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Should We Maintain Baby Hatches in Our Society? Atsushi Asai1* and Hiroko Ishimoto2

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Should We Maintain Baby Hatches in Our Society? Atsushi Asai1* and Hiroko Ishimoto2 Asai and Ishimoto BMC Medical Ethics 2013, 14:9 http://www.biomedcentral.com/1472-6939/14/9 DEBATE Open Access Should we maintain baby hatches in our society? Atsushi Asai1* and Hiroko Ishimoto2 Abstract Background: A baby hatch called the “Stork’s Cradle” has been in place at Jikei Hospital in Kumamoto City, Japan, since May 10, 2007. Babyklappes were first established in Germany in 2000, and there are currently more than 90 locations. Attitudes regarding baby hatches are divided in Japan and neither opinions for nor against baby hatches have thus far been overwhelming. To consider the appropriateness of baby hatches, we present and examine the validity of each major objection to establishing baby hatches. Discussion: There are various objections to baby hatches as follows: It violates a child’s right to know the identity of his or her biological parents by allowing anonymous birth; it neglects fulfillment of the biological parents’ basic obligation to raise their child and its very availability induces abandonment of infants; some people abuse it for very selfish reasons; it cannot save babies’ lives; the rights of one parent can be ignored if the other surrenders a child without his or her consent; it puts a baby in medical jeopardy; and it has no clear legal basis. The authors would argue that there are many plausible refutations for each objection mainly based on priority of child’s right to life, pregnant women’s vulnerability and necessity of anonymity, social responsibility to protect and raise children, differences between dropping a child off at a baby hatch and child neglect, limited function of social childcare center, inevitability of abuse by a minority of people, necessary distinction between outcomes that occur only because baby hatches exist and those that occur regardless of their existence, important local direct and upmost measures for women in trouble, and difference between ambiguous legality and illegality. Summary: We argue that a certain number of baby hatches should continue to be established as a last resort, in a form that can maintain anonymity if the parent dropping the child off so desires. It should be supported if it is initiated with good intentions; if the maximum possible effort is made at said facility to protect the interests, rights, and safety of the child; and if no clear evidence of harm exists. Keywords: Baby hatch, “Stork’s Cradle (Kounotori no Yurikago)”, Babyklappes, Japan, Child abuse, Child abandonment, Abortion Background women worried about pregnancy. The hospital established Current situation regarding baby hatches in general and a facility that accepts children anonymously, modeled on the “Stork’s Cradle (Kounotori no Yurikago)” of German Babyklappes, in hopes of saving newborn babies Kumamoto City that die from abandonment as well as lives lost to abortion A baby hatch called the “Stork’sCradle” has been in place [1]. Babyklappes were first established in Germany in at Jikei Hospital in Kumamoto City, Japan, since May 10, 2000, and there are currently more than 90 locations. 2007. In the five years since its establishment, 81 children Facilities with similar functions exist in 20 countries, have been placed in its care. Eight of the 40 male and 41 including Poland, the Czech Republic, Hungary, Italy, female children were disabled. Since 2002, Jikei Hospital Austria, Vatican City, USA, India, and South Africa [2,3]. has taken measures to protect the lives of fetuses and chil- Thirty parents who placed their babies in the care of the dren, for example, by conducting telephone counseling for “Stork’sCradle” within the past two years provided the following reasons for doing so: poverty (nine responses), unmarried (nine responses), public image/unwillingness * Correspondence: [email protected] 1Department of Bioethics, Kumamoto University Graduate School of Medical to enter in family register (six responses), problems with Science, Kumamoto University, Kumamoto, 1-1-1 Honjo, Kumamoto partner (six responses), and extramarital affair (four 860-8556, Japan responses). A report acknowledged that many children Full list of author information is available at the end of the article © 2013 Asai and Ishimoto; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Asai and Ishimoto BMC Medical Ethics 2013, 14:9 Page 2 of 7 http://www.biomedcentral.com/1472-6939/14/9 had been saved by the “Cradle.” On the other hand, the objection to establishing baby hatches. Then, we argue report also noted cases in which children were dropped that a certain number of baby hatches should continue to off for simplistic reasons such as, “can’t find a facility to be established, literally as a last