CHAPTER 2
Abortion
There is probably no more controversial issue in bioethics today, or one that touches so many lives, as abortion. Prior to the early 1960s, however, there was little public debate over the morality of abortion or support for reform of the restrictive abortion laws that had been on the books in the United States since the turn of the century.
In 1962 Sherri Finkbine, the star of a popular Arizona children’s show and mother of four, discovered that the drug thalidomide, which she had taken early in her pregnancy to help her sleep, could cause birth defects such as missing limbs or seal-like flippers, paralysis, and malformed internal organs. After much tortured soul-searching, the Finkbines decided that the best course of action for them was abortion.
Shortly before the scheduled day for her abortion, Sherri Finkbine decided to go public in order to warn other women about the dangers of thalidomide. As a result of the publicity, the hospital, fearful of legal prosecution, withdrew its consent to perform the abortion. Finkbine eventually obtained an abortion in Sweden. The fetus was severely deformed. Her tragic ordeal helped galvanize public support for relaxing laws regulating therapeutic abortions.
BACKGROUND
Abortion involves the intentional termination of a pregnancy resulting in the death of the fetus. Abortion was legalized in the United States in January 1973 by the U.S. Supreme Court Roe v. Wade ruling. Between 1973, when 760,000 abortions were performed, and 1980, the national abortion rate increased rapidly every year. It continued to increase at a slower rate between 1980 and 1990. The abortion rate has been steadily decreasing since 1990, when 1.6 million abortions were reported, to 1.2 million abortions in 2014, the lowest level since 1976.1 Nevertheless, the abortion rate in the United States is still higher than that in most other industrialized nations.
In the United States today, about 18 percent of pregnancies are ended by abortion. Of these, 92 percent are performed at less than thirteen weeks of gestation. Rates are highest among black women. The primary reasons women seek abortions are that having a child would interfere with their education, work, or ability to care for dependents and that they could not afford to have a baby now. Three percent of abortions are performed because of the mother’s health problems, 1 percent because of rape and incest, and another 1 percent because of fetal abnormalities.2
Worldwide there have been almost one billion reported abortions since 1922. Abortion rates have been dropping globally, with the largest declines being in Eastern Europe and central Asia. The abortion rate in China, which accounted for one-third of the world’s abortions in 1996, has declined more than 20 percent since then.3 Poverty seems to be one of the factors most closely associated with abortion, in the United States as well as worldwide.
THE HISTORY OF ABORTION IN THE UNITED STATES
Abortion was not uncommon in America during the colonial period up until the late 1800s. It was not the abortion itself that was usually condemned but the violation of other social taboos, such as sexual relations outside of marriage, that led to the abortion. Many middle- and upper-class women also used abortion as a means of birth control.
During the early 1820s, physicians began to take an interest in the legal regulation of abortion.4 In 1821, Connecticut passed the country’s first antiabortion law. Early nineteenth-century antiabortion laws, for the most part, applied only to women “quick with child.” It was generally believed at this time that the unborn child did not come to life until “quickening”—the moment, generally between sixteen and eighteen weeks, when the pregnant woman first feels the movement of her fetus. Despite laws against abortion, folk remedies and patented medicines continued to be widely available to women.
In the mid-nineteenth century, the newly founded American Medical Association (AMA) spearheaded a movement to outlaw abortion. In an 1859 resolution, the AMA condemned abortion as an “unwarranted destruction of human life,” calling upon state legislators to pass or toughen their existing antiabortion laws.5
Although many people blamed the prevalence of abortion on feminist ideas, the early feminists disapproved of abortion, which they considered to be “a revolting outrage against … our common humanity” and a form of infanticide.6 Unlike the physicians, however, the feminists did not think that outlawing abortion without getting to the root cause of abortion—the oppression of women—would have the desired effect. Instead they wanted the need for abortion to be eliminated. “We want prevention, not merely punishment,” Susan B. Anthony wrote in 1869. “We must reach the root of the evil, and destroy it.”7 Elizabeth Cady Stanton also regarded abortion as just one more result of degradation of women.8 Serrin Foster, in “Refuse to Choose: Women Deserve Better than Abortion,” presents the pro-life feminists’ argument that abortion is immoral except to save the life of the mother (see reading at end of this chapter).
By 1900 every state had laws prohibiting or restricting abortion; all but six included a “therapeutic exception” in their abortion laws. These laws remained virtually unchanged until the 1960s.
Several events during the 1960s led to an increasing dissatisfaction with the restrictive abortion laws. These included an increase in the number of women in the workforce, a desire for smaller families, increased publicity about the dangers of illegal abortion, improvements in the safety of surgical abortion, and a series of front-page stories chronicling the desperate circumstances of women such as Sherri Finkbine. The thalidomide tragedy was closely followed by a German measles epidemic in the United States. Many pregnant women who came down with German measles were unable to obtain legal therapeutic abortions. As a result of this outbreak, 15,000 babies were born with birth defects—including blindness, mental retardation, and heart problems—between 1963 and 1966.
Fueled by the publicity generated by these tragedies, the push for legal reform came primarily from the medical and legal professions. Although most people supported more liberal laws regarding the regulation of therapeutic abortions, there was little public support in the late 1960s for nontherapeutic abortions or “abortion on demand”—what later became known as the pro-choice position.9
In 1969 Planned Parenthood, which had historically been opposed to abortion, reversed its position and came out in support of repealing all antiabortion laws. The following year the AMA voted to support a physician’s right to perform abortions if the woman’s social and economic circumstances would make it difficult for her to have a baby. These changes, together with the first legal acknowledgment of a constitutional “right to privacy” in the 1965 Supreme Court Griswold v. Connecticut case, provided lawyers with the grist they needed to challenge the constitutionality of existing antiabortion laws. Between 1967 and 1970, twelve states, including California, Hawaii, New York, Alaska, and Washington, repealed their restrictive abortion laws.
THE U.S. SUPREME COURT ROE V. WADE DECISION
In January 1973 the Supreme Court in Roe v. Wade ruled that the Texas antiabortion law violated a woman’s constitutional right to privacy as implied in the Fourteenth Amendment. It also ruled that the fetus was not a person according to the Fourteenth Amendment. The effect of this ruling was to legalize abortion prior to viability, throughout the United States. Viability is defined as “the capacity to survive disconnection from the placenta.”10 After viability, set at twenty-eight weeks, the state has a legitimate interest in “potential life” and can pass laws to regulate abortion. (See selection from Roe v. Wade at the end of this chapter.)
Rather than settling the abortion question, Roe v. Wade has left Americans deeply divided. The challenge to Roe v. Wade comes not only from the pro-life movement but also from pro-choice groups who would like to see all restrictions on abortion removed.
According to a 2017 Gallup Poll, abortion remains one of the most divisive issues in the United States with 43 percent of Americans polled stating that it is “morally acceptable” and 49 percent that it is morally wrong.11
The number of abortion providers has declined over the past twenty-five years because of lower demand for abortion services as well as more restrictive abortion laws.12 Since 1973 many states have passed legislation that places restrictions on abortion. These restrictions include parental and spousal notification requirements, mandatory waiting periods, mandatory counseling, and bans on federal funding for abortions. Several bills for a constitutional amendment that would overturn Roe v. Wade have been introduced, including the Human Life Amendment, which would extend “personhood” or legal protection to “all human beings.”
In the 1992 Planned Parenthood v. Casey case, the U.S. Supreme Court replaced the trimester framework used in Roe v. Wade with a floating viability line. Since modern technology keeps pushing back the date of viability, this ruling has the potential of placing further restrictions on a woman’s opportunity to obtain an abortion. Indeed, since the passing of Roe v. Wade, the age of viability has been pushed back a month to as early as 20 to 22 weeks.
In the 2000 Stenberg v. Carhart case, the U.S. Supreme Court struck down a Nebraska law that banned “partial-birth” abortion. This decision was reversed by the federal Partial-Birth Abortion Ban Act of 2003. The act was immediately challenged. In 2007, in Gonzales v. Cahart, the Supreme Court upheld the ban, stating that it did not violate the Constitution.
In Hill v. Colorado, the U.S. Supreme Court ruled in favor of a Colorado statute that restricted protesters from coming within eight feet of women who were within one hundred feet of an entrance to an abortion clinic. Three years previously the Court had upheld a New York law that established buffer zones around abortion clinics in which antiabortion demonstrations are prohibited. These restrictions have been challenged as a violation of the protesters’ rights. In 2006 a federal court ruled that a Florida law restricting abortion protesters violates their freedom of speech, and in 2014 laws creating buffer zones around abortion clinics to restrict protesters were ruled unconstitutional.
The fact that abortion is currently legal—at least under most circumstances—does not mean that it is moral; nor does believing that abortion is immoral necessarily imply that it ought to be outlawed. The resolution of most moral issues that confront us as a society involves not just discerning right from wrong, but determining how best to embody this moral wisdom in a just public policy. This involves balancing concerns about abortion with other concerns such as equal rights for women. As both Confucius and Aristotle maintain, good laws and public policy are important because they make it easier for people to be virtuous.
ABORTION AND RELIGION
Religious views on abortion vary widely. Muslims believe that human life is sacred and that the fetus is a person with rights under the law from the moment of “ensoulment,” or about four months. This is tempered by practical concerns, however, and Islamic law generally permits abortion on medical and health grounds.
In Hinduism the killing of a conscious fetus carries the same penalty as the murder of a learned Brahman. However, the current emphasis on having sons in some Asian countries, such as China, has led to a high rate of selective abortion despite laws specifically prohibiting abortion for sex selection.
There is little mention of abortion in the Bible, and what there is is ambiguous. Orthodox Jews emphasize passages in Genesis that teach that, because we are created in the image of God, all human life is inviolable and sacred. Thus abortion is prohibited except to save the life of the mother. Liberal and reform Jews, on the other hand, point out that Adam did not become a living being or fully human until God breathed life into him. In line with this, the infant does not become a nephesh, or a person with a soul, until he or she takes the first breath of air. Abortion, therefore, is morally permissible at any time during the pregnancy.
The position of the early Christian Church was similar to that of the Orthodox Jews. The Didache, written no later than A.D. 100, contains a prohibition against abortion, calling those who procure abortions “destroyers of God’s image.” The only exception to the prohibition was abortion to save the life of the mother.
Unlike the early Church, Thomas Aquinas set the time of ensoulment at forty days for males and eighty days for females. Based on this distinction, for centuries the Church regarded late-term abortions as more sinful than early abortions. The belief that early abortions are less morally problematic is still common today. In the nineteenth century, the Roman Catholic Church changed its position, returning to the early Christian prohibition against abortion at any time of the pregnancy.
The reaction of modern Protestants to abortion is varied. Most fundamentalist, evangelical, and African American Protestant churches take a position similar to that of the Roman 72Catholics, whereas most mainstream Protestant churches take a moderate stand, supporting abortion prior to viability.
The moral controversy over abortion cannot be resolved simply by uncritically accepting religious dogma. At the same time, the arguments used by the different religions should not be dismissed offhand, because they are generally based on philosophical rather than purely theological arguments. Good ethical analysis, while eschewing arguments based solely on faith, entails being open to, listening to, and subjecting to critical analysis the moral arguments put forth by the various religions.
METHODS OF ABORTION
There are three primary types of abortions: medical abortions, surgical abortions, and medical induction of uterine contractions. The method used depends primarily on the time of gestation.
Medical Abortions
Medical abortions include the morning-after pill and mifepristone, popularly known as RU 486. Medical abortions can be done only early in pregnancy.
The morning-after pill. The morning-after pill is actually a high dose of birth control pills taken over the three days following intercourse. The doses may prevent ovulation, prevent fertilization, or, prevent the blastocyst from implanting in the uterine wall. This method is 75 percent successful at preventing an implanted pregnancy.
Mifepristone (RU 486). Mifepristone was approved by the U.S. Food and Drug Administration (FDA) in 2000 for sale to the public, thus decreasing the need for surgical abortions in early pregnancies. Mifepristone induces menstruation, thus expelling the implanted embryo. It is more than 90 percent effective in terminating pregnancies of less than seven weeks’ gestation.
Surgical Abortions
Most abortions are still performed surgically. The 98- to 99-percent success rate of surgical abortion is much higher than that of medical abortion.
Dilation and curettage (D & C). Dilation and curettage involves expanding the cervix of the uterus so a curette can be inserted to scrape the surface of the uterine wall. This method can be used in the first trimester, although D & E is generally preferred for safety reasons.
Dilation and evacuation (D & E). The development in China in the early 1960s of the safer dilation and evacuation method, also know as vacuum aspiration, was accompanied by a sharp decline in the death rate of women from abortions. D & E was first used in the United States in the late 1960s. This method is similar to D & C, but the fetus is suctioned rather than scraped out of the uterus. Today most abortions performed in the United States after 12 weeks’ gestation are vacuum aspirations.
