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The Complex Problem of Abortion

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Ethics in Reproductive Medicine

Abstract

The problem of the morality of abortion is one of the most complex and controversial in the entire field of applied ethics. It may therefore appear rather surprising that the most popular proposed “solutions” to it are extremely simple and straightforward, based on clear-cut universal rules which typically either condemn abortion severely in virtually every case or else deem it to be morally quite unproblematic, and hence permissible whenever the mother wishes. This polarised situation in the theoretical debate, however, is in clear contrast with the abortion law in many countries (including Britain), where abortions are treated very differently according to the stage of pregnancy at which they are carried out, so that early abortions are permitted relatively easily, whereas very late abortions are sanctioned only in exceptional cases. It seems likely, moreover, that in thus taking account of the time of an abortion, the law genuinely reflects the weight of public opinion — there may be no overall consensus on the underlying moral issues, but it does appear to be part of “commonsense” morality to accept that, whatever the ultimate rights and wrongs of abortion in general may be, at any rate abortion early in pregnancy is morally greatly preferable to late abortion. Let us call this “the developmental view”, since it holds that the moral gravity of abortion increases with the degree of development of the fetus.1

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Notes

  1. For simplicity, I shall generally use the single word “fetus” indiscriminately to refer to the conceptus, zygote, pre-embryo, embryo, and fetus, so that the word will carry no implications concerning stage of development.

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  2. I shall often speak, apparently uncritically, of such things as the “commonsense moral framework” and even of commonsense moral “intuitions”. Such language should not be taken to indicate any particular meta-ethical view, or any naive illusions about the existence of a unified and coherent moral consensus - it is simply a way of referring concisely to those widely shared “intuitive” moral beliefs (such as that it is wrong to kill children but permissible to kill mosquitos) to which any moral theory which hopes to gain general acceptance must ultimately be answerable. To keep the paper reasonably accessible, I have tried to make my arguments entirely independent of meta-ethics, and have generally framed them using the standard terms (“moral status” etc.) of the popular debate, even though the moral ontology which such terms suggest seems highly problematic. I am confident, however, that a more critical meta-ethical approach would lend further support to my overall position (for example, in providing additional theoretical justification for my appeal to the “principle of sympathetic respect” on pages 178–180).

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  3. In philosophical contexts it is hard to avoid “sexist” language grammatically but without clumsiness, and I have therefore conformed to the traditional policy of using masculine pronouns to include both sexes. I sincerely hope that this policy will cause no offence to the reader, even if he happens to be female.

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  4. For a discussion of precisely this issue see Lee (1986) chapter 2.

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  5. For my own view on the rationality of the belief in a supremely good God, whose will is therefore morally authoritative, see Millican (1989).

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  6. For references to the work of these theologians, and for further details on the historical points that follow, see Dunstan (1984, 1988 ), Engelhardt (1974), and especially Noonan (1971).

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  7. See Dunstan (1988) for evidence of this influence.

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  8. An appeal to what is “natural” is still very common amongst both religious and non-religious anti-abortionists, but unfortunately tends to beg the question. For clearly much medical treatment that would be enthusiastically defended by them (e.g., the use of incubators and life- saving drugs) is “unnatural” in the obvious sense, while many manifest evils (such as earthquakes, floods, drought, and pestilence) have been entirely due to natural causes, so it is hard to draw the distinction which they require without relying on other controversial moral or religious considerations.

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  9. For a sober assessment of the various biblical passages that have been thought relevant to the abortion debate, see Wilkinson (1988) pp 232, 252–8.

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  10. Aristotelianism was by no means the only major philosophical influence here - Stoicism for example significantly moulded the early Christian attitude to sex.

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  11. Including those concerned with immortality and infant baptism.

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  12. Such a person might do well to read the classic and trenchant attack on the doctrine of infallibility provided by Salmon (1888).

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  13. I explore the implications of this last possibility in Millican (1989). In particular, I begin by attempting to refute the suggestion that “what the Supreme Being wills” is good by definition (a suggestion famously attacked in Plato’s Euthyphro) by showing not only the moral, but also the epistemological and religious unacceptability of understanding His “goodness” in a way that would make it entirely different from human goodness.

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  14. Strictly this is somewhat oversimplified, since a persuasive moral argument can have an indirect form, in which for example a moral premise is shown to lead to an unacceptable conclusion, the point of the argument being not so much to deduce anything from that premise, but rather to demonstrate its own falsity. Likewise, much moral investigation takes the form of an attempt to find a “best fit” between theory and “intuition”, rather than merely involving deductions from a pre-established baseline. It obviously remains true even here, however, that such moral discussion can only get started on the basis of at least some antecedent moral agreement.

