Medical Ethics Abortion
Medical Ethics Abortion
Most moral issues in medicine and healthcare will instigate lively debate, but no subject seems to inflame tempers more than the question of abortion. The gulf between pro-life and pro-choice can be an uncompromising stance of deeply held beliefs and principles. On the one hand, there is the claim that the foetus is a human being with the same right to life as any other human being, and abortion is therefore nothing less than murder. On the other hand, it is argued that a woman has a right to choose what happens within her own body, and is therefore justified in deciding to have her foetus removed if she so wishes.
Even a liberal view is problematic; these tend to take the view that it is permissible for an abortion to take place before a certain stage in the foetuses development, but not beyond that given point. Such an arbitrary perspective does seem difficult to quantify; how can anyone determine the criteria that would navigate a decision that finds termination acceptable today but morally reprehensible tomorrow? It is sometimes argued that the foetus reaches personhood well before birth.
“By the tenth week, for example, it already has a face, arms and legs, fingers and toes; it has internal organs, and brain activity is detectable.” But does this undermine a woman’s right to self determination—can it still be reasonable for her to choose abortion, given its level of development? We shall explore this question; not from the perspective of whether the foetus is human, but from the premise “that the woman’s rights over her body are more important than the life of the person or part person in her womb.”
A Woman’s Right to Self-Defence
Judith Jarvis Thomson presents the following hypothesis: a woman becomes pregnant and then learns that she has a cardiac condition that will cause her death if the pregnancy continues. Let us grant the foetus personhood, with a right to life. Obviously the mother too has a right to life, so how can we decide who’s right to life is greater? A way of answering this question could be to say that an abortion is an act of aggression with the sole intention to kill. Whereas to do nothing would not be an attempt by anyone to murder the mother, rather to just let her die.
The passivity of the latter could be seen as morally preferable than directly killing an innocent person. Thomson argues that “It cannot seriously be said that…she must sit passively by and wait for her death.” There are two people involved, both are innocent, but one is endangering the life of the other. Thomson believes that in this scenario a woman is entitled to defend herself against the threat posed by the unborn baby, even if ultimately this will cause its death.
I feel Thomson is correct in her appraisal. If an impartial judgement was sought by an individual as to whose life has greater worth; the foetus or the woman, they might not feel able to choose—both lives could be seen to hold equal value. But there is nothing objective about the woman’s situation—her life is endangered. If a person threatens my life—even if they are not conscious of their actions—I have a right to kill them, if that is the only course of action I can take to repel the attack.
The scenario becomes less clear when we consider if a woman holds the same right to defend herself if the continuation of her pregnancy causes her serious health problems that are not terminal. Again, I would assess the situation in terms of an attack. Do I have a right to kill an assailant if he attempts to wound me? The answer, I think, is dependent upon degree—the injury that would be inflicted. It seems reasonable that the degree of retaliation should be proportional to the severity of the attack.
Similarly, a woman has the right to terminate her pregnancy if its continuation instigates a degree of illness that is severe enough to warrant that decision. The problem then is quantifying such comparatives. It might seem reasonable to nominate the woman involved as the person best qualified to make that decision, but shouldn’t such judgments emanate from an objective source? After all, should I be able to ‘take the law into my own hands’ and choose whatever reprisal I thought necessary against my attacker?
A Woman’s Right to Ownership
A woman holds ownership of her own body; therefore she may abort her foetus if that is what she chooses “it is in a very real sense her own—to dispose of as she wishes.” Professor Thomson analogises: it is not that the woman and foetus are like two tenants occupying a small house that has been mistakenly rented to both of them—the mother owns the house. But not all claims of ownership hold an automatic right to dispose of their property. John Harris gives an example suppose I own a life-saving drug, and have nothing planned for its use other than placing it on my shelf. If I meet a person who was dependent on that drug otherwise they will die, I would not be morally entitled to withhold the drug—it would be wrong of me to exercise that right.
What Harris is expressing is that a woman may have the right to do what she wishes to her own body, but it would be wrong of her to exercise that right. The question then is; does the value of ownership of your body take precedence over the value of the foetus? Property is sometimes commandeered during war, and this action is usually justified because national security is thought to take priority over an individual’s right to ownership. Another compelling, and I think decisive, argument comes from Mary Anne Warren. She states that ownership does not give me a right to kill an innocent person on my property, furthermore, it is also immoral to banish a person from my property; if by doing so they will undoubtedly perish.
If one does not accept that a foetus is a human being, then the woman may have it removed from her body, similarly to having a kidney stone taken out. But if the foetus is believed to be a person, then I do not think any argument of ownership can hold up against the soundness of the given examples.
