Born-Alive Does Not Mean Viable: Exploring the Ethical Nexus of Anti-Abortion Laws and Neonatal Care

Abstract: The Born-Alive Abortion Survivors Protection Act (H.R.26) is a proposed law mandating care for infants of any gestational age that are “born-alive” following an attempted abortion. It dictates that healthcare practitioners must “1) exercise the same degree of care as would reasonably be provided to any other child born alive at the same gestational age, and (2) ensure the child is immediately admitted to a hospital” or be subject to criminal penalties. Building on the politically-charged language of the Born-Alive Infants Protection Act of 2002, which confers the legal status of “person” entitled to all protections of the law on any expelled fetus that “breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.” This legislation promulgates misinformation about fetal/neonatal physiology and encourages non-beneficial treatment and misallocation of healthcare resources. Comparable bills have been proposed and passed in several states.

In this session we will explore this collision of anti-abortion politics and neonatal practice, parsing the erroneous logic of equating “presence of a heartbeat” with “viability” from the standpoint of neonatal ethics. We argue that healthcare centers ranging from level IV neonatal intensive care units to abortion clinics are ethically obligated instead to withhold non-beneficial therapies from delivered pre-viable neonates. Additionally, we will explore the role of parental authority in decision-making at the limits of gestational viability, and how such laws threaten to override parental values when outcomes are uncertain and the acceptability of potential quality of life among survivors differs between individuals.

Christy Cummings – Boston Children's Hospital; Katie Watson – Northwestern University