Response to "The Ethics of Abortion: Clarifying Misconceptions"
I recently was able to have a lot of what I consider to have been very productive discussions on abortion. As part of this, a good friend of mine sent me a link to a Meridian Magazine article discussing what the author considered were "misconceptions" in the pro-choice arguments. I've highlighted direct quotations for the article, but for brevity have not included the entire article. The full article is linked for reference. This article article was originally written by Melissa Moschella, an associate professor at the Catholic University of America and republished in the Meridian Magazine article.
First, my overall thoughts
Overall, I don't think anyone wants more abortions. We focus so much on restricting women's access to abortion without sufficiently addressing the underlying reason for most abortions - which is unplanned pregnancies. Like many other areas of healthcare in the US, we address the symptom but not the root cause. Interestingly, some of the most impactful solutions to preventing unwanted pregnancies, such as the Affordable Care Act making birth-control widely available, are generally not popular among most politically conservative pro-life groups because it costs money to help people, which may impact our tax bills. People may forever disagree on when protected human life begins, whether consent to sex is consent to be compelled against your will to remain pregnant and give birth, or what the Bible or other religious texts say on abortion, but I think there really is significant room to find common ground in these discussions in providing better support and resources so as to make most abortions unnecessary regardless of the legal status.
"Misconception" #1 We don't know when life begins.
"the underlying science makes it clear that the fusion of sperm and egg results in a new human being that is genetically and functionally distinct from the mother, with all of the internal resources necessary to direct himself or herself to maturity."
1. I think most would generally agree with the statement that human life has its origin at conception (though one could argue that the genetic material was also present in the separate sperm and egg). I also think that's the wrong question in these discussions. As the article later points out in their "misconception #3" the question is really when does the fetus become a person or "a human being regarded as an individual" with rights of life and liberty that are equal to the mother's, and then when does any person have the legal right to use someone else's body without their ongoing consent.
2. A woman is not considered pregnant until implantation of the fertilized embryo in her uterus, up to about a week after fertilization. Claiming life should be protected from the moment the sperm fertilizes the egg infers that we should protect life before pregnancy even occurs. Viewing protected life as beginning at conception would make common birth control methods such as the birth control pill and IUD (intra-uterine devices) forms of abortion as they are specifically designed to prevent implantation of a fertilized embryo in the uterus. In vitro fertilization and embryo cryopreservation where not all fertilized eggs may be ultimately used could also be considered abortions. Banning birth control, in-vitro fertilization and embryo cryopreservation would result in significantly more unplanned pregnancies (and by extension increase the demand for abortion) and less chances for planned pregnancies as well. The Catholic church actually does oppose all forms of contraception and in vitro fertilization precisely because they feel life should be protected from conception - they feel that the act of sex should always allow for the possibility of conception and preventing conception is an act against God. To their credit, the Catholic view is consistent and coherent, but Catholics also are the largest religious affiliation of US abortion patients. Not surprisingly, this article was written by a Catholic author.
3. The quotation above asserts that at conception that the "new human being is... functionally distinct from the mother with all of the internal resources to direct himself or herself to maturity." This is patently false. The fetus is not functionally distinct and cannot survive without directly using the mother's bodily resources until it is considered viable outside the uterus - with current advances in medical technology around 24-28 weeks of pregnancy.
Misconception #2 Abortion is about the woman's right to what she wants with her own body
"Even many who admit that a new human life begins at conception nonetheless argue that abortion should be legal because a woman shouldn’t be forced to carry a child"
Correct. Among other reasons.
"reactions to the decision [to overturn Roe v Wade] portray it as creating [a] dystopian world"
Worth pointing out here that since 2000, 38 countries have changed their abortion laws and all but one (Nicaragua) have expanded the legal grounds for women to get access to abortion services. Banning abortion is a conscious decision to increase childbirth mortality rates for women in the US based on the simple fact that abortion is medically significantly safer than childbirth. Many women in the US are now fearful that their lives will be put at risk while doctors and hospital administrators debate the legal liability for their judgements around when the life of the mother is at risk.
"Everyone recognizes that there are moral and legal limits to our bodily autonomy. My right to swing my fist ends where your nose begins."
Correct. You cannot hit me in the face. There was actually a chapter in a book I recently read devoted to the question of whether it would be ethical to punch someone in the face for no reason (spoiler: no).