Intact dilation and extraction (IDX or “partial-birth” abortion). This method was used only in late-term abortions. After partially delivering an intact fetus feet-first, the doctor punctures the fetus’s skull, suctions out the brain, and then crushes the skull so the fetus can fit easily through the birth canal. Prior to a 2003 federal law banning “partial-birth” abortion, an estimated 2,200 such abortions were performed annually.13
Hysterectomy and hysterontomy. Surgical removal of the fetus is generally reserved for late-term abortions. A hysterectomy entails the surgical removal of the whole uterus; a hysterontomy, 73the removal of the fetus through an incision in the uterus. Because of the number of fetuses that survive these procedures and the high incidence of maternal complications, these methods are rarely used except in emergencies.
Medical Induction of Uterine Contractions
Abortions between sixteen and twenty weeks can be carried out using either surgical removal of the fetus or medical induction of uterine contractions.
Saline solution. With a saline abortion, about 200 milliliters of amniotic fluid is withdrawn from the amniotic sac and replaced with saline solution. Although the saline solution is meant to kill the fetus, this method occasionally results in a live birth.
Prostaglandins. This method involves an intramuscular or intravaginal injection of prostaglandins to induce labor. The use of prostaglandins is associated with fewer live births than using just saline solution.
THE MORAL ISSUES
The Moral Status of the Fetus
By eight weeks all organs and structural features are in place and the fetus resembles a very small newborn child. The question of fetal personhood is important because persons have rights that we ought to respect. Is there a distinct point when embryos or fetuses achieve personhood, or do they gradually achieve this status based on developmental criteria? Mary Anne Warren proposes the following five criteria for personhood. They are:
Consciousness (of objects and events external and/or internal to the being) …
Reasoning (the developed capacity to solve new and relatively complex problems);
Self-motivated activity …
The capacity to communicate, by whatever means, messages of an indefinite variety or types …
The presence of self-concepts, and self-awareness … (See Warren’s article at the end of this chapter).
Most pro-life advocates maintain that there is no distinction between biological humanhood and personhood. We have moral value simply because we have a human genotype. Therefore, even the zygote is a person with moral standing. Mary Anne Warren, in contrast, argues that a fetus does not become a person until sometime after birth, when the infant becomes a “socially responsive member of a human community.”
Most definitions of personhood fall between these extremes. According to utilitarians, only sentient beings need to be given moral consideration. Abortion, therefore, becomes a moral issue only after the fetus is able to experience pain. While there is controversy over this question, most physicians agree that by thirteen weeks the fetus can experience pain.14 A related developmental milestone that has been suggested as marking the beginning of personhood is the presence of brainwaves, which occurs at about six weeks. This criterion has the advantage of being symmetrical with definitions of the end of personhood. On the other hand, an adult whose brainwaves have ceased is no longer alive, whereas an embryo, despite lack of a brain, is.
Viability replaced quickening after the 1973 Roe v. Wade ruling as the most widely accepted point for granting the fetus moral rights. Viability is problematic as a criterion, however, because personhood becomes dependent on medical technology rather than on any characteristic of the fetus. In 1950, viability occurred at about thirty weeks’ gestation. Now fetuses as young as twenty weeks are surviving. If an artificial womb, or another means for the young fetus to breathe and survive outside the womb, is created, viability could occur much earlier, making Roe v. Wade a pro-life ruling.
A final criterion is that of potentiality, according to which the potential to develop into a full-fledged adult confers personhood on a fertilized egg. Judith Jarvis Thomson rejects this criterion in her analogy between human development and the development of an acorn into an oak tree (to read Thomson’s “In Defense of Abortion,” go to http://spot.colorado.edu/~heathwoo/Phil160,Fall02/thomson.htm).
The moral status of the fetus is currently being challenged at both ends of the continuum in debates on the morality of embryonic stem cell research, which involves the destruction of embryos, and debates on “partial-birth” abortion, which was outlawed in 2003.
Some people, frustrated with the lack of consensus on a definition of personhood, argue that it is better left to personal or religious opinion. To say that one’s definition of personhood is a matter of opinion, however, is to mire the debate in ethical subjectivism. Not only is abortion morally permissible, if in one’s opinion a fetus is not a person, but so would be infanticide, slavery, and genocide, so long as the perpetrators believe that their victims are not persons. Because of this implication, it is important that we give careful consideration to the criteria for personhood and not uncritically accept cultural definitions or those that are politically and economically expedient, as happened with declaring slaves nonpersons.
Some abortion rights advocates oppose granting the fetus rights or personhood at any stage, arguing it will weaken a woman’s legal right to an abortion. On the other hand, denying the fetus any moral status, pro-life feminists point out, denies the pregnant woman’s special status and relationship with her unborn child and limits her options. The moral status and rights of the fetus are also an issue in maternal alcohol and drug use (see Case Study 2: Jennifer Johnson: Maternal Drug Use and Fetal Rights).
Even if we grant the fetus some moral status, it is still possible to argue that abortion is morally permissible under some circumstances. If a fetus is a person who can feel pain, however, the method used for abortion becomes a moral concern, since it is wrong to cause unnecessary pain.
Don Marquis, in his article “Why Abortion Is Immoral,” argues that the killing, human beings who are able to enjoy their future experiences is wrong because it deprives them of the value of their future. Because the fetus, like an adult human, has a future that he or she can value, abortion, according to Marquis, is immoral (see Marquis’ article “Why Abortion Is Immoral” at end of this chapter).
The Rights and Autonomy of the Mother
Some people think that the emphasis on the personhood of the fetus has been at the expense of concerns about the rights of the woman. Mary Anne Warren maintains that a woman’s liberty rights or autonomy is paramount; women should have the right to make decisions about their own bodies. To deny women this basic right, according to Warren, is to treat them as a means only. Opponents of abortion, in response, argue that autonomy is not an absolute right. While women have a moral right to control their bodies, this right does not extend to abortion, because abortion involves destroying the body of an unborn child (see reading by Warren at the end of this chapter).
The extent to which women have a right to control their own bodies also arises in the debate over whether women have a responsibility to refrain from prenatal behaviors, such as drug and alcohol use, that may harm fetuses. Fetal alcohol syndrome, according to the Centers for Disease Control, is the leading cause of mental retardation in the United States. More infants are born with fetal alcohol syndrome than the combined total of Down’s syndrome, spina bifida, muscular dystrophy, and HIV. Women who smoke during pregnancy are also at higher risk for having babies with low birth weight, respiratory problems, and sudden infant death syndrome (SIDS).
Advocates of abortion rights argue that as long as we have a patriarchal society in which pregnant women and mothers are socially and economically disadvantaged, abortion must remain a legitimate alternative. To have it otherwise is to deny women full and equal participation in society. Autonomy is especially an issue when the pregnancy is the result of rape or when the woman is a teenager (see Case Study 4: Date Rape and Abortion). Justice is also an issue in access to abortion services. Restrictive abortion laws, lack of money, unavailability of a clinic in one’s area, and harassment outside of abortion clinics—all contribute to a situation in which some women, especially poor women, do not have adequate access to abortion. Many providers have stopped performing abortions because of death threats and violence against clinics (see Case Study 3: The Limits of Protest: Bombing of Abortion Clinics). Pro-life feminists such as Serrin Foster, in contrast, maintain that abortion degrades women, by pitting women’s rights against babies’ rights, and harms women because it removes the incentive for government, schools, and workplaces to provide resources for pregnant women to continue their education and careers (see reading by Foster at end of this chapter).
It should be noted that a right to have an abortion to avoid future unjust burdens applies only to burdens caused by the pregnancy and giving birth, since adoption provides a mechanism for avoiding the burdens of raising the child after birth. Because adoption is an option, the decision to carry a pregnancy to term and the decision to raise the child should be seen as two separate decisions. This being said, the burdens of pregnancy in terms of discrimination faced in the workplace, and the stigma and pain of giving up a child for adoption, are very real. Whether or not permissive abortion policies are exacerbating this injustice needs further study.
Abortion and Fathers’ Rights and Duties
Service providers of contraception and abortion have focused almost exclusively on women. The exclusion of fathers when it comes to abortion decisions is reflected in the U.S. Supreme Court ruling in Planned Parenthood of Central Missouri v. Danford (1976), which stated that fathers have no rights over a child in the womb. But, should fathers have rights?
Philosopher Steven Hales argues that because women have a right to avoid future burdens through abortion, the principle of equality requires that men should also have the right of refusal when it comes to contributing to the financial support of his child after birth. Women have a similar right through the mechanism of adoption, in which the natural parents can turn over their rights and obligations toward their child to the adoptive parents15 (see Case Study 5: The Reluctant Dad).
Others maintain that it is fair to force fathers to pay child support should a woman decide to keep her child, even though she does not have a duty to consult the father about whether to terminate the pregnancy. This is because men bear some responsibility for the child’s conception and birth, and because of the social consequences of the father’s refusing to support his child. Indeed, studies show that unmarried fathers are far more interested in their children than we generally give them credit for.
Selective Abortion and the Principle of Discrimination
Unlike elective abortion, in which the pregnancy itself is unwanted, in selective abortion it is the particular fetus, rather than the pregnancy, that is unwanted. Discrimination is a key issue in selective abortion. According to the Centers for Disease Control, about 3 percent of infants are born with a physical and/or mental disorder. Prenatal diagnosis provides parents with information about most of these disorders as well as the gender of the fetus. The overwhelming majority of pregnancies in which the fetus is diagnosed as having a genetic disorder are terminated by selective abortion.
In countries such as China and India, where sons are preferred, selective abortion may be used more for sex selection than for genetic disorders. As a result, there is a discrepancy in some parts of India and China between the number of males and the number of females.16 India banned the use of abortion for sex selection in 1994 and China followed suit in 2003. However, these laws are hard to enforce given the strong preference for boys in parts of these countries and the easy availability of ultrasound for determining the gender of the fetus (see Case Study 1: The Unwanted Daughters).
Abortion for sex selection is legal in the United States, where there is a preference for sons as firstborn and only children. American physicians are most supportive worldwide of the practice, citing the woman’s autonomy as their reason for performing the procedure.17 With increasing knowledge of the human genome, geneticists may soon be able to prenatally diagnose tendencies toward obesity, cancer, and homosexuality—to name only a few traits that most Americans consider undesirable in their children.
It is now possible for women to purchase over-the-counter prenatal genetic testing kits at their local pharmacy. This enables women to make a decision about whether or not to terminate a pregnancy without first seeking genetic counseling. Whether this development will enhance women’s autonomy or put additional pressure on parents to have the perfect baby remains to be seen.
The principle of nondiscrimination requires that we not be denied benefits or equal treatment for morally irrelevant reasons, such as sex or skin color or physical abilities. Does selective abortion involve discrimination against females and people with handicaps? Even if it does, this has to be weighed against women’s autonomy as well as against the social consequences of having “undesirable” children who will be a burden on their parents and on society.
Consequentialist Arguments: Abortion as a Benefit to Born Children
Those who favor a permissive abortion policy point to the harmful consequences of restrictive abortion policies. These include complications and deaths from self-induced and illegal abortions, overpopulation, the burden on women of mandatory motherhood, at least during the nine months of pregnancy, and the burden on society when unwanted children are neglected or abandoned.
The use of consequentialist or utilitarian arguments requires that we base our arguments in fact. One of the arguments for abortion rights, summarized in the slogan Pro-Child/Pro-Choice, is that abortion not only benefits women but also benefits children by ensuring that all born children are wanted children. However, studies have not shown that legalized abortion leads to a decrease in child abuse nor that it improves the quality of life of born children.
Indeed, some pro-life feminists, such at Serrin Foster, maintain that abortion, rather than benefiting children, has led to a devaluation of children and an increase in child abuse. While the general well-being of the nation remained relatively stable in the 1970s, declining slightly in the first part of the 1980s, the “social health” of children and youth began a steady course of decline 77beginning in 1974, the year after abortion was legalized.18 In addition, the rates of child abuse began rising after 1973, increasing 566 percent between 1977 and 1980.19 The rate of child abuse leveled off after 1993 along with a drop in the rate of abortion. However, it has still remained almost four times what it was in the 1970s.20 These figures cannot be attributed solely to better reporting of child abuse cases because most of the improvement in reporting techniques took place in the early 1980s in response to the alarming increase in child abuse. A study conducted at Johns Hopkins Hospital by the Baltimore, Maryland, Department of Social Services of 532 abused children found that previous abortions and stillbirths place a family at significantly higher risk for child abuse, independently of other factors such as socioeconomic and marital status.21 While a positive correlation between child abuse and previous abortions may sound counterintuitive, psychiatrist Phillip Nye suggests that by legitimating the death of the fetus in utero we have weakened the normal instinctual restraint and social taboo against the use of violence against young children dependent on our care.22
On the other hand, the harms to born children may be corrected by creating better support systems for parents and young children. These harms also have to be weighed against the harm to women of depriving them of control over their bodies during pregnancy. In any case, we cannot argue in favor of abortion on the grounds that it benefits born children. Instead, we must be willing to examine the morality of abortion, using factually correct premises and consistent arguments. For a summary of the issues in the abortion debate, see Linda Lowen’s reading “20 Arguments from Both Sides of the Abortion Debate” at the end of this chapter.
