May 25, 2004

Medical Ethics

 

Abortion, Viability and the Right to Life

 

 

����������� Abortion is arguably the most controversial topic of the present century and the last because it uniquely pits the supposed rights of potential people against the rights of women to control their bodies and their futures.As technology progresses, one�s view of the rightness or wrongness of abortion will color his or her view of the acceptability of certain scientific research and developments, from assisted reproduction to the use of stem cells to develop therapies.Even when rational people remove religious beliefs from their opposition to abortion, a compelling case can be made for the rights of the fetus, particularly, its right to be born.But equally compelling arguments exist for the interests of women who want to terminate their pregnancies, for those who have come to be pregnant by their own �fault� and by forces outside their control.

In �Hyperactive Ethics�, Julia Driver uses the issue of abortion as one example where society should be �morally restrained� because of its controversial nature and the complex tit-for-tat points that can be made in regards to its rightness or wrongness.�� Like slavery, for example, the issue of abortion is controversial�legal access to it is widely supported, with a large minority in opposition to it.But unlike slavery, the controversy rests on the �supposed rights� of the unborn about which reasonable people disagree, whereas, with slavery, �no reasonable person could believe that it is permissible.�Furthermore, the act of holding slaves clearly restricted the autonomy of human beings to benefit others with free labor.While anti-abortionists may hold that abortion destroys the potential autonomy of a human being, the autonomy is just that�potential�and any right to realize a potential has been well argued by both sides of the debate.

Because of what seems like the un-decidable nature of this dispute, abortion should not be outlawed.But when examined logically and without the biases of our �cultures� or religions, the controversy that surrounds abortion still seems difficult, but closer to resolvable in terms of ethics.

***

One of the most successful routes taken in the philosophical literature regarding the morality of abortion has been granting the anti-abortionist claim that the fetus is a person, but showing that that alone is not enough to endow it with a right to life.Judith Jarvis Thomson�s influential essay �A Defense of Abortion� is her attempt to show that personhood alone does not guarantee a right to life.Thomson�s view is that the traditional argument�at conception the fetus is a person, it is immoral to kill a person, so therefore fetuses ought not be killed�skips an important step between having a right to life and having a right not to be justly killed.

In the case of her famous violinist to whom one finds herself connected against her will in order to sustain his life for nine months, Thomson concludes that the nice thing to do�to spend the time required to save him�is not the only just thing to do, as unplugging him from herself so as not to forfeit the nine months required to sustain him to independence is morally acceptable because, as famous and talented as he is, he has no right to the use of her kidneys.Only she can grant that right, and she can of course decide against doing so without being unjust.

However, Thomson notes that deciding to unplug and thereby kill him after reaching the point of having one hour left, say, of the required time for his full recovery would be �morally indecent�.It would be too easy a thing to do, to allow that her hour of inconvenience is more valuable than the innocent life of the violinist.Just as she notes some scenarios where disconnecting oneself from the violinist would be wrong, Thomson never claims that a woman�s having an abortion is always morally right.Rather, her arguments are against the �extreme view� that abortion is always morally wrong.She does well in showing that cases of pregnancy caused by rape or where carrying the child to term would endanger the woman�s life are situations in which the woman violates no (hypothetical) right of the fetus and creates no injustice�but that there are still �trivial� reasons for some abortions that make the decision to have one wrong.

Thomson�s arguments for abortion take into account the issue of viability, and as she does not commit herself to unrestricted abortion, she maintains that terminating a viable fetus is an unjust killing, given that it is not threatening the woman�s health.Thompson also notes at the end of her paper that despite her assumption therein for argument�s sake, a very early fetus is not a human being in the moral sense�it is �no more a person than an acorn is a tree��and it is therefore not subject to the conditions she sets up for later term abortions.

