Monday, October 8, 2007

The rights to rights

Here is a tough one. A mother wants her severely disabled child to have a hysterectomy, to spare her the discomfort of menstruation. She is opposed by Scope, the disability organisation that supports people with cerebral palsy.

I don't have a view on whether the mother should go ahead with the operation. It's plain from Scope's comments, as reported by teh Graun, that they think the mother is thinking of her own convenience. I don't think that's a terrible sin though. It must be a tough job to care for someone badly disabled.

A couple of things Scope said struck me though.

Society should adapt to accommodate disabled children, rather than modify them to fit into society, Mr Rickell said.

Should it? I don't know. I know it is the orthodoxy that the world should mould itself to the individual, not the other way round, and in general, I believe that, but in everything, you have to consider the costs and the benefits. Some things have no cost at all, so it's hard to see why they shouldn't be done, but others do, and those who want it should be prepared to explain why they should. Putting a ramp on a train, for instance, has a cost, but a low one, so it's reasonably easy to defend calling for it. Providing special educational facilities though would have a high cost, and while you might believe that the principle of providing universal education is important enough to make it worth it (and on the whole I do), it is not indefensible to consider the benefit too slight for the cost. (The same issues apply to considerations of the right to life where defending that right would involve extremely expensive medical treatment; we do not in fact defend it in cases of kidney failure: we do not expend sufficient money to guarantee a machine for everyone with failed kidneys.)

Costs, I should point out, can be measured in other things than money. Disabled people often require a huge investment of time and energy. I'm not saying they don't merit it (just as I'm not saying that they do not merit monetary expense), but I am saying that it is not beyond debate. (And again, considering the right to life, we do not defend it by barring the use of cars, which are responsible for ending many lives. We understand that rights need to be balanced, and your right not to be endangered by motor vehicles is outweighed by others' right to drive.)

I am not going to touch on the notion that others must fit themselves to society, which is clearly so. Society imposes norms on some that involve those imposed on not being permitted to express some part of themselves or their culture. You cannot kill goats in the high street, even if it's something you did back in Whereveristan. (Does anyone actually do that? It's the sort of thing them crazy furriners are accused of, but I don't know of any group that actually does publicly slaughter goats or any other animal, except for those Spanish guys who torture donkeys.) Neither can you have sex with children (so you do not have the unbounded right to express your sexuality), and so on.

Scope sees the issue in terms of rights. It says:

This case raises fundamental ethical issues about the way our society treats disabled people and the respect we have for disabled people's human and reproductive rights.

But rights are not something that inhere in you. They are something the society you are part of endows you with. Unless you have a mystical or religious understanding of rights and their origin, this is not something you can contest (although people do). And societies must consider costs and benefits of rights. Just as with adaptations of society for disabled people, some rights have no cost; others cost significantly. The right to free speech is not particularly costly, but the right to free education is. (And those who think that rights inhere in you should think about the right to education: how can that possibly be an inherent right? Would you argue that you have a right to transmission of your culture? Why?)

And I have to say, if a child is particularly badly disabled, allowing them reproductive rights has a heavy cost. If the child cannot look after itself, how can it in turn look after a child? Scope is not saying that Katie Thorpe has the right to have her own children. It is saying that she has the right to create children that her parents or the state will have to care for. Its spokesperson specifically notes that Scope is calling for more resources, presumably to that end.

I can understand why it is dangerous to suggest that rights should be restricted, or should not be universal. If Katie is not permitted her reproductive rights -- so that we allow the principle that not everyone should have kids -- then who else might not be granted them? Will there be a disability bar? Perhaps we should disallow them to the stupid? The ugly? The poor? Blacks?

But on the other hand, we allow bars in other areas. Everyone has the right to become a doctor, but Katie will never become one. It's not just that she won't have the qualifications that I'm thinking about here. It's that the qualifications needed are set to disbar her. So her right is worthless to her. Is it any different to say you have the right to have children so long as you can care for them?

Bars based on capability still deny rights, even if they don't do so explicitly. Equally so capacity. It's fine to say you have the right to hold shares in any company you choose, but you will not be able to exercise that right if you have no money.

But it is an ethical minefield. Should we provide resources to support people who cannot singlehandedly care for their children? Well yes, of course I think we should. We do in so many other ways, and I think it's right to do so. (I am a beneficiary of this kind of assistance; not least that my children's education is and will be provided by the state, but also that I receive government money to help provide for them. I won't discuss here the benefit that society receives in return for that, but it does clearly receive one, and I'm not sure that it's so clear in Katie's case what that benefit would be -- although you could argue, and I think it would have merit, that caring for all of society's members improves a society in and of itself.) But on the other hand, there are other classes of people whom I think should be discouraged from having children, and I don't consider it an infringement of their rights to do so. (Although, to be fair, if I discourage my children from having their own children before they are grown themselves, I am asking them to defer the exercise of their right to reproduce, rather than denying it to them altogether.)

As I say, I don't have a view on what Ms Thorpe should or shouldn't do. It would be easy to be glib, and condemn or support her on "principle". (How often our principles are shallow and unconsidered! It's easy to say, god no, the girl has the right to her own body, but much harder to comprehend in that view a child who cannot express what she wants with her body, for whom the mother already makes decisions that the child does not share responsibility for.) It's easy to talk about rights without contextualising them. (For instance, Americans are afforded the right to carry guns by their constitution: a right specifically aimed at preventing the government from monopolising force in a world in which that was a legitimate concern. Now the context is different, and the right no longer makes the same sense it once might have. In the same way, one can have some, albeit limited, sympathy for the argument that the modern world, and the threats it contains, militates against absolute rights to private communication and so on. In a world in which a group of men can in theory wipe out a whole city, however distant a prospect that is, the negotiability of rights might seem more apparent -- and they are negotiable: again, I point out that rights are agreements among us, not something that we pick out of the aether. We have the right to free speech in the West because we agree that it's a good thing, not because God gave us it or because it's evident that men should have it: it is not our natural condition, clouded over by society, that we should speak freely, and it is not a coherent position to say it is. I intend to revisit this issue, because I think rights are a more difficult issue in the postmodern world than they are generally taken to be, and I think liberals tend to be glib about them: but of course you have this or that right. It's an important issue because there is quite a difference between denying a right and simply not allowing it, and this difference becomes important in talking with people who do not allow the rights we allow: often we insist that they are denying rights, while they deny their existence.) At the same time though, allowing that rights have contexts creates the danger of allowing those who would suppress them a framework in which they can easily achieve that end.


Anonymous Anonymous said...

If the girl's disability makes it difficult for her to take care of herself during her cycle, and if she is never going to be able to take care of any child she may have (and is it likely that she will find someone who will want to make a life with her and have a child with her?), then it's abuse to make her suffer through menstruation if she doesn't need to.

This *man* who supposedly is championing the disabled person's right to whatever doesn't know shit of what he's talking about.

However, the girl is 15, and should certainly be consulted as to what she wants for her life, but I think people should be honest with her, just as I have been with my own daughter in as gentle a way as I can, as to the inadvisability of having children you cannot care for, thereby causing the lives of those taking care of you to be a never-ending struggle with no possibility of parole or having lives of their own. Where do the rights of one end and the other begin?

A (if only my doctor would allow me to have a hysterectomy. I asked. He won't. Men! Bah!)

October 9, 2007 at 4:26 AM  

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