CONCLUSION
As members of a pluralistic society, can we ever reach a resolution to the current abortion debate? Should we even bother to try? Why can’t we just be tolerant of other people’s views: “If you don’t believe in abortion, don’t have one.” Unfortunately, the hands-off approach doesn’t work, because those who are opposed to abortion are not merely expressing a personal opinion about abortion; they are saying that abortion is wrong because it violates universal moral 78principles. Furthermore, to claim that we should be tolerant of other people’s moral opinions is to advocate tolerance not only of abortion but also of other practices. Few of us would be willing to carry a bumper sticker sporting the slogan “If you don’t believe in slavery, don’t own slaves.”
Ethical analysis should not be a matter of personal opinion or majority consensus. It should be logical and consistent in its application. Until we can approach the issue of abortion rationally, it is unlikely to be resolved. The following readings are an invitation to rethink the abortion issue with an open and analytical mind.
JUSTICE HARRY BLACKMUN, Majority Opinion
JUSTICE WILLIAM C, Dissenting Opinion
Roe v. Wade (U.S. Supreme Court, 1973)
In 1970 Norma McCorvey (“Roe”), who was pregnant at the time, filed a lawsuit against Henry Wade, the district attorney of Dallas County, arguing that the Texas law prohibiting her from getting an abortion violated her personal liberty and Constitutional right to privacy, as expressed in the First, Fourth, Ninth, and Fourteenth Amendments. In 1973 the case went to the U.S. Supreme Court which, in its Roe v. Wade decision, invalidated the Texas Statute making it a felony to perform most abortions, thus legalizing abortion. In the following excerpts from the ruling Justice Harry Blackmun delivers the majority opinion while Justice William Rehnquist presents a dissenting opinion.
Justice Blackmun, Majority Opinion, Justice Rehnquist, Dissenting Opinion, Roe v Wade 410 U.S. 113 (1973).
Mr. Justice Blackmun delivered the opinion of the Court
It is … apparent that at common law, at the time of the adoption of our Constitution, and throughout the major portion of the nineteenth century, abortion was viewed with less disfavor than under most American statutes currently in effect. Phrasing it another way, a woman enjoyed a substantially broader right to terminate a pregnancy than she does in most states today….
Three reasons have been advanced to explain historically the enactment of criminal abortion laws in the nineteenth century and to justify their continued existence.
[First] It has been argued occasionally that these laws were the product of a Victorian special concern to discourage illicit sexual conduct….
A second reason is concerned with abortion as a medical procedure. When most criminal abortion laws were first enacted, the procedure was a hazardous one for the woman…. Modern medical techniques have altered this situation….
The third reason is the state’s interest—some phrase it in terms of duty—in protecting prenatal life. Some of the argument for this justification rests on the theory that a new human life is present from the moment of conception…. Only when the life of the pregnant mother herself is at stake, balanced against the life she carries within her, should the interest of the embryo or fetus not prevail. Logically, of course, a legitimate state interest in this area need not stand or fall on acceptance of the belief that life begins at conception or at some other point prior to live birth. In assessing the state’s interest, recognition may be given to the less rigid claim that as long as at least potential life is involved, the state may assert interests beyond the protection of the pregnant woman alone….
The Constitution does not explicitly mention any right of privacy…. [Earlier Supreme Court] decisions make it clear that only personal rights that can be deemed “fundamental” or “implicit in the concept of ordered liberty” …are included in this guarantee of personal privacy. They also make it clear that the right has some extension to activities relating to marriage … [and] procreation….
We therefore conclude that the right of personal privacy includes the abortion decision, but that this right is not unqualified and must be considered against important state interests in regulation.
… [N]o case could be cited that holds that a fetus is a person within the meaning of the Fourteenth Amendment…. All this, together with our observation, supra, that throughout the majority portion of the nineteenth century prevailing legal abortion practices were far freer than they are today, persuades us that the word “person,” as used in the Fourteenth Amendment, does not include the unborn….
There has always been strong support for the view that life does not begin until live birth…. Physicians and their scientific colleagues have … tended to focus either upon conception or upon live birth or upon the interim point at which the fetus becomes “viable,” that is, potentially able to live outside the mother’s womb, albeit with artificial aid. Viability is usually placed at about seven months (28 weeks) but may occur earlier, even at 24 weeks….
With respect to the state’s important and legitimate interest in the health of the mother, the compelling point, in the light of present medical knowledge, is at approximately the end of the first trimester. This is so because of the now established medical fact … that until the end of the first trimester mortality in abortion is less than mortality in normal childbirth. It follows that, from and after this point, a state may regulate the abortion procedure to the extent that the regulation reasonably relates to the preservation and protection of maternal health. Examples of permissible state regulation in this area are requirements as to the qualifications of the person who is to perform the abortion….
With respect to the state’s important and legitimate interest in potential life, the “compelling” point is at viability. This is so because the fetus then presumably has the capability of meaningful life outside the mother’s womb. State regulation protective of fetal life after viability thus has both logical and biological justifications. If the state is interested in protecting fetal life after viability, it may go so far as to proscribe abortion during that period except when it is necessary to preserve the life or health of the mother….
MR. JUSTICE REHNQUIST, dissenting.
The Court’s opinion brings to the decision of this troubling question both extensive historical fact and a wealth of legal scholarship. While the opinion thus commands my respect, I find myself nonetheless in fundamental 80disagreement with those parts of it that invalidate the Texas statute in question, and therefore dissent.
I
The Court’s opinion decides that a State may impose virtually no restriction on the performance of abortions during the first trimester of pregnancy. Our previous decisions indicate that a necessary predicate for such an opinion is a plaintiff who was in her first trimester of pregnancy at some time during the pendency of her lawsuit. While a party may vindicate his own constitutional rights, he may not seek vindication for the rights of others…. We know only that plaintiff Roe at the time of filing her complaint was a pregnant woman; for aught that appears in this record, she may have been in her last trimester of pregnancy as of the date the complaint was filed…
II
Even if there were a plaintiff in this case capable of litigating the issue which the Court decides, I would reach a conclusion opposite to that reached by the Court. I have difficulty in concluding, as the Court does, that the right of “privacy” is involved in this case. Texas, by the statute here challenged, bars the performance of a medical abortion by a licensed physician on a plaintiff such as Roe. A transaction resulting in an operation such as this is not “private” in the ordinary usage of that word. Nor is the “privacy” that the Court finds here even a distant relative of the freedom from searches and seizures protected by the Fourth Amendment to the Constitution, which the Court has referred to as embodying a right to privacy…. [T]he Fourteenth Amendment protects, embraces more than the rights found in the Bill of Rights. But that liberty is not guaranteed absolutely against deprivation, only against deprivation without due process of law. The test traditionally applied in the area of social and economic legislation is whether or not a law such as that challenged has a rational relation to a valid state objective. The Due Process Clause of the Fourteenth Amendment undoubtedly does place a limit, albeit a broad one, on legislative power to enact laws such as this. If the Texas statute were to prohibit an abortion even where the mother’s life is in jeopardy, I have little doubt that such a statute would lack a rational relation to a valid state objective…. But the Court’s sweeping invalidation of any restrictions on abortion during the first trimester is impossible to justify under that standard, and the conscious weighing of competing factors that the Court’s opinion apparently substitutes for the established test is far more appropriate to a legislative judgment than to a judicial one.
The Court eschews the history of the Fourteenth Amendment in its reliance on the “compelling state interest” test…. But the Court adds a new wrinkle to this test by transposing it from the legal considerations associated with the Equal Protection Clause of the Fourteenth Amendment to this case arising under the Due Process Clause of the Fourteenth Amendment. Unless I misapprehend the consequences of this transplanting of the “compelling state interest test,” the Court’s opinion will accomplish the seemingly impossible feat of leaving this area of the law more confused than it found it.
…The decision here to break pregnancy into three distinct terms and to outline the permissible restrictions the State may impose in each one, for example, partakes more of judicial legislation than it does of a determination of the intent of the drafters of the Fourteenth Amendment.
The fact that a majority of the States reflecting, after all, the majority sentiment in those States, have had restrictions on abortions for at least a century is a strong indication, it seems to me, that the asserted right to an abortion is not “so rooted in the traditions and conscience of our people as to be ranked as fundamental,” Even today, when society’s views on abortion are changing, the very existence of the debate is evidence that the “right” to an abortion is not so universally accepted as the appellant would have us believe.
To reach its result, the Court necessarily has had to find within the scope of the Fourteenth Amendment a right that was apparently completely unknown to the drafters of the Amendment. As early as 1821, the first state law dealing directly with abortion was enacted by the Connecticut Legislature. By the time of the adoption of the Fourteenth Amendment in 1868, there were at least 36 laws enacted by state or territorial legislatures limiting abortion. While many States have amended or updated their laws, 21 of the laws on the books in 1868 remain in effect today. Indeed, the Texas statute struck 81down today was, as the majority notes, first enacted in 1857, “has remained substantially unchanged to the present time.”
III
Even if one were to agree that the case that the Court decides were here, and that the enunciation of the substantive constitutional law in the Court’s opinion were proper, the actual disposition of the case by the Court is still difficult to justify. The Texas statute is struck down in toto, even though the Court apparently concedes that, at later periods of pregnancy Texas might impose these self-same statutory limitations on abortion. My understanding of past practice is that a statute found to be invalid as applied to a particular plaintiff, but not unconstitutional as a whole, is not simply “struck down” but is, instead, declared unconstitutional…. For all of the foregoing reasons, I respectfully dissent.
MARY ANNE WARREN
The Moral Significance of Birth
Mary Anne Warren (1946–2010) was a professor of philosophy at San Francisco State University. Warren defends a pro-choice position on abortion: Women have a fundamental right to make their own decisions about their bodies. Warren argues that personhood does not begin until after birth. Because the fetus is not a person, abortion can be justified under any circumstances.
Warren, Mary Anne, “The Moral Significance of Birth,” Hypatia: A Journal of Feminist Philosophy, vol. 4, issue 3, September 1989. Copyright © 1989 Hypatia. Used with permission of John Wiley & Sons.
Does birth make a difference to the moral rights of the fetus/infant? Should it make a difference to its legal rights? Most contemporary philosophers believe that birth cannot make a difference to moral rights. If this is true, then it becomes difficult to justify either a moral or a legal distinction between late abortion and infanticide. I argue that the view that birth is irrelevant to moral rights rests upon two highly questionable assumptions about the theoretical foundations of moral rights. If we reject these assumptions, then we are free to take account of the contrasting biological and social relationships that make even relatively late abortion morally different from infanticide.
English common law treats the moment of live birth as the point at which a legal person comes into existence. Although abortion has often been prohibited, it has almost never been classified as homicide. In contrast, infanticide generally is classified as a form of homicide, even where (as in England) there are statutes designed to mitigate the severity of the crime in certain cases. But many people—including some feminists—now favor the extension of equal legal rights to some or all fetuses (S. Callahan 1984, 1986). The extension of legal personhood to fetuses would not only threaten women’s right to choose abortion, but also undermine other fundamental rights. I will argue that because of these dangers, birth remains the most appropriate place to mark the existence of a new legal person….
THE DENIAL OF THE MORAL SIGNIFICANCE OF BIRTH
The view that birth is irrelevant to moral rights is shared by philosophers on all points of the spectrum of moral views about abortion. For the most conservative, birth adds nothing to the infant’s moral rights, since all of those rights have been present since conception. Moderates hold that the fetus acquires an equal right to life at some point after conception but before birth. The most popular candidates for this point of moral demarcation are (1) the stage at which the fetus becomes viable (i.e., capable of surviving outside the womb, with or without medical assistance), and (2) the stage at which it becomes sentient (i.e., capable of having experiences, including that of pain). For those who hold a view of this sort, both infanticide and abortion at any time past the critical stage are forms of homicide, and there is little reason to distinguish between them either morally or legally.
