Saturday, November 19, 2016

An essay on abortion

Within the context of politics, the abortion debate is usually framed as having two sides: pro-life and pro-choice. Those who are pro-life believe that abortions are immoral. Pro-choice is the view that a woman should have the right to decide the outcome of the fetus, and that at least some abortions are morally permissible. Note that the pro-life view seems to make an absolute claim about abortion, namely, that it is always objectionable, though, some who consider themselves pro-life allow for a few exceptions to the rule (e.g. rape, incest). The pro-choice view is committed to a far weaker claim; there are some instances of morally acceptable abortions. Making broad moral generalizations about the practice of abortion would require one to ignore the fact that abortions involve a highly diverse set of circumstances that may make a difference to the moral evaluation of any given procedure. In order to make a well-informed moral evaluation of abortion, as a practice, one must consider all of the morally relevant details. I will argue that the vast majority of abortions (in the United States) are morally acceptable but that some late-term abortions are morally objectionable.

I think there are at least three broad kinds of moral difference makers when it comes to abortion. First, there is the fetal stage of development. Second, there is the type of procedure (relevant in how much harm it involves). Lastly, the health and well-being of the fetus and the mother. I must first set some groundwork defending the, perhaps, most controversial claim, that the stage of fetal development is morally relevant.

Human life is said to have intrinsic moral worth. That is to say, human lives have a certain kind of moral value that a rock or chair does not. Some believe that God bestowed souls or moral qualities upon us that give us a natural right to life. This is known as the sanctity of life view. On this view, all humans—no matter what stage of development—have equal moral value. Humans have a right to life, and it is simply wrong to kill them. An alternative view, which I shall call the developmental approach, argues that humans have moral worth because of certain mental capacities and features, and that these features emerge at different stages of development. At perhaps the earliest stage, creatures acquire the capacity to feel pain and to experience pleasure. It is at this stage where creatures begin to have interests (e.g. avoid pain and suffering) and when it becomes wrong to harm them. Later on in development, creatures acquire more complex psychological traits such as self-awareness, the capacity to form life narratives and long-term goals, the formation of complex social bonds, and an understanding of morality. Philosophers call creatures that possess such features persons. Persons have a far greater number of interests than do creatures lacking personhood, making it morally worse to do them harm. For instance, persons may have an interest in self-survival and in cultivating one’s abilities.

The sanctity of life view is not plausible because it is overcommitting and too restrictive. While it may sound intuitive to say that ‘it is always wrong to kill or end the life of an innocent human being’ there are some widely agreed upon exceptions to the rule. Anencephalic infants—which are born missing most of their brain—are not conscious beings. Their life expectancy is typically between several hours to a few days; at most, a few months. Few—on both sides of the debate—accept that it is wrong to end the life of a human with anencephaly. A second exception is the case of an adult human who lapses into a permanent vegetative state. It is commonly believed that a fully formed adult human that permanently loses all of their mental capacities, also loses their moral worth. It is not wrong to end the life of an individual in a vegetative state because there is no person to harm or stream of consciousness to end. The only subjects of harm would be their close family members, and even they, in most cases, decide to end their loved one’s life.

The sanctity of life view is also limited, as it seems to apply only to humans. It is implicitly speciesist (analogous to sexist or racist views). After all, there may be other kinds of creatures that are have as much moral worth as humans. Adult chimpanzees seem to be self-aware, possess a rudimentary sense of fairness and morality, and engage in long-term planning and complex sociality. If we were to ever run into any, we would be probably be inclined to attribute moral qualities to intelligent extra-terrestrials as well (e.g. ET, Spock).

Bearing in mind the developmental stage is relevant for making moral judgments because each stage comes with its own measure of moral worth based upon the capacities present. Personhood, I think, unfolds gradually. That is just to say that I do not think that all of the morally relevant capacities emerge at the same time. It is also the case that many of the features fall on a continuum, rather than being all-or-nothing. For instance, 10-month old children seem to possess a rudimentary understanding of moral norms and punishment. But the 10-month old’s understanding is nowhere as sophisticated as, say, a five or six year old’s understanding of moral norms. Exactly when the personhood features emerge is an empirical matter. Hence, one should take my estimations with a grain of salt. I think most would agree that it is more wrong to end the life of an adult than a young child; a young child than newborn; a newborn than 6-week old fetus. Those who hold the sanctity of life view might be inclined to agree with this, but would likely reject the idea that a fetus before 6 months lacks moral worth altogether. They might argue that while fetuses lack the features and capacities that are morally relevant, they have the potential to acquire them later in life. There is a lot more to be said about this point and I plan to take up it up in a future post. For now, the developmental view still seems to capture our intuitions about the value of human life at differing stages.

