Saturday, March 24, 2012
ETHICISTS ARGUE IN FAVOR OF ‘AFTER-BIRTH ABORTIONS‘ AS NEWBORNS ’ARE NOT PERSONS’
FAITH
Two ethicists working with Australian universities argue in the latest online edition of the Journal of Medical Ethics that if abortion of a fetus is allowable, so to should be the termination of a newborn.
Alberto Giubilini (Photo: Academia.edu)
Alberto Giubilini with Monash University in Melbourne and Francesca Minerva at the Centre for Applied Philosophy and Public Ethics at the University of Melbourne write that in “circumstances occur[ing] after birth such that they would have justified abortion, what we call after-birth abortion should be permissible.”
The two are quick to note that they prefer the term “after-birth abortion“ as opposed to ”infanticide.” Why? Because it “[emphasizes] that the moral status of the individual killed is comparable with that of a fetus (on which ‘abortions’ in the traditional sense are performed) rather than to that of a child.” The authors also do not agree with the term euthanasia for this practice as the best interest of the person who would be killed is not necessarily the primary reason his or her life is being terminated. In other words, it may be in the parents’ best interest to terminate the life, not the newborns.
The circumstances, the authors state, where after-birth abortion should be considered acceptable include instances where the newborn would be putting the well-being of the family at risk, even if it had the potential for an “acceptable” life. The authors cite Downs Syndrome as an example, stating that while the quality of life of individuals with Downs is often reported as happy, “such children might be an unbearable burden on the family and on society as a whole, when the state economically provides for their care.”
Francesca Minerva (Photo: Academia.edu)
This means a newborn whose family (or society) that could be socially, economically or psychologically burdened or damaged by the newborn should have the ability to seek out an after-birth abortion. They state that after-birth abortions are not preferable over early-term abortions of fetuses but should circumstances change with the family or the fetus in the womb, then they advocate that this option should be made available.
The authors go on to state that the moral status of a newborn is equivalent to a fetus in that it cannot be considered a person in the “morally relevant sense.” On this point, the authors write:
Both a fetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’. We take ‘person’ to mean an individual who is capable of attributing to her own existence some (at least) basic value such that being deprived of this existence represents a loss to her.[...]Merely being human is not in itself a reason for ascribing someone a right to life. Indeed, many humans are not considered subjects of a right to life: spare embryos where research on embryo stem cells is permitted, fetuses where abortion is permitted, criminals where capital punishment is legal.
Giubilini and Minerva believe that being able to understand the value of a different situation, which often depends on mental development, determines personhood. For example, being able to tell the difference between an undesirable situation and a desirable one. They note that fetuses and newborns are “potential persons.” The authors do acknowledge that a mother, who they cite as an example of a true person, can attribute “subjective” moral rights to the fetus or newborn, but they state this is only a projected moral status.
The authors counter the argument that these “potential persons” have the right to reach that potential by stating it is “over-ridden by the interests of actual people (parents, family, society) to pursue their own well-being because, as we have just argued, merely potential people cannot be harmed by not being brought into existence.”
And what about adoption? Giubilini and Minerva write that, as for the mother putting the child up for adoption, her emotional state should be considered as a trumping right. For instance, if she were to “suffer psychological distress” from giving up her child to someone else — they state that natural mothers can dream their child will return to them — then after-birth abortion should be considered an allowable alternative.
The authors do not tackle the issue of what age an infant would be considered a person.
The National Catholic Register thinks that these authors are right — once you accept their ideas on personhood. The Register states that the argument made by the ethicists is almost pro-life in that it “highlights the absurdity of the pro-abortion argument”:
The second we allow ourselves to become the arbiters of who is human and who isn’t, this is the calamitous yet inevitable end. Once you say all human life is not sacred, the rest is just drawing random lines in the sand.
First Things, a publication of the The Institute on Religion and Public Life, notes that while this article doesn’t mean the law could — or would — allow after-birth abortions in future medical procedures, arguments such as “the right to dehydrate the persistently unconscious” began in much the same way in bioethics journals.
by Matthew Archbold
Monday, February 27, 2012 8:37 AM Comments (109)
In the Journal of Medical
Ethics, two ethicists argue plainly for the killing of babies post
birth. They’re not hedging their bets. They’re saying it plain and
simple. And I, for one, thank them for it.