Finally, liberals hold that even relatively late abortion is sometimes morally acceptable, and that at no time is abortion the moral equivalent of homicide. However, few liberals wish to hold that infanticide is not—at least sometimes—morally comparable to homicide. Consequently, the presumption that being born makes no difference to one’s moral rights creates problems for the liberal view of abortion. Unless the liberal can establish some grounds for a general moral distinction between late abortion and early infanticide, she must either retreat to a moderate position on abortion, or else conclude that infanticide is not so bad after all.
To those who accept the intrinsic-properties assumption, birth can make little difference to the moral standing of the fetus/infant. For birth does not seem to alter any intrinsic property that could reasonably be linked to the possession of a strong right to life. Newborn infants have very nearly the same intrinsic properties as do fetuses shortly before birth….
Prenatal neurophysiology and behavior suggest that human fetuses begin to have rudimentary sensory experiences at some time during the second trimester of pregnancy….
These two theories are worth examining, not only because they illustrate the difficulties generated by the intrinsic-properties and single-criterion assumptions, but also because each includes valid insights that need to be integrated into a more comprehensive account. Both Sumner and Tooley are partially right. Unlike “genetic humanity”—a property possessed by fertilized human ova—sentience and self-awareness are properties that have some general relevance to what we may owe another being in the way of respect and protection. However, neither the sentience criterion nor the self-awareness criterion can explain the moral significance of birth.
THE SENTIENCE CRITERION
Both newborn infants and late-term fetuses show clear signs of sentience. For instance, they are apparently capable of having visual experiences. Infants will often turn away from bright lights, and those who have done intrauterine photography have sometimes observed a similar reaction in the late-term fetus when bright lights are introduced in its vicinity. Both may respond to loud noises, voices, or other sounds, so both can probably have auditory experiences. They are evidently also responsive to touch, taste, motion, and other kinds of sensory stimulation.
The sentience of infants and late-term fetuses makes a difference to how they should be treated, by contrast with fertilized ova or first-trimester fetuses. Sentient beings are usually capable of experiencing painful as well as pleasurable or effectively neutral sensations…. Thus, sentient beings may plausibly be said to have a moral right not to be deliberately subjected to pain in the absence of any compelling reason. For those who prefer not to speak of rights, it is still plausible that a capacity for sentience gives an entity some moral standing….
But it is not clear that sentience is a sufficient condition for moral equality, since there are many clearly-sentient creatures (e.g., mice) to which most of us would not be prepared to ascribe equal moral standing….
The 1973 Roe v. Wade decision treats the presumed viability of third-trimester fetuses as a basis for permitting states to restrict abortion rights in order to protect fetal life in the third trimester, but not earlier. Yet viability is relative, among other things, to the medical care available to the pregnant woman and her infant. Increasingly sophisticated neonatal intensive care has made it possible to save many more premature infants than before, thus altering the average age of viability. Someday it may be possible to keep even first-trimester fetuses alive and developing normally outside the womb. The viability criterion seems to imply that the advent of total ectogenesis (artificial gestation from conception to birth) would automatically eliminate women’s right to abortion, even in the earliest stages of pregnancy. At the very least, it must imply that as many aborted fetuses as possible should be kept alive through artificial gestation. But the mere technological possibility of providing artificial wombs for huge numbers of human fetuses could not establish such a moral obligation. A massive commitment to ectogenesis would probably be ruinously expensive, and might prove contrary to the interests of parents of children. The viability criterion forces us to make a hazardous leap from the technologically possible to the morally mandatory.
The sentience criterion at first appears more promising as a means of defending a moderate view of abortion. It provides an intuitively plausible distinction between early and late abortion. Unlike the viability criterion, it is unlikely to be undermined by new biomedical technologies….
The strong version of the sentience criterion treats sentience as a sufficient condition for having full and equal moral standing. The weak version treats sentience as sufficient for having some moral standing, but not necessarily full and equal moral standing….
[According to the strong version] any being which has even minimal capacities for sensory experience is the moral equal of any person. If we accept this theory, then we must conclude that not only is late abortion the moral equivalent of homicide, but so is the killing of such sentient nonhuman beings as mice…. [According to the weak version] all sentient beings have some moral standing, but beings that are more highly sentient have greater moral standing than do less highly sentient beings. This weaker version of the sentience criterion leaves room for a distinction between the moral 84standing of mice and that of sentient humans—provided, that is, that mice can be shown to be less highly sentient. However, it will not support the moral equality of late-term fetuses, since the relatively undeveloped condition of fetal brains almost certainly means that fetuses are less highly sentient than older human beings….
THE SELF-AWARENESS CRITERION
Although newborn infants are regarded as persons in both law and common moral conviction, they lack certain mental capacities that are typical of persons. They have sensory experiences, but, as Tooley points out, they probably do not yet think, or have a sense of who they are, or a desire to continue to exist. It is not unreasonable to suppose that these facts make some difference to their moral standing. Other things being equal, it is surely worse to kill a self-aware being that wants to go on living than one that has never been self-aware and that has no such preference. If this is true, then it is hard to avoid the conclusion that neither abortion nor infanticide is quite as bad as the killing of older human beings. And indeed many human societies seem to have accepted that conclusion….
But if infanticide is to be considered, it is better that it be done immediately after birth, before the bonds of love and care between the infant and the mother (and other persons) have grown any stronger than they may already be. Postponing the question of the infant’s acceptance for weeks or months would be cruel to all concerned. Although an infant may be little more sentient or self-aware at two weeks of age than at birth, its death is apt to be a greater tragedy—not for it, but for those who have come to love it. I suspect that this is why, where infanticide is tolerated, the decision to kill or abandon an infant must usually be made rather quickly. If this consideration is morally relevant—and I think it is—then the self-awareness criterion fails to illuminate some of the morally salient aspects of infanticide….
WHY PROTECT INFANTS?
I have already mentioned some of the reasons for protecting human infants more carefully than we protect most comparably-sentient nonhuman beings. Most people care deeply about infants, particularly—but not exclusively—their own. Normal human adults (and children) are probably “programmed” by their biological nature to respond to human infants with care and concern. For the mother, in particular, that response is apt to begin well before the infant is born. But even for her it is likely to become more intense after the infant’s birth. The infant at birth enters the human social world, where, if it lives, it becomes involved in social relationships with others, of kinds that can only be dimly foreshadowed before birth. It begins to be known and cared for, not just as a potential member of the family or community, but as a socially present and responsive individual…. The newborn is not yet self-aware, but it is already (rapidly becoming) a social being.
Thus, although the human newborn may have no intrinsic properties that can ground a moral right to life stronger than that of a fetus just before birth, its emergence into the social world makes it appropriate to treat it as if it had such a stronger right. This, in effect, is what the law has done, through the doctrine that a person begins to exist at birth….
Another reason for condemning infanticide is that, at least in relatively privileged nations like our own, infants whose parents cannot raise them can usually be placed with people who will love them and take good care of them. This means that infanticide is rarely in the infant’s own best interests, and would often deprive some potential adoptive individual or family of a great benefit….
But have I not left the door open to the claim that infanticide may still be justified in some places, e.g., where there is severe poverty and a lack of accessible adoption agencies or where women face exceptionally harsh penalties for “illegitimate” births? I have, and deliberately. The moral case against the toleration of infanticide is contingent upon the existence of morally preferable options. Where economic hardship, the lack of contraception and abortion, and other forms of sexual and political oppression have eliminated all such options, there will be instances in which infanticide is the least tragic of a tragic set of choices. In such circumstances, the enforcement of extreme sanctions against infanticide can constitute an additional injustice.
WHY BIRTH MATTERS
I have defended what most regard as needing no defense, i.e., the ascription of an equal right to life to human infants. Under reasonably favorable conditions that policy can protect the rights and interests of all concerned, including infants, biological parents, and potential adoptive parents.
But if protecting infants is such a good idea, then why is it not a good idea to extend the same strong protections to sentient fetuses? The question is not whether sentient fetuses ought to be protected: of course they should. Most women readily accept the responsibility of doing whatever they can to ensure that their (voluntarily continued) pregnancies are successful, and that no avoidable harm comes to the fetus. Negligent or malevolent actions by third parties which result in death or injury to pregnant women or their potential children should be subject to moral censure and legal prosecution. A just and caring society would do much more than ours does to protect the health of all its members, including pregnant women. The question is whether the law should accord to late-term fetuses exactly the same protections as are accorded to infants and older human beings.
The case for doing so might seem quite strong….
But there is one crucial consideration which this argument leaves out. It is impossible to treat fetuses in utero as if they were persons without treating women as if they were something less than persons. The extension of equal rights to sentient fetuses would inevitably license severe violations of women’s basic rights to personal autonomy and physical security. In the first place, it would rule out most second-trimester abortions performed to protect the women’s life or health. Such abortions might sometimes be construed as a form of self-defense. But the right to self-defense is not usually taken to mean that one may kill innocent persons just because their continued existence poses some threat to one’s own life or health. If abortion must be justified as self-defense, then it will rarely be performed until the woman is already in some extreme danger, and perhaps not even then. Such a policy would cost some women their lives, while others would be subjected to needless suffering and permanent physical harm.
Other alarming consequences of the drive to extend more equal rights to fetuses are already apparent in the United States. In the past decade it has become increasingly common for hospitals or physicians to obtain court orders requiring women in labor to undergo Caesarean sections, against their will, for what is thought to be the good of the fetus…. Forced Caesareans threaten to reduce women to the status of inanimate objects—containers which may be opened at the will of others in order to get at their contents….
Another danger in extending equal legal protections to sentient fetuses is that women will increasingly be blamed, and sometimes legally prosecuted, when they miscarry or give birth to premature, sick, or abnormal infants. It is reasonable to hold the caretakers of infants legally responsible if their charges are harmed because of their avoidable negligence. But when a woman miscarries or gives birth to an abnormal infant, the cause of harm might be traced to any of an enormous number of actions or circumstances which would not normally constitute any legal offense. She might have gotten too much exercise or too little, eaten the wrong foods or the wrong quantity of the right ones, or taken or failed to take certain drugs. She might have smoked, consumed alcohol, or gotten too little sleep. She might have “permitted” her health to be damaged by hard work, by unsafe employment conditions, by the lack of affordable medical care, by living near a source of industrial pollution, by a physically or mentally abusive partner, or in any number of other ways.
Are such supposed failures on the part of pregnant women potentially to be construed as child abuse or negligent homicide? If sentient fetuses are entitled to the same legal protections as infants, then it would seem so….
Such an approach to the protection of fetuses authorizes the legal regulation of virtually every aspect of women’s public and private lives, and thus is incompatible with even the most minimal right to autonomy. Moreover, such laws are apt to prove counterproductive, since the fear of prosecution may deter poor or otherwise vulnerable women from seeking medical care during pregnancy. I am not suggesting that women whose apparent negligence causes prenatal harm to their infants should always be immune from criticism. However, if we want to improve the health of infants we would do better to provide the services women need to protect their health, 86rather than seeking to use the law to punish those whose prenatal care has been less than ideal….
Such arguments will not persuade those who deeply believe that fetuses are already persons, with equal moral rights. How, they will ask, is denying legal equality to sentient fetuses different from denying it to any other powerless group of human beings? If some human beings are more equal than others, then how can any of us feel safe? The answer is twofold.
First, pregnancy is a relationship different from any other, including that between parents and already-born children. It is not just one of innumerable situations in which the rights of one individual may come into conflict with those of another; it is probably the only case in which the legal personhood of one human being is necessarily incompatible with that of another. Only in pregnancy is the organic functioning of one human individual biologically inseparable from that of another. This organic unity makes it impossible for others to provide the fetus with medical care or any other presumed benefit, except by doing something to or for the woman. To try to “protect” the fetus other than through her cooperation and consent is effectively to nullify her right to autonomy, and potentially to expose her to violent physical assaults such as would not be legally condoned in any other type of case. The uniqueness of pregnancy helps to explain why the toleration of abortion does not lead to the disenfranchisement of other groups of human beings, as opponents of abortion often claim….
But, granting the uniqueness of pregnancy, why is it women’s rights that should be privileged? If women and fetuses cannot both be legal persons then why not favor the fetus, e.g., on the grounds that they are more helpless, or more innocent, or have a longer life expectancy? It is difficult to justify this apparent bias towards women without appealing to the empirical fact that women are already persons in the usual, nonlegal sense—already thinking, self-aware, fully social beings—and fetuses are not. Regardless of whether we stress the intrinsic properties of persons, or the social and relational dimensions of personhood, this distinction remains. Even sentient fetuses do not yet have either the cognitive capacities or the richly interactive social involvements typical of persons.