However, the question on abortion is essentially asking whether a fetus has the legal right to be allowed hit you in the face for at least nine months without your continued consent. Except, in the case of pregnancy, it's a lot more traumatic than allowing someone to be hit in the face - it's whether the fetus has the right to directly cause nausea, vomiting, fatigue, extreme discomfort, insomnia, constipation, hemorrhoids, permanent stretch marks and separation of the abdominal muscles, and violent tearing of the birth canal in what is described as one of the most painful human experiences possible. And those are all normal effects of a smooth pregnancy. In more complicated cases, pregnancy results in bed rest, surgical removal of the baby through a cesarean section, severe depression, gestational diabetes, eclampsia (seizures that may be followed by coma or death), hemorrhaging, and death.
I think this is what pro-choice advocates mean by "my body, my choice" - whether or not the fetus is a distinct entity, there is no doubt that pregnancy directly impacts a woman's body in significant ways.
"Misconception" #3 The unborn child is not a person
This section of the article explains how many argue that fetuses "are not persons with full moral status and moral rights, because the unborn lack qualities like self-awareness and rationality that they believe to the basis of our special moral status and accompanying rights." The article then states that the problem with this argument is that, if true, "then infants, toddlers, the severely cognitively disabled, and many other human beings after birth would also not count as persons with moral status and rights."
I think this is one of the stronger points of the article and would agree that attempting to define life as cognitive awareness or any other single characteristic may be problematic. However, the key difference between a fetus and an infant, toddler or severely cognitively disabled individual is that in the latter cases, these individuals are not granted legal rights to use someone else's body against their will and continued consent. I'm surprised that this article does not directly reference the famous (infamous?) violinist argument - which is a thought experiment originally formulated by JJ Thompson where an individual is surgically connected without their knowledge to a famous violinist to support the violinist's life until an organ donor is found. While the violinist is certainly a "person" valued highly by society, most would agree that the other individual should have the right to separate themselves from the violinist even though such would almost certainly cause the death of the violinist because we value bodily autonomy. A similar argument is whether a parent could be legally required to donate a kidney to a child if the parent was the only known match. Donation would almost certainly save the child's life with a low likelihood of severe complications for the donor, yet most would argue that such a donation should not be legally required even if it would be morally praiseworthy. In the United States, childbirth is at least three times as likely to kill the mother/patient as kidney donation.
"Misconception" #4 Abortion is healthcare
"Pregnancy is actually a sign of health, not an illness that needs to be “cured” through abortion."
As noted previously, under the best of circumstances, pregnancy causes significant distress and permanent changes to a woman's body and overall health. Pregnancy also impacts which medications a mother can and cannot take for her own health conditions without causing undue harm to the growing fetus. Pregnancy carries a risk of death even where the mother and baby were presumed to be healthy throughout the pregnancy.
Abortion is significantly safer than continued pregnancy and childbirth. The CDC reported 0.41 deaths per 100,000 legal abortions between 2013-18 and the maternal mortality rate was 23.8 deaths per 100,000 live births in 2020. See link here. The simple truth is that banning abortions will result in the death of more women.
Legal bans on abortion also have a chilling effect on doctors who will now be hesitant to perform life-saving procedures for the mother until it is more legally defensible that the mother is more likely than not die. After Texas' "heartbeat bill" for example, Texas doctors reported that "they have postponed abortion care until a patient's health or pregnancy complication has deteriorated to the point that their life was in danger, including multiple cases where patients were sent home, only to return once they were in sepsis." Sepsis is an urgent life-threatening medical emergency.
Here's a response on this topic from an emergency room doctor in South Carolina (who also happens to be my brother).
"Easy for politicians and lawmakers to make decisions when they are so far removed from the problem. They lack a fundamental knowledge of human anatomy, what constitutes a viable pregnancy, and even more so the consequences of limiting access to HEALTHCARE for an already vulnerable population, because ABORTION IS HEALTHCARE. They have never seen a young female on the verge of death because of complications from her pregnancy. They have never had to resuscitate a dead neonate. These are my patients."
"Misconception" #5 Abortion is necessary for women's equality
I agree and support maternity leave and flexible work options of which the United States ranks VERY poorly among developed nations.
Abortions disproportionately impact those already in poverty (50% below the poverty level and another 25% are "low income") and forcing someone to carry a child against their will seems like it will continue to perpetuate cycles of poverty. For someone who is struggling emotionally, financially or otherwise, adding a child at the wrong time may have a permanent impact on their ability to better themselves and consequently the child may also be raised in poverty or worse in abusive situations. For many, having an abortion allows women to continue their degree, leads to more meaningful employment, and may allow them to find a more loving and supportive partner for their future planned family. With forced pregnancy, you may end up with a single parent struggling to make ends meet working multiple dead-end jobs and aren't around as much as they would like for their children. Allowing women choice, you may be more likely to end up with more two-parent households where the mother has the opportunity for higher paying and more meaningful employment should she so choose or more opportunities to stay at home with her children.