Alberto Giubilini and Francesca Minerva, associated respectively with Monash University, in Melbourne, Australia, and with the Oxford Uehiro Centre for Practical Ethics, in the UK, wrote a piece called “After-birth abortion: why should the baby live?”
I could buy the article for $30 and I was close to doing it but then I thought why am I giving these animals my money. I’d essentially be paying these “ethicists” to write more about the right of killing humans.
So, in the “abstract” that’s available for free at the site, it says:
The second we allow ourselves to become the arbiters of who is human and who isn’t, this is the calamitous yet inevitable end. Once you say all human life is not sacred, the rest is just drawing random lines in the sand.
An ethicists job is like a magician’s. The main job of both is to distract you from the obvious. The magician uses sleight of hand to pretend to make people disappear. But when ethicists do it, people disappear for real.
It’s almost a pro-life argument in that it highlights the absurdity of the pro-abortion argument.
These two “ethicists” seem to draw the distinction I’ve seen elsewhere of “self awareness.” But isn’t that a sliding scale? Isn’t that a bit of a judgement call? Doesn’t this also put the crosshairs on the mentally disabled or those who have suffered brain injuries?
They throw around this term “potential person” like it’s a real thing. As if it’s science. But there’s no such thing as potential persons. It’s anti-science. There’s defenseless people. Maybe that’s what they mean. In fact, isn’t that really the point. There’s defenseless people and indefensible ethicists.
Alberto Giubilini and Francesca Minerva, associated respectively with Monash University, in Melbourne, Australia, and with the Oxford Uehiro Centre for Practical Ethics, in the UK, wrote a piece called “After-birth abortion: why should the baby live?”
I could buy the article for $30 and I was close to doing it but then I thought why am I giving these animals my money. I’d essentially be paying these “ethicists” to write more about the right of killing humans.
So, in the “abstract” that’s available for free at the site, it says:
Abortion is largely accepted even for reasons that do not have anything to do with the fetus’ health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call ‘after-birth abortion’ (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled.Here’s the thing - they’re right. If you accept their premises, they’re absolutely right.
The second we allow ourselves to become the arbiters of who is human and who isn’t, this is the calamitous yet inevitable end. Once you say all human life is not sacred, the rest is just drawing random lines in the sand.
An ethicists job is like a magician’s. The main job of both is to distract you from the obvious. The magician uses sleight of hand to pretend to make people disappear. But when ethicists do it, people disappear for real.
It’s almost a pro-life argument in that it highlights the absurdity of the pro-abortion argument.
These two “ethicists” seem to draw the distinction I’ve seen elsewhere of “self awareness.” But isn’t that a sliding scale? Isn’t that a bit of a judgement call? Doesn’t this also put the crosshairs on the mentally disabled or those who have suffered brain injuries?
They throw around this term “potential person” like it’s a real thing. As if it’s science. But there’s no such thing as potential persons. It’s anti-science. There’s defenseless people. Maybe that’s what they mean. In fact, isn’t that really the point. There’s defenseless people and indefensible ethicists.
‘JOURNAL OF MEDICAL ETHICS’ STANDS BY PUBLICATION OF ‘AFTER-BIRTH ABORTIONS’ ARTICLE
HEALTH
Yesterday, The Blaze reported the logic of two ethicists who suggested that termination of a newborn — a practice they called “after-birth abortion” — should be allowable on the basis of newborns having the same status of that of fetuses. The article by Alberto Giubilini with Monash University in Melbourne and Francesca Minerva at the Centre for Applied Philosophy and Public Ethics at the University of Melbourne was published in the Journal of Medical Ethics.
(Image via Facebook)
The Journal of Medical Ethics (JME) has since written a post on its blog stating that it has received several emails questioning its decision to publish such an article in a respected journal on ethics. JME stands by its decision. Here‘s what the journal’s editor Julian Savulescu writes:
As Editor of the Journal, I would like to defend its publication. The arguments presented, in fact, are largely not new and have been presented repeatedly in the academic literature and public fora by the most eminent philosophers and bioethicists in the world, including Peter Singer, Michael Tooley and John Harris in defence of infanticide, which the authors call after-birth abortion.The novel contribution of this paper is not an argument in favour of infanticide – the paper repeats the arguments made famous by Tooley and Singer – but rather their application in consideration of maternal and family interests. The paper also draws attention to the fact that infanticide is practised in the Netherlands.Many people will and have disagreed with these arguments. However, the goal of the Journal of Medical Ethics is not to present the Truth or promote some one moral view. It is to present well reasoned argument based on widely accepted premises. The authors provocatively argue that there is no moral difference between a fetus and a newborn. Their capacities are relevantly similar. If abortion is permissible, infanticide should be permissible. The authors proceed logically from premises which many people accept to a conclusion that many of those people would reject.[...]The Journal does not specifically support substantive moral views, ideologies, theories, dogmas or moral outlooks, over others. It supports sound rational argument. Moreover, it supports freedom of ethical expression.
