Ethical Issues of Abortion by F.R. Abrams MD

I have been asked to consider the ethical issues of abortion. Knowing there are many different ethical views, and that they continue to be debated despite centuries of contention, I had to choose which of them I could express in less than ten minutes. Ought I speak about what we ought to do—technically that’s called “normative” ethics? Or, should I approach the most frequent behavior of a particular group—doing what most of them think is right—that’s defined as the “moral” view. Then again, on the issue of abortion, that definition is itself a paradox, because many people who think abortion is wrong nevertheless make that choice!


So I decided to do away with labels, because so many people involved in the abortion debate intermingle legal, religious and secular starting points on abortion. Then they end up at loggerheads because you can’t debate logically if you start from different basic assumptions. Although religious doctrine was the basis of many laws, it is clear that religious considerations in the US decidedly did NOT produce the Supreme Court’s original Roe v. Wade decision. Roe v. Wade was first to define the conditions and limits nationally for legally acceptable abortion. At least for the moment, basic abortion law remains predominately in the secular sphere—but obviously not without ongoing vigorous dissent from many groups.


Where do the heated arguments—or even calm and rational arguments—diverge? In many traditional societies, even within parts of the United States, male relatives are still in control of a woman’s sexuality until they pass the responsibility on to a husband. A frequent ceremonial marriage question remains, “Who gives this women to this man?” It’s an echo of the transfer of property, usually from the father to a new “owner.” This evolution of strict control must have originated because a man had to be certain he was investing his wealth and energy in his own genetic offspring—that the kid really was his! But nowadays, most of the objections come from viewpoints usually categorized as religious. Some religions allow abortion, but usually under very specific and limited conditions, but it is when religious and secular views conflict, that’s when most arguments are initiated.


Certain people against abortion declare that the fetus has—or should have— the same personhood rights as adult citizens, but these advocates seem to disregard the geography. By that I mean, they seem to ignore the obvious—that fetuses occupy space inside a uterus that is inside a women who has a great investment in her own personhood.


Who has a right and where does it come from? People who say, “I know my rights,” usually don’t. No one actually has a right unless there is a method to enforce it. What is autonomy and who has it? Autonomy, in medical ethics, means self-determination. I doubt there ever will be a time that everyone will agree that a woman’s autonomy overrides a fetus’s right to life. Are there concerns of the state that are so important to society that they may prohibit personal behavior? Recall that it was not many years ago that in Georgia a male couple was jailed for the then crime of sodomy. It was several more years before that decision was reversed. Now, on the contrary, we endorse such personal behavior nationally. The same-sex couple may marry! If courts representing society have made it clear that they ought not be involved with private consensual sexual relations between persons, should they interfere with other private personal decisions?


And now, because pregnancy is a process that usually takes many months, legislators and courts have begun to decide that the stage of the pregnancy is important in permitting abortion. At least part of the question is—when is each fetus sentient—that is, aware of pleasure or pain? That’s an issue that continues to be debated, and probably will never, nor can ever be settled for any individual fetus.


No doubt many of you have read the latest Guttmacher report, noting that the abortion rate has reached its lowest point since 1973, about 17 per 1000 women of reproductive age, nationally. Colorado’s rates over the years have usually been below national rates. In recent Guttmacher studies of those who sought abortion, less than 0.5% pregnancies were a result of incest and 1% only were victims of rape.


All of the other major reasons ranged from concern that pregnancy would cause dramatic changes in life plans—such as education, career or else interfere with the needs that their current children had (61% had children)—or economic straits made a baby unaffordable, or single motherhood was unfeasible (45% were unmarried and not living with anyone). Further reasons given for abortion included the woman’s unwillingness to make a pregnancy known, or she felt she was not mature enough to raise a child, or she was unable to leave a job to raise a baby.


So, what makes a dilemma? A dilemma is a choice in which none of the outcomes are indisputably and totally good or bad. It is a situation that demands a choice in which some good will be accomplished while some bad will be perpetuated. That is why medical ethics is often described as “the logic of tragedy.” Medicine is a shades-of-gray discipline because it does not readily polarize into the black or white categories that the law demands. So, if we are concerned with the ethics of abortion, those who support abortion are fortunate because currently, it’s primarily in the black or white realm of law. But there are continuing challenges, some of which have achieved successful abridgments of the right.


From the point of view of ethics, indeed abortion is a dilemma. Why? Not because of the disparity between how behavior ought to be, versus behavior as it actually is. Abortion is a dilemma not because of any philosophical dispute or misunderstanding, but rather because of the beliefs of some persons who find that abortion is a human failure that is beyond their tolerance or forgiveness—and that is impossible to reconcile with the beliefs of other persons that do recognize and try hard to forgive human fallibility and its sometimes unfortunate consequences.

I suspect there are people who always write with a pen, but others appreciate the acquired wisdom of pencil manufacturers. They provide one blunt end to sharpen for writing, but after mature reflection they have learned they must provide erasers on the other end to account for inevitable human error. (1085wds)


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