Thursday, 24 August 2017

Abortion revisited


2310 words, 12 min read

Of all moral questions, abortion has for a long time been of very little interest to me, primarily because it just looked like such an open and shut case. A fetus is a human being and killing it is intrinsically evil,1 just like the killing of any other human. Since the fetus is furthermore defenseless and voiceless, its murder is even more reprehensible and unjustifiable. This, complemented by a strong sense of the need for mercy and compassion for all involved, regardless of their views or actions, is pretty much where I stood in 2013, when I last wrote about this subject, reflecting also on Pope Francis’ words about it at the time.

As far as the fetus is concerned, nothing has changed and I stand by what I wrote some four years ago. But, what about the mother? Where does the fetus’ right to life and the absolute evil of his or her murder heave her? What if she herself is a victim and feels coerced to abort? And why is it that abortion is promoted by clearly rational, well-meaning people and presented as intrinsic to curbing the injustice of gender-based discrimination? Yes, there may also be ulterior motives behind a promotion of abortion, but I find it increasingly hard to believe that that is all there is to it. As a result, I have set out to look into what motivates the promoters of abortion, with a desire to discover what good I may find.2

Let me start with philosophy, where my enquiry into abortion has lead me to the work of Judith Jarvis Thomson, who wrote “A Defense of Abortion” in 1971. Unlike the customary discussions about the human personhood or otherwise of the fetus, where abortion opponents affirm it and proponents deny it, Thomson asks the question of whether the inadmissibility of abortion can be taken for granted even if the fetus is taken to be a human person. With that starting point, she proposes the following thought experiment to test whether the fetus’ human personhood, and the right to life derived from it, necessarily lead to a prohibition of abortion:
“[I]magine this: You wake up in the morning and find yourself back to back in bed with an unconscious violinist. A famous unconscious violinist. He has been found to have a fatal kidney ailment, and the Society of Music Lovers has canvassed all the available medical records and found that you alone have the right blood type to help. They have therefore kidnapped you, and last night the violinist’s circulatory system was plugged into yours, so that your kidneys can be used to extract poisons from his blood as well as your own. The director of the hospital now tells you, “Look, we’re sorry the Society of Music Lovers did this to you--we would never have permitted it if we had known. But still, they did it, and the violinist is now plugged into you. To unplug you would be to kill him. But never mind, it’s only for nine months. By then he will have recovered from his ailment, and can safely be unplugged from you.” Is it morally incumbent on you to accede to this situation? No doubt it would be very nice of you if you did, a great kindness. But do you have to accede to it? What if it were not nine months, but nine years? Or longer still? What if the director of the hospital says. “Tough luck. I agree. but now you’ve got to stay in bed, with the violinist plugged into you, for the rest of your life. Because remember this. All persons have a right to life, and violinists are persons. Granted you have a right to decide what happens in and to your body, but a person’s right to life outweighs your right to decide what happens in and to your body. So you cannot ever be unplugged from him.” I imagine you would regard this as outrageous, which suggests that something really is wrong with that plausible-sounding argument I mentioned a moment ago.”
In the process of developing this initial thought experiment, which I think is ingenious and a great tool for digging deeper into what is involved when considering the rights and relationship of a mother and her unborn child, Thomson argues that unplugging the violinist would not be unjust since “you gave him no right to use your kidneys, and no one else can have given him any such right.” She then goes on to suggesting that a key difference between the thought experiment and the mother-fetus relationship is that the “fetus is dependent on the mother, [...] that she has a special kind of responsibility for it, a responsibility that gives it rights against her which are not possessed by any independent person--such as an ailing violinist who is a stranger to her.” Thomson argues though that this special relationship “would give the unborn person a right to its mother’s body only if her pregnancy resulted from a voluntary act, undertaken in full knowledge of the chance a pregnancy might result from it. It would leave out entirely the unborn person whose existence is due to rape.”

What Thomson’s clever thought experiment and in-depth analysis of its variants and consequences have done for me is first of all make me realize that there are relevant questions to consider here and that dialogue with those who support at least some forms of abortion (since Thomson herself is not in favor of blanket, indiscriminate use) could be possible. Secondly, it has shown me more clearly that my own convictions derive from considering the right to life and its value to be unconditional, since, if it were not, then, rationally, Thomson’s conclusions do follow.

Let me now turn to abortion as a phenomenon today, where even just a cursory glance quickly leads to some horrifying statistics. According to a paper provided by the World Health Organization, the annual worldwide rate of abortion in 1995 was 46 million, of which 26 million were legal and 20 million were not. Looking into the reasons behind abortion, a 1998 study, analyzing data from 27 countries (developing countries from Sub-Saharan and Northern Africa, Latin America, Asia + Czech Republic, Japan and US), presents the following sequence. In around half of the over 64 000 cases in question, the main reason for a mother to abort was “to postpone their next birth or to stop childbearing.” Second were economic reasons and poverty, which were cited as the main reason in around one fifth of cases, and as one of the deciding factors between a third and two thirds of the time, depending on geography. In third place were relationship problems, including “the partner’s objection to carrying the pregnancy to term,” which were a factor in between 10 and 40% of the cases. Being too young and unmarried had a similar frequency, although in some countries (e.g., Honduras and Mexico) it accounted for around a third of abortions. Finally, the risk to maternal health was also given as the main reason for abortion by 5-10% in seven countries and by 20-38% in three others (Kenya, Bangladesh, India) with the possibility of fetal defects playing a negligible role overall. Then there are even harsher cases, like those of rape and incest, whose occurrence in the US alone is a staggering 1% of the former and under 0.5% of the latter, i.e., 8000 and below 4000 at a US annual rate of abortion of around 800 000.

