Toward an Ethic of Ambiguity

The public debate on care of gravely impaired newborns is seen as preoccupied with procedural issues as opposed to more substantive, less clear-cut, moral considerations. In exploring whether there are significant differences between normal and handicapped infants that justify differential treatment, the author analyzes the most compelling, that of the "best interests" of the child. He sees limitations in standard, including problems of prognostic uncertainty, the unjust impact socioeconomic factors on quality of life, and the potential for bias when adults determine the best interests of impaired children. He concludes there is need for a supplementary standard, geared to the presence or of distinctly human capacities in the infant, which recognizes two fundamental but contradictory moral imperatives--to sustain life and ameliorate suffering. (KIE abstract)