A Foetuses Right to its Mothers Body
Can a woman’s right to choose abortion take priority over the foetuses right to life? Professor Thomson argues that “…a right to life does not guarantee
having either a right to be given the use of or a right to be allowed continued use of another person’s body—even if one needs it for life.” Thomson goes on to give an example, that if she was terminally ill, and the only thing that would save her life was the touch of Henry Fonda’s cool hand on her fevered brow, she would have no right to expect him to travel to her side and assist her in this way. No doubt, Thomson adds; that it would be frightfully nice of him, but she holds no right against him that he should do so.
An obvious criticism is to argue that a woman has a special responsibility to her foetus, simply because she is its mother—a responsibility that ‘Henry Fonda’ does not owe, so the analogy, is rendered useless. But Thomson postulates that “we do not have any such ‘special responsibility’ for a person unless we have assumed it, explicitly or implicitly.” Thomson therefore argues that if a pregnancy is unwanted, and the woman holds no emotional bond to the foetus, there is no attachment and so no responsibility. A possible dispute to Thomson’s idea is to suggest that the ‘special responsibility’ is bonded through genes rather then emotion. If a child is born and the mother abandons it, her culpability is held through their ‘mother and baby relationship’ rather then what the mother ‘thinks’ of her baby.
Another argument that can give claim by the foetus to its mother’s body is one of contract. It could be said that by voluntarily engaging in sexual intercourse a woman—even if using contraception—risks the chance of pregnancy. By understanding the possible consequences of her actions, she must be seen as responsible for the existence of the foetus, because no method of contraception is known to be infallible. Since the woman is accountable for bringing the foetus into the world (albeit in her womb) she assumes an obligation to continue to provide nourishment for its survival.
Michael Tooley offers an example that he believes analogises this argument there is a pleasurable act that I practice. But by engaging in it, it can have the unfortunate risk of destroying someone’s food supply. This will not cause the person any problem, as long as I continue to make such provisions, even though it causes me immense trouble and expense. Tooley says that he arranges things so that the probability of the ‘pleasurable act’ having such an effect is as small as possible (contraception). But he says that if things do go wrong, he is still responsible for the person needing food, and therefore obligated to supplying the food needed. Tooley believes that once we engage in an activity that can potentially create a child, then we assume responsibility for its needs, even if bringing that child into existence was accidental and precautions were taken to prevent that outcome.
Professor Thomson offers her own powerful analogy in contrast to the above view:
If the room is stuffy, and I therefore open a window to air it, and a burglar climbs in, it would be absurd to say, “Ah, now he can stay, she’s given him a right to the use of her house—for she is partially responsible for his presence there, having voluntarily done what enabled him to get in, in full knowledge that there are such things as burglars, and that burglars burgle.” It would be still more absurd to say this if I had had bars installed outside my windows, precisely to prevent burglars from getting in, and a burglar got in only because of a defect in the bars.
Abortion, Due to Rape
As already stated, most views against abortion base their position from the value they place on the foetuses life. Even so, in the case where pregnancy had occurred through rape, most opponents of abortion would believe that there would be sufficient justification for termination. Obviously, there is something paradoxical about this—if the foetus is valuable because it is human, it is obviously no less human because its mother had been raped.
So how can some opponents of abortion hold such contradictory ideas? Janet Radcliffe Richards’ explains that when a woman is forced to continue pregnancy until childbirth, “…the child is being used as an instrument of punishment to the mother, and that talk of the sanctity of life is being used to disguise the fact.” The only thing that a woman that wants to abort for reasons of accidental pregnancy has done differently, is to of engaged willingly to sex—and that is what she is being punished for.
Richards’ offers an interesting approach to the apparent inconsistency stated, although I don’t find its supposition altogether convincing. I think the ‘double-standards’ described, portray an individual that holds only a relative opinion to the value of life that is held by the foetus. That is, the foetus is human, with rights, but not as human and not as much rights as an adult human being. And this is how I feel critics of abortion consider priority to women in rape cases.
A Father’s Right
To what degree, if any, does the father’s opinion count on whether his unborn child should die at the hands of the mother? After all, the foetus is very much a part of him—sharing his genetic make-up. It is noted by John Harris that a man is not entitled to violate a woman for the purpose of impregnating her—that is rape—so then it follows that he must not violate her by forcing his wishes for a pregnancy to continue until birth. The counter argument is that by agreeing to sex, a woman has tacitly agreed to carry the man’s child.