This is not to say that single mothers can't do amazing feats and raise wonderful children - they can and they absolutely do often despite all the odds seemingly stacked against them. We should absolutely seek to provide as much support as we can to single mothers and fathers so that women feel that the decision to keep a pregnancy is a meaningful option. But allowing for choice allows women to create more opportunities for themselves and their families.
"Misconception" #6 Abortion can "fix" an unwanted pregnancy
Abortion might seem like the “easy way out,” but as experts who have offered post-abortion counseling to thousands of women attest, and as studies show, post-abortion trauma is real and has lasting effects, though many resources for support and healing are available.
I actually would agree with a lot of this section of the article. Abortion is in many cases not an easy decision nor one that most women would take likely. I also think we should increase awareness of mental health challenges and increase access to support and help. I would also suspect that much of the post-abortion trauma is caused by the shame and guilt that we either learn from others' judgmental reactions to our decisions or that we silently accumulate from hiding our acts that we considered socially unacceptable to talk about based on cultural taboos. This is why I have been encouraged by those who have been brave enough to share their experiences with abortion and other vulnerable experiences.
One thing to point out here though is five years after an abortion, over 95% of women say it was the right decision - not necessarily an easy decision, but the right one for them and their families. I generally think we should trust women to make the best decision for themselves and provide as much love and support as we can for their decisions, whether or not they would be the outcome we think we would choose if we were in their shoes.
"Misconception" #7 Abortion is a religious issue
"...If abortion is a “religious issue,” it is no more or less so than racial justice, immigration reform, environmental protection, or poverty relief... Indeed, not one of the arguments presented in this article has been based on a religious claim.
I mostly agree with this that abortion discussions don't have to be religious based. There are certainly religious viewpoint on all sides of this matter such as (legally recognized) life beginning at first breath, at quickening, or at conception. Some who oppose religious structures have even presented a case for why the God of the Bible is not very pro-life. People's religion is one of the most reliable predictors of what their opinion is on this or most other social matters because we tend to use our religion's view on things as our default view until we've had time and put in more effort to flesh out our own opinions. Many religions have historically and continue to be significantly slower to recognize and affirm women's equality and autonomy. So ultimately, religious ideologies influences the arguments being made but arguments for or against women's bodily autonomy do not have to be religious in nature.
"Misconception" #8 Consent to sex is not consent to pregnancy
Ok, the article says nothing about consent, so I'm adding this one on my own because I think it's important to address. The pro-life argument is that consent to sex is consent to pregnancy and consent to childbirth since one causes the other and consent to actions is a consent to the consequences of that action. Other forms of this may say that if someone didn't want to get pregnant, they shouldn't have unprotected sex or if someone touches a hot stove, they cannot avoid being burned.
I would agree with the sentiment that someone should not have unprotected sex if they do not intend to get pregnant. This is where I think better sex education in schools and broader access to contraception and women's healthcare in general should absolutely be encouraged and legislated. It's also worth noting that in an annual survey, about half of abortion patients did use contraception in the month of conception. Some of these methods such as the "pull out" method are obviously not very effective and I would hope that we can make efforts to decrease unprotected sex where pregnancy is not a desired outcome.
With those caveats, I see this as going back to the violinist argument. In JJ Thompson's original formulation of the violinist argument, you wake up and are surprised that you have been connected to the violinist without your knowledge, so you did not consent to the arrangement. But let's say, that I initially gave permission for someone to be surgically connected to me in order to preserve their life. Do I then still have the right to withdraw that consent at a later date to prevent further bodily harm? I think the answer is still yes, I still have the basic right to protect my own body from further harm even if doing so will likely be detrimental to the violinist. So in the case of abortion, the question becomes whether a woman has the right to prevent future bodily harm to herself. In the example of the touching a hot stove, the question is not so much can she avoid having been burned from touching the stove but does she have the right to take her hand off the stove to prevent future bodily harm?
Of course, there are various refutations of the violinist argument. I think the strongest refutation of the violinist argument is that in the case of the violinist, he was in a dying state originally and so refusing to continue to sustain his life through your body would be returning him to his original dying state, but in the case of abortion, the condition is one that you directly caused. I think this is a fair point worth serious consideration. However, even in the case were you somehow were actually responsible for the violinist's condition, I don't think that would means you must then give up your bodily autonomy and say be required to donate a kidney to his cause - I think it could make sense that you could be potentially held financially responsible, such as requiring men to provide child support. But where there is non trivial risk of serious bodily harm or death, I still think that women (and whoever they decide to consult with such as their partner, faith leader, family or friends) should have a choice in the matter.
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