To the Editor:
As the mother of a beautiful and bright but genetically-defective (spina bifida) son, I was encouraged to read Norman Podhoretz’s and Samuel McCracken’s defense of life and reproductive freedom in the May issue [“Beyond ZPG” and “The Population Controllers,” respectively]. The authors express justified horror over the eugenic implications in population control. Surely the state should never interfere in so personal a matter as whether or not two people want to have or keep a child.
But Messrs. Podhoretz and McCracken in their own emotional rebuttals to the population alarmists address themselves only to the theoretical aspects of the question. The hard, immediate problems remain; for example, to what ends should a doctor go to keep alive a defective child? Or should a doctor use such new tools as amniocentisis to detect a defective fetus?
When my son was born in 1950 very little was known about spina bifida and few surgeons would or could operate to close the spine. The tough and lucky babies survived. Now a rapidly growing number of very severely handicapped children survive. By and large doctors make the decision to fight for life regardless of the consequences, and the mother and child bear the brunt of heartache, physical pain, emotional burdens, and financial strain.
The neurosurgeon made the decision to operate on my son, and I am thankful that he is one of the fortunate few who survived with a minimal handicap. Even so, it has been hard for him and for me; we can appreciate the terrible burdens of the severely afflicted and their families. Their survival is one of the tragic ironies of medical progress. One cannot write this irony off with the “slippery-slope” argument as Mr. Podhoretz does.
Now that the authors have purged themselves of their repugnance to the population planners, I would like them to address themselves to the practical problems of what to do now with the knowledge we have. Where and how do we strike a balance between what we know and what we should do? Theory is fine, but it is a long way from the firing line.
Samuel McCracken writes:
Because Luree Miller writes from the firing line, I would naturally listen to her very carefully, even did I not already generally agree with her. As I have pointed out, one of the great weaknesses of much population-control writing is a fondness for a terrible simplification (“a woman should have the right to control her own body”; “quality of life, not quantity”), perhaps plausible in theory but certainly very difficult in practice. It is easier to recite the slogan about control of the body than to decide when, if ever, a fetus has rights one must respect. (The fetus is currently in a confused legal status: because it can inherit property, the court will appoint a guardian to protect its right to do so; but its right to life itself is increasingly compromised.) Also, it is rather easier to establish criteria for quantity than for quality.
Just such an awareness of practical complications makes me very skeptical of terrible simplifications, one of which is Mrs. Miller’s term “genetically defective.” Her son, as she says, has beauty, intelligence, and a defective spinal cord. Does this make him more or less defective than someone with a dull-normal intellect and a normal spinal cord? Or, for that matter, than someone with the same beauty and intelligence and a genetically impeccable spinal cord damaged by accident? Or, on balance, are we to regard all three as equally defective?
Setting up a system of genetic bookkeeping is not going to be simple.
If we continue the traditional policy of protecting life at all costs, inevitably we will produce more and more handicapped persons, many of whom, along with their families, will endure the anguish of which Mrs. Miller writes; this is one of those costs. But the complementary policy of singling out for death the genetically inadequate (even if we knew what the term meant) will have its own little ironies, perceived or not. In an age when respectable physicians write in respectable medical journals of the desirability of involuntary affirmative euthanasia as a tool for population control, we seem to be freeing ourselves of silly sentimentalisms about the sanctity of life in general; but even the new realists ought to have second thoughts about the possibility of killing someone who but for his cleft palate or club foot might have lived to vanquish cancer for the rest of us.
The traditional attitude to this question awards the benefit of the doubt to life, the view now being so widely urged upon us, to death. As long as these are the alternatives, choosing between them turns out not to be so difficult after all.
Norman Podhoretz writes:
I have nothing to add to Samuel McCracken’s letter except to say Amen.