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  15. Discussions of abortion which invoke this kind of criterion of personhood and moral significance include Harris (1985) chapter 1; Tooley (1983) especially chapter 5; Warren (1973) pp 54–7.

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  16. A similar ambiguity, between a purely descriptive and a moral notion, is possible in connection with the term “human being”. Warren (1973 p 53) suggests that the Human Being Argument derives its superficial plausibility from such an ambiguity.

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  17. The most notable “feminist” contribution to the debate is probably that of Thomson (1971), though she does not endorse the extreme Feminist position presented above. Her “Famous Violinist Argument” would certainly need to be taken into account in any comprehensive treatment of abortion, but I do not discuss it here because it does not, like the other arguments we are discussing, address the question of the status of the fetus. For useful criticism, with which I am broadly in sympathy, see Hursthouse (1987) chapter 5.

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  18. Thus would-be basic moral principles such as “everybody should obey me”, or “all foreigners should be deferential to the English” would be not only morally absurd but even logically unacceptable.

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  19. Many liberals apparently take it to be obvious that a being’s species is in itself morally irrelevant (for example Glover 1977 pp 50–51; Harris 1990 pp 69–70), and therefore see no need for a theoretical argument to that conclusion (Tooley 1983 pp 61–77 is the most notable exception). Singer (1979) presents an explicit two-stage argument from universalisability in which he first (pp 10–12, 18–19) uses it to derive a principle of “equal consideration of interests”, and then (pp 48–54) goes on to deploy this derived principle against speciesism.

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  20. The point here is that to be human is not just to have those general properties which are common to humans: a synthetic copy of a man made by an advanced alien civilisation might have these properties, but would not be a member of our species, because it would not be related to the common stock of humanity. Thus any definition of what it is to be human must inevitably mention particular individuals or particular groups, and this is what violates the principle of universalisability. It may seem surprising that Kant himself, considered by many the apostle of universalisability, states that we should “always treat humanity… as an end” in one of his formulations of the Categorical Imperative, often quoted by conservative moralists (Kant 1785, p 91). But it is clear from the context that Kant is no speciesist, since his rule is intended to apply to any rational being - he simply knows of no others.

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  21. See for example Stone (1987) pp 820–3. Devine (1978 chapters II and III) appeals to the wrongness of both infanticide and the killing of the reversibly comatose to reject what he calls the “present enjoyment principle” (that a being’s rights depend only on its present qualities) in favour of a potentiality principle.

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  22. Most notably Kuhse and Singer (1985) chapter 6; Singer (1979) pp 122–6; Tooley (1983) chapter 11.

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  23. For example Glover (1977) p 122; Harris (1990) pp 70-71; Kuhse and Singer (1982) pp 61–62; Tooley (1983) pp 182–3. Singer and Dawson (1988) extend this standard objection, with added force, to the case of human embryos in vitro.

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  24. See for example Buckle (1988) pp 93–96 (though Buckle is no conservative); Johnstone (1982) pp 49–50; Stone (1987) p 818.

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  25. Very difficult and controversial issues arise here concerning identity and individuation in the pre-embryo stage. See for example Dawson (1988); Holland (1991); Kuhse and Singer (1990).

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  26. For details see Johnson (1989) pp 2–4.

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  27. The estimate that 50% of fertilised ova might be lost through spontaneous abortion is quoted by Potts et al. (1977) p 60: the figure is very uncertain, since most spontaneous abortions probably occur before the mother is aware that she is pregnant. Of those pregnancies which survive long enough to be recognised clinically, only about 15% abort spontaneously (Bieber and Driscoll 1989 p 59).

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  28. It seems that between 30% and 60% of spontaneously aborted fetuses have chromosomal abnormalities (Bieber and Driscoll 1989 p 63 ). The Conservative might try to salvage a plausible policy here by appealing to the distinction between acts and omissions, so that killing early embryos will be wrong, but allowing them to abort permissible. However a complementary problem could arise in the case of an embryo with cleavage arrest, incapable of progressing beyond the early stages of cell division. Suppose that such an embryo were able to implant and survive indefinitely without intervention - how could the strict Conservative, who endorses the Human Being Argument, justify its (surely desirable) termination, since on his own principles it is apparently a human being?

