The Right to Live, The Right to Die

Charles Everett Koop (October 14, 1916 – February 25, 2013) was an American pediatric surgeon and public health administrator. He was a vice admiral in the Public Health Service Commissioned Corps, and served as the 13th Surgeon General of the United States under President Ronald Reagan from 1982 to 1989. According to the Associated Press, “Koop was the only surgeon general to become a household name.” Koop was known for his work on tobacco use, AIDS, and abortion, and for his support of the rights of disabled children.

From 1946 to 1981, Koop was the surgeon-in-chief at the Children’s Hospital of Philadelphia (CHOP). Koop was able to establish the nation’s first neonatal surgical intensive care unit there in 1956. He helped establish the biliary atresia program at CHOP when Japanese surgeon Morio Kasai came to work with him in the 1970s. He also established the pediatric surgery fellowship training program at CHOP. During his tenure there he graduated thirty-five residents and fourteen foreign fellows, many of whom went on to become professors of pediatric surgery, directors of divisions of pediatric surgery, and surgeons-in-chief of children’s hospitals.

Koop became a professor of pediatric surgery in 1959 and professor of pediatrics in 1971 at the University of Pennsylvania School of Medicine. While a surgeon in Philadelphia, Koop performed groundbreaking surgical procedures on conjoined twins, invented techniques which today are commonly used for infant surgery, and saved the lives of countless children who otherwise might have been allowed to die. He invented anesthetic and surgical techniques for small bodies and metabolisms and participated in the separation of several sets of conjoined twins whose condition other physicians at the time considered hopeless. He first gained international recognition in 1957 by the separation of two female pygopagus infants (conjoined at the pelvis)^[11] and then, again, in 1974 by the separation of two ischiopagus twins (conjoined at the spine) sharing a liver, colon, and parts of the intestines with their entire trunks merged.

Koop was active in publishing articles in the medical literature. Koop later wrote that “Each day of those early years in pediatric surgery I felt I was on the cutting edge. Some of the surgical problems that landed on the operating table at Children’s had not even been named. Many of the operations I performed had never been done before. It was an exuberant feeling, but also a little scary. At times I was troubled by fears that I wasn’t doing things the right way, that I would have regrets, or that someone else had performed a certain procedure successfully but had never bothered to write it up for the medical journals, or if they had I couldn’t find it.^”

Koop helped rectify this by publishing his own findings and results. Additionally, he became the first editor of the Journal of Pediatric Surgery when it was founded in 1966.

In contrast to his years as surgeon general, when it was his policies and speeches that had bearing on other people, his years as an operating pediatric surgeon involved a more individualized, direct, hands-on effect on others. During the course of his long career, for example, he performed some seventeen thousand inguinal hernia repairs and over seven thousand orchidopexies (surgery for correcting undescended testicle). He developed new procedures, such as the colon interposition graft for correcting esophageal atresia (congenital lack of continuity of the esophagus) or ventriculoperitoneal shunts for treatment of hydrocephalus (accumulation of excessive cerebral spinal fluid in and around the brain causing neurological problems). He also tackled many difficult cases ranging from childhood cancer to surgeries done on conjoined twins, of which he and his colleagues operated upon ten pairs during his 35-year tenure. In all he operated on many children and babies with congenital defects ‘incompatible with life but amenable to surgical correction’.

In 1976, Koop wrote The Right to Live, The Right to Die, setting down his concerns about abortion, infanticide, and euthanasia. Koop also took some time off from his surgical practice to make a series of films with Christian apologists Frank Schaeffer and his father Francis Schaeffer in 1978, entitled Whatever Happened to the Human Race? based on the book of the same title that was previously written by the elder Schaeffer. Frank Schaeffer and his associate, Jim Buchfuehrer provided a private, five hour screening to U.S. Rep. Jack Kemp and wife Joanne on their home that, according to Frank Schaeffer’s account of the late evening and early morning event in his book Crazy for God, led to both the Schaeffers and Koop obtaining “…access to everyone in the Republican Party”.