Tiller is by no means the only abortionist killing near-full-term babies, and there are plenty of other abortionists on the Net. But none of his colleagues showcase their handiwork with such self-promotional audacity. Tiller is either completely contemptuous of public opinion or convinced that the public is beyond caring. Either way , his global ads seem to be reaching their target audience; German and Japanese television teams recently visited his home base, Wichita, in search of interviews concerning the European and Asian women who are making the long journey to engage his grisly services. He recently doubled the size of his abortion clinic, and approximately tripled his killing capacity.

It is difficult to confer clinical respectability on the killing of a neonate, but Tiller takes a shot with the Orwellian term "fetal indications termination of pregnancy." The idea is that certain disorders are so serious that there is no point attempting to prolong the child's life. Among these conditions are several maladies which are not fatal and in fact may be only mildly disabling. Tiller names "encephalocele" (hernia of the brain) for instance, which The Merck Manual says "can be repaired, and the prognosis is good for many of these patients." He also cites "hydrocephalus" (water on the brain) concerning which Diseases of the Newborn, by Schaffer & Avery, says that with few exceptions "every infant with neonatal hydrocephalus should be treated surgically... [and] 86 per cent of infants survived following their shunt placement. Of these infants, 46 per cent were reported normal on follow-up."

Tiller also matter-of-factly observes that the average age of the more than a thousand late-term babies he has killed is 26 weeks (or the seventh month of pregnancy). Meanwhile, the neonatal intensive-care unit at Via Christi Hospital in Wichita cares for preemies born at 24 and 25 weeks' gestation. Indeed, babies born earlier than that often survive nowadays; the New York Times (May 16,1997), citing the National Center for Health Care Statistics, reports that approximately 15 per cent of babies born at 222 weeks will survive, 25 per cent at 23 weeks, 42 per cent at 24 weeks, and 57 per cent at 25 weeks.

Of course, these babies require intensive care, and Tiller apparently thinks that a baby who can't survive without help is not entitled to survive at all. A story in the Kansas City Star (August 26, 1991) quoting Tiller spokeswoman Peggy Jarman said that "elective abortions should be considered acceptable into the 26th week because these fetuses are not capable of surviving outside the womb without artificial life supports. 'You're talking about the difference between natural survival and intensive care...."

In the same interview, Miss Jarman admitted that "about three-fourths of Tiller's late--term patients are teenagers who have denied to themselves or their families that they were pregnant until it was too late to hide it"; abortions are performed on them with no reference to health problems in either the baby or the mother. Since Tiller's web site lists the average age of the mothers on whom he performs his fetal-abnormality abortions as 29 years, there can't be much overlap between these two groups. This admission raises the possibility that Tiller could be killing as many as three healthy late-term babies, being carried by healthy mothers, for each "disabled" child he aborts.

One of the conditions for which Tiller says he "terminates" is Trisomy 21--the scientific name for Down's Syndrome. Yet according to World magazine (January 18, 1997), of the 250,000 Americans currently living with Down's Syndrome, most score in the "mild to moderate" range of mental retardation, and most can learn to read, hold jobs, and live independently. Ought they to have been executed?

The Centers for Disease Control and Prevention (CDC) report that in the 1980s, abortion reduced the number of children with Down's Syndrome born to white women over 35 in the metropolitan Atlanta area by about 70 per cent. As someone recently put it, eugenics is still a dirty word but it has become a common practice.

But don't Down's Syndrome babies put a tremendous strain on other family members? The National Committee for Adoption reports that "there is a waiting list of screened families who want to adopt seriously disabled newborns, including babies born with Down's Syndrome and spina bifida." (The latter disability is also among Tiller's conditions warranting abortion.) Most of the parents who don't want these children could place them for adoption by having them delivered alive at the same point in the pregnancy at which Tiller is killing them.