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  29. Even without an appeal to the distinction between acts and omissions, the Conservative need not be committed to the prevention of as many spontaneous abortions as is medically possible (just as he need not be committed to maintaining large numbers of elderly patients indefinitely on life-support systems), since available resources will obviously impose some limit. However, it remains true that he must view this limitation on prevented spontaneous abortions, even in the first few days of pregnancy and even in the case of severely abnormal fetuses, as gravely regrettable, and this in itself seems implausible enough.

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  30. This example, which Thomson (1971 pp 65-66) calls “indecent”, is considered morally unproblematic by Warren (1973 p 59).

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  31. For impressive evidence of the dangers posed by back-street abortions, see Chapter 14.

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  32. Radcliffe Richards (1980 pp 221–6) argues that the exception which conservatives commonly make for abortion in the case of rape can only make sense on the assumption that their prohibition in other cases is based on the disapproval of women who have “indulged willingly in sex without being willing to bear a child” (p 223).

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  33. The assumption that moral status must be all-or-nothing seems to lie behind the popular conservative “Argument from Continuity”, according to which the gradual and continuous development of the fetus from conception to birth implies that it has the same moral status throughout. Clearly such an argument is hopeless if moral status, like the fetus’ physical dimensions, can increase by gradual degrees.

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  34. Generally in legal contexts, anything that is not forbidden is permitted, but we should not be seduced by quasi-legal talk of “rights” into assuming that the same is true of morality. For even some acts which are characterised by a strict observance of “rights” can nevertheless be morally objectionable, for example if they are grudging, heartless, mean, or even legalistic.

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  35. Two other possibilities are made use of by Devine (1978). First, he proposes a “modified species principle” (pp 53–4) which ascribes personhood to all members of any sufficiently intelligent species (even to those members which are not themselves intelligent). Secondly, he endorses an “overflow principle” (p 101), according to which “the principle of respect for persons extends… to things closely associated with persons”. He takes the latter to indicate both that “corpses ought not to be treated as ordinary garbage”, and that “a modicum of reverence should be accorded to processes by which persons come to be” (and hence presumably to human fetuses).

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  36. Something like this principle of special obligation was apparently the basis for the Warnock Committee’s ascription of a “special status” to the human embryo (Warnock 1987 p 10). Warnock hints at an argument founded on our natural “preference” for our own species, but such a biased preference would only justify a moral conclusion here on the strength of the sort of argument which I give below, which presupposes the principle of sympathetic respect.

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  37. This point helps to explain the widely felt relevance of viability to the moral status of the fetus. For a fetus which is viable will be at the same developmental stage as some infants who have already been born alive, making a sympathetic extension of concern almost irresistible since, as Zaichik (1980 p 21) puts it, “it is only due to this fetus’ bad luck” that it is not already born.

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  38. Thus we would rightly be outraged by a mother who, while in hospital awaiting in vitro fertilisation treatment, elected to save from a fire a test-tube containing her newly fertilised ovum rather than her existing child.

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  39. For a recent discussion of the concept of “brain birth” which reviews some of the neurological data, see Jones (1989).

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  40. This need not imply that the problem is insoluble, but does suggest that illumination must be sought not from the extrapolation of moral conclusions from analogous real-life situations, but rather from the consideration of imaginary “thought-experiments” such as the following. Suppose that fertilisation in a humanlike species of alien were to occur not through genetic combination of the gametes, but rather through selective “activation” of some of the (vast number of) genes already present in the ovum - instead of itself contributing genetic material, the sperm would simply activate whatever genes within the ovum correspond most closely to its own. Thus the unfertilised ovum would be manifestly one and the same individual as the fertilised ovum, and would plausibly therefore be just as much a potential person. But it is hard to believe that this makes a significant difference to its “moral status” when it is so far from achieving any “actualized” moral significance: for example, would we really change our mind about contraception if it turned out that our own reproduction functioned in this way? I suspect, but cannot prove, that all such thought-experiments which relate to the status of the pre-embryo will similarly favour a liberal rather than a conservative position at that stage.

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  41. For help and useful criticism I am very grateful to Nina Collins, Christopher Coope, Gordon Dunstan, Chris Megone, Jim Parry, Roger White, and especially Jennifer Jackson.

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Millican, P. (1992). The Complex Problem of Abortion. In: Bromham, D.R., Dalton, M.E., Jackson, J.C., Millican, P.J.R. (eds) Ethics in Reproductive Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-1895-4_15

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  • DOI: https://doi.org/10.1007/978-1-4471-1895-4_15

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