Monthly Archives: April 2016

Medical Ethics and Paternity Fraud

medical ethics

Medical ethics is the latest area which has come to my attention as having fallen to feminist corruption.

On the 6th April 2016 Mike Buchanan was interviewed by Shelagh Fogerty on LBC radio on the subject of paternity fraud. The issue discussed was whether DNA testing should be carried out at birth automatically. Also involved in the discussion was Dr Anna Smajdor, lecturer and researcher in medical ethics, Norwich medical school. Just two days later the news broke about the Archbishop of Canterbury, Justin Welby, having been misled about the identity of his father. My personal reaction was: why the great surprise? Not casting any aspersions on the Archbishop’s parents, you understand, merely recognising that paternity fraud is common.

I’ll not address the ever-fraught issue of how common paternity fraud might be – see here for a review. Shelagh Fogerty thought that even a rate of 2% – almost certainly a serious underestimate – was appalling, and rightly so. But she wasn’t very keen on the idea of (what she called) “compulsory” DNA testing. She objected on the grounds that she didn’t think it fair or appropriate that “the state should check whether I am a liar“.

Before getting down to the main issue, let’s just sort that one out. DNA testing does not have to be presented in such a manner. After all, what has the mother got to do with this? The proposal is that any man who wished to have his name on the birth certificate – and hence gain paternity rights – must be subject to a paternity test. It is, after all, the man who is being tested, not the mother. There is a clear ethical motivation for enforcing a legal obligation to ascertain the biological paternity status of any man whose name appears on the child’s birth certificate. This will be spelt out below. This is not primarily directed at the rights of the putative father or the mother, but the child’s rights.

A highly desirable by-product of this is that it would also prevent paternity fraud, and hence be beneficial for the man. It would also prevent legal and financial disputes arising when paternity misattribution is discovered many years later. As things are at present, very few men would ask for a DNA test, even if they entertained doubts. The vote of no confidence in their relationship might well be terminal. So Shelagh Fogerty missed the point. By making DNA testing an automatic legal requirement whenever a man’s name is to appear on the birth certificate, any aspersion regarding the mother’s honesty is avoided. An automatic legal requirement makes the issue non-personal.

If no man’s name is to appear on the birth certificate, then no DNA testing is required. But, in order to avoid the issue of mistrust arising, DNA testing must be obligatory in all cases that a man wishes to claim paternity rights by having his name on the birth certificate. Waiving of this requirement must not be allowed or it would undermine both this benefit, and the rights of the child. Of course, a man may opt to have his name on the birth certificate even if he is not the biological father if no other candidate is forthcoming (and if the mother agrees).

The ethical case for a child being accurately informed of the identity of her father might be argued on the basis of simple honesty; of having the correct knowledge of her place in the extended family, etc. However, there is a more direct and purely medical argument. Increasingly in modern medicine one’s genetic inheritance is relevant to one’s medical prognosis. How many times will the child, including when adult, be asked whether there is a history of heart disease, diabetes, and so forth, in her family? She will potentially answer such questions incorrectly if in ignorance of her true father. Thus, the issue of correct paternity identification has a direct bearing on potentially disadvantaging the child medically – for life. This alone is sufficient reason for carrying out DNA testing on an automatic legal basis. After all, DNA testing is cheap, quick, simple and highly reliable. There is no ethical counter-argument.

Which brings us to Dr Anna Smajdor. She was firmly against DNA testing. Despite being a medical ethicist, she appeared not to have given any thought to how the child would be medically disadvantaged by having a misattributed paternity. Dr Smajdor’s position was to claim that paternity fraud was of no significance. She claimed that it was a case of, “over-valuing the importance of genetic relationships, and that’s why we think of it as fraud“. Her view, it seems, is that genetic paternity is an irrelevance. That a man should have any interest in whether a child is biologically his is, in her opinion, fussing over nothing. She said,

Until recently we didn’t even know what genes were…..The issue should not be whose genes are in this child….We should have a situation in which people didn’t think about genes at all“.

Do you think Dr Smajdor really believes what she says here – or only in the context of claims of male parental rights? If she truly believes what she says, then it would be perfectly acceptable to send women home from the maternity ward with the wrong child. Never mind about those name tags any more, nurse, just give ’em any baby. They’re all the same.

Do you think this is what Dr Smajdor really believes? Would anyone? No, of course not. If maternity wards took this attitude the Nation would be in uproar. And Dr Smajdor doesn’t believe this either. The ‘views’ she was expressing were intended only to be interpreted in the context of male parentage. No one, including Dr Smajdor, would be happy about giving women the wrong baby. It is only the unimportance of paternity which Dr Smajdor is actually asserting. Maternity remains sacred.

I don’t pretend to have any training in philosophical ethics, but even I know that Kant advised that the guiding Categorical Imperative was that we “act only according to that maxim whereby you can, at the same time, will that it should become a universal law “. But Dr Smajdor’s dictum is gender-specific, not universal. It is gendered and therefore unethical.