resort, in a form that can look after the child while I work” and “can’t bring up the maintain anonymity if the parent dropping the child off so child because I will study overseas,” and called for desires. Finally, we conclude that a baby hatch should be measures that would encourage parents to seek counsel- supported if it is initiated with good intentions; if the ing in advance [1,4]. maximum possible effort is made at said facility to protect Attitudes regarding baby hatches are divided in Japan. the interests, rights, and safety of the child; and if no clear Baby hatches are often criticized as evil and encouraging evidence of harm exists. irresponsible child abandonment; moreover, people are not necessarily accepting of this experimental effort [5]. In Discussion a July 2007 Kumamoto Nichinichi Newspaper survey of Critical appraisal regarding major objections to the eligible voters in Kumamoto Prefecture, 49% responded establishment of baby hatches that “the Cradle is necessary,” 14.9% responded that it was The baby hatch violates a child’s right to know the identity of “unnecessary,” and 33% responded that they “could not his or her biological parents by allowing anonymous birth say.” The fact that many people were unable to decide This objection holds that a child’s right to know their demonstrates that the existence of the “Cradle” is parents and origins is disregarded for children dropped off complicated [6]. In a 2007 Asahi Shimbun online survey at a baby hatch. Article 7 of the 1989 UN Convention on of 4400 people, approximately 59%, 28%, and 13% of the Rights of the Child declares that “the child shall be respondents replied, “(baby hatches are) necessary,”“(baby registered immediately after birth and shall have the right hatches are) unnecessary,” and “not sure,” respectively, from birth to a name, the right to acquire a nationality and an online poll of 1092 people by the Mainichi and, as far as possible, the right to know and be cared for Shimbun found that 63% were in favor of and 37% were by his or her parents” [13]. Discussions of the right of chil- against baby hatches [7,8]. dren born from artificial insemination by sperm donation Corresponding numbers for and against hatches were to know their origins have articulated three disadvantages found among neonatologists: 54.4% of 68 respondents for a child who does not know his or her origins: [1] the were for and 38.2% were against baby hatches. Examined lack of genetic information may infringe on the child’s separately by age and sex, young female physicians with right to health, [2] the inability to exclude the possibility less than ten years’ experience showed the most support, of a consanguineous marriage when the child marries, and with 66.7% for and 22.3% against baby hatches. Supporting [3] the child will lack information on his or her biological opinions ranged from “I value it as a life-saving measure” parents and his or her own birth, which are crucial to the to “It should be implemented carefully given the risk of establishment of independence and identity [14]. These encouraging child abandonment” [2]. The situation in perspectives are all important and undoubtedly must be which there are arguments both for and against baby respected in principle to protect children who are placed hatches seems similar in Germany which has the most in a vulnerable position. baby hatches in the world, according to the interviews Recently, some countries have started requiring a donor with scores of people conducted by the Kumamoto to allow disclosure of his identity if a child born by artifi- Nichinichi Newspaper staff, although the same kind of cial insemination requests it [14]. In this case, those who data based on research surveys or public-opinion poll has do not desire disclosure of their identity are unlikely to not been available [6,9]. become donors. Similarly, parents who wish to remain In both Japanese and German surveys, neither opinions anonymous and women who wish to conceal their preg- for nor against baby hatches have thus far been nancies may choose abortion, infanticide, or child aban- overwhelming. Although the results depend on how the donment if anonymous drop-offs are not allowed. Fixating questions are worded, the respondents are either evenly exclusively on respecting the right of the child to know his divided or those in favor of baby hatches slightly exceed or her parents without considering the circumstances will those against, although many are also undecided. Some lead to violation of the right to life. If the child cannot sur- view them as necessary despite being opposed to them, vive, then the right to know his or her origins can neither while others find them difficult to accept based on personal be claimed nor protected. Discussions should thus con- beliefs but feel they are unavoidable when considering sider the temporal order of realizing rights.
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