This “not yet” is morally decisive. It is wrong to treat persons as if they do not have equal basic rights. Other things being equal, it is worse to deprive persons of their most basic moral and legal rights than to refrain from extending such rights to beings that are not persons. This is one important element of truth in the self-awareness criterion. If fetuses were already thinking, self-aware, socially responsive members of communities, then nothing could justify refusing them the equal protection of the law. In that case, we would sometimes be forced to balance the rights of the fetus against those of the woman, and sometimes the scales might be almost equally weighted. However, if women are persons and fetuses are not, then the balance must swing toward women’s rights.
CONCLUSION
Birth is morally significant because it marks the end of one relationship and the beginning of others. It marks the end of pregnancy, a relationship so intimate that it is impossible to extend the equal protection of the law to fetuses without severely infringing women’s most basic rights. Birth also marks the beginning of the infant’s existence as a socially responsive member of a human community. Although the infant is not instantly transformed into a person at the moment of birth, it does become a biologically separate human being. As such, it can be known and cared for as a particular individual. It can also be vigorously protected without negating the basic rights of women. There are circumstances in which infanticide may be the best of a bad set of options. But our own society has both the ability and the desire to protect infants, and there is no reason why we should not do so.
We should not, however, seek to extend the same degree of protection to fetuses. Both late-term fetuses and newborn infants are probably capable of sentience. Both are precious to those who want children; and both need to be protected from a variety of possible harms. All of these factors contribute to the moral standing of the late-term fetus, which is substantial. However, to extend equal legal rights to fetuses is necessarily to deprive pregnant women of the rights to personal autonomy, physical integrity, and sometimes life itself. There is room for only one person with full and equal rights inside a single human skin. That is why it is birth, rather than 87sentience, viability, or some other prenatal milestone that must mark the beginning of legal personhood.
REFERENCES
Callahan, Sidney. 1984. Value choices in abortion. In Abortion: Understanding differences. Sidney Callahan and Daniel Callahan, eds. New York and London: Plenum Press.
Callahan, Sidney. 1986. Abortion and the sexual agenda. Commonweal, April 25, 232–238.
Tooley, Michael. 1983. Abortion and infanticide. Oxford: Oxford University Press.
DON MARQUIS
Why Abortion Is Immoral
Don Marquis is a professor of philosophy at the University of Kansas. Marquis disagrees with philosophers such as Warren who believe that birth is morally significant in terms of the value of a human’s life. He argues instead that while abortion may sometimes be morally permissible, the moral presumption against killing a fetus is as strong as the 88moral presumption against killing an adult human or newborn because abortion deprives the victims of the value of the activities, experiences, and enjoyments of their future.
Marquis, Don, “Why Abortion Is Immoral,” The Journal of Philosophy, LXXXVI, 4 (April 1989) pp 183–202. Used with permission of The Journal of Philosophy.
The view that abortion is, with rare exceptions, seriously immoral has received little support in the recent philosophical literature. No doubt most philosophers affiliated with secular institutions of higher education believe that the anti-abortion position is either a symptom of irrational religious dogma or a conclusion generated by seriously confused philosophical argument. The purpose of this essay is to undermine this general belief. This essay sets out an argument that purports to show, as well as any argument in ethics can show, that abortion is, except possibly in rare cases, seriously immoral, that it is in the same moral category as killing an innocent adult human being….
A necessary condition of resolving the abortion controversy is a more theoretical account of the wrongness of killing. After all, if we merely believe, but do not understand, why killing adult human beings such as ourselves is wrong, how could we conceivably show that abortion is either immoral or permissible?
In order to develop such an account, we can start from the following unproblematic assumption concerning our own case: it is wrong to kill us. Why is it wrong? Some answers can be easily eliminated. It might be said that what makes killing us wrong is that a killing brutalizes the one who kills. But the brutalization consists of being inured to the performance of an act that is hideously immoral; hence, the brutalization does not explain the immorality. It might be said that what makes killing us wrong is the great loss others would experience due to our absence. Although such hubris is understandable, such an explanation does not account for the wrongness of killing hermits, or those whose lives are relatively independent and whose friends find it easy to make new friends.
A more obvious answer is better. What primarily makes killing wrong is neither its effect on the murderer nor its effect on the victim’s friends and relatives, but its effect on the victim. The loss of one’s life is one of the greatest losses one can suffer. The loss of one’s life deprives one of all the experiences, activities, projects, and enjoyments that would otherwise have constituted one’s future. Therefore, killing someone is wrong, primarily because the killing inflicts (one of) the greatest possible losses on the victim. To describe this as the loss of life can be misleading, however. The change in my biological state does not by itself make killing me wrong. The effect of the loss of my biological life is the loss to me of all those activities, projects, experiences, and enjoyments which would otherwise have constituted my future personal life. These activities, projects, experiences, and enjoyments are either valuable for their own sakes or are means to something else that is valuable for its own sake. Some parts of my future are not valued by me now, but will come to be valued by me as I grow 89older and as my values and capacities change. When I am killed, I am deprived both of what I now value which would have been part of my future personal life, but also what I would come to value. Therefore, when I die, I am deprived of all of the value of my future. Inflicting this loss on me is ultimately what makes killing me wrong. This being the case, it would seem that what makes killing any adult human being prima facie seriously wrong is the loss of his or her future….
The view that what makes killing wrong is the loss to the victim of the value of the victim’s future gains additional support when some of its implications are examined. In the first place, it is incompatible with the view that it is wrong to kill only beings who are biologically human. It is possible that there exists a different species from another planet whose members have a future like ours. Since having a future like that is what makes killing someone wrong, this theory entails that it would be wrong to kill members of such a species. Hence, this theory is opposed to the claim that only life that is biologically human has great moral worth, a claim which many anti-abortionists have seemed to adopt. This opposition, which this theory has in common with personhood theories, seems to be a merit of the theory.
In the second place, the claim that the loss of one’s future is the wrong-making feature of one’s being killed entails the possibility that the futures of some actual nonhuman mammals on our own planet are sufficiently like ours that it is seriously wrong to kill them also. Whether some animals do have the same right to life as human beings depends on adding to the account of the wrongness of killing some additional account of just what it is about my future or the futures of other adult human beings which makes it wrong to kill us. No such additional account will be offered in this essay. Undoubtedly, the provision of such an account would be a very difficult matter. Undoubtedly, any such account would be quite controversial. Hence, it surely should not reflect badly on this sketch of an elementary theory of the wrongness of killing that it is indeterminate with respect to some very difficult issues regarding animal rights.
In the third place, the claim that the loss of one’s future is the wrong-making feature of one’s being killed does not entail, as sanctity of human life theories do, that active euthanasia is wrong. Persons who are severely and incurably ill, who face a future of pain and despair, and who wish to die will not have suffered a loss if they are killed. It is, strictly speaking, the value of a human’s future which makes killing wrong in this theory. This being so, killing does not necessarily wrong some persons who are sick and dying. Of course, there may be other reasons for a prohibition of active euthanasia, but that is another matter. Sanctity-of-human-life theories seem to hold that active euthanasia is seriously wrong even in an individual case where there seems to be good reason for it independently of public policy considerations. This consequence is most implausible, and it is a plus for the claim that the loss of a future of value is what makes killing wrong that it does not share this consequence.
In the fourth place, the account of the wrongness of killing defended in this essay does straightforwardly entail that it is prima facie seriously wrong to kill children and infants, for we do presume that they have futures of value. Since we do believe that it is wrong to kill defenseless little babies, it is important that a theory of the wrongness of killing easily account for this. Personhood theories of the wrongness of killing, on the other hand, cannot straightforwardly account for the wrongness of killing infants and young children.* Hence, such theories must add special ad hoc accounts of the wrongness of killing the young. The plausibility of such ad hoc theories seems to be a function of how desperately one wants such theories to work. The claim that the primary wrong-making feature of a killing is the loss to the victim of the value of its future accounts for the wrongness of killing young children and infants directly; it makes the wrongness of such acts as obvious as we actually think it is….
*Feinberg, Tooley, Warren, and Engelhardt have all dealt with this problem.
The claim that the primary wrong-making feature of a killing is the loss to the victim of the value of its future has obvious consequences for the ethics of abortion. The future of a standard fetus includes a set of experiences, projects, activities, and such which are identical with the futures of adult human beings and are identical with the futures of young children. Since the reason that is sufficient to explain why it is wrong to kill human beings after the time of birth is a reason that also applies 90to fetuses, it follows that abortion is prima facie seriously morally wrong.
This argument does not rely on the invalid inference that, since it is wrong to kill persons, it is wrong to kill potential persons also. The category that is morally central to this analysis is the category of having a valuable future like ours; it is not the category of personhood. The argument to the conclusion that abortion is prima facie seriously morally wrong proceeded independently of the notion of person or potential person or any equivalent….
Of course, this value of a future-like-ours argument, if sound, shows only that abortion is prima facie wrong, not that it is wrong in any and all circumstances. Since the loss of the future to a standard fetus, if killed, is, however, at least as great a loss as the loss of the future to a standard adult human being who is killed, abortion, like ordinary killing, could be justified only by the most compelling reasons. The loss of one’s life is almost the greatest misfortune that can happen to one. Presumably abortion could be justified in some circumstances, only if the loss consequent on failing to abort would be at least as great. Accordingly, morally permissible abortions will be rare indeed unless, perhaps, they occur so early in pregnancy that a fetus is not yet definitely an individual. Hence, this argument should be taken as showing that abortion is presumptively very seriously wrong, where the presumption is very strong—as strong as the presumption that killing another adult human being is wrong.
How complete an account of the wrongness of killing does the value of a future-like-ours account have to be in order that the wrongness of abortion is a consequence? This account does not have to be an account of the necessary conditions for the wrongness of killing. Some persons in nursing homes may lack valuable human futures, yet it may be wrong to kill them for other reasons. Furthermore, this account does not obviously have to be the sole reason killing is wrong where the victim did have a valuable future. This analysis claims only that, for any killing where the victim did have a valuable future like ours, having that future by itself is sufficient to create the strong presumption that the killing is seriously wrong….
In this essay, it has been argued that the correct ethic of the wrongness of killing can be extended to fetal life and used to show that there is a strong presumption that any abortion is morally impermissible. If the ethic of killing adopted here entails, however, that contraception is also seriously immoral, then there would appear to be a difficulty with the analysis of this essay.
But this analysis does not entail that contraception is wrong. Of course, contraception prevents the actualization of a possible future of value. Hence, it follows from the claim that futures of value should be maximized that contraception is prima facie immoral. This obligation to maximize does not exist, however; furthermore, nothing in the ethics of killing in this paper entails that it does. The ethics of killing in this essay would entail that contraception is wrong only if something were denied a human future of value by contraception. Nothing at all is denied such a future by contraception, however….
At the time of contraception, there are hundreds of millions of sperm, one (released) ovum and millions of possible combinations of all of these. There is no actual combination at all. Is the subject of the loss to be a merely possible combination? Which one? This alternative does not yield an actual subject of harm either. Accordingly, the immorality of contraception is not entailed by the loss of a future-like-ours argument simply because there is no nonarbitrarily identifiable subject of the loss in the case of contraception.
The purpose of this essay has been to set out an argument for the serious presumptive wrongness of abortion subject to the assumption that the moral permissibility of abortion stands or falls on the moral status of the fetus. Since a fetus possesses a property, the possession of which in adult human beings is sufficient to make killing an adult human being wrong, abortion is wrong. This way of dealing with the problem of abortion seems superior to other approaches to the ethics of abortion, because it rests on an ethics of killing which is close to self-evident, because the crucial morally relevant property clearly applies to fetuses, and because the argument avoids the usual equivocations on “human life,” “human being,” or “person.” The argument rests neither on religious claims nor on Papal dogma. It is not subject to the objection of “speciesism.” Its soundness is compatible with the moral permissibility of euthanasia and contraception. It deals with our intuitions concerning young children.
Finally, this analysis can be viewed as resolving a standard problem—indeed, the standard problem—concerning the ethics of abortion. Clearly, it is wrong to 91kill adult human beings. Clearly, it is not wrong to end the life of some arbitrarily chosen single human cell. Fetuses seem to be like arbitrarily chosen human cells in some respects and like adult humans in other respects. The problem of the ethics of abortion is the problem of determining the fetal property that settles this moral controversy. The thesis of this essay is that the problem of the ethics of abortion, so understood, is solvable.
SERRIN M. FOSTER
Refuse to Choose: Women Deserve Better Than Abortion
Serrin Foster is president of Feminists for Life of America, an organization that is dedicated to eliminating and finding practical solutions to the root causes that drive women to seek abortions. In her article Foster points out that feminists have traditionally been opposed to abortion. She argues that, rather than benefiting women, abortion harms women.
Foster, Serrin M., “Refuse to Choose®: Women Deserve Better® Than Abortion” (2005) Used with permission of Feminists for Life of America
For more than two centuries feminists have opposed abortion.