Savulescu also writes that those with opposing views to Giubilini and Minvera are welcome to write well-thought, “coherent” responses for consideration for publication in the journal.
Savulescu also responds to several “hostile, abusive, threatening responses” that were made in the comments section on the Blaze’s post about the journal article. He writes that he considers many of the comments disturbing and as showing that “proper academic discussion and freedom are under threat from fanatics opposed to the very values of a liberal society.”
The Blaze has full-time comment moderators who work as quickly as possible to remove comments that violate our comment policy or terms of use, which includes those that are considered “abusive, harassing, threatening or vulgar.”
The Blaze story did generate close to 1,000 comments in the first 24 hours and registered over 7,000 “likes” on Facebook.
JME is a peer-reviewed journal owned by the Institute for Medical Ethics and BJM group. According to its website, it features stories on the “ethical aspects of health care, as well as case conferences, book reviews, editorials, correspondence, news and notes.”
After-birth abortion: why should the baby live?
J Med Ethics
- Received 25 November 2011
- Revised 26 January 2012
- Accepted 27 January 2012
- Published Online First 23 February 2012
Abstract
Abortion is largely accepted
even for reasons that do not have anything to do with the fetus' health.
By showing that (1)
both fetuses and newborns do not have
the same moral status as actual persons, (2) the fact that both are
potential persons
is morally irrelevant and (3) adoption
is not always in the best interest of actual people, the authors argue
that what we
call ‘after-birth abortion’ (killing a
newborn) should be permissible in all the cases where abortion is,
including cases
where the newborn is not disabled.
Introduction
Severe abnormalities of the
fetus and risks for the physical and/or psychological health of the
woman are often cited as valid
reasons for abortion. Sometimes the two
reasons are connected, such as when a woman claims that a disabled
child would represent
a risk to her mental health. However,
having a child can itself be an unbearable burden for the psychological
health of the
woman or for her already existing
children,1
regardless of the condition of the fetus. This could happen in the case
of a woman who loses her partner after she finds
out that she is pregnant and therefore
feels she will not be able to take care of the possible child by
herself.
A serious philosophical
problem arises when the same conditions that would have justified
abortion become known after birth.
In such cases, we need to assess facts
in order to decide whether the same arguments that apply to killing a
human fetus can
also be consistently applied to killing
a newborn human.
Such an issue arises, for
example, when an abnormality has not been detected during pregnancy or
occurs during delivery. Perinatal
asphyxia, for instance, may cause
severe brain damage and result in severe mental and/or physical
impairments comparable with
those for which a woman could request
an abortion. Moreover, abnormalities are not always, or cannot always
be, diagnosed
through prenatal screening even if they
have a genetic origin. This is more likely to happen when the disease
is not hereditary
but is the result of genetic mutations
occurring in the gametes of a healthy parent. One example is the case of
Treacher-Collins
syndrome (TCS), a condition that
affects 1 in every 10 000 births causing facial deformity and related
physiological failures,
in particular potentially
life-threatening respiratory problems. Usually those affected by TCS are
not mentally impaired and
they are therefore fully aware of their
condition, of being different from other people and of all the problems
their pathology
entails. Many parents would choose to
have an abortion if they find out, through genetic prenatal testing,
that their fetus
is affected by TCS. However, genetic
prenatal tests for TCS are usually taken only if there is a family
history of the disease.
Sometimes, though, the disease is
caused by a gene mutation that intervenes in the gametes of a healthy
member of the couple.
Moreover, tests for TCS are quite
expensive and it takes several weeks to get the result. Considering that
it is a very rare
pathology, we can understand why women
are not usually tested for this disorder.
