When children are born with severe, debilitating conditions like some forms of spina bifida—in which some vertebrae on top of the spinal cord remain unfused and open—their lives can often amount to little more than a few months of extended agony. If they do survive, they usually need multiple operations, and often live out their lives with severe physical limitations.

In some cases, says Princeton bioethics professor Peter Singer, when a physician describes what their child's condition entails, parents come to the conclusion that it would be better for their child not to live. This is why he thinks that we should allow parents to decide whether to euthanize these severely disabled children.

Singer says he was presented with the issue by doctors in Australia who were, at the instructions of parents, not treating sick children—allowing them to slowly die from their conditions, usually before they were six months old. Singer says he and his colleague decided it is a "reasonable decision for the parents and doctors to make that it was better that infants with ... the more severe variance of this condition should not live. ... But we couldn’t defend the idea that the right thing to do then was to let them die. This seems slow and painful and ... terribly emotionally draining on their parents and others."

"The difficult decision is whether you want this infant to live or not," says Singer. "That should be a decision for the parents and doctors to make on the basis of the fullest possible information about what the condition is. But once you’ve made that decision, it should be permissible to make sure that baby dies swiftly and humanely."

In a 2005 op-ed in the Los Angeles Times, Singer looked at cases of such infant euthanasia in the Netherlands, where doctors were not prosecuted. He suggested that if we believe euthanasia should be allowed for infants who require a respirator to live, then we should also allow parents to euthanize children with conditions that have "'hopeless prognosis' and who also are victims of 'unbearable suffering.'"

In addition to spina bifida, Singer told Big Think in an email that he thinks that there are many other conditions in which such euthanasia is defensible, if the family wishes it.  "I would include severe cases of epidermolysis bullosa, Lesch-Nyhan sydrome, babies born without an intestine, trisomy 13 and trisomy 18," he says. "And in a family unwilling or unable to care for a developmentally disabled child, and when there are no other families wishing to adopt such a child, I would include Down's syndrome."

Singer says there's no absolute cut-off line in deciding which conditions should warrant this and which should not. "It depends on the family's wishes," he says. "Some families may be equipped, emotionally and financially, to cope with a severely disabled child, and others may not be, or may not want to have such a child. The final decision should be that of the family."

Why We Should Reject This

Eva Kittay, a professor of philosophy at Stony Brook University says in an email to Big Think that she is "appalled to think that parents, in most cases supported by their physicians, allowed [children with spina bifida] to die—slowly or swiftly."