British feminist author Mary Wollstonecraft decried, in scathing 18th century terms, the sexual exploitation of women in A Vindication of the Rights of Women. She went on to condemn those who would “either destroy the embryo in the womb or casting it off when born” saying: “Nature in everything deserves respect, and those who violate her laws seldom violate them with impunity.”
Elizabeth Cady Stanton, who in 1848 organized the first women’s convention in Seneca Falls, New York, and suffragist organizer Susan B. Anthony were active in the abolitionist movement. Their basic belief in the rights of all human beings extended to women, slaves, and children—born and unborn. While history books are filled with their efforts to win rights for women, it is less well known that the early American feminists also opposed abortion.
Without known exception, the early feminists condemned abortion in the strongest terms. Susan B. Anthony and Elizabeth Cady Stanton’s radical feminist newspaper, The Revolution, called abortion “child murder.” Stanton classified abortion as a form of “infanticide” and said, “When we consider that women have been treated as property, it is degrading to women that we should treat our children as property to be disposed of as we see fit.” …
Sarah Norton, the first woman to successfully argue admission to Cornell University, wrote in an 1870 edition of the Sisters’ Weekly, “Child murderers practice their profession without let or hindrance, and open infant butcheries unquestioned…. Is there no remedy for this antenatal murder? … Perhaps there will come a day when … an unmarried mother will not be despised because of her motherhood … and when the right of the unborn to be born will not be denied or interfered with.”
Feminists who fought for the rights of women—to vote, sit on a jury, testify on their own behalf, control their own money, and defend themselves from marital rape—also fought for our right to life.
Yet like today’s pro-life feminists, they recognized that women do not have to bear children to share in this celebration of womanhood. Susan B. Anthony, once complimented by a friend who thought that she would have made a wonderful mother, responded, “Sweeter even than to have had the joy of caring for children of my own has it been to me to help bring about a better state of things for mothers generally, so their unborn little ones could not be willed away from them.”
Alice Paul, Anthony’s successor and author of the original Equal Rights Amendment, once told a friend, “Abortion is the ultimate exploitation to women.”
Properly defined, feminism is a philosophy that embraces basic rights for all human beings without exception—without regard to one’s race, religion, sex, size, age, location, disability or parentage. Feminism rejects the use of force to dominate, control, or destroy one another. Abortion violates the core principles of feminism: nondiscrimination, nonviolence and justice for all.
In our own day Feminists for Life’s Honorary Chair Patricia Heaton, winner of two Emmy awards and a bestselling author, says, “Women experiencing an unplanned pregnancy also deserve unplanned joy.” The sad reality is that the “unplanned joy” Patricia Heaton envisions for women is all too rare. Instead, women experiencing an unplanned pregnancy often end up experiencing the tragic violence of abortion.
OUR BODY. OUR CHOICE. OUR PROBLEM.
Statistics gathered by abortion supporters reveal that the overarching reasons women with unintended pregnancies turn to abortion are lack of financial resources and lack of emotional support. Many women also say they felt abandoned, or even coerced into having an abortion. 93Despite child support laws, some fathers threaten to withhold support. Domestic violence against pregnant women at the hands of a partner is being reported with greater frequency….
The women at highest risk of resorting to abortion are those of college age. One out of five abortions is performed on a college student. For many years, Feminists for Life’s College Outreach Program has been listening to women on campuses across the country. Women who tested positive for pregnancy at a campus health center tell us—almost universally—that the next words they heard from clinic staff were “I’m so sorry.”
Then they were handed a business card for a local abortion clinic. University counselors and professors echo this message, telling students that they can’t possibly continue their education and have a child—as if pregnancy makes women incapable of reading, writing or thinking.
Resources are similarly lopsided. Some colleges offer $300 loans for an abortion, but no financial aid if the young woman gives birth. Pregnant and parenting students report that housing, maternity coverage, childcare and telecommuting options are nonexistent on many campuses, and expensive on others. Women who are visibly pregnant are stared at like exotic animals when they cross the campus.
Forcing a woman to choose between sacrificing her education or career plans and sacrificing her child is not much of a “free choice.”
Beyond the campus, support is also lacking for any choice other than abortion. Pregnant and parenting women in the workplace still cannot count on basic benefits such as maternity coverage, job sharing, flex time, telecommuting, or the ability to make a living wage.
Even well meaning family and friends often fail to give women what they really need and want—congratulations and unconditional support. Instead of saying “How can I help?” they say, “A baby will ruin your life.”
In other words, most women “choose” abortion precisely because they believe they have no other choice.
More than 30 years since the U.S. Supreme Court handed down the Roe v. Wade decision legalizing abortion, the pro-choice mantra “Our body, Our choice” still means the same thing: Our problem. Abortion is not a measure of society’s success in meeting the needs of women; it’s a measure of its failure.
ABORTION HARMS WOMEN
The damage that abortion causes to women’s bodies can result in infertility, future miscarriages, and even death. Second-term abortions performed on teens with a family history of breast cancer elevate their risk of breast cancer. Many women carry emotional scars from the experience. Studies from Finland, Great Britain, Canada and the United States reveal higher rates of suicide, attempted suicide and psychiatric admissions among women who have had an abortion compared to women who have given birth.
Feminists for Life board member Marion Syversen had two abortions as a teenager while living in an extremely abusive home. She supports studies of abortion’s impact on women—especially since abortion is the most common surgery in America. Reminded that former Surgeon General C. Everett Koop said it was problematic to study the impact of abortion because half the women who had them may deny it, Syversen responded, “Well, doesn’t that tell you something? If it was such a great thing we’d all be talking about it!”
At a July 2002 briefing on Capitol Hill, actor and Feminists for Life Honorary Co-Chair Margaret Colin challenged members of Congress to “remember the woman” and ask themselves, “Is this the best we can do for her?” Abortion is a symptom of—never a solution to—the problems faced by women. Americans like to say. “Failure is not an option.” Yet abortion has completely failed as a social policy designed to aid women. Women have had to settle for far less than they need and deserve.
REFUSE TO CHOOSE
Abstract rhetoric that pits “women’s rights” against “the baby” does nothing to solve the unmet needs of women. As a result, more than a million times a year in America, women lay their bodies down or swallow a bitter pill. 94Every day that goes by with the needs of pregnant women unmet is another day marked by thousands of abortions. Although Americans are deeply divided on abortion, there is no disagreement that the number of abortions needs to be reduced. No compassionate person wants a woman to suffer through the personal tragedy of abortion.
Abortion is a reflection that we have not met the needs of women. Susan B. Anthony urged activists to address the root causes that drive women to abortion. It’s time for feminism to return to its roots with a women-centered plan to significantly eliminate abortion.
Women’s advocates on both sides need to work together for better outcomes for women and children. We should seek a comprehensive review of the reasons that drive women to abortion. We must listen to women from all walks of life—women who have had abortions, single and married mothers, birthmothers. Men should be welcomed as partners in problem solving. We need to listen, to hear women and create a step-by-step plan to systematically eliminate the root causes that drive so many women to abortion—primarily the lack of financial resources and lack of emotional support.
We need to engage those in higher education, healthcare, technology, corporations, small businesses, the entertainment industry, government and the media to help redirect the debate toward positive outcomes for all concerned.
We must begin by finding solutions for those at highest risk of abortion—college women, young working women and low-income women.
College campuses should reexamine their policies, attitudes and support for pregnant and parenting students and staff. Through programs like Feminists for Life’s Pregnancy Resource Forums, people on all sides of the debate within the campus community can put aside their differences to address the needs of pregnant and parenting students, including housing, childcare and maternity benefits in student health-care plans.
Family-friendly workplaces that offer childcare, flex time and telecommuting solutions can help lessen the pressure on women to choose between their careers and their children. Farsighted employers like Steelcase Corporation of Michigan set up offices in the homes of employees who are new parents to help them telecommute.
Pregnancy care centers need funding to assist women to follow through on nonviolent, life-affirming choices—whether that involves married parenthood, single parenthood, extended family or co-parenting options, or adoption.
We need to replicate the success achieved in Pennsylvania, where abortions have been greatly reduced through state funding of resource centers that promote life-affirming alternatives. Pennsylvania law also mandates that a woman seeking an abortion be accurately and adequately informed about the procedure, fetal development, and the father’s rights and responsibilities so she can make an informed choice. The late Governor Robert Casey knew that women deserve—and can handle— this information. We can work with states to implement the State Children’s Health Insurance Program (SCHIP), whose services include prenatal care for low-income women and their unborn children.
It is also important that we reverse the negative attitudes toward children and parenting that have become so prevalent in our culture. Our society needs once again to cherish motherhood, champion fatherhood, and celebrate the benefits and rewards of parenthood.
RETURN TO FEMINISM’S ROOTS
In 1869, Mattie Brinkerhoff wrote in The Revolution: “When a man steals to satisfy hunger, we may safely conclude that there is something wrong in society. So when a woman destroys the life of her unborn child, it is evidence that either by education or circumstances she has been greatly wronged.” Every woman deserves better, and every child deserves a chance at life.
It is time to reaffirm the strength and dignity of women, the importance of fathers, and the value of every human life. It’s time women refuse to choose between sacrificing education and career plans or sacrificing their children. We must raise expectations and focus our efforts on what is best for women, children and families—so that one day soon we will look back at this barbaric practice and wonder why any woman ever felt coerced into suffering through an abortion.
Women deserve better.
LINDA LOWEN
20 Arguments from Both Sides of the Abortion Debate
Linda Lowen is a radio and broadcast journalist and producer with a special interest in women’s issues. In 2009 she was recipient of the Exceptional Merit Media Award (EMMA). In the following reading, Lowen presents arguments both for and against abortion.
Many points come up in the abortion debate. Here’s a look at abortion from both sides: ten arguments for abortion and ten arguments against abortion, for a total of twenty statements that represent a range of topics as seen from both sides.
Lowen, Linda, “20 Key Arguments from Both Sides of the Abortion Debate” Thought Co. Updated June 1, 2018. www.thoughtco.com. Copyright © 2018 ThoughtCo. Used with permission.
10 PRO-LIFE ARGUMENTS
Since life begins at conception, abortion is akin to murder as it is the act of taking human life. Abortion is in direct defiance of the commonly accepted idea of the sanctity of human life.
96No civilized society permits one human to intentionally harm or take the life of another human without punishment, and abortion is no different.
Adoption is a viable alternative to abortion and accomplishes the same result. And with 1.5 million American families wanting to adopt a child, there is no such thing as an unwanted child.
An abortion can result in medical complications later in life; the risk of ectopic pregnancies doubles and the chance of a miscarriage and pelvic inflammatory disease also increases.
In the instance of rape and incest, proper medical care can ensure that a woman will not get pregnant. Abortion punishes the unborn child who committed no crime; instead, it is the perpetrator who should be punished.
Abortion should not be used as another form of contraception.
For women who demand complete control of their body, control should include preventing the risk of unwanted pregnancy through the responsible use of contraception or, if that is not possible, through abstinence.
Many Americans who pay taxes are opposed to abortion, therefore it’s morally wrong to use tax dollars to fund abortion.
Those who choose abortions are often minors or young women with insufficient life experience to understand fully what they are doing. Many have lifelong regrets afterward.
Abortion frequently causes intense psychological pain and stress.
10 PRO-CHOICE ARGUMENTS
Nearly all abortions take place in the first trimester when a fetus is attached by the placenta and umbilical cord to the mother. As such, its health is dependent on her health, and cannot be regarded as a separate entity as it cannot exist outside her womb.
The concept of personhood is different from the concept of human life. Human life occurs at conception, but fertilized eggs used for in vitro fertilization are also human lives and those not implanted are routinely thrown away. Is this murder, and if not, then how is abortion murder?
Adoption is not an alternative to abortion because it remains the woman’s choice whether or not to give her child up for adoption. Statistics show that very few women who give birth choose to give up their babies; less than 3 percent of white unmarried women and less than 2 percent of percent black unmarried women.
Abortion is a safe medical procedure. The vast majority of women (88 percent) who have an abortion do so in their first trimester. Medical abortions have less than 0.5 percent risk of serious complications and do not affect a woman’s health or future ability to become pregnant or give birth.
In the case of rape or incest, forcing a woman made pregnant by this violent act would cause further psychological harm to the victim. Often a woman is too afraid to speak up or is unaware she is pregnant, thus the morning after pill is ineffective in these situations.
Abortion is not used as a form of contraception. Pregnancy can occur even with responsible contraceptive use. Only 8 percent of women who have abortions do not use any form of birth control, and that is due more to individual carelessness than to the availability of abortion.
The ability of a woman to have control of her body is critical to civil rights. Take away her reproductive choice and you step onto a slippery slope. If the government can force a woman to continue a pregnancy, what about forcing a woman to use contraception or undergo sterilization?
