Ekland-Olson - Who lives, who dies, who decides?: abortion, neonatal care, assisted dying, and capital punishment

From evidence gathered in these widely varying arenas, a general proposition emerges: dilemmas, especially ones involving competing and deeply important moral principles, produce cyclical social change. In the early twentieth century, loosely linked networks of individuals and organizations, building on the findings and theorizing of Charles Darwin and others, coalesced, mobilized resources, and framed issues to produce a Supreme Court decision that legitimized the mandatory sterilization of those judged to be feeble-minded, less worthy of support and protection. The attendant logic of exclusion, aimed at enhancing and protecting life of the greater whole, formed a cornerstone for eliminating persons judged to be parasitesuseless eaters as they were called. In Hitlers Germany, legal boundaries were drawn, and empathy-diluting rhetoric was devised to further divide society. Suffering and death were inflicted on Them to support and protect lives among Us. It was not until the soul-searing consequences of the Final Solution became evident that a civil rights movement, aimed at achieving a more inclusive sense of social worth, was fully energized. As barbaric as it was, Germany was not alone. Testimony during the Nuremburg trials pointed to exclusionary injustices of a fissured social structure in the United States, and the legitimacy of existing law and practice was brought into question. Unjust laws were no laws at all.

In the aftermath of the Nuremburg Trials, a rethinking and restructuring of social worth began to take place. There emerged renewed interest in human rights, rights transcending the civil rights defined within legal jurisdictions. Occurring at the same time was a scientific and technological revolution, which also impacted how we defined, protected, and prolonged life. One thing became clear. Without a careful, more inclusive restructuring of our sense of social worth, we stood in danger of becoming scientific giants but ethical infants.

The glaring presence of cultural lag was undeniable, and a movement to advance the importance of applied ethical thinking was launched. What did it mean to be a person? What were the limits of individual autonomy? Where should the boundaries of tolerable suffering be drawn? When did life worthy of protection and support begin? What role should social worth play in the allocation of scarce, newly devised medical treatments?

The major testing grounds for the emerging moral adjustments were abortion, neonatal care, and assisted dying, with capital punishment entering the discourse from time to time. The political arena separated into camps: pro-life and pro-choice. Those claiming the pro-life position accused their opponents of devaluing life and promoting a culture of death. The pro-choice movement countered by saying that none of its proponents was anti-life or in favor of a culture of death, dismissing such claims as nonsense. Rather, the pro-choice mindset gave reverence to the autonomy of individuals, the quality of life, and the elimination or reduction of suffering.