Even with adoptive homes available, there is no reason to doubt the sincerity of parents who, contemplating the prospect of a severely deformed or retarded child, say they wish "to spare my baby a life of hardship." But how are we to decide what will lead to intolerable hardship? As George Will has frequently written regarding his son Jonathan, and as I can attest from the observation of a good friend of mine, people with Down's Syndrome appear to be among the happiest people on the planet. As for babies with spina bifida, an article in the New England Journal of Medicine in 1985 said that, following surgery, "72 per cent were ambulatory and 79 per cent had normal intellectual capacity." Orel Hershiser would have been lost to the world if his parent had known that spina bifida is an "intolerable" condition.

Nor is there much to be said for what on the face of it is a strong reason for abortion: to preserve the health of the mother. In May of 1997 the Board of the American Medical Association approved a report finding that, "Except in extraordinary circumstances, maternal health factors which demand termination of pregnancy can be accommodated without sacrificing the fetus, and the near certainty of the independent viability of the fetus argues for ending the pregnancy by appropriate delivery."

One reason frequently given for the toleration of large-scale abortion of birth-defective infants is that the cost of caring for them is unmanageable. And certainly, there are many cases in which such costs, if they had to be borne by the family alone, would be crushing. But a recent article in the New England Journal of Medicine put the annual figure for the country as a whole at $2 billion. That's less than the 2.3 billion Americans spend each year on chewing gum. The CDC estimates that care for people with Down's costs $1.8 billion per year. That is about half the $3.4 billion we spend each year on cookies.

It is, in other words, a question of priorities--and America's today do not seem to be human-centered. The Pet Industry Joint Council says we spend around $63 billion each year on the acquisition, food, training, grooming, etc. of our pets.

Perhaps more to the point, on May 11, 1997, the Associated Press reported that the San Francisco SPCA had announced that "no adoptable animal... with a treatable disease will be euthanized... and it will pay for medical care for an animal with a long-term health problem after it is adopted." Milwaukee, St. Louis, and New York are also taking steps to become "no kill" cites. Somehow I don't expect them within the foreseeable future to become "no kill" cities for human babies.

The euphemism Tiller uses to describe the actual killing of "disabled" children is "premature delivery of a stillborn." Of course, the baby is "born still" because Tiller has injected his heart with a lethal dose of digoxin. Tiller says this ensures that the child "will not experience any discomfort during the procedure." But most people who have suffered a heart attack--which is what occurs in this case--describe it as an excruciatingly painful experience. One is also left to wonder how much "discomfort" is experienced by the many thousands of younger, healthy fetuses Tiller routinely tears limb from limb before he kills them, without benefit of anesthesia.

As Vincent J. Collins, M.D., professor of anesthesiology and author of the textbook Principles of Anesthesiology (Third Edition, Williams and Wilkins, 1992) reminds us, neurological structures necessary to feel pain, pain receptive nerve cells, nerual pathways, and the thalamus of the brain begin to form eight weeks after fertilization and become functional during the thirteenth week. Collins also teaches that the cerebral cortex is not necessary for pain sensation but even if it were, the New England Journal of Medicine (November 29, 1987) reports cortical function in both hemispheres of the brain by twenty weeks. That is much younger than the average "fetal indications" baby Tiller admits to killing.

Actually, the efficiency of the killing process is important to late-term abortionists for reasons quite apart from concern for the pain felt by the baby. In instances where babies have inconveniently survived the abortion procedure, abortionists have undergone criminal prosecution for killing them outside the mother's body. Far safer to remove any possibility that they will survive.

There is also a juris precedential reason for the medical world's toleration of widespread abortion. Newborn babies in intensive care pose major legal risks for treating physicians. University of Chicago neonatologist William Meadow reports in the Pediatrics Electronic Pages for May 6, 1997, that most U.S. doctors treating premature babies will be sued for medical malpractice at some point in their careers, no matter how competent they are. It must be tempting to refer high-risk, late-term unborn babies for abortion rather than treat them and risk a law suit.

