'New Ethics of Abortion'?
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J Med Ethics: first published as 10.1136/jme.27.suppl_2.ii5 on 1 October 2001. Downloaded from Journal of Medical Ethics 2001;27 suppl II:ii5–ii9 Is there a ‘new ethics of abortion’? Raanan Gillon Imperial College, London Abstract being? The answers to these questions are not pri- This paper argues that the central issue in the abortion marily moral answers, though of course they have debate has not changed since 1967 when the English major moral implications. Overwhelmingly moral parliament enacted the Abortion Act. That central communities do not doubt that to kill a person, at issue concerns the moral status of the human fetus. The least if he or she is not an aggressor, is, as stated debate here is not, it is argued, primarily a moral above, a morally terrible action. They agree that debate, but rather a metaphysical debate and/or a people should be protected against such killing by theological debate—though one with massive moral acceptance by all moral agents that every person implications. It concerns the nature and attributes that has a moral and legal right to life. What they disa- an entity requires to have “full moral standing” or gree about is the scope of that obligation—just what “moral inviolability” including a “right to life”. It sorts of entities are persons in this sense, and why? concerns the question when, in its development from Conversely what sorts of attributes manifested by newly fertilised ovum to unequivocally mature, any entity would/should ensure that it is acknowl- autonomous morally inviolable person does a human edged to be a person and have full moral standing being acquire that nature and those attributes, and including a right to life? These are primarily meta- thus a “right to life”. The paper briefly reviews physical and/or theological issues rather than standard answers to these questions, outlining some directly moral issues, and people of moral integrity problems associated with each. Finally there is a brief can and do come to carefully thought out but discussion of one way in which the abortion debate has widely diVerent conclusions without in any way changed since 1967—notably in the increasingly undermining that moral integrity, without in any vociferous claim, especially from disability rights way being “wicked” -or stupid– points that those sectors, that abortion on grounds of fetal abnormality who are inclined to impugn the morality or intelli- implies contempt for and rejection of disabled gence of those who oppose them on this issue people—a claim that is rebutted. should bear in mind and take to heart! A variety of standard positions have emerged (Journal of Medical Ethics 2001;27 suppl II:ii5–ii9) over the centuries. At one end of the spectrum is the Keywords: Abortion; moral status of fetus; abortion of fundamentalist stance that claims either that the http://jme.bmj.com/ abnormal fetuses newly fertilised human ovum is a human person from the moment of conception, or at least that it must be treated as such even if we cannot know Killing another person if that person is a non- precisely when in its subsequent development it aggressor is regarded as a morally terrible action in becomes “ensouled”—roughly speaking the theo- most moral communities, which have major moral logical equivalent of becoming a “person” as and legal prohibitions and sanctions against such defined above. The latter position is the position of killing. Far fewer moral communities have similar the contemporary Roman Catholic Church as attitudes and prohibitions against killing all living expressed in its 1974 Declaration on Abortion by the on September 28, 2021 by guest. Protected copyright. beings and most cultures are willing to kill some Roman Congregation for the Doctrine of Faith1 and is living beings for food and for use of their skins and shared by some other faith communities. A little for other benefits such as the advancement of further on from the “moment of conception” medicine. But what of the human being as it devel- stance is the 14 days stance, developed by the War- ops from newly fertilised ovum, to pre-embryo, nock Commission in the UK when it was consider- embryo, fetus, new born baby, to unequivocally ing in vitro fertilisation.2 Here development of the mature autonomous person with full moral stand- “primitive streak”, at 14 days, was determined to be ing including a moral and legal right not to be killed the cut oV point after which research on, followed at least if he or she is not an aggressor? When and by destruction of, human embryos was to be on what basis during that development does the prohibited—a cut oV point subsequently enshrined unequivocally living human being acquire the in the Human Fertilisation and Embryology Act, moral status of a living human person, here used 1990. Although the Warnock commission pro- simply as a shorthand for a human being of full duced little justification for its choice of 14 days, moral status (of the sort all readers of this paper this was subsequently defended in depth by the uncontroversially ascribe to each other) including a Roman Catholic philosopher Norman Ford, who right to life, again here used as a convenient short- argued that the primitive streak stage marked the hand for the right not to be killed if not an aggres- true formation of a new living individual with a sor. Conversely, when, if at all, and why, is it morally human nature.3 This occurs after a two-week devel- justified to kill (“abort”) the developing human opmental process that follows fertilisation, within www.jmedethics.com J Med Ethics: first published as 10.1136/jme.27.suppl_2.ii5 on 1 October 2001. Downloaded from ii6 Is there a ‘new ethics of abortion’? what he dubbed the “proembryo” and what Mary Full moral status from conception or soon Warnock called the “pre-embryo”. afterwards Interestingly St Thomas Aquinas, one of the First the standard Roman Catholic “moment of greatest philosophers of the Roman Catholic faith, conception” stance—which for reasons of space I proposed (following, as he often did, an Aristotelian shall here assimilate to the oYcial Roman Catholic lead) that ensoulment or “hominisation” did not 4 stance that while we cannot know when ensoulment occur until 40