Thoughts on “post-birth abortion”

Introduction

 Last week’s highlighting of an article in the Journal of Medical Ethics (JME) on “post-birth abortion” [sorry, the article may have pulled from the site, which is why this link no longer works] prompted much comment, among the most cogent of which was Andrew Brown of the Guardian. Another post I highly recommend you read is at Phil’s Treehouse, where a comparison is made with Jonathan Swift’s “modest proposal”.

The overriding verdict from both conservatives and liberals has been that the paper is abhorrent. This is a view I agree with, but here I wanted to go beyond the knee-jerk reaction and to think through why it is abhorrent. This is, of course, linked in with the notion of abortion in general, so I think I am compelled to state my thinking on the matter, which I have until now been generally reluctant to do. The reason for this reluctance is that abortion is not an issue that directly affects me though it does affect those close to me.

Where I stand

In many debates there are often a wide spectrum of views, though the debate can often be cast in terms of polarity. In this case there is ‘pro choice’ on one hand and ‘pro life’ on the other. If I had to pick one, I would have to consider myself ‘pro life’ though this is more a case of ‘leaning’ towards this view than necessarily agreeing on all points shared by those who identify themselves as such.

Arguments I have often read from pro choice advocates rely heavily on the idea that it is solely the woman’s choice what she does with her own body. This is a very good argument and one that I would normally support. However, implicit within this, though, is the idea that the foetus being aborted is not an “actual person” however one might try to determine that (see further down for details). Taking the argument reductio ad absurdum it could be argued that it is entirely my choice as to whether to pull the trigger on a gun held against a bystander’s head. Yes, we have free will, but we have a moral duty to exercise it well. Exercising the free will to end another person’s life without their explicit consent is, in my view, morally wrong is the majority of circumstances.

That said, I believe abortion is justified in some cases. Such cases include, but are not limited to, instances where the health (mental or physical) of either the mother or the child is at significant risk (although this is admittedly very difficult to quantify). While there are arguments based on unplanned pregnancies (where those brought about by violent means, I would consider may likely cause significant psychological distress and thus would be justified by my previous sentence) or economic considerations do need to be considered but that in such instances adoption is preferable to termination. How to improve the adoption system is a matter that would need to be addressed, though I would make no such attempt here.

I know this brief discussion is all too brief, but I want to get on the JME paper.

The state of the debate

One weapon used by both sides in the debate is that of semantics. This is highly evident in the JME paper where the term “post-birth abortion” is preferred to “infanticide” even though in substance they are exactly the same thing. But the relative novelty of the former lacks the raw impact of the latter.

Pro life supporters tend to word their views in such a way as to portray an unborn child as being a human. Pro choice supporters will often distinguish between an unborn child and one that has been born.

One thing that made the JME paper stand out was that its rhetoric did not distinguish between the recently born and those that were unborn. In this respect, their view seemed to be more akin to the pro life group. However, the crucial difference here was that the newly born were only considered “potential persons” rather than actual human beings.

The growth and development of any person is a gradual thing. The law is generally not very good at recognising this. For example, it is legal for someone to purchase alcohol on their 18th birthday, but not the day before. The age of consent is 16, but not 15 months & 11 years. While recognising that there may be good reasons for setting age limits, I can see no scientific reason for such sharp boundaries. If anyone has any references for these, please pass them on to me.

I think the same is true of the abortion debate. According to Marie Stopes  the time limit for an abortion is 24 weeks, but can be extended “if there are foetal abnormalities”. The scientific basis for the 24 week limit is interesting. If you do a search for “24 weeks evidence” then you come up with references to 2 reports from the Royal College of Obstetricians and Gynaecologists (RCOG) in 2010.

Guardian: http://www.guardian.co.uk/lifeandstyle/2010/jun/25/human-foetus-no-pain-24-weeks
BBC: http://www.bbc.co.uk/news/10403496
Telegraph: http://www.telegraph.co.uk/health/healthnews/7853321/Foetus-cannot-feel-pain-before-24-weeks.html
RCOG: http://www.rcog.org.uk/news/rcog-release-rcog-updates-its-guidance

The issue that was considered here was whether or not the foetus was capable of feeling pain. The paper that is linked to is not a research paper, but rather a summary of other research; all of which is referenced, but much of which is hidden from public view behind paywalls. This has the effect of making the methodologies and resulting evidence extremely difficult to review and assess. What I would be particularly interested are the margins of error. For example, was it a case that there was no evidence found that any babies felt pain before this period, or was it an average with a margin of error of 10 days either side?