Taxpayer dollars are used to enable poor women to access the same medical services as rich women, and abortion is one of these services. Funding abortion is no different from funding a war in the Mideast. For those who are opposed, the place to express outrage is in the voting booth.
97Teenagers who become mothers have grim prospects for the future. They are much more likely to leave school; receive inadequate prenatal care; rely on public assistance to raise a child; develop health problems; or end up divorced.
Like any other difficult situation, abortion creates stress. Yet the American Psychological Association found that stress was greatest prior to an abortion and that there was no evidence of post-abortion syndrome.
JAMES Q. WILSON
On Abortion
Political scientist James Q. Wilson (1931–2016) was professor of Government at Harvard University. In 2003 President George W. Bush awarded Wilson the Presidential Medal of Freedom. In the following reading Wilson argues developing life emerges gradually and that aborting a fetus near the end of its term is morally more serious than aborting one shortly after conception.
Abortion is a moral question….
Were abortion not a moral issue, then infanticide would not be one, either, because the difference between a 265-day-old fetus and a newborn infant is a matter of but a few hours. We recoil in horror at the thought of deliberately killing a newborn infant, though we may recognize a few circumstances in which that might become a tragic necessity. We must, therefore, recoil in equal horror at the thought of killing an infant that does not differ from the newborn in any respect other than that it receives oxygen and food via an umbilical cord instead of through its nose and mouth.
Wilson, James Q., “On Abortion” Reprinted from Commentary, January 1, 1994 by permission; copyright © 1994 by Commentary, Inc.
The moral debate over abortion centers on the point in the development of the fertilized ovum when it has acquired those characteristics that entitle it to moral respect. This issue is sometimes framed to require one to define a “person” or to decide when “life” begins. I hope to show that it is so difficult to supply a persuasive answer to these questions as to raise the possibility that they are the wrong questions. Each implies that there is a moment at which life has not begun or a person does not exist and then, immediately following it, a moment at which life has begun or a person has come into being …
The moral qualms we have about abortion arise, I think, chiefly from the instinctive appeal of the infant, a feeling of compassion and attachment that is as natural as any sentiment that ever enters the human breast. 99Whatever we mean by life or the value we attach to it, few if any of us are likely to deny that our judgment is at root a moral one or to say that it is irrelevant to the position we take on abortion.
That is not, in general, how the courts see the matter…. In Roe v. Wade, the decision that legalized abortion, the Supreme Court acknowledged that the state had an “important and legitimate interest in potential life,” but did not define that interest as a moral one. On the contrary, it went to great lengths to disavow any interpretation of those words that might seem even vaguely moral.
The Court majority ruled that during the first trimester a woman had an unqualified right to terminate her pregnancy at will; during the second trimester the state could regulate abortions only to protect the mother’s health; and during the third trimester, when the fetus was viable, the state, “in promoting its interest in the potentiality of human life,” might choose to forbid abortions, unless the woman’s health or life were at risk. Now, if the Court were concerned about protecting life on moral grounds, one might suppose that it would not only allow a ban on third-trimester abortions but would insist upon it. But no. In fact, by defining “health” to mean a woman’s “well-being,” the Court virtually assured that any state law that tried to ban even third-trimester abortions would be open to challenge.
The reason seems clear: if the Court’s position were to be even arguably defensible on constitutional grounds, it had to maintain that the fetus was not a person within the meaning of the Fourteenth Amendment…. Since the Court could not establish when a fetus changed from a nonperson to a person, it could not allow the fetus ever to be defined as a person, for then abortions would always be murder. Determined to create a right to abortion based on the assumption that the mother was a person with a “right to privacy” and the fetus was a nonperson with no rights at all, the Court when it came to defining what a state might do during the third trimester allowed the government to “regulate, and even proscribe, abortion,” but it did not insist that it do either….
Americans have made it clear in repeated opinion polls that they oppose both abortion on demand and a prohibition on all abortions. A majority will support abortions under carefully defined circumstances, such as a pregnancy that endangers the mother’s life or is the result of rape, particularly (and possibly only) during the first trimester. There has been little change in these views since Roe was decided. They seem to reflect an underlying belief that the fetus is entitled to some degree of moral respect, especially after it has developed for a few weeks, a degree of respect that does not preclude taking into account important competing considerations, such as the health of the mother. In short, Americans are philosophically at odds with the Justices who have fashioned their abortion law….
In a recent book, Ronald Dworkin argues that if we think a fetus is a person with constitutional rights, then American opinions about abortion are inconsistent. In particular, the exceptions for rape and incest make no sense. If it is wrong to kill a person, and the fetus is a person, then it is as wrong to kill a fetus that is the product of rape or incest as it would be to kill a newborn infant who was conceived in that manner. If a fetus is a person with rights, then it has those rights whether it is in its first trimester or third and whether it is healthy or deformed.
If, however—Dworkin goes on—our views about abortion are shaped, not by the logic of rights but by the value we attach to human life, then American opinions become more coherent. As a fetus grows it becomes more lifelike, and the more lifelike it is the greater claim it has to our moral respect. If it is horribly deformed (owing, say, to a chromosomal abnormality or a prenatal injury), then it is less human and exercises somewhat less claim on our moral respect.
… Like most supporters of a woman’s right to abort, he [Dworkin] finds no clear line that determines unambiguously when life begins. As I have already indicated, I agree with this judgment. Life emerges, or more accurately, the claims that developing life exert upon us emerge, gradually but powerfully. Everyone recognizes the force of this emergence because everyone (or, I suppose, nearly everyone) recognizes that aborting a fetus near the end of its term is morally a far more serious matter than aborting one shortly after it has become implanted in the womb. Similarly, a mother will usually grieve more deeply over the death of her three-year-old child than over the death of her newborn infant, and more deeply over the latter’s death than over the miscarriage of an embryo.
Dworkin explains these near-universal reactions by the concept of investment. The death of an infant is 100worse than that of a fetus because a greater investment has been made in the former than in the latter. The investment is of two sorts, biological and social.
I think this is too narrow a view of the matter….
The greater grief a mother experiences at the death of an infant than at the death of a ten-week-old fetus does not arise, I think, from the mother’s feeling that her carrying the fetus to term was more costly or constituted a greater waste of resources than carrying the fetus for only ten weeks…. [The] death of an actual or potential child do not reflect lost investment but lost humanity: the newborn infant is distinctly human, a person whom the mother loves and of whom she expects a full and mutually rewarding life, while the fetus is somewhat less fully human. Moreover, the mother sees the infant but not, ordinarily, the fetus. There are bonds in both cases, but the bonds are far greater and the loss far more poignant when the infant has been held in her arms.
I want to assert that it is precisely the degree of resemblance between a fetus and an infant that is of moral significance. We should focus on this point if we believe, as both Dworkin and I do, that because society has an interest in making certain that the intrinsic value of human life is respected, it also has an interest in “maintaining a moral environment in which decisions about life and death are taken seriously and treated as matters of moral gravity.”
… To some people, [moral objections] requires one to ban all abortions because life begins at the moment of conception. This position has the apparent virtue of drawing a bright, clear line. But I am not convinced that such a bright line can in fact be drawn because I am not convinced that there is such a thing as the “moment of conception.”
Long before conception, each female egg and each male sperm is alive and each contains within it, encoded in DNA, human life. Though the production of a human being cannot begin until the egg and the sperm are united in the zygote, the elements (some would say the blueprints) of human life already exist. Conception does not summon forth life where none existed before; it permits life to begin developing toward its infant form. If the penetration of the egg by the sperm is the crucial moment, then one must oppose not only abortion but many kinds of contraception, since some of these—such as the IUD and some birth-control pills—prevent the already fertilized egg from becoming implanted on the wall of the uterus.
It is consistency purchased at a high price, however, for it requires one to believe that contraception is immoral. I do not think most people anywhere believe that or can be made to believe it. Nor do I believe it. A sperm and an egg, whether separate or just joined, do not arouse the moral sentiments that we associate with human life. It is just as well that people feel this way, because not every zygote becomes an embryo. Many fail to implant on the uterine wall; of those that do implant, perhaps no more than half survive for two weeks. …
But if the line is not drawn at conception (or implantation), then where? Surely it must be drawn well before birth, since the fetus is viable many weeks before a normal delivery. Yet I doubt that a sharp line can be drawn at all. Embryonic and fetal development does not proceed by crossing lines; it is a continuous process governed by no fixed blueprint but by the iteration of many succeeding cell divisions, the outcome of which it is impossible to foretell.
But life in general is filled with circumstances in which the alternatives are not clearly defined. I cannot define twilight, but that does not mean that I cannot tell the difference between night and day. Our inability to draw a line should no more disable us from making moral judgments about a fetus than it prevents us from making such judgments about children or adults….
Though no line can be drawn, we can identify, I think, the rough stage in embryonic development when, if we are made unmistakably aware of it, our moral sentiments begin to be most powerfully engaged. People treat as human that which appears to be human; people treat as quasi-human that which appears quasi-human….
In the first and second weeks of pregnancy, all that is visible, and just barely visible, is a fertilized egg, or zygote…. By the tenth week at the very latest, the fetal face has a clearly human appearance.
[The mother, at this point, will] be generally aware that abortion is a grave step and vaguely aware that another life may be at stake. But these sentiments will, of necessity, be somewhat vague or unfocused. She will be keenly aware of whatever is at stake in her personal circumstances—her married or unmarried status, her career plans, her economic or social position—that may incline her to abort. She will not be as keenly aware, 101I suspect, of what is at stake in the development of the fetus. We all find it easier to prefer an outcome we value and can visualize to one that we value but cannot visualize. Being required to see—literally, see—both sides of the issue makes the moral issue clearer and heightens the sense that the choice is, inescapably, a moral one.
All of us are in asymmetrical moral positions of this sort at one time or another. We worry more about a stray cat when it is at our doorstep than when it is out of sight. We may have a policy about giving to a beggar, but no policy quite prepares us for a personal confrontation with one…. A soldier may find it less troubling to shoot an enemy he cannot see than one with whom he has suddenly come face to face….. For our moral sentiments to provide a useful guide to our actions, it is often necessary for us to experience, and not simply imagine, those sentiments and the conditions that evoke them.
The theologian Paul Ramsey once described what the current situation now entails:
In this instance, the darkness of the womb makes unnecessary resort to a mortician’s art to cover the grim reality. As long as we do not see the deaths inflicted or witness the dying, the direct killing of nascent life has only to be compared with the greater or lesser convenience of other solutions in an antiseptic society.
Shine the photographer’s light into the dark womb, and things change, not perhaps as much as Ramsey would have liked—he was a stern and uncompromising foe of abortion—but to some material degree. Even after viewing the photographs, a woman might elect an abortion long after the fetus had become distinctly baby-like. Her life might be in serious danger, or delayed fetal abnormalities might appear. But I believe—or, at any rate, I very much hope—that only such grave circumstances would lead to abortions much beyond the eighth week.
And that includes abortions when the mother has been the victim of rape or incest. In a purely rights-only perspective on abortion, a pregnancy resulting from rape violates a woman’s right not to become pregnant against her will. That violation would justify an abortion even at a late stage in the pregnancy. But a moral perspective would suggest that, if there is to be an abortion, it ought to be before the fetus appears human, which is to say precious, innocent, vulnerable, appealing; if the woman waits beyond that point, then a moral perspective would suggest that the baby, however conceived, should be carried to term and, if the woman wishes, put up for adoption….
In 1930, Pius XI issued an encyclical that denied there were any grounds for allowing abortion at any stage in fetal development. The Bible does not mention abortion, but to Pius it seemed clear that killing a fetus violated the commandment against killing; every life was sacred, and since embryos were alive, every embryo was sacred. When uncertain knowledge and rare events permitted complex judgments, the Church uttered them, but when events—greater knowledge, common events—forced its hand, the Church drew a clear line and stuck to it.
But was drawing such a line really necessary? John T. Noonan, Jr., a profound historian of Church doctrine from whose writings I have drawn much of the account that appears above, thinks it was. The central question is, “How do you determine the humanity of a being?” To Noonan there is only one possible answer: if you are conceived by human parents, you are human…. Viability is not a guide to an embryo’s humanity, since viability can be determined by the skill and resources of modern science; in principle, any fetus might be made viable. Nor is the capacity for having sensory experience a determinant of humanity, because the fetus long before birth has such experiences, and some adults, owing to neurological damage, might stop having experiences without ceasing to be human. I agree with these views.