Who checks whether ethicists are ethical? Dr Smajdor ignores the rights of the child and adopts an unethical stance in relation to paternity.

The video made me wonder whether this view might be widespread in the medical ethics community. It would appear that it is. Take, for example, Heather Draper, Professor of Biomedical Ethics in the Institute of Applied Health Research, Birmingham University. Her paper “Paternity fraud and compensation for misattributed paternity”, J Med Ethics (2007) 33(8): 475–480 has this Abstract,

Claims for reimbursement of child support, the reversal of property settlements and compensation can arise when misattributed paternity is discovered. The ethical justifications for such claims seem to be related to the financial cost of bringing up children, the absence of choice about taking on these expenses, the hard work involved in child rearing, the emotional attachments that are formed with children, the obligation of women to make truthful claims about paternity, and the deception involved in infidelity. In this paper it is argued that there should not be compensation for infidelity and that reimbursement is appropriate where the claimant has made child support payments but has not taken on the social role of father. Where the claimant’s behaviour suggests a social view of fatherhood, on the other hand, claims for compensation are less coherent. Where the genetic model of fatherhood dominates, the “other” man (the woman’s lover and progenitor of the children) might also have a claim for the loss of the benefits of fatherhood. It is concluded that claims for reimbursement and compensation in cases of misattributed paternity produce the same distorted and thin view of what it means to be a father that paternity testing assumes, and underscores a trend that is not in the interests of children.

Ah, “not in the best interests of the child”. There’s a phrase to send shivers down the spine of anyone familiar with the machinations of the family courts. Not that there’s anything wrong at all with the principle, obviously. But we know that it’s used as a cover for “the best interests of the mother”, don’t we?

Let’s dispose of that one first. Heather Draper has also authored a paper “Why there is no right to know one’s genetic origins“. So she appears to be blind to the obvious fact  that a person is medically disadvantaged by having unknown, or misattributed, parentage. Remarkable. You could almost think these people believe that babies enter the world, not only tablula rasa as regards their psychology and gender, but as regards their purely physical biology too. As noted above, this observation alone is enough to refute their position as unethical, without any reference to men or fatherhood at all.

But let’s look at the paternity issues. I am not concerned here with the issue of financial compensation – except in as far as regarding a financial claim to be valid is an indication of mistreatment. The view expressed by Draper is the same as that of Anna Smajdor: that genetic paternity does not matter much. To think otherwise is “a thin view of what it means to be a father” – as if being concerned about biological paternity somehow excludes recognition of the significance of parenting. This is verbal legerdemain.

The background to Draper’s paper was the fact that, in 2005, the Child Support Agency had to refund hundreds of thousands of pounds in maintenance payments to more than 3,000 men after DNA tests revealed that they had been wrongly named by mothers in paternity suits. (19% of cases tested were found to be misattributed). One can imagine the consternation in some quarters that this might be the beginning of a vastly greater tsunami of such claims. Heather Draper’s paper discusses many of the wide range of different scenarios which can arise in the context of paternity fraud. Quite a mishmash of moral dilemmas she makes it all seem. What she singularly fails to consider at all is that legally obligating DNA testing at birth would cut through all these dilemmas like Alexander’s sword through the Gordian knot.

So – and I’m speaking to The Establishment now – why not adopt DNA testing as a legal obligation prior to a man taking on paternity rights via his name on the birth certificate? It immediately, and simply, obviates any future claims in regard to paternity fraud. It’s a win for the man, it’s a win for the State, and it’s a win for the child.

Hmm…so who does not benefit? And whose position carries the day?

Why does Heather Draper not see the benefits of DNA testing? She notes that,

The discovery of misattributed paternity often arises in the context of relationship breakdown: the discovery may instigate the breakdown, or paternity tests may be requested after a relationship has collapsed.

Yes, indeed. And this source of relationship breakdown, or reason for acrimony during relationship breakdown, could so very easily be avoided – by obligatory DNA testing. So why is this not recognised as a solution? The reason, I suspect, is to ensure that power over child-rearing issues remains with the woman. This includes the traditional woman’s power to attribute social paternity independently of biological paternity. (In evolutionary terms I believe this is connected with the phenomenon of sexual crypsis, but that’s a topic for another day).

Draper opines,

Misattributed paternity is sometimes referred to as paternity fraud, a term that suggests that the mother (and possibly her lover) knew about the true paternity and deceived the man for financial gain.

Let’s talk turkey here. The mother is either certain about the father or she is not. If she pretends to be certain when uncertainty exists, this is dishonest – hence fraudulent. The claim that the mother’s motivation is financial gain might be true, but I suspect this is not typically the case. If the mother is doubtful about the true father she will be reluctant to admit to having had sexual relations with more than one man within a short time span. Most often, I suspect, the motivation for paternity fraud will be to avoid embarrassment and a tacit admission of infidelity – whether married or not.

