To cut or not to cut?
All the generalities of chapter 9 only take us so far with any real- life decision. Now we need to get into the nitty-gritty dilemmas of the philosophical parent. New parents have to decide about vaccination. They have to decide about circumcision, if they have a boy. Mothers have to decide whether they will breastfeed, and if so, for how long. Decisions have to be made about whether the baby sleeps in the parent’s bed, or in a different bed, or in a different room. There might be an issue about whether to pierce the ears of a baby girl. Even naming the baby could be perplexing. Is it fair to give a child a name like “God” or “Apple” or "Ima Hogg” or “Nutella”? (These are real examples.)
Though all these issues are interesting and some of them (like the last) are fun, I’m going to prioritize the questions that seem to have the most urgency and philosophical complexity: circumcision (here) and vaccination (in chapter 13). To remove a boy’s foreskin or leave the boy intact? For some parents, this is an easy choice. One father I asked about it said he gave the issue absolutely no thought before having his son circumcised. Another father said he never seriously considered circumcision an option. Others think about this, and think, and think.
Parents, not doctors, decide about optional procedures like circumcision and immunization. We sometimes spin this as being due to the fact that parents know what’s best for their children, but how could that be true? All sorts of people are parents, some with lots of ideological baggage and not a lot of education. Furthermore, it really can’t be best for one newborn to be circumcised and another to be uncircumcised just because their parents have different views about circumcision. Parents are in charge not because they know best, but because medical decision-making, up to a point and in certain specific areas, is a prerogative that comes with being the mom or being the dad.
One question is who makes the decision. Another is about the content of the deliberations. What should parents take into account before making up their minds? The fact that the child is a second self might make it seem right to unreflectively decide, based on your own values or based on a gut-level preference; a father might quickly opt for "like father, like son.” But the parent also ought to be thinking of the child as a separate being, and aiming for what’s in the child’s best interests. Foreskin reduction is a medical procedure that can have serious consequences—even death—if it’s done, but also if it’s not done. This isn’t the time to act out of one’s own values unthinkingly, as one might do if the issue were something minor, like what name to give the child or whether to pierce a baby girl’s ears.
Before going on, we should notice something puzzling. In chapter 8, I argued that parents will sometimes permissibly keep custody of a child, even knowing the child would be better off elsewhere. It’s legitimate for them to think "my child, myself” and hold on tight, like they’d hold on to their own right arm. The focus of parents, at that point, is on their own rights. A decision about circumcision might be made on the very same day, but now it seems inappropriate for the parent to simply assert his own rights. "I choose circumcision (or not) and so be it!” Taking on the parenting role can involve an insistence on one’s own rights, but fulfilling that role competently requires caring about the child as a second self— but separate. And that means carefully sifting the pros and cons, so one can arrive at the choice that best reflects all the facts and considerations. Does this shift in stance make sense?
I think it does, if we consider that relinquishing a child is a gigantic loss for a parent, but making the less personally satisfying decision, out of concern for the child’s well-being, is not a gigantic loss. Once a child is in our care, and we are confident of our role as the decision-makers, nothing stops us from thinking things through in light of both our own personal values and the best interests of the baby, taken as a separate human being who will have a long life, starting with but going beyond childhood. The fact that the child is mine and the decision is mine doesn’t justify me in making the decision in a self-indulgent, unreflective fashion.