Other moral difference makers include how the abortion is performed, and the reasons for why it is performed.

When we hear of abortions, we tend to think of rather graphic surgical procedures. Those only make up 1% of abortions performed. About 25% of abortions come in the form of a pill. RU-486 is a common form of medical abortion, effective up until the second trimester. The most common form of abortion is surgical vacuum aspiration, a procedure performed when the fetus weighs less than an ounce and is only two inches tall. According to the CDC, the vast majority of abortions (92%) occur before the thirteenth week, and only 1% of abortions occur after week 22. Neuroscientists have determined that fetuses probably don’t develop the capacity to feel pain until week 26. They have determined this by looking at the development of the fetal brain. Most neuroscientists think the neocortex is involved in the processing and sensation of pain, and fetuses do not start developing neocortical regions until around week 26. Therefore, fetuses probably lack the capacity to feel pain until that time. Even if scientists are off by a wide margin (say 13 weeks), it would still be true that a majority of abortions would be morally permissible on this view. After all, if the procedure involves no fetal pain or suffering, the fetus is not harmed. One may argue that there may be other sources of harm (e.g. to society), but it is implausible to suggest that there is harm in killing the 13 week old fetus in itself.

Why do most women have abortions? A study conducted by the Guttmacher Institute found the following answers:
0.3 % (0.1-0.6 %)
0.03 % (0.01-0.1 %)
physical life of mother
0.1 % (0.01-0.2 %)
physical health of mother
0.8 % (0.1-3 %)
fetal health
0.5 % (0.1-1.0 %)
mental health of mother
?? (0.1-8 %)
--too young/immature/not ready for responsibility
--to avoid adjusting life
--mother single or in poor relationship
--enough children already
--sex selection
--selective reduction
98.3% (87-99 %)
--? (32 %)
--30% (25-40 %)
--? (16 %)
--? (12-13 %)
--? (4-8 %)
--0.1% (<0.1-? %)
--0.1% (<0.1-0.4 %)
(Johnston 2016)

Most agree that certain circumstances absolve the mother from blame. This is true when a rare genetic abnormality is detected late (e.g. huntington’s disease, microcephaly), potential harm or death to the mother is likely, and when the pregnancy resulted from rape or incest. But it turns out that 98% of abortions are performed for elective reasons, rather than for reasons related to the health of the fetus or mother. Based on such results, one may think that most abortions are morally objectionable. But on the developmental view, this would be a mistake. We need to also consider when most of these procedures take place. As stated earlier, 99% of abortions are carried out before a fetus has the capacity to feel pain. There is limited data to draw from when determining why most late-term abortions are carried out. But Professor Diane Foster, a researcher at the Bixby Center for Reproductive Health, suspects that fetal anomalies “make up a small minority of later abortions,”. If we assume that most late term abortions are morally objectionable, we still end up with a fairly low figure for morally objectionable abortions. Put in terms of numbers, there would be approximately 7000 morally objectionable abortions carried out each year in the US. On the developmental view, these 7000 abortions would not be the moral equivalent of killing 7000 adults. It might be more like killing 7000 non-human animals (e.g. cows, chickens) a year, or 20 a day. One might object that this comparison between human and non-human fetuses is illegitimate. It may be argued that only human fetuses have the potential to realize personhood and other morally relevant properties. Therefore, human fetuses have more moral worth than non-human animals. I will not take a stand on this issue here and will simply leave it to the reader to dwell over.

In this post, I’ve defended a developmental stance on abortion against the sanctity of life doctrine. On the developmental view, the moral permissibility of an abortion depends largely on when the procedure is carried out, but there are other morally relevant factors (e.g. procedure, health of fetus/mother). Given that most abortions occur before the fetus develops any of the morally relevant features, I have argued that most abortions are morally permissible. While the sanctity of life doctrine may be popular amongst laypeople (especially those who are religious), it is not the most sophisticated anti-abortion view to hold. In a future post, I will return to the subject of abortion to take on what I take to be the strongest positions.

Further reading:


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