However, such rare and severe
pathologies are not the only ones that are likely to remain undetected
until delivery; even
more common congenital diseases that
women are usually tested for could fail to be detected. An examination
of 18 European
registries reveals that between 2005
and 2009 only the 64% of Down's syndrome cases were diagnosed through
prenatal testing.2
This percentage indicates that, considering only the European areas
under examination, about 1700 infants were born with
Down's syndrome without parents being
aware of it before birth. Once these children are born, there is no
choice for the parents
but to keep the child, which sometimes
is exactly what they would not have done if the disease had been
diagnosed before birth.
Abortion and after-birth abortion
Euthanasia in infants has been proposed by philosophers3 for children with severe abnormalities whose lives can be expected to be not worth living and who are experiencing unbearable
suffering.
Also medical professionals
have recognised the need for guidelines about cases in which death seems
to be in the best interest
of the child. In The Netherlands, for
instance, the Groningen Protocol (2002) allows to actively terminate the
life of ‘infants
with a hopeless prognosis who
experience what parents and medical experts deem to be unbearable
suffering’.4
Although it is reasonable to
predict that living with a very severe condition is against the best
interest of the newborn,
it is hard to find definitive arguments
to the effect that life with certain pathologies is not worth living,
even when those
pathologies would constitute acceptable
reasons for abortion. It might be maintained that ‘even allowing for
the more optimistic
assessments of the potential of Down's
syndrome children, this potential cannot be said to be equal to that of a
normal child’.3 But, in fact, people with Down's syndrome, as well as people affected by many other severe disabilities, are often reported
to be happy.5
Nonetheless, to bring up such
children might be an unbearable burden on the family and on society as a
whole, when the state
economically provides for their care.
On these grounds, the fact that a fetus has the potential to become a
person who will
have an (at least) acceptable life is
no reason for prohibiting abortion. Therefore, we argue that, when
circumstances occur
after birth such that they would have justified abortion, what we call after-birth abortion should be permissible.
In spite of the oxymoron in
the expression, we propose to call this practice ‘after-birth abortion’,
rather than ‘infanticide’,
to emphasise that the moral status of
the individual killed is comparable with that of a fetus (on which
‘abortions’ in the
traditional sense are performed) rather
than to that of a child. Therefore, we claim that killing a newborn
could be ethically
permissible in all the circumstances
where abortion would be. Such circumstances include cases where the
newborn has the potential
to have an (at least) acceptable life,
but the well-being of the family is at risk. Accordingly, a second
terminological specification
is that we call such a practice
‘after-birth abortion’ rather than ‘euthanasia’ because the best
interest of the one who dies
is not necessarily the primary
criterion for the choice, contrary to what happens in the case of
euthanasia.
Failing to bring a new person
into existence cannot be compared with the wrong caused by procuring
the death of an existing
person. The reason is that, unlike the
case of death of an existing person, failing to bring a new person into
existence does
not prevent anyone from accomplishing
any of her future aims. However, this consideration entails a
much stronger idea than the one according to which severely handicapped
children should be euthanised. If the
death of a newborn is not wrongful to her on the grounds that she cannot
have formed
any aim that she is prevented from
accomplishing, then it should also be permissible to practise an
after-birth abortion on
a healthy newborn too, given that she
has not formed any aim yet.
There are two reasons which, taken together, justify this claim:-
The moral status of an infant is equivalent to that of a fetus, that is, neither can be considered a ‘person’ in a morally relevant sense.
-
It is not possible to damage a newborn by preventing her from developing the potentiality to become a person in the morally relevant sense.
We are going to justify these two points in the following two sections.
The newborn and the fetus are morally equivalent
The moral status of an infant is equivalent to that of a fetus in the sense that both lack those properties that justify the
attribution of a right to life to an individual.
Both a fetus and a newborn
certainly are human beings and potential persons, but neither is a
‘person’ in the sense of ‘subject
of a moral right to life’. We take
‘person’ to mean an individual who is capable of attributing to her own
existence some
(at least) basic value such that being
deprived of this existence represents a loss to her. This means that
many non-human
animals and mentally retarded human
individuals are persons, but that all the individuals who are not in the
condition of
attributing any value to their own
existence are not persons. Merely being human is not in itself a reason
for ascribing someone
a right to life. Indeed, many humans
are not considered subjects of a right to life: spare embryos where
research on embryo
stem cells is permitted, fetuses where
abortion is permitted, criminals where capital punishment is legal.
