Abortion
Abortion
1. Basic Biology - a reminder
2. What the Church has Taught
3. Moral status of a foetus
4. Conflict of rights
5. Rights and Responsibilities
6. Morals and Law
7. Further issues: emotional language; interchangeability of children; infanticide
8. What conclusions can we draw?
1. Basic Biology - a reminder
1. Wastage We should not forget the high degree of natural wastage of eggs and sperm: • A woman’s eggs are present in her ovaries from before birth; it would even be possible to use eggs from a foetus for IVF. Most of these never descend and die with the woman. About 13 a year descend from ovaries to the womb. Most are simply flushed out unfertilised. Of those that are fertilised about 50% will fail to implant. Some of those that do implant will spontaneously abort - the woman may not even be aware that they were fertilised • Sperm is produced in millions, and even if there is a successful pregnancy, vast amounts of sperm are wasted. We should therefore be cautious of moral attitudes which give too much value to sperm or eggs.
2. Terminology Egg + sperm = zygote, which becomes an embryo which becomes a foetus (The American spelling is fetus). This is very much simplified, and biologists use other terms as well, especially for the initial stages. Even if these stages are reasonably clear, there is no cut-off point between one and the next; we can only see a continuous process, and there is no fact of biological development which we can use as a moral marker.
3. Twins Even as late as fourteen days, the zygote can split into identical twins. We must therefore be cautious of calling the zygote before that time an “individual”.
4. “Quickening”An old term, no longer used in biology, but sometimes met in the literature on abortion. The quickening is the first time the mother becomes aware of the foetus as a separate living entity in her womb - the first movement or first kick. 5. Contraception An IUD (intra-uterine device, such as the coil) allows fertilisation but prevents the egg implanting; the morning-after pill allows fertilisation and implantation. It may not be strictly correct to call either of these an “abortion”, but there may be different questions about the morality of these methods of contraception, compared to other methods.
6. “Ensoulment”It used to be believed that the soul entered the foetus at some stage, either at conception or during pregnancy. This moment was called “ensoulment”. Before that time the foetus was considered not properly to be a person.
7. Ectopic Pregnancy Occasionally the fertilised egg implants outside the womb, for example in the fallopian tube. This can cause extreme medical danger for the mother.
2. What the Church has Taught
A. The Bible Miscarriage is mentioned in the Old Testament (the Hebrew Bible), but intentional abortion is not mentioned in the Old or New Testaments.
B. Earliest Christian writings outside the NT The Didache treats abortion just like infanticide, and takes a stand against pagan culture by condemning it. The Epistle of Barnabas says, “the foetus is your neighbour” and says we therefore may not kill it. [Both these works are first century AD, and therefore the same time as the New Testament.]
C. Early Church Tertullian (c200 AD) says, “He who is man-to-be is man, as all fruit is already in the seed.” i.e. a potential human should be treated as a human; we may not kill it. Augustine (c400AD) believed ensoulment was at 46 days. He recognised that there is no solution to the questions that surround abortion. He made little distinction between abortion and contraception. The biological process was not understood, and sperm were seen as “little men”, the woman’s role being like that of the fertile soil in the germination of any other seed.
D. Mediaeval Aquinas (c1200AD) taught that ensoulment was at 40 days for a male, 90 for a female. Abortion was homicide after ensoulment, and a “grave sin” before. He recognised that there might be values equal to or greater than the life of the foetus, such as the life or health of the mother.
E. Enlightenment and Post-Enlightenment 18th Century: generally, Christians argued that a person is potentially present from the moment of conception, and therefore abortion was killing. 19th Century: Pius IX in 1869 condemned abortion from the moment of conception. Abortion was allowed only by the “double effect” argument, where an action has two effects, one of which is intended, and the other is foreseen and tolerated, but unwished. For example when we remove a cancerous uterus, or the fallopian tube in the case of an ectopic pregnancy, our intention is to save the life of the mother. The subsequent death of the foetus is an unfortunate, but allowed, side-effect, so the action was considered morally acceptable. If the intention had been to kill the foetus, it would not be acceptable.