Giving RCOG the benefit of the doubt, and assuming there are sound medical reasons for supposing that a foetus cannot feel pain before 24 weeks, it is still a huge leap from there to link that to an abortion limit. Abortion is not merely the affliction of something which is painful; it is the termination of life (or a potential life).

However, the pain argument does not figure in the line of reasoning provided by the JME paper. The word itself only crops up 3 times (in close succession) and is dismissed as being an irrelevant factor.

Instead the main consideration here is whether or not “the well-being of the family is at risk.” This would seem to coincide with my own view on when an abortion is acceptable. However, this remains incredibly hard to quantify. Having a child is always going to carry some risk and that cannot be eliminated. It is a question of how much risk one is willing to tolerate.

The justification for the paper

The abstract states that the proposition hangs on 3 points:

1) That fetuses [sic] and newborns do not have the same moral status as actual persons,
2) the fact [sic] that both are potential persons is morally irrelevant and
3) adoption is not always in the best interest of actual people.

To deal briefly with point 3, I would actually agree. The use of the term ‘always’ means that the opposite statement would be that “adoption is always in the best interest of actual people”. Logically, this is a universal statement, so could be falsified by a single counter-example. Though I do not have such an example to hand, I think it is more probable that such an example exists than not. As noted earlier, I think adoption is preferable but it cannot be a panacea for unwanted pregnancies.

On the other two points, the crux of the issue is the demarcation between a “potential person” and an “actual person.”  The authors boldly state “Both a fetus [sic] and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life.’” The lines that follow, which ought to attempt to justify this statement, wholly fail to do so. Instead, there is a line of thinking given about whether or not a person can make plans for themselves. However, none of that provides adequate reason for the supposition quoted.

In the JME paper no specific time limit was proposed. I interpret this as meaning the authors simply failed to put a number on it, rather than proposing that there should be no limit. But this really then asks very similar questions to those involved in the pre-birth abortion debate. Personally, I think the authors failed to propose such a limit because they lacked any evidence that would back up such a proposal.

Conclusion

The key issue is when one considers a human being to have become an “actual person.” The wilful causation of the death of such a person is, in my view, morally wrong, unless it can be shown that it prevents greater harm to that individual or another at a later time. Some may wish to add the word “innocent” into that, though my own view is that the statement stands well enough as it is.

The paper’s authors acknowledge that a foetus is a human being, though deny it the status of “actual person”, downgrading it to “potential person.” The justification provided for this is weak to the point of non-existence. I can see no good reason for setting demarcation on the development of a human being from the point of being a foetus through a continuum of development into a newborn baby and beyond.

Therefore, I would regard a foetus as having the same moral right to life as a child about to be born, a child just born, a toddler, an adolescent and an adult. Wilfully taking their life away is an act of murder and one I would not support.

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3 responses to “Thoughts on “post-birth abortion”

  1. Do you think it’s different if the pregnancy is only 2 weeks old?

    • Potentially. The lack of public availability of the papers is frustrating. I remember a public lecture I was at a few years ago given by Lord Winston, who was asked how he reconciled his endorsement of abortion with his orthodox Judaism.

      Part of his response was that not every fertilised egg necessarily goes on to full development. So it would be interesting to find out that at any given stage (say, 2 weeks) what is the probability that the pregnancy would carry to term. This may be where there could be medical justification for the use of the term “potential person” though my understanding (which may, of course, be flawed) is that at 20+ weeks it is more likely than not that it would carry to term. But correct me if I am wrong.

      Then there is a secondary matter of would anyone know at this stage. According to NHS guidelines, women are advised to test 21 days after the potential conception.

      This would then lead on to a moral choice where, in my view, there is a difference between 1) knowing one is pregnant & seeking to termininate it and 2) taking general action (such as the pill) which is untargeted.

      Here, my position is very much more tentative. I only answer because you asked, but am very willing to concede there may be better evidence and reasoning than mine.

  2. Annabakes

    My view is that it is worthy of protecting the moment it implants into the uterus. Before then, it isn’t much of anything, and it doesn’t have to be forcefully removed. Of course, once born, it is a baby, and killing it is murder. These people amaze me!