Our point here is that,
although it is hard to exactly determine when a subject starts or ceases
to be a ‘person’, a necessary
condition for a subject to have a right
to X is that she is harmed by a decision to deprive her of X. There are
many ways
in which an individual can be harmed,
and not all of them require that she values or is even aware of what she
is deprived
of. A person might be ‘harmed’ when
someone steals from her the winning lottery ticket even if she will
never find out that
her ticket was the winning one. Or a
person might be ‘harmed’ if something were done to her at the stage of
fetus which affects
for the worse her quality of life as a
person (eg, her mother took drugs during pregnancy), even if she is not
aware of it.
However, in such cases we are talking
about a person who is at least in the condition to value the different situation she would have found herself in if she had not been harmed. And such a condition depends
on the level of her mental development,6 which in turn determines whether or not she is a ‘person’.
Those who are only capable of
experiencing pain and pleasure (like perhaps fetuses and certainly
newborns) have a right not
to be inflicted pain. If, in addition
to experiencing pain and pleasure, an individual is capable of making
any aims (like
actual human and non-human persons),
she is harmed if she is prevented from accomplishing her aims by being
killed. Now, hardly
can a newborn be said to have aims, as
the future we imagine for it is merely a projection of our minds on its
potential lives.
It might start having expectations and
develop a minimum level of self-awareness at a very early stage, but not
in the first
days or few weeks after birth. On the
other hand, not only aims but also well-developed plans are concepts
that certainly
apply to those people (parents,
siblings, society) who could be negatively or positively affected by the
birth of that child.
Therefore, the rights and interests of
the actual people involved should represent the prevailing consideration
in a decision
about abortion and after-birth
abortion.
It is true that a particular
moral status can be attached to a non-person by virtue of the value an
actual person (eg, the
mother) attributes to it. However, this
‘subjective’ account of the moral status of a newborn does not debunk
our previous
argument. Let us imagine that a woman
is pregnant with two identical twins who are affected by genetic
disorders. In order
to cure one of the embryos the woman is
given the option to use the other twin to develop a therapy. If she
agrees, she attributes
to the first embryo the status of
‘future child’ and to the other one the status of a mere means to cure
the ‘future child’.
However, the different moral status
does not spring from the fact that the first one is a ‘person’ and the
other is not, which
would be nonsense, given that they are
identical. Rather, the different moral statuses only depends on the
particular value
the woman projects on them. However,
such a projection is exactly what does not occur when a newborn becomes a
burden to its
family.
The fetus and the newborn are potential persons
Although fetuses and newborns
are not persons, they are potential persons because they can develop,
thanks to their own biological
mechanisms, those properties which will
make them ‘persons’ in the sense of ‘subjects of a moral right to
life’: that is,
the point at which they will be able to
make aims and appreciate their own life.
It might be claimed that
someone is harmed because she is prevented from becoming a person
capable of appreciating her own
being alive. Thus, for example, one
might say that we would have been harmed if our mothers had chosen to
have an abortion
while they were pregnant with us7
or if they had killed us as soon as we were born. However, whereas you
can benefit someone by bringing her into existence
(if her life is worth living), it makes
no sense to say that someone is harmed by being prevented from becoming
an actual
person. The reason is that, by virtue
of our definition of the concept of ‘harm’ in the previous section, in
order for a harm
to occur, it is necessary that someone
is in the condition of experiencing that harm.
If a potential person, like a
fetus and a newborn, does not become an actual person, like you and us,
then there is neither
an actual nor a future person who can
be harmed, which means that there is no harm at all. So, if you ask one
of us if we
would have been harmed, had our parents
decided to kill us when we were fetuses or newborns, our answer is
‘no’, because they
would have harmed someone who does not
exist (the ‘us’ whom you are asking the question), which means no one.
And if no one
is harmed, then no harm occurred.
A consequence of this position is that the interests of actual people over-ride the interest of merely potential people to
become actual ones. This does not mean that the interests of actual people always over-ride any
right of future generations, as we should certainly consider the
well-being of people who will inhabit the planet in the
future. Our focus is on the right to
become a particular person, and not on the right to have a good life
once someone will
have started to be a person. In other
words, we are talking about particular individuals who might or might
not become particular
persons depending on our choice, and
not about those who will certainly exist in the future but whose
identity does not depend
on what we choose now.
