BTW, hope you didn’t take that comment as directed at you personally, I made it just after going through the comments to Sebastian’s post.

Jake

Jake

What if the death is certain, but it is a year away? What if the chances of effecting the separation are better now than when that year is nearly up?

Then I suppose they should be separated, though preferably by waiting as long as possible while still allowing for the best possible chance of effecting the separation.

But look: I’m not a bioethicist, at all, and these are hugely challenging cases – both medically and ethically. We’ve pretty much reached the limits of my untutored intuitions here, and we’ve also gone well beyond the scope of the original post.

I am not asking you to respond to outlandish situations in order to compromise your position. I suppose that could happen, were I much cleverer than I am. What I want is to understand the limits of your position, and how we can work together in this world that we share. And since you are articulate AND responsive, you get the duty – at least for today. :)

Jake

But the principle is the same, and what works for one works for the other …

Yes, but as I said – and having checked very quickly, I believe this is the Catholic position – unless it’s a case where a life is at stake and so the principle of double effect is relevant, I don’t think the twins should be separated if it means the certain or probable death of one of them.

It is a question of how long and how fruitful and with what probabilities, isn’t it? It’s a judgment call. As is the health and well-being of the mother, or of the fetus.

I don’t agree with you on the fundamentals, but I am interested in finding what common ground we can. Not so much because you and I must agree on anything, but because you are legion, as am I.

Jake

Passing a mandate that hospitals be able to be hospitals …

Huh? So a hospital can’t be a hospital unless it’s willing to kill – sorry, “remove” – a fetus that has a serious medical condition, or that poses a risk to its mother’s health? Even if it should be legally allowed, how is this a thing that hospitals should be legally required to do? Unbelievable …

She doesn’t say all providers must provide abortions, she says all providers of women’s health must be trained, specifically for cases when the fetus has died and there are no religious objections to be made.

Again, I don’t think it’s at all the government’s business to mandate what medical professionals must be trained in; if anything, that’s a question for the AMA. Moreover, I think that a doctor who has a religious or otherwise moral objection – which I don’t share – even in this case should still be allowed to exempt him or herself. But if it’s training for the removal of dead fetuses that’s the issue, then that should be what the training is geared toward; the fact that the same or very similar techniques can be used to kill – er, “remove” – fetuses that are still alive doesn’t mean that Ob/Gyns need “training in late-term abortion techniques”: insisting otherwise would be like saying that telling your child about the birds and the bees is the same as teaching him how to rape someone.

The question about conjoined twins is a challenging one, and I haven’t thought about it a lot; I suppose my initial view would be that in a case where (1) separating the twins will almost certainly cause one of them to die and (2) they really can “live long and perhaps even fruitful lives” if left conjoined, then they shouldn’t be separated. But I doubt that there are very many cases that really fit these criteria; much more often, I think, the cases will have the sorts of characteristics that makes abortion permissible in cases where a woman’s life really is at stake.

As to your final question, the person who should perform it is the person who’s most able to do it without risking the mother’s life; I’m not sure how this is controversial at all. But why should ensuring that there is such a person available mean requiring hospitals to perform abortions in circumstances entirely different from these?