Turning to illegal abortions, it can be seen that 97% of them take place in developing countries (~10M in Asia and around ~4M each in Africa and Latin America), where these illegal abortions are unsafe, since they are performed “by individuals without the necessary skills or in an environment that does not conform to minimum medical standards, or both.” As a result, 68 000 women die annually due to the unsafe abortions performed on their fetuses by others or themselves - a mortality rate hundreds of times higher than for safe abortions (i.e., 367 versus less than one deaths per 100 000). This makes abortion be the cause of 13% of all maternal deaths, in 4th place after haemorrhage (25%), indirect causes (20%) and infection (15%). In some regions, such as parts of Latin America and Eastern Europe, abortion related deaths are the cause of as much as 30% of maternal deaths. Beside the scale of maternal mortality from unsafe abortions, their means too are bone-chilling and range from the ingestion of turpentine or laundry bleach, via the insertion of foreign bodies, such as knitting needles, sticks, coat hangers, ballpoint pens etc., into the uterus through the cervix, to the self-infliction of physical trauma, e.g., by jumping from the top of stairs or a roof.

Why is it that a woman would subject herself to such horrors to kill her own child? Again, remaining with the intrinsic evil of the fetus’ murder is not enough and a deeper understanding of the mother is needed.

It is not hard to see from the above that there is a clear element of violence, abuse, poverty, exclusion and discrimination here and that the disregard for the life of the fetus extends to that of its mother. The victims of abortion, on the part of the mothers include girls and women who are driven to abort by their environment and to do so in ways that are gruesome and potentially lethal to themselves. And there is no shortage of girls and women with names and surnames here who have suffered greatly before, during and after abortion. A high profile case here is that of the nearly 300 Nigerian high school girls - as young as nine years old! - kidnapped by Boko Haram in a single day, who were subsequently raped and impregnated “to create a new generation of fighters.”

Most of the time though, the trauma of sexual abuse and rape does not make the news, and the victims remain nameless. Had it not been for investigative journalism, that would have also been the case for Consolatta Wafula,3 who was raped by a local farmer and politician, a friend of her father and uncle, when she was a teenager. Her rapist arranged for an illegal abortion to be performed, which left Consolatta fighting for her life when she developed sepsis in response to an infection cause by the botched procedure. Subsequently she was arrested for having had an illegal abortion. To pay for bail and continuing medical bills, her family had to sell several of the cows that were their livelihood, as a result of which three out of six of of the family’s children had to stop attending school. Yes, I still believe that the murder of Consolatta’s fetus is inexcusable, but it is part of a much greater tragedy of exploitation, violence and evil, where it is Consolatta and her family who need to be mourned too included among the victims alongside her aborted child.

Looking at all of the above, I can understand why the United Nations speak about abortion in the context of human rights and women’s rights. Its Committee on the Elimination of Discrimination Against Women holds that “laws that criminalize medical procedures only needed by women and that punish women who undergo those procedures” are a barrier to women’s access to health care and discriminate against women. The Committee has also asked for “decriminalizing abortion when the pregnancy results from rape or sexual abuse,” which was further extended by the Maputo protocol’s Article 14 to cover “incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus.”

I still can’t think how aborting a fetus could be justified, but I see how it is morally a far less open and shut case than I thought before, when abortion takes place in a landscape of discrimination, violence, abuse, poverty and a disregard for all human life.

1 St. John Paul II sets out what is meant by “intrinsically evil” in the context of Catholic moral theology in Veritatis Splendor (§80), saying that such acts “are such always and per se, in other words, on account of their very object, and quite apart from the ulterior intentions of the one acting and the circumstances. Consequently, without in the least denying the influence on morality exercised by circumstances and especially by intentions, the Church teaches that “there exist acts which per se and in themselves, independently of circumstances, are always seriously wrong by reason of their object”. The Second Vatican Council itself, in discussing the respect due to the human person, gives a number of examples of such acts: “Whatever is hostile to life itself, such as any kind of homicide, genocide, abortion, euthanasia and voluntary suicide; whatever violates the integrity of the human person, such as mutilation, physical and mental torture and attempts to coerce the spirit; whatever is offensive to human dignity, such as subhuman living conditions, arbitrary imprisonment, deportation, slavery, prostitution and trafficking in women and children; degrading conditions of work which treat labourers as mere instruments of profit, and not as free responsible persons: all these and the like are a disgrace, and so long as they infect human civilization they contaminate those who inflict them more than those who suffer injustice, and they are a negation of the honour due to the Creator”.”
2A corollary of my method is that I will not seek out opinions that I consider to derive from contemptible motives, for the sake of the sport of attacking them, and that I will also apply the principle of charity to the material I do reflect on here.
3 Shown at the top of this post.