New Semester, New Case

In which we consider a difficult pregnancy in Texas and how it might get the students engaged.

Professors working on their syllabi be like . . .

Thanks for your patience while I and the substack took a much needed break (mostly me, the substack is remarkably impervious to fatigue). I’m preparing my syllabi for classes that start next week and we’ve got some extras and commentary for those of you who preparing to teach or take Bioethics using Practical Bioethics this semester (or quarter, or tri-mester, I won’t judge).

For instructors, since Practical Bioethics is so dependent on cases, why not start with a case guaranteed to rev up the intuitions. A third rail case about Kate Cox who had to leave Texas to get an abortion.

What makes this media soaked case so relevant? I would say it’s the recognition of just how complication and uncertainty can surround a decision to abort or carry a fetus to term. And the question that looms, “If there is so much risk and uncertainty, isn’t this something best kept between doctor and patient?”

Kate Cox was told that her baby had Trisomy 18 (Edwards Disease). Trisomy-18 is one of those gene abnormalities that is rarely survivable. 95% die in the womb. Those that dont, die shortly after birth. 10% go on to live a year. A precious few live past a year.

On top of all this, Cox made four trips to the ER during the pregnancy and was told continuing the pregnancy could result in

“gestational hypertension, gestational diabetes, uterine rupture from Caesarean section and post-operative infections,”

If that wasn’t enough, she was told that continuing the pregnancy would endanger her ability to have other children. According to Texas’ new law, an exception to the ban on abortion required that life of the mother or a serious risk to a vital bodily function. In fact, the Texas Supreme court said that no court order was needed just a doctor saying that in their “reasonable medical judgement” the abortion was necessary to prevent loss of life or vital bodily function.

Is future fertility a vital bodily function or is it just a bodily function that is outweighed by the baby’s right to life? (If you want to understand the Supreme Court decision, I recommend this podcast explainer)

That’s a philosophical question. In fact, this case brings several moral intuitions into focus.

1. Isn’t the best thing to prevent the most amount of suffering overall? (utility)

2. Does Texas have any moral authority to prevent the mother from getting an abortion given that her future fertility and good health is at stake? (autonomy)

3. Doesn’t the child deserve just as much time living as is possible? (presumption in favor of life)

4. Even if the baby dies shortly after birth, isn’t this passive euthanasia better than the state supporting active euthanasia. (passive vs. active euthanasia)

Since this is such a third rail, students may be very concerned about speaking up in favor of either position. So if I was going to start the semester with this case to get the juices flowing, I’d use polleverywhere.com. I love this software! It allows students to answer anonymously on a screen in real time using their phones. And its my favorite price: free.

If you are instructor, I highly recommend it especially when you are worried about students self-censoring. It’s also great for getting a feel for where the class is on any third-rail issue instead of just assuming the opinions of Millenials. I’ve been very surprised by where the class was on an issue on several occasions.