life and 2) costly treatments.  Parents are not expected to take on high costly burdens especially when the child is in high risk of an abnormal life.  In the end, the decision is the parent’s, whether to have a normal or deformed child and at what costs.  Even though the decision is left up to the parent, if the parents denies a child who is of value the society can intervene especially if the weight is light and the value of life is great.  Society values mother-child relationships and family-relationships and in turn don’t won’t intervene unless 1) neglect is unreasonable and therefore would undermine respect and care for children and/or 2) where social intervention would prevent children from suffering unnecessary pain.   

The Injury of Continued Existence 

What about the child?  What about who the child might become in the future?  It’s a good thing to save the life of a child but what about forcing the child to suffer and live?  It would be a duty not to treat in those circumstances that would prolong suffering and give a pathway in cases where costs of treatments are not severe but the child’s survival would be full of grief, suffering and pain.  Sometimes the concept of life is pursued being in turn the “wrongful life.”  Sometimes just the pain of survival, existence can bring about injury and harm to the living person.  The forced life, the person has to endure are less preferable than the person’s nonexistence.  Life has been seen as an injury when a person’s existence under terrible circumstances leaves them suffering.  These cases have raised quite a few issues.  Issues insinuating that life can be a gift and also an injury.  We had the autonomy to create and make our own judgments.  People have the choices to bring a life as a gift in to the world or an injury.  If a person doesn’t have a positive input in the world, only negative, their life can be seen as an injury.  But adults who are responsible for them see this as being a controversial issue.   

A painful life must not be forced upon a child because1) medicine can now cause the prolongation of the life of seriously deformed children who in the past would have died young and that, 2) it is not clear that life so prolonged is a good for the child.  The decisions of euthanasia are in turn based upon the child’s suffering and life.  If an injury is a basis for life then it provides excuses for passive euthanasia of children instead of the duty to treat. 

Conclusion