The alleged right of individuals (such as fetuses and newborns) to develop their potentiality, which someone defends,8
is over-ridden by the interests of actual people (parents, family,
society) to pursue their own well-being because, as we
have just argued, merely potential
people cannot be harmed by not being brought into existence. Actual
people's well-being
could be threatened by the new (even if
healthy) child requiring energy, money and care which the family might
happen to be
in short supply of. Sometimes this
situation can be prevented through an abortion, but in some other cases
this is not possible.
In these cases, since non-persons have
no moral rights to life, there are no reasons for banning after-birth
abortions. We
might still have moral duties towards
future generations in spite of these future people not existing yet. But
because we
take it for granted that such people will exist (whoever they will be), we must treat them as actual
persons of the future. This argument, however, does not apply to this
particular newborn or infant, because we are not justified
in taking it for granted that she will
exist as a person in the future. Whether she will exist is exactly what
our choice
is about.
Adoption as an alternative to after-birth abortion?
A possible objection to our argument is that after-birth abortion should be practised just on potential people who could never
have a life worth living.9
Accordingly, healthy and potentially happy people should be given up
for adoption if the family cannot raise them up. Why
should we kill a healthy newborn when
giving it up for adoption would not breach anyone's right but possibly
increase the
happiness of people involved (adopters
and adoptee)?
Our reply is the following.
We have previously discussed the argument from potentiality, showing
that it is not strong enough
to outweigh the consideration of the
interests of actual people. Indeed, however weak the interests of actual
people can be,
they will always trump the alleged
interest of potential people to become actual ones, because this latter
interest amounts
to zero. On this perspective, the
interests of the actual people involved matter, and among these
interests, we also need
to consider the interests of the mother
who might suffer psychological distress from giving her child up for
adoption. Birthmothers
are often reported to experience
serious psychological problems due to the inability to elaborate their
loss and to cope with
their grief.10
It is true that grief and sense of loss may accompany both abortion and
after-birth abortion as well as adoption, but we
cannot assume that for the birthmother
the latter is the least traumatic. For example, ‘those who grieve a
death must accept
the irreversibility of the loss, but
natural mothers often dream that their child will return to them. This
makes it difficult
to accept the reality of the loss
because they can never be quite sure whether or not it is irreversible’.11
We are not suggesting that
these are definitive reasons against adoption as a valid alternative to
after-birth abortion. Much
depends on circumstances and
psychological reactions. What we are suggesting is that, if interests of
actual people should
prevail, then after-birth abortion
should be considered a permissible option for women who would be damaged
by giving up their
newborns for adoption.
Conclusions
If criteria such as the costs
(social, psychological, economic) for the potential parents are good
enough reasons for having
an abortion even when the fetus is
healthy, if the moral status of the newborn is the same as that of the
infant and if neither
has any moral value by virtue of being a
potential person, then the same reasons which justify abortion should
also justify
the killing of the potential person
when it is at the stage of a newborn.
Two considerations need to be added.
First, we do not put forward
any claim about the moment at which after-birth abortion would no longer
be permissible, and
we do not think that in fact more than a
few days would be necessary for doctors to detect any abnormality in
the child. In
cases where the after-birth abortion
were requested for non-medical reasons, we do not suggest any threshold,
as it depends
on the neurological development of
newborns, which is something neurologists and psychologists would be
able to assess.
Second, we do not claim that
after-birth abortions are good alternatives to abortion. Abortions at an
early stage are the
best option, for both psychological and
physical reasons. However, if a disease has not been detected during
the pregnancy,
if something went wrong during the
delivery, or if economical, social or psychological circumstances change
such that taking
care of the offspring becomes an
unbearable burden on someone, then people should be given the chance of
not being forced
to do something they cannot afford.
Acknowledgments
We would like to thank Professor Sergio Bartolommei, University of Pisa, who read an early draft of this paper and gave us
very helpful comments. The responsibility for the content remains with the authors.
Footnotes
-
Competing interests None.
-
Provenance and peer review Not commissioned; externally peer reviewed.
+ Author Affiliations
- Correspondence to Dr Francesca Minerva, CAPPE, University of Melbourne, Melbourne, VIC 3010, Australia; francesca.minerva@unimelb.edu.au
-
Contributors AG and FM contributed equally to the manuscript.
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