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Kevin Miller responds one more time to my last posting on the Ashley Treatment

Second, I think it’s simply wrong to define “mutilation” as only that which destroys something “essential for life.” That would make mutilation nothing more than a synonym for “murder.” But, at least in Catholic moral thought, the two are distinct. One can, in fact, mutilate without killing. One can destroy something necessary for normal function – but not for life.

Actually when I initially attempted to define mutilation, I also mentioned disfigurement. One could argue easily that there is nothing disfiguring about a hysterectomy. Lots of women have had them and you’d never guess which ones! Neither is there anything disfiguring about short or small stature! The only possible case for disfigurement could be for the mastectomy. But again with large pendulous breasts, that also require care for skin breakdown underneath the breast as well as fungal infections (a frequent site for infection is under large breasts) one could argue about which is truly more disfiguring.

But I’d like to explore the “mutilate without killing” aspect a bit further. This was done in Nazi Germany (sometimes without anesthesia) to dehumanize victims, for perverse pleasure, for medical experiments and other truly evil reasons. I just cannot wrap my brain around the terms “mutilate, deform, mar, injure, etc” for what was done by loving parents for their young daughter. I think to apply that to this situation is a very extreme (as well as erroneous) position to take.

Third, mutilation is defined in terms of proximate intention – in terms of the chosen act – not in terms of the remote intention (“disrespect”).

Since I don’t agree that this is mutilation I’m not sure this applies. Nonetheless, I’m not a moral theologian so I had to do some digging. I came up with this:

When there is a clash between the two universal norms of “do good” and “avoid evil,” the question arises as to whether the obligation to avoid evil requires one to abstain from a good action in order to prevent a foreseen but merely permitted concomitant evil effect. The answer is that one need not always abstain from a good action that has foreseen bad effects, depending on certain moral criteria identified in the principle of double effect. Though five are listed here, some authors emphasize only four basic moral criteria (the fifth listed here further specifies the third criterion):

The object of the act must not be intrinsically contradictory to one’s fundamental commitment to God and neighbor (including oneself), that is, it must be a good action judged by its moral object (in other words, the action must not be intrinsically evil);
The direct intention of the agent must be to achieve the beneficial effects and to avoid the foreseen harmful effects as far as possible, that is, one must only indirectly intend the harm;
The foreseen beneficial effects must not be achieved by the means of the foreseen harmful effects, and no other means of achieving those effects are available;
The foreseen beneficial effects must be equal to or greater than the foreseen harmful effects (the proportionate judgment);
The beneficial effects must follow from the action at least as immediately as do the harmful effects.

Fourth, as I said before, it’s true that this girl’s bodily growth/maturation would coincide with severe disability. But her growth to normal size, and her sexual maturation, would still be, in themselves, normal.

Well I’m not arguing that. Of course they would be normal. The question is whether it was “evil” to alter them. Kevin says yes because it is mutilation. I don’t see it that way and I certainly find his continued use of the term “mutilation” to be problematic, almost inflammatory language.

Fifth, I was not making a circular argument. I simply didn’t provide an argument that mutilation is intrinsically evil.

Nor did I argue that because what was done in this case was evil, therefore it must be mutilation. I argued that because it destroyed normal organs/functions, it was mutilation – and therefore, it was evil. And Elena says she agrees that mutilation is intrinsically evil. So the sticking point here is either (as Elena says above) whether what was done was mutilation, or whether “mutilation” as encompassing acts short of murder is still intrinsically evil.

Unfortunately, I am not a mind reader. It sure looked like a circular argument from what was provided.


With the Catholic tradition, I maintain that it is. Respect for human life entails refraining from not only intentional killing, but also acts short of killing that still destroy normal bodily functioning.

In all instances? Always? What about circumcision? A widely practiced unnecessary removal of tissue that many Catholic parents still request for their newborn sons.

Elena’s post goes on to respond to the last reader’s comment that I blogged. I would say that, first, one doesn’t have to know whether institutionalizing the girl would be more or less moral than mutilating her, to know that mutilating her was wrong. The question is a red herring.

Perhaps, but frankly the tone of Kevin’s commenter ticked me off. How dare they get “ticked” because these parents are being “selfish.” As my commenter Kay said, this wasn’t about being selfish, this was about a valid assessment of what was doable.

Second, it simply isn’t correct to say that the girl’s normal growth would be any sort of direct incumbrance to her life.

One wonders when was the last time Kevin had to do any caretaking for an immobile 200 pound, possibly resistant adult. If she can’t be moved, if she can’t be cleaned properly, she could suffer skin breakdown and decubitus ulcers. Those can lead to system infections and death. That to me seems like it could incumber her life!

Third, no, I don’t think prophylactic mastectomies or hysterectomies are necessarily evil. For instance, if there is a genetic condition directly affecting breast tissue by strongly predisposing it to tumor formation, then the tissue is already pathological, and can be removed. In fact, I said in my original post on this topic that to the extent that the parents were worried about breast cancer, the mastectomy might have been morally licit. But that’s far from all they had done to the girl.

Don’t get me wrong. I think prophylactic mastectomies and hysterectomies including oophorectomies can be a very wise decision if that’s what the patient chooses to prevent a disease. I don’t see the actions of Ashley’s parents as being much different than that choice.

Fourth and finally, Elena’s own previous post on the topic spoke of concern that the girl might be sexually assaulted. But one of the arguments for sterilization of the disabled has been, historically, and still is, that they might be raped – and thus impregnated. So I don’t think my other reader’s comparison of this case with the eugenics agenda is off the mark.

The other reader’s comparison was asinine, unkind and un compassionate, particularly since the parents on their public site never even mentioned it as a consideration. There are enough perverts out there that would be more than happy to fondle and assault a big busted handicapped girl unable to defend herself. It happened just a few years ago in my state at a public high school in broad dailight I think it’s foolish to pretend that that is not a real problem.

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