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J Clin Ethics. 1995 Fall;6(3):264-70.

On learning from mistakes.

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School of Medicine, University of Virginia, Charlottsville, USA.



This article is a response to criticism of a previous paper by the same author. In the previous paper, an ethical justification was given for assuring the death of anomalous fetuses scheduled for second trimester abortion by the intracardiac administration of potassium chloride (KCl). The ethical justification responded to three anticipated criticisms of use of the technique: all abortions are unjust, newborns and second-trimester fetuses with similar anomalies should be managed similarly, and the mother is entitled to termination of pregnancy but not to fetal death. The critic agreed with the ethical conclusion that the use of the procedure is justifiable but took issue with the arguments presented in response to the anticipated criticisms. The author of the present article accepts the criticisms with only slight reservations but takes issue with additional subjects presented in the critique. The author of the critique maintained that a woman's autonomy includes assurance of stillbirth by KCl injection even in healthy, viable, but unwanted fetuses. Her justification for holding this position is that children should be born only if they are wanted by someone "ready, willing, and able to assume responsibility for that child's flourishing." This position is easily expanded to state that our society is so evil that, until we reform, it is better to consider killing newborns than to bring them into this hostile environment. This argument, in fact, represents a surrender to moral and social failure as a justification for euthanasia and has eugenic overtones. Other avenues must be explored to effect the necessary social changes to address the issue of unwanted children, just as other, more preferable, means should be sought to avoid the problem of assuring stillborns in late abortions.

[Indexed for MEDLINE]

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