D. Twentieth Century
(i) New Understandings: New sciences have developed, such as embryology, foetology, and genetics, which affect our moral judgements. There is a realisation that human life is a continuum from the moment of union of sperm and egg, and labels such as zygote, embryo, foetus, infant are arbitrary.
(ii) New Moral Arguments: (a) Such things as mental anguish, lifestyle disruption, financial cost, and women’s rights and now used by some ethicists to argue for the acceptability of abortion. (b) The moral distinction between born and unborn has been disputed, either allowing infanticide as “post-natal abortion”, or treating abortion the same as infanticide. This issue is raised by the Stinton case (1976), discussed a few lines below. (c) There is a wider vision of the purpose or aims of sexuality; it is not just about having children.
(iii) New Conclusions: Biomedical science cannot say when a being with the rights of a human person comes into existence; neither is an answer likely from Philosophy, Theology or Law.
(iv) Roman Catholic Attitudes: (a) Vatican II: Gaudium et Spes (1960’s): “From the moment of conception life must be guarded with the greatest care. Abortion and infanticide are unspeakable crimes.” There was a recognition that personhood is hard to define for a foetus. (b) In 1975, the Congregation of Faith (a body in the Catholic church which establishes doctrine) said: “Although it cannot be established with certainty that a person is made at the moment of conception, nevertheless it may be so, and it is therefore better to act as if it is so.” (c) In 1976, the attitude of Vatican II was repeated. Laws allowing abortion were declared immoral. IUD and the mini-pill were declared “abortion”.
The Stinton Case (1976) Peggy Stinton asked for an abortion when she was 24½ weeks pregnant. There was a chance that both mother and baby could die, and if the baby survived, it would have severe brain damage. The courts agreed to this, but the very next day, before the abortion could be performed, she gave birth. The baby was born alive, but brain damage was definite. The Stintons demanded no “heroic measures” to save the life of the baby, but the US courts overruled them. Any resistance from the Stintons would have left them open to prosecution. So we had the bizarre situation of extreme medical efforts being made to save the life of a baby which was due for abortion. The fact that the birth was natural and not induced triggered a totally different moral response. Does this lead us to question birth as a morally significant marker?
3. The Moral Status of a Foetus: does it have human rights?
1. We feel differently about killing humans and non-humans. This raises moral issues, for example: Which should we value more, an intelligent baboon or a grossly retarded child? Are we guilty of “species-ism”? And if so, is it wrong? Do we have a greater responsibility to our own kind?
2. If there is a genuine moral difference between killing humans and non-humans, then we need to determine the status of the foetus; is it fully human? Some people claim that foetuses are certainly alive, and certainly human - they can never turn into anything but a human being. So the right question might be, is it a person? We therefore need to define “personhood”, or to clarify the signs of being a person. The trouble is that any attempt to do so appears to suggest that disabled or handicapped people, or people in a coma, or people with Alzheimer’s are somehow not people. For example, we might look at: (i) Independence. But when is a child independent? 10? 16? When they leave home? And what about a person on a life support machine? (ii) Rationality? But when does rational thought begin? 4? 7? 17? And what of a person who is mentally handicapped or who develops Alzheimer’s? (iii) Self-consciousness? The same arguments apply. Generally we feel that the fewer signs there are of personhood, the less evil it might be to kill. So we tolerate contraception more than the morning-after pill, the morning after pill more than killing a zygote, killing a zygote more than killing an embryo, and so on. Likewise at the end of life, we find it easier to allow someone to die when there are fewer signs of personhood, for example Tony Bland.