Draper continues,

It is difficult to assert with confidence that the unfaithful woman has wronged the deceived man. Likewise, a mother may have had good reasons for not telling her partner about the paternity of the children, making it difficult to argue that on balance she has done the wrong thing in not being truthful even if the truth was owed.

Well, goodbye any ethical credibility. Suppose a malicious nurse sent a new mother home with the wrong baby. Would it be “difficult to assert with confidence that the nurse has wronged the deceived woman“? No. No one would have any difficulty at all. The matter has no moral ambiguity whatsoever. That Draper does not perceive this is because she starts from a gendered perspective. She could have identified this personal bias by application of Kant’s Categorical Imperative, but she fails to deploy ethical analysis, favouring traditional gender bias instead.

Draper suggests the mother may have “good reasons” for the fraud. What a huge moral leap there is in the word “good” in this context. Whether “good” applies is precisely the ethical issue. In a footnote Draper elaborates thus,

A woman could have good reasons to keep the paternity a secret. For instance, she may think that her partner will be a better father to the child than her lover, or she may have other children and think that it is better for all if the family stays together –  a state of affairs that may be threatened if her infidelity is revealed along with the paternity of the child.

It does appear to be a fact that some women regard it as their right to attribute social paternity (i.e., responsibility for resource provision) independently of biological paternity. What Draper asserts in this footnote, without argument or evidence, is that this is a “good” reason for paternity deception. She betrays that she is starting from the position that paternity fraud is a woman’s fair game – not actually providing any justification for this stance at all.

It is easy to envisage that a willingness by mothers to misattribute paternity might be evolved behaviour. It permits the mother to optimise separately on genetic and social issues. The man who is a fine physical specimen may be great as breeding material, but be dodgy as a resource provider. It makes sense to opt for the more reliable, but less physically imposing, chap as the social partner. If this is evolved behaviour, some women may regard it as their “right”, regardless of its morality. Draper herself appears to be a case in point. This is not ethical analysis, it is traditional gender bias.

Much of the paper is actually misdirection. The discussion should revolve around the child and the father, but instead revolves around the mother. The mother is not really relevant. The mother only becomes relevant if she provides the sole determinant of paternity. But if DNA testing were universal, then the mother disappears from the picture. The discussion focuses on the mother simply because of a determination to protect the status quo: that paternity be a status conferred upon the man by the mother. In a fair world, legal paternity would not be determined by the mother’s wish to conceal sexual betrayal. Draper quotes Kaebnick thus, “sexual betrayal is not… a feature of the relationship between a man and his child. It is a feature of his relationship with his wife”.

Do note that the State actively frustrates a man discovering if a child is biologically his. I have noted previously that the annual report of the Chief Medical Officer, 2014,  “The Health of the 51%: Women” includes a chapter on “A human rights approach to women’s health”. One of these human rights which is claimed for woman is “the right to enjoy the benefits of scientific progress“. In respect of reproduction, the introduction of the contraceptive pill in the 1960s was a huge boon to the emancipation of women. The development of cheap, easy and reliable DNA testing could – and should – be a similar boon to men, and their children. But this is being denied to men – and children. Since “enjoying the benefits of scientific progress” has been declared a human right the unavoidable conclusion is that the human rights of men and their children are being violated.

A minor but annoying point in Draper’s paper is the use of the phrase “the cuckolded man”. The term “cuckold” is a colloquialism and a pejorative. It is not an expression which should be used in a serious academic discussion. It is rather derisory of the victim of a fraud. It is analogous to referring to the victim of rape as “the ruined woman” – not that anyone would.

There is a little thing I find disproportionately chilling in Draper’s Abstract: the quote marks around “other”: the “other” man. What is the purpose of putting scare quotes around a word? It is intended to convey that the author does not truly believe that the word is appropriate, but is being used merely for the sake of convention. It denotes irony or sneering. For example, we may speak disparagingly of “celebrities” who we do not, in truth, regard as deserving of any celebrity status at all – and the quote marks convey just that. So what function does “other” serve in Draper’s Absract? In poker players’ terminology, it is a tell. It gives away the author’s true mindset.

The simple factual position is that there are two men in the case: the misattributed father and the biological father; there is the mother’s partner and the other man. There is nothing about that to invite sneer quotes. So why did Draper use those sneer quotes? It appears to betray a view that it is invalid to regard the second man as truly other. It betrays a mindset which views all men as the same; all men are merely identical instances of the monolithic mass called Man. This is why, in Draper’s view, it matters not at all which man provided the sperm – they are all the same. Distinctions need only be drawn between a man who fulfils his social paternal role as resource provider and one who does not.

These two observations can be expressed thus: men do not have individual rights (genetic paternity), they only have obligations to fulfill certain roles (social paternity). In other words, men are not human beings, they are human doings. Sound familiar?