ENDEAVOUR FORUM NEWSLETTER No. 113, FEBRUARY 2004

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ACPeds.org) was born out of a genuine concern for the welfare of children and the traditional family.  It began with a group of Pediatricians who recognized that children are at great risk emotionally and physically. 

In a June 12, 2003  Position Statement on  Termination of Pregnancy,  the College states: 

"The Supreme Court, in Roe v. Wade, limited states' ability to regulate abortion in the first two trimesters strictly to issues of maternal health. It therefore denied that a fetus might have interests equal to that of the mother. The organized pediatric community, to this day, has offered no comment to this interpretation, reportedly because the decision centered on the mother and not on a viable infant. (Of course 30 years ago even early third-trimester births raised questions about viability.)    

“More recently, controversy has centered on late-term abortion and the procedures that are sometimes used at this stage. In its 1997 report the AMA stated ' Although third-trimester abortions can be performed to preserve the life or health of the mother, they are, in fact, generally not necessary for those purposes. Except in extraordinary circumstances, maternal health factors which demand termination of the pregnancy can be accommodated without sacrifice of the fetus, and the near certainty of the independent viability of the fetus argues for ending the pregnancy by appropriate delivery.'   

"This issue has relevance for pediatricians since it involves infants whose viability is not questioned. Refusing to take a stand in support of the infant requires denying, at minimum, a tradition spanning over thirty years, maintaining the pediatricians responsibility for the infant from conception. This  indeed is a reason-for-being of the profession. 

“The issue is clear with respect to the viable fetus, as infants of the same gestational age are admitted to neonatal intensive care units routinely. Those infants receive, and their families demand, intensive medical efforts to preserve life, and society clearly approves. At this stage of viability (currently considered to be as early as 22 to 23 weeks gestation), termination of pregnancy does not automatically entail or imply termination of a fetus.  

“Decisions regarding the care of a fetus in the termination of a pregnancy should always have ethical symmetry with that of a fetus prematurely delivered at the same stage. The Supreme Court has also supported the concept that such infants should be offered medical support. The Court (In Planned Parenthood of Kansas City vs. Ashcroft) upheld a law requiring that a second physician attend at the abortion of a viable fetus. The statute further required the physician to take all reasonable steps, in keeping with good medical practice, to preserve the life and health of the viable fetus, provided that such steps did not pose an increased risk to the life and health of the woman. The court found the second-physician requirement reasonably furthered the states compelling interest in protecting the lives of viable fetuses.  

"It is also unconscionable, therefore, to believe that we should avoid taking a position regarding the elective abortion of pre-viable fetuses, on grounds that there is a lack of consensus on this issue among pediatricians or in society at large. Human life, irrespective of stage of development, or condition, is inviolable and worth pediatric defense despite some contrary societal opinion. We may, therefore, as pediatricians, accept a civil Court's definition of viable fetus to mean capable of meaningful life outside the womb, albeit with artificial aid , as determined by the physician.  

“Yet, we understand that this concept of viability is in no way a reflection on the moral worth of the fetus, but rather reflects only the limitations of what medicine has to offer. All infants, before and after successful delivery, are dependent on support and care from others for their continued existence. As such, they are no less valued as persons.  

“In light of these considerations the American College of Pediatricians makes the following recommendations:  

"1) In recognition of the constitutional principles regarding the right to an abortion articulated by the Supreme Court in Roe v. Wade, but with higher regard for the advance of science and the values of medicine, we recommend that elective abortions not be performed. Although some abortions are said to be performed to preserve the life of the mother, they are in fact, rarely necessary for this purpose. Maternal health factors that are said to demand termination of the pregnancy can also be accommodated without sacrifice of the fetus. When there is possibility of independent viability of   the  fetus,  we  argue   for   ending    the    pregnancy  by appropriate delivery. 

"2) All pre-term deliveries should be done with the health and safety of both mother and infant in mind, and, whenever possible, with a second physician present to safeguard the life and health of the fetus. 

"3) Decisions regarding the provision of life-sustaining medical treatment for the newly born infant should then proceed as for any other infant or child.

"Addendum: .....

“Pediatricians must advocate for all children, not just for those determined 'viable.'

“We should honor the advocacy proclaimed interestingly by the American Academy of Pediatrics in 1971, preceding Roe v. Wade by some thirteen months, to include pediatricians' responsibility for the child from conception through young adulthood.

“We must uphold scientific integrity. We must speak out against further 'sacrifice of the fetus'. The American College of Pediatricians shall not waiver from that commitment."

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