3. Can we find a morally significant dividing line anywhere on the continuum of life from conception to adulthood? A number of suggestions have been put forward: (i) Ensoulment? These days very few people think in these terms. (ii) Birth? This actually functions as a moral marker for many people today. We feel rights can be granted to the baby without infringing the mother’s rights. But what of premature babies, as in the Stinton case? And is killing a baby just before birth is less evil than killing it just after birth? (iii) Viability (when the baby is sufficiently developed to survive outside the womb)? This depends on the medical treatment available, and so morality alters with place and time. That does not feel satisfactory. For information, there is a 75% chance of premature babies surviving in England after 28 weeks, but only 30% chance after 24 weeks, so something significant happens to the baby’s viability during that time. (iv) Heartbeat? begins very early, about 14 days. (v) Ability to feel pain? disputed at the moment, so no clear decisions possible. (vi) Ability to react to external stimulus? Does this depend on our ability to observe the reaction? In any case, the ability develops gradually. (vii) Quickening? This also depends on our observation.
4. Entry into rights may be gradual, and finally developed only after birth. Some ethicists see “personal rights” in the way the foetus is perceived by the human community, so that an unwanted foetus has no rights. Christians would argue that society as a whole wants the foetus, even if the mother does not, and so society accords it rights.
5. Even if the foetus is not a person, it is certainly a potential person. Should we therefore give it the rights of a person? Generally we do not think that a potential X is actually an X, and in no other case do we give a potential X the rights of an X. For example, we don’t give a potential voter the right to vote, and we don’t think that a potential car-driver is a car-driver. Why then should we give a potential person the rights of an actual person? One answer might be to say that we consider it wrong to deprive a potential X of the chance to become an actual X. So that when we argue it is wrong to kill a potential person, it is not that we are giving it the rights of person, but rather, we are merely protecting its right to achieve its potential. It is also not clear when a potential person becomes a person. And if we say that we grant rights to potential persons, do we withdraw them when that potential is lost, as in senility or comas, or in cases of irreversable damage, such as with Christopher Reeves. And if not, why not?
6. Some people argue that the foetus is of immense value because it has a unique combination of genetic material. It should therefore be respected, which means according it rights, which means we should acknowledge our responsibility towards it. On the other hand, identical twins share the shame genetic material, but we feel we cannot simply abort one of them on the grounds that the genes are preserved in the other. Therefore our instinct is not about preservation of genetic material, but something else.
7. On the other hand, some people argue that it is morally acceptable to abort one baby, in order to have another later. For example, if this foetus is handicapped, I might choose to abort it and then try to conceive a non-handicapped foetus who will lead a fuller and happier life. This subsequent baby would not have been conceived if the first had not been aborted. The problem with this is that it makes babies interchangeable or replaceable. If this foetus is inconvenient to me, I can replace it with another to be born at a more convenient time. But we feel that babies are not simply replaceable at whim.
8. Judith Jarvis Thomson says that there is no such thing as a right to life. If I die of cancer, no one says my rights have been infringed. Nor do I have the simple right not to be killed. There are circumstances in which we think it is justifiable to kill, for example, self-defence, war, and in some societies, the death penalty. A famous story from the Herald of Free Enterprise disaster involved the killing of one passenger in order to save the lives of many more. Therefore the human right is perhaps “the right not to be killed unjustly”. The issue with abortion is then not whether we are killing a human being or a person, but whether such killing is justified. J J Thomson argues that at times it may be.
4. Conflict of rights
1. Is it possible to grant full moral rights to a foetus without denying those same rights to the mother? Only with abortion do we deny one person’s rights to save another’s.
2. Is the foetus’s right to life (or right not to be killed unjustly) greater than a mother’s right to her own body?
3. The Roman Catholic Church used to argue that in a case where only the mother or the baby could be saved, it was right to save the baby and let the mother die. Abortion was seen as actively killing, while letting the mother die is the lesser evil of omission.
4. Judith Jarvis Thomson argues that mother has the right to defend herself against the baby, by aborting the child, and since she often cannot effectively do this for herself, she has the right to ask a third party to do it for her.
