desperate attempt to wish the circumstances other than they actually were. Most
religious beliefs do form a system, they are shared by large numbers of people and
they are culturally transmitted ± they have rational validation even if not by those
who do not share them. This is hardly conclusive, but it is persuasive.
10.8.2 Balancing rights and duties
There is another factor, however, in section 10.3.2 which is disquieting. What if
the mother's refusal of treatment did not just involve herself, but also her unborn
baby. The case ofRe S1992) cannot be considered a precedent in English law, but
it raises the issue of how far a person's refusal of treatment can be allowed to
impact on a third party. For it is clear that the judgement arrived at in that case
where a full term fetus in a transverse lie threatened the life of both fetus and
mother) turned on consideration of the welfare of the fetus as well as the ration-
ality of the mother's decision. Whatever the legal position, this cannot be ducked.
The fetus was at term. The law may not recognise the rights of an unborn child, but
morally it would be curious to assert that a fetus at term is in any significant way
different from a newborn baby. What might be arguable is whether its life may be
saved at the cost of what has been called `a massive intrusion into a person's body'
[6], i.e. a caesarean section.
In a parallel American case, that of Angela Carder, the original decision to
permit the caesarean section was overturned on appeal and Angela Carder's par-
ents won undisclosed damages from the hospital in a separate action for medical
malpractice, wrongful death and violation of civil rights. In that case neither the
mother nor the child survived the operation. Though the mother was suffering
widespread and irreversible cancer of the bone and lungs, the death certificate
listed the caesarean as a contributing factor [7].
Acaesarean section is a major surgical intervention, with all the risks and
dangers that that involves. It would seem unreasonable torequiresomeone to take
those risks in order to benefit someone else. In an American case, the courts ruled
that someone cannot be forced to donate bone marrow a procedure considerably
less risky than a caesarean section) even where failure to do so would result in the
death of a third party because only one person could be found who was tissue-
type compatible) [8]. But it does not follow that that person had no moral
obligation to be a bone-marrow donor, and that we may not think badly of him for
ducking it. Nor is there an exact carry-over from that case toRe S.Those who
willingly become pregnant have, in doing so, already accepted a degree of
responsibility for the welfare of the child they carry. And a caesarean section is not
so dangerous or unusual an intervention that it is obvious that no one could be
expected to risk it. Nor are the declared grounds for refusal as coherent as they
may seem. The couple inRe Swere reported as believing that a caesarean was
against their principles as born-again Christians. According toThe Guardian,most
evangelical Christians would not share the view that a caesarean section was
impermissible and would, indeed, advocate one if the child's life was at risk, and
Jehovah's Witnesses do not object to caesareans as long as they do not involve
blood transfusions [9].
Here there is clearly a balance to be struck between anyone's right to refuse life-
216 Nursing Law and Ethics