Noonan also rejects the test I have proposed, but for reasons I do not find convincing. He acknowledges that the grief of a woman over the miscarriage of a fetus is not as great as the grief she would feel over the loss of a child, but he opposes any test based on such feelings because “feeling is a notoriously unsure guide to the humanity of others.” He grants that a mother is more attached to an infant she can see than to a fetus she cannot, but says that “sight is even more untrustworthy than feeling in determining humanity.” He reaches these conclusions by way of this analogy: since people are known to discriminate against others on the basis of color, race, religion, and language, then feelings and sight are unreliable guides to what is human and thus deserving of respect.
But this is not, I think, a proper analogy. There is no doubt that our feelings about others are sometimes 102hateful or that seeing the other person does not always draw us to him. But these consequences of the natural human tendency to prefer our own kind do not apply, except in the rarest of cases, to our own offspring. Quite the contrary: that we are led by nature to prefer our own kind, and especially our own children, is the surest reason for believing that we will cherish them, and cherish them the most when we can see and touch them….
In sum: saying that a human being with full and absolute claims on our moral respect exists from the “moment” of conception is not consistent with either modern science or natural sentiments;…. Therefore, one should try to clarify the moral issue in ways that draw on the natural respect people have for innocent life by making them, and especially pregnant women, more fully aware of the presence of that life and of the claims it makes on us.
I have yet to discuss how, if at all, the law should take account of this position. If my experiment were carried out and there developed a consensus as to when an embryo became a baby, should the law recognize this and ban abortions after that period? I believe that it should, provided there were exceptions for grave and special cases (such as a severe deformity), and even then only after the woman had obtained the advice and consent of disinterested and expert parties. But before voting for such a law, I would prefer to wait and see what would happen if my procedure were followed.
For it to be followed, the Supreme Court would have to change its position…. But having said that, the Court then went on to rule out any regulations that would create an “undue burden” or present “a substantial obstacle” to a woman seeking an abortion. I suspect that my procedure would fail the undue-burden test, ….
I would much prefer the Court to give greater latitude to state and federal legislatures to define a policy in this area, one that takes as its first principle the protection of human life….
I do not think that there is any possibility of a consensus among pro- and anti-abortion activists, and as long as the matter is defined in terms of rights, the pro-abortion activists will win. For hardly any politician is willing to vote against “rights.” By contrast, the American people are less preoccupied with rights and more respectful of life. Even though they are ultimately willing to let a woman make the final decision, they want to ensure that it is a morally constrained and fully informed decision.
CASE STUDIES
1. THE UNWANTED DAUGHTERS
Chandra and Ramdas Malik were poor farmers who lived in a small village outside of Bombay. They had one son and one daughter. Although they would have welcomed the birth of another son, they did not want another daughter, because the required dowry to her future husband’s family would have been financially crippling for them. Sons also provided the best social security for elderly parents. In India minivans carrying ultrasound equipment cruise the countryside, providing prenatal diagnosis of the sex of fetuses. Although the price of an ultrasound was high, it was worth it to the Maliks. “Better 800 rupees now for an abortion,” Ramdas Malik said before the procedure, “than tens of thousands of rupees later for a dowry.”25 The ultrasound operator informed them that the child was a boy. Malik let out a sigh of relief.
Chandra Malik’s cousin, Indira, emigrated to Canada in 1989. Two years later she married a successful engineer, John Sarava. With her son and daughter now in high school, Indira Sarava had decided to return to college when she found out she was pregnant. Because she was forty, Indira had amniocentesis at sixteen weeks to see if the fetus had any genetic disorders. The following week Dr. Lee called her and said, “Congratulations. You’re going to have a healthy baby girl!” Two weeks later Indira asked him to perform an abortion. She explained that although she would have continued the pregnancy had it been a boy, she is not interested in having another daughter. Her husband John is opposed to the abortion. He points out that having another daughter would not be a burden for the family since they are financially secure. Also, because he is semiretired, he is willing to do most of the child care.
2. JENNIFER JOHNSON: MATERNAL DRUG USE AND FETAL RIGHTS
When twenty-three-year-old Jennifer Johnson arrived to give birth to her fourth child, hospital drug tests found traces of cocaine in her blood. It was later revealed that her other children had all been cocaine-affected babies. Johnson was arrested in a crack house. A Florida judge found her guilty of delivery (through the umbilical cord) of a controlled substance to a child. Johnson was sentenced to fifteen years’ probation, drug treatment, random drug testing, and educational and vocational training. She was also ordered to participate in an intensive prenatal care program if she should ever become pregnant again.26
According to the Physicians Committee for Responsible Medicine, the cost of caring for a cocaine-exposed infant can run into the millions of dollars. In response, several states have passed civil child abuse and neglect laws, which state that taking illicit drugs or alcohol during pregnancy constitutes child abuse. As a result of these laws, thousands of women have lost custody of their children and some have even been jailed or placed in mandatory drug treatment programs.
Twenty-four states, including South Carolina, consider drug abuse during pregnancy to be child abuse. As in the case of Jennifer Johnson, addicted women can avoid prison by agreeing to undergo drug treatment.27
3. ANTIABORTION ACTIVISTS AT ABORTION CLINICS
In 2009 Dr. George Tiller, one of few physicians who still performed late-term abortions, was murdered at his church by Scott Roeder, an anti-abortion activist. Roeder told journalists that he had killed Tiller because “preborn lives were in danger.” Roeder was sentenced to life in prison for the murder. Since 1977, antiabortion activists have committed more than 7,000 acts of violence against abortion clinics and providers in at least twenty-eight states and the District of Columbia including bombings, assaults, death threats, and eleven murders.29 Several health care providers and staff have been murdered and many others seriously injured.
In 1994, in response to increasing violence and threats against abortion providers, Congress passed the Freedom of Access to Clinic Entrances Act (“FACE”) which “prohibits use of force, obstruction and property damage intended to interfere with reproductive health care services” and allowed the establishment of buffer zones around clinics.30 Despite this law, antiabortion activities such as trespassing, death threats, hate mail, and threatening phone calls directed at clinics in 2017 more than doubled over the previous year.31 The increase in antiabortion activities in the past few years has been attributed in part to President Trump’s antiabortion stand. Although no abortion providers were killed in 2017, the threat of violence and emotional toll from the harassment has caused many providers to stop performing abortions.
4. DATE RAPE AND ABORTION
Lisa, an eighteen-year-old college freshman, attends a fraternity party with her twenty-year-old boyfriend, Derek. Although alcohol is forbidden on campus, there is plenty of liquor at the party. Derek and his roommate have already started drinking when Lisa arrives. Lisa reluctantly agrees to join them for a drink. After a few drinks, she becomes so tipsy that she is having trouble 106walking, so she lies down on Derek’s bed. Derek’s roommate winks and tells him to “go for it.” Then he leaves the room. Derek then has sex with Lisa, who neither consents nor protests.
The next morning Lisa deeply regrets what has happened. She tells Derek that she is worried she might be pregnant. He gives her the name of an out-of-town doctor and reassures her that the doctor will take care of everything. Lisa goes to the doctor that morning. The doctor gives her the morning-after pill.
Lisa doesn’t tell anyone else what has happened, nor does she keep her follow-up appointment with the doctor. When her periods don’t return and she begins putting on weight, she dismisses the changes as stress. Six months after the incident, Lisa goes to the doctor for what she thinks are stomach problems or possibly a tumor. After examining her, the doctor tells her that she is six months pregnant.
5. THE RELUCTANT DAD
Rose and Joe have been living together in a monogamous relationship for more than a year—since the beginning of their junior year at college. They both agreed at the time they moved in together that either could leave the relationship at any time. Although they were using birth control, Rose has unexpectedly become pregnant.
Joe suggests that she get an abortion and offers to pay for it. However, because Rose is morally opposed to abortion, she resigns herself to having the baby. Joe does not bring up the subject again. When Rose is six months pregnant, Joe decides to leave. He leaves a short note saying, “It was fun while it lasted, but it’s time for me to move on.”
Rose is distraught. Even though it had never been discussed, she had thought that she and Joe would raise the baby together.
NOTES
1. Centers for Disease Control, “Abortion Surveillance—United States Nov 24, 2017/66(24), pp. 1–48.
2. “Abortion Statistics,” www.abortiontv.com/Misc/AbortionStatistics.htm.
3. Gilda Sedgh, “Legal Abortion Worldwide: Incidence and Recent Trends,” Perspectives on Sexual & Reproductive Health 39, no. 4 (December 2007): 216–225.
4. James C. Mohr, Doctors and the Law: Medical Jurisprudence in Nineteenth-Century America (New York: Oxford University Press, 1993): 42–43.
5. Reva Siefel, “Reasoning from the Body: A Historical Perspective on Abortion Regulation and Questions of Sexual Protection,” Stanford Law Review 44 (1992): 286.
6. Elizabeth Cady Stanton, “Child Murder,” The Revolution 1, no. 10 (1868): 146–147.
7. Susan B. Anthony, “Marriage and Maternity,” The Revolution 1, no. 1 (1869): 4.
8. Elizabeth Cady Stanton, “Infanticide,” The Revolution 1, no. 4 (1868): 57–58.
9. Judith Blake, “Abortion and Public Opinion: The 1960–1970 Decade,” Science 171 (1971): 540–548.
10. Clifford Grobstein, Science and the Unborn (New York: Basic Books, 1988), 109.
11. Alex M. Gallup and Lydia Saad, “Abortion Attitudes Stable: No Concensus on Legality.” Gallup.com, June 9, 2017.
12. Dorothy Samuels, “Where Abortion Rights Are Disappearing,” The New York Times, September 24, 2011.
13. “Data on ‘Partial Birth’ Abortion in the United States.” November 28, 2006, www.johnstonarchive.net.
14. Robert J. White, “Partial-Birth Abortion: A Neurosurgeon Speaks,” Testimony by U.S. House Committee on the Judiciary, June 19, 1996.
15. Stephen Hales, “Abortion and Fathers’ Rights,” in Reproduction, Technology, and Rights, eds. James M. Humber and Robert F. Almeder (Totowa, NJ: 1996), 5–29.
16. Therese Hesketh and Zhu Wei Xing, “Abnormal Sex Ratios in Human Populations: Causes and Consequences,” Proceedings of the National Academy of Sciences 3, no. 36 (September 5, 2006): 13271–13275.
17. Dorothy Wertz and John Fletcher, “Ethics and Medical Genetics in the United States,” American Journal of Medical Genetics 29 (April 1988): 815–827.
18. Marc Miringoff, The Index of Social Health, 1989: Measuring the Social Well-Being of Children (New York: Fordham Institute for Innovations in Social Policy, Fordham University, 1989), 7–8. See also Child Trends, “Child Maltreatment,” 2015. https://www.child trends.org/indicators/child-maltreatment/
19. Martha Goldsmith, “Researchers Amass Abortion Data,” JAMA 26 (September 15, 1989): 1431–1432.
20. Marc L. Miringoff, “2003 Index of Social Health: Monitoring the Social Well-Being of the Nation,” Fordham Institute for Innovation in Social Policy.
21. Mary Benedict, Roger White, and Donald Cornely, “Maternal Perinatal Risk Factors and Child Abuse,” Child Abuse and Neglect 9 (1985): 222.
22. Philip Ney, “Infant Abortion and Child Abuse: Cause and Effect,” in The Psychological Aspects of Abortion, ed. David Mall and Walter Walls (Washington D.C., University Publications of America, 1979), 26. See also Judith Boss, “Pro-Child, Pro-Choice: An Exercise in Doublethink?” Public Affairs Quarterly 7 (1993): 85–91.
23. “The Right Ear,” Human Events 53, no. 45 (1997): 24.
24. Michael Gerson, “Abortion’s Gray Areas,” The Washington Post, July 4, 2013.
25. “Ultrasound Effects,” Economist 336, no. 7926 (1996): 34.
26. Paul A. Logli, “Drugs in the Womb: The Newest Battlefield in the War on Drugs,” Criminal Justice Ethics (Winter/Spring 1990): 25.
27. “Supreme Court: Debates Pregnancy Drug Testing Policy,” American Health Line 29 (February 2000).
28. Quoted in “A Proposal to Control Fetal Alcohol Hell,” Report, February 17, 2003, p. 19.
29. NARAL, “Anti-Choice Violence and Intimidation,” January 2017, http://www.prochoiceamerica.org/report/anti-choice-violence-intimidation/
30. “National Task Force on Violence Against Health Care Providers,” U.S. Department of Justice, 2008, http://www.usdoj.gov.crt/crim/faceweb.php.
31. Op cit, http://www.prochoiceamerica
32. “For what reasons are partial-birth abortions usually performed?” www.nric.org/abortion/pba/pbafact10.html.
33. Stephen Hales, “Abortion and Fathers’ Rights,” in Reproduction, Technology, and Rights, eds. James M. Humber and Robert F. Almeder (Totowa, N. J.: Springer), 5–26.