5. In what circumstances does the foetus have the right to the mother’s body, and when does it forfeit, or simply not have, that right? (i) Rape? Some people feel that abortion is more acceptable after rape. Others argue that the baby has not committed the crime, but is being killed for someone else’s wrong deed. (ii) Irresponsibility? Many people feel it would be irresponsible for a sexually active woman to take no precautions on the grounds that abortion is always available in case of pregnancy. Some people therefore think abortion is more acceptable if the mother has tried to prevent pregnancy. They argue that if the mother’s lack of action is responsible for the baby’s presence, then the foetus has a right to her body and abortion would be unjust killing. But this makes abortion a reward for responsible behaviour, and also means we punish the baby for someone else’s act, this time the right deed of the mother. (iii) Family health? Some people argue that just as the mother has the right to defend herself from a baby whose birth would endanger her own life, so she has the right to protect her family from a baby which would make excessive demands on it, for example, if a baby were known to be handicapped, or if the family were already rather large, or if the family were supposedly too poor to look after the baby. Others argue that the right solution here is adoption. (iv) Mental health? This is the main reason actually given in Britain today for abortions. It is very hard to define adequately. (v) Social events? Some people have argued that the mother has the right to abort a baby if it would interfere with the mother’s social life, such as a skiing trip or a particular social function. These are known as social abortions. (vi) Sport? Abortion because of an approaching sporting event would be a social abortion, but recently in China there has been evidence of female athletes deliberately becoming pregnant, and then having an abortion, in order to change the hormones in the body so that performance is enhanced.
5. Rights and Responsibilities
Conflict of rights between mother and foetus is difficult to resolve. Sometimes it is easier to think in terms of the responsibilities of the mother, both to the foetus, and to herself and her existing family. We should also consider the rights and responsibilities of the father and the doctors and the nurses involved.
Exercising rights: Judith Jarvis Thomson points out that we must distinguish between having a right and being morally justified in exercising that right in a particular case. The mother may have the right to her own body, but it may still be wrong of her to exercise that right.
Judith Jarvis Thomson’s article on the unconscious violinist should be studied closely.
6. Morality and Law
Law and morality are not the same. Something which a society considers immoral may be allowed in its laws, in order to prevent a greater evil.
There are two cases in Britain where a law about a sensitive moral issue has been passed only because those arguing for it said they were not suggesting the issue was morally acceptable, only that allowing it in law would prevent greater harm. The two issues were abortion and male homosexuality.
In the case of abortion, the claim was that allowing it would prevent “back-street abortions” and be safer for the women involved. It was intended to allow abortion in extreme cases only, but now some people are claiming that there are far too many abortions, and that we almost have abortion on demand.
7. Further issues
1. Emotional language. Baroness Warner warns us of the way in which emotionally laden terms replace logical argument in the abortion debate. Various pressure groups attempt to influence the outcome of the debate by their choice of terms, for example, do we say, “killing a baby” or “terminating a pregancy”? “Pro-life” and “pro-choice” are equally bad: who would be against either? Groups like SPUC are particularly bad at this.
2. Infanticide and euthanasia. a) It is difficult to produce good clear boundaries for when abortion should in general be allowed or not allowed; but a special difficulty arises when those same boundaries are applied to infants or people suffering from a range of medical conditions such as Alzheimer’s. Should we be consistent, and avoid using criteria in abortion which we would hesitate to apply elsewhere? b) “There is a potential for devaluing all human life in a society which accepts abortion. Abortion may be a symptom of a society which uses and oppresses persons for commercial gain, neglects the elderly and handicapped, shows gender and sexual discrimination and spends more for defense that for education, health and emplyment needs combined.”
3. Adoption. It is too glib to say that adoption is an alternative to abortion. We must take into consideration the effect of the nine-month’s pregancy on the mother, the effect of the separation at birth, and the long-term effects of knowing one’s child is out there somewhere. But we must also beware of suggesting that abortion is without emotional complications. There can be considerable grief after an abortion.
8. Conclusions
We make these moral decisions in the context of an imperfect world, where some mothers do not want their babies, the mother’s health can be at risk, or the mother’s family can be disadvantaged by the extra child. Therefore we cannot talk so much of absolute “moral rights”, as of “the lesser evil”.
The issue may be a conflict of ethical approaches: deontological or utilitarian?
There is also an issue of ownership; to what extent is a person’s body their own in a society?