Sappho I Think, in the Hypothetical Situation

Sappho

I think, in the hypothetical situation described, it is morally permissible for Wendy to obtain a Caesarian section by choice. The chief difficulty is that Wendy herself seems like a shallow and frivolous person, and the majority of the reasons that she offers for wanting a CSBC seem rather shallow and frivolous. Wendy's reasoning is that, as a personal trainer for other women, her body is a form of business advertising and that -- based on the fact that a celebrity like Britney Spears has a CSBC -- the operation will leave her body more aesthetically attractive. She also prefers the convenience of being able to schedule a surgical appointment in advance, rather than having to wait around for her cervix to dilate. And finally she notes that the father of her child, Harry, believes that her vagina will be tighter if she has a CSBC rather than undergoes the process of natural childbirth. If Wendy has a better reason than any of these, it might be that she notes that her mother's experience of natural childbirth was hardly a joyful or unproblematic one -- Wendy's mother suffered from incontinence and prolapse for the rest of her life. But we must ask ourselves whether Wendy's right to medical autonomy trumps our analysis of her own reasoning -- and surely it does. After all, medicine is not permitted to observe Wendy having sex with Harry and pass judgment over whether they are too shallow in their approach to moral reasoning in order to conceive a child: that would be eugenics. And six weeks after Harry impregnates Wendy, medicine will not forbid Wendy to have an abortion for reasons as shallow and frivolous as those she offers in seeking a CSBC -- the reasoning here is that abortion would be adequately covered under Wendy's right to autonomy as a patient. It is hard to understand, therefore, why anyone might find it morally impermissible for Wendy to obtain a CSBC, despite the overall shallowness of her reasoning. We do not require Wendy to have a "good" reason to have sex with Harry, or to get pregnant when she does, or (by and large) to obtain an abortion if the pregnancy is unwanted. If the lines of argument that Wendy presents to her first physician were instead being offered several months earlier to an abortionist -- about wanting to keep an attractive physique for professional reasons and a tight vagina for Harry's enjoyment -- it seems unlikely she would be forced to have a baby because her reasons for seeking an abortion are too shallow. It therefore seems ridiculous to suggest that her reasons are too shallow for obtaining a surgical procedure in order to give birth to a child. The claims that CSBC in some way "endangers" the child seem to be dubious at best, since the only statistics involve births where the Caesarian section was medically necessary (i.e., births that are already complicated and problematic to begin with, and that are already endangering the child quite naturally without any recourse to analysis of the mother's ethical decision-making skills).

And yet the objection could be raised here that Wendy's physician is more knowledgeable and responsible than Wendy, and his opinion that a Caesarian section is not warranted in Wendy's case should be valued above Wendy's. (This is not much of an objection -- given the quality of her moral reasoning, we might very well value the opinion of a circus clown or a wise hobo over the opinion of Wendy herself.) At the same time, we have no problem saying that it is morally permissible for Wendy to seek a second opinion, medically speaking -- in fact we tend to view seeking the second opinion as advisable, especially in important cases. But it is a worthwhile objection to suggest that Wendy's doctor thinks that her autonomy is irrelevant, and that she should be persuaded not to have a Caesarian section. If that is the case, however, then it is a shame that Wendy's doctor is not more persuasive. Then again, this indicates something about the way in which we view medical professionals societally -- presumably Wendy is supposed to be persuaded merely because the doctor is a doctor. In other words, in a situation where the ethics of an action like CSBC come down to whether or not the reason for performing the action is good or bad, we are supposed to question whether or not Wendy has a good or bad reason for wanting the CSBC, but we are schooled never to question whether Wendy's doctor might have good or bad reasons either for approving or denying her request for a CSBC.