Thompson�s views about �drawing the line� on abortion reflect the Supreme Court�s decision in the case of Roe v. Wade.The decision of the Court made unrestricted abortion legal for women in the first trimester of their pregnancies, as well as the second except in cases where it would jeopardize the health of the woman.(It should be noted that the usual case is that the fetus jeopardizes the woman�s health, though, not the process of abortion.)

In the third trimester, however, the ruling considers the fetus �viable� and limits abortion to those performed out of concern for the woman�s health.Outside of her granting that the fetus is a person from conception for argument�s sake, Thompson agrees that there is a definite moral difference between a fertilized egg and a fetus in its seventh month and beyond of development.

But with ever-advancing medical technologies that enable a fetus to survive outside of the woman�s body earlier and earlier in its development, and a wide disparity of the availability of those technologies in different time periods and different places, it is difficult to demarcate �viable� and �unviable� in a way that it would apply to every fetus in every place and time.Perhaps twenty years ago, a fetus at 25 weeks would have been more viable than a fetus at 24.In the present day, a fetus at 23 weeks, or perhaps less, has better chances of surviving if removed.Furthermore, a seventh-month fetus in New York City is more viable than a seventh-month fetus in, for example, Haiti, given what is available in each of those places to sustain it.Further still, a prematurely born infant may be less developed than a fetus that still resides in the womb.The success of the fetus surviving once removed from the body or if born too early in any place or time is always unforeseeable, and given survival its normal development is likely to be stunted causing lifelong problems�including the likelihood of a shortened life�as the true need for a healthy infancy is to have been brought to term�to have been born.So it does not seem that viability alone endows a fetus with the right not to be killed, as there is no moment where its beginning can be pinpointed.

����������� Nonetheless, even to proponents of legal abortion, there is an intuition that there is a difference between aborting early on and aborting at a later stage, after much development has taken place and human features are describable as part of the neonate.While its life still depends on the �machinery� it is hooked to inside the woman�s body, something seems more �icky��both visually and emotionally�about terminating something that not only has more �blood and guts� but also looks more like us, or at least more like our babies.This difference lays in the increased �capacities� the organism has as its development moves along.Unlike a fertilized egg, it is easier to imagine that an fetus that is close to its birthday feels things, and pain is the one with which humane individuals and societies are most concerned.

Mary Ann Warren, in �On the Moral and Legal Status of Abortion�, seems to agree with this assessment insofar as she claims that the �fetus comes into existence as the result of the woman�s actions [which might] give her the right to refuse to keep it alive.�Warren dislikes Thomson�s route to disproving that a right to life always makes abortion immoral because Thomson�s approach stops short�it only leaves room for abortion in cases where the woman is not at �fault�.Thomson only gets her foot in the door of morally acceptable abortion, and, Warren claims, even if the fetus does have a right to life based in its �potential personhood,� that right does not trump the rights of an actual person.

Warren also challenges the intuitive belief in the moral difference between an embryo and a fully developed fetus.Warren claims that even at the latest stage of pregnancy, the fetus is not much more �personlike� than a fertilized egg, and that while it may in fact feel pain and have brain activity, �it is safe to say that it is not fully conscious, in the way that an infant of a few months is.�Whereas the belief that abortion is always the unjust killing of a person is the �extreme view�, Warren�s view that abortion is never morally wrong is the extreme view on the opposite side of the spectrum.

That people respond with �emotional repulsion� is not enough to judge the morality of late-term abortion �since mere emotional responses cannot take the place of moral reasoning in determining what ought to be permitted.�Indeed, emotional responses are not enough upon which to base moral claims, but the emotional response in this case is much like the moral response of most human beings to the thought of infanticide.Warren�s concern for limiting abortion in terms of the developmental stage of the fetus stems from justifiable interests in �a woman�s right to protect her health, happiness, freedom, and even her life.�But though a fetus on the verge of being born may not, in fact, be the conscious entity that a three month child is, that a fetus at that stage is very much different morally from a newborn is not well defended.

