Mere Practicality? Infants, interests and the value of life

Richard Hain

HT15 St Cross Special Ethics Seminar: Mere Practicality? Infants, interests and the value of life

Venue: St Cross Room, St Cross College, Oxford

Speaker:  Dr Richard Hain (Children’s Hospital for Wales)

Date and time: Week 2, Thursday 29 January, 5.30 - 7pm

Abstract: Anyone who has been present at the memorial service for an infant knows that, in practice, people accord the life of a child a special value. Those caring for infants, like those caring for children who are cognitively impaired, intuitively respond to their patients as though they were particularly precious, and feel an obligation to care for infants - that is, to act in their interests - that expresses that value. 

Principlism is the dominant paradigm in medical ethics. It explains the value of life using both a utilitarian subjectivist account (there is a rational sense in which the individual’s continued existence will be in her own interests and/or those of others) and a deontological objective one (there are ‘contracts’ or ’ties of family’ whose nature, other things being equal, expresses an obligation to act in the interests of the individual, independently of any impact on the interests of others). 

Both accounts are problematic in infants. Infants reason differently from adults, and they are by definition dependent on others. They apprehend the universe in a way that is meaningful, but probably does not link moral action with outcome. The infant therefore values its life in the moment, but does not have an interest in its continuing existence in the way a subjectivist account of intrinsic value requires. An obligation to act in the interests of an infant is complicated by the fact that those interests must be articulated by adults. Adults can be owner, carer, proxy or advocate for the infant, and may speak in all four voices simultaneously. It is often impossible in practice (it may not even be possible in principle), to explicate the interests of adults from those of an infant in the way the objective deontological account of an infant’s value requires.

In order to explain rationally the value of an infant’s life, we need to consider a different account of interests; one that does not depend on characteristics such a reason and independence that infants definitionally do not possess, but instead flows from characteristics such as meaning-making and relationality that they self-evidently do.

Bio: Richard Hain is Consultant in Paediatric Palliative Medicine at the Children’s Hospital for Wales and a Graduate Student in Christian Ethics in the Faculty of Theology and Religion at Oxford. He graduated in medicine from Guy’s Hospital (King’s College London) in 1986 and trained clinically in paediatrics, paediatric oncology and adult palliative medicine before becoming the UK’s second paediatric palliative medicine specialist in 2000. His early research interests were in opioids in children, and he has Master’s and Doctoral degrees in Pharmacology. He designed the undergraduate curriculum in ethics for Cardiff University School of Medicine, and it was that and his clinical work with terminally-ill children that led to his developing an academic interest in end of life ethics in paediatrics. In 2011 he spent a sabbatical studying Christian Ethics with Nigel Biggar in Oxford. Alongside his work as a clinician, he is currently doing a part-time DPhil on the subject of infanticide as an exemplar of the difficulty in accounting for value in beings who are neither rational nor independent. He has written and/or co-edited a number of books, chapters and journal articles on various aspects of palliative care in children, including the Oxford Textbook of Palliative Care in Children which was awarded first prize for medical writing in both its first and second editions. In 2012 he became the first paediatrician to receive the Vitorrio Ventafridda award for Palliative Medicine.

All are welcome to this public event but booking is required.https://v1.bookwhen.com/jc3wp