What if you couldn’t save everybody? This is a hypothetical question found in the “lifeboat game” and often designed in our day to persuade people into accepting the notion that some lives are less valuable than others and therefore expendable. The origins of the game itself in 1974 can be attributed to ecologist Garrett Hardin, whose purposes were not to promote the situation ethics of Joseph Fletcher in individual cases, but rather to illustrate the dangers of a population explosion and promote his notions on how to implement coercive world-wide population control. There is a connection between the two, however, as Planned Parenthood and many advocates of birth control also support Population Control. Hardin wrote:
The only way we can preserve and nurture other and more precious freedoms is by relinquishing the freedom to breed, and that very soon. “Freedom is the recognition of necessity”–and it is the role of education to reveal to all the necessity of abandoning the freedom to breed. Only so, can we put an end to this aspect of the tragedy of the commons.
Usually the teacher or professor in the lifeboat “game” sets up a scenario where you must choose to save some and choose to throw one or more other passengers in a lifeboat overboard. The “leader” usually also defines the race, age, gender, occupation, marital and parental status, handicaps and other information about the passengers, lending a supposed rationality to your decision making.
In real life, nobody wants to face a decision on who they must try to save if you can’t save everybody. Firemen and EMTs must cringe at the thought it could happen to them. There is a legitimate “triage” used to determine the priorities of treatment at the scene of a catastrophe or on the battlefield, based upon the medical conditions and needs of the patients. But in all of my readings on the subject, no one has ever dared determine treatment based upon the social or personal attributes of the patients or victims as listed above.
The pro-life movement has allowed itself to be conned into playing this game. When we say in advance that there is an abortion exception “for the life of the mother”, we have given away the core of the life argument. To be sure, this dilemma rarely—if ever—occurs. Providence has given us an answer that is rather simple in most cases: Doctors and families must try to save both lives. The most frequent circumstances don’t require “the choice” often presented in these discussions. In rare emergency cases, for example, the mother may be at risk of dying if the baby is not removed right away. If the baby is too young to live outside the womb, obviously he or she will die if the mother dies. This is not a matter of choosing to save the mother over the baby. The baby needs the mother. Since you can only save the mother, it is acceptable, though tragic to take the baby. An ectopic pregnancy would be in this category. There was no choice to be made. Only one person could be saved: the mother.
If a baby could potentially survive outside the womb, you must remove the baby and try to save him or her, as well as the mother. This might be the case later in the pregnancy when the mother has severe complications from gestational diabetes or high blood pressure and is at great risk of dying if the pregnancy continues. Again there is no choice to be made. You must try to save both.
Finally, in the case where cancer has been detected in the mother and the treatment will certainly kill the baby and perhaps allow the mother to survive or live longer, what should the family do? With great gravity I would suggest that the mother must forgo that kind of treatment at least until the baby can be safely removed from her womb. The key words in the scenario I gave were “certainly” and “perhaps”. The decision, of course, becomes more difficult depending on the diagnosis.
The evil found in the aphorism “the life of the mother exception” is that we are expected to immediately sacrifice the life of the child for the mother, without thought and without condition. If you have a doctor who comes to you with the attitude of “what baby?” in a scenario like this, get a different doctor. For example, if one doctor told you that you must have major surgery tomorrow and that you would only have a 3% chance of getting out of the surgery alive, you would get another opinion before making a decision. Give the baby the same consideration you give the mother, and you have begun to deal justly.