Both Thomson and Warren briefly cover the way in which natural rights are generated.Thomson writes, �Surely we do not have any �special responsibility� for a person unless we have assumed it, explicitly or implicitly.If a set of parents do not try to prevent pregnancy, do not obtain an abortion, but rather take it home with them, then they have assumed responsibility for it, they have given it rights, and they cannot now withdraw support at the cost of its life because they now find it difficult to go on providing for it.� Seeing that the way in which rights come to be is far more important not only to Thomson�s argument but also to the defense of stronger positions on the terms in which abortion should be allowed, Rosamond Rhodes defines rights and how they come into existence in �Abortion and Assent�.

In short, Rhodes notes that rights against others exist when others grant those rights.The fetus, therefore, has a right not to be killed only when the person it is dependent on�the owner of the body in which it must reside�commits to give it such a right.When a woman assents to remain pregnant until giving birth, she has taken obligations upon herself and endowed the fetus with rights that did not exist before.

The right to life is implicitly granted when the pregnant woman does not take action to terminate the pregnancy as early as possible, or as early as a reasonable person needs to decide what to do.

There is no right to life when the woman decides to terminate rather than make preparations inside and outside of her body for the potential infant�s wellbeing.By Rhodes� account, what is important is the woman�s early decision about what course of action to take regarding her pregnancy�whether she will grant it a right to life and carry the fetus to term or whether she will forgo the obligation and abort it�and that her decision is under the assumption that the potential adult will be able to become an �independent moral agent.�

The right to life can be granted but reneged when it is learned that the child will have defects that will not only burden his or her life but also the mother�s.When the pregnancy is found to be dangerous for the woman�s health late in the pregnancy, there is no right not to be killed as the woman has the right to seek assistance to defend her own health.When the child is found to have irreparable defects that change the right it was granted�when �to be cared for and nurtured until �it can become an independent moral agent�� changes to �to be cared for an nurtured forever� or �to be cared for and nurtured for the few hours, days or months that it may live��the woman may choose to abort the fetus as the deal she had struck with herself has changed dramatically.

The concept of assent to obligations may be disputed, but when it faces down the variety of reasons a woman may want to obtain an abortion, it provides a model by which a reasonable woman can make a moral choice early on in her pregnancy, or later in her pregnancy when new information can be collected that was unavailable before she assented to carry the fetus to term.

The assentist position that Rhodes describes explains the way in which fetuses come to have rights, if and when they are granted them at all.Like Thomson, it leaves room for abortions that are morally wrong.With equal concern for women�s rights and interests as Warren, Rhodes notes that viability is a concern��reasonableness can help draw a line� in how long a woman might equivocate.If a reasonable amount of time passes the woman �should be seen as accepting responsibility whether or not she notices the significance of what she is doing.�

Clearly, abortion is an important right for women�s health and autonomy.Having the right to abortion entails the responsibility to endow a fetus with the right to life and take on the obligations granting such a right creates, or to refuse the obligations and deny the fetus the right to life.Exceptions are of course in order in those cases where the obligations are found to be different than what they were believed to be when the right to life was granted.And legal restrictions on abortion should be few, even over cases that are arguably past the point of viability, so as not to err at the expense of any special circumstances a particular woman�s pregnancy might have.

Women who seek abortions should be made aware of the psychological and physical effects that are possible results thereof.In the interest of women�s medical concerns and their social, financial, and emotional concerns, access to methods for ending pregnancy should be widely available and should be both sought after and provided as early as possible.

Works Cited

Driver, Julia.�Hyperactive Ethics.�The Philosophical Quarterly 44, no. 174 (1994)

 

Thompson, Judith Jarvis. "A Defense of Abortion." Philosophy and Public Affairs 1, no. 1  (Fall 1971)

 

Warren, Mary Anne.�On the Moral and Legal Status of Abortion.�The Monist 57, no.1 (1973)

 

Rhodes, Rosamond.�Abortion and Assent.�Cambridge Quarterly of Healthcare Ethics 8.(1999)

 

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