Ultimately the woman’s opinion must take priority over the man’s—because she has to carry the foetus, but, once a foetus is formed, one can have a degree of sympathy for the man’s situation. If copulation had taken place for the purpose of impregnation, then why should the man suffer a feeling of loss just because his partner changes her mind? Where contraception is used, his argument may be weakened—they did not intend parenthood. But if both were planning for a baby, is it fare that once that child exists, the mother can take it away from its father, even though he has done no wrong?
A Right to Death
If a pregnancy is terminated during its early stages, the foetus will undoubtedly die. But if an abortion takes place later in pregnancy, and by some miracle survives, the mother has no “right to secure the death of the unborn child.” If the baby was still unwanted, the “woman may be utterly devastated by the thought of a child, a bit of herself, put out for adoption and never seen or heard of again” but she can only demand her separation from it; she may not order its execution.
I guess there would be few opponents to this assertion; but it is interesting to understand why. If a person accepts the permissibility of abortion, how is it so different to kill a child that survives its attempted termination? Presumably the foetus has acquired rights that it didn’t hold inside the womb, or perhaps the woman loses her rights during that transition. It seems strange that location should alter the foetuses perspective so drastically—after all, it is the same being. It could be argued that it is independence that qualifies the foetus for its right to live. When it no longer needs its mother for survival, and is not ‘reliant’ upon her in any way, she loses the right to decide its fate.
Professor Thomson’s explanation is somewhat different; she too agrees that there is no justification for a woman to order the death of a foetus that lives following an abortion, but her reasoning is not dependent upon any acquisition or loss of rights. Thomson argues that a termination is just the right for a woman to detach the foetus from her body. This is not an act of murder (even though its death is inevitable during its infancy) but an entitlement to liberation, whatever its outcome.
Professor Thomson presents an account that would be reasonable if the act of abortion was purely an attempt of separation. But in fact the procedure used is an attempt, not only to detach and remove the foetus, but to kill it. If the abortionist fails in this task, then Thomson allows the baby a right to live. But as the method of termination is designed for the foetus to die, I believe it renders Thomson’s point unsound.
Professor Thomson concedes that “It would be indecent in the woman to request an abortion, and indecent in a doctor to perform it, if she is in her seventh month, and wants the abortion just to avoid the nuisance of postponing a trip abroad.” So, even staunch defendants of feminist ethics feel compelled to consider the foetuses interests once its development reaches a mature stage. It could be argued that the foetus has become a baby, and abortion is therefore tantamount to infanticide.
I believe that anyone can exercise their right to self-defence if their life is threatened, and a woman can use her prerogative against the unborn baby at any stage of its development without recrimination. However, I feel that a woman’s right to expel her foetus for any other reason has only relative justification. Relative: because a woman’s rights to abort become less valid as the foetus develops.
There is, in my opinion, a necessary correlation between foetal development and a woman’s right to termination. A woman may exercise her choice without compromise during early pregnancy, because the foetus is nothing more then potential, but justification becomes less palatable as potential becomes actualised. Can a woman really hold the same rights to ‘choose what happens within her own body’ when the foetus is twenty five weeks old, as she did when it was ten weeks old?
As previously mentioned, arbitrarily choosing a point in the foetuses life and exclaiming ‘before this point the thing is not a person, after this point it is a person,’ does appear contrived. But its comparison with ‘before this point a woman can choose, after this point she can’t; does seem vindicated against less satisfactory views. The purpose of this essay was to assess a case for abortion that was not dependent on the foetuses right to life, but instead to appreciate a woman’s right to choose. I don’t believe that either position can be considered without respecting the rights of the other. Therefore, in my opinion; a woman holds considerable rights; but they are only relative to the foetuses level of development.
Dwyer, Susan, The Problem of Abortion. London: Wadsworth
Publishing Company, 1997
Glover, Jonathan, Causing Death and Saving Lives. London: Penguin Books, 1997
Harris, John, The Value of Life. London: Routledge, 1985
Info on Abortion “Abortion”, Wikipedia, the Free Encyclopaedia, http://en.wikipedia.org/wiki/Abortion#Other_means_of_ abortion
Richards, Janet, The Sceptical Feminist. Harmondsworth: Pelican, 1982
Sherwin, Susan, No Longer Patient. Philadelphia: Temple University Press, 1992
Thomson, Judith, “A Defence of Abortion”, Philosophy and Public Affairs, Vol. 1, No. 1, 1971: pp. 47-66
Tooley, Michael, Abortion and Infanticide. London: Oxford University Press, 1983
Warren, Marry Anne, “On the Moral and Legal Status of Abortion”, The Monist, 1973
University/College: University of California
Type of paper: Thesis/Dissertation Chapter
Date: 27 November 2016
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