In one of the more macabre sections of his advertisement, Tiller recommends that "couples elect to view or hold the baby after the woman has recovered from anesthesia." Of course, he concedes that "some couples initially find this a very frightening thought." Indeed.

He also said, in a "Dear Colleague" letter dated April 19, 1991, in which he solicited abortion business from referring physicians, that "Patients are encouraged to speak directly to their baby if they wish, and finally to say 'goodbye.' (Not all patients choose to be involved in this process...)" In a 1996 promotional video, Tiller offers patients an opportunity to obtain a "family photo" with them holding their dead baby. He also suggests that, as a memento, they might wish to have a lock of the baby's hair or a fetal footprint.

Even more bizarre is the fact that the Rev. George Gardner, pastor of Wichita's College Hill United Methodist Church and an outspoken Tiller apologist, publicly admits to performing post-mortem baptisms on Tiller's victims. If the deceased aren't babies with souls, what do these parents think they are baptizing? If they are babies with souls, why isn't this infanticide?

On December 9, 1996, a grand jury in Wilmington, Delaware handed down first degree murder indictments against Brian C. Peterson Jr. and Amy Grossberg for allegedly fracturing the skull of their 6-pound-2-ounce newborn baby boy and throwing his body into the trash. Their baby had apparently been born alive. But was his situation materially different from that of babies who are three-fourths born before being killed by "partial-birth" abortion?

Abortion opponents have long used such questions as a way of awakening their listeners to what is going on. The danger is that abortion advocates will turn these questions upside down. In AMA Prism (May, 1973) Nobel laureate James Watson said, "If a child was not declared alive until three days after birth, then all parents could be allowed the choice... the doctor could allow the child to die." Beverly Harrison, professor of Christian ethics at Union Theological Seminary, agrees. In Policy Review (Spring, 1985) she said, "I do not want to be construed as condemning women who, under certain circumstances, quietly put their infants to death." As a practical matter, the utilitarian views of Professors Watson and Harrison aren't where we're headed, they're where we are.

And there is no sign that the direction is about to be reversed. One on the darker consequences of the current effort to map the human genome will be withering pressure to test unborn children for genetic predispositions to certain "disabilities." And why should we stop at Trisomy 21 and spina bifida? If, for instance, as is argued by homosexual advocacy groups, there is a genetic component to homosexuality, how many parents will want their unborn babies tested for the operative gene? In China and India, fetuses are already aborted for the defect of being female. And a recent study determined that more than one in ten mothers would abort a child susceptible to obesity.

On April 30, 1997, USA Today reported that the city of Brandenburg, Germany, had dedicated a memorial to nine thousand physically disabled, mentally retarded, and other persons deemed "inferior" and "unworthy" by the Thousand Year Reich. They were, as the world grows weary of being reminded, systematically executed in the Nazis' euthanasia program. The former prison building in which the victims were held will now house their memorial. I hope and believe that similar memorials will one day be established in the buildings now occupied by abortionists like George Tiller.

Of course, George Tiller is not the problem. He is only a symptom. The community is the problem; those who take their children to be killed by him and those who make the killing possible by their silence.

This abomination is allowed to continue because there is a great deal of confusion among people of good will as to the circumstances under which early abortions should be legal. But George Tiller's hubris has stripped us of any excuse for confusion over the killing of near-newborns. Those who defend his infanticide for fear of losing their "choice" are taking self-absorption to new and sickening depths.

In January of 19998 a crisis-pregnancy center called Choices Medical Clinic (www.choicesmc.org) will open at 538 South Bleckley Street in Wichita, the building next door to George Tiller's abortion clinic. It will be run by pro-life volunteer physicians, nurses, and medical technicians. They will be led by a hospital administrator who resigned from Via Christi Hospital to take this job, although there is, as yet, hardly any money to pay his salary, Please pray for him and his colleagues. You can make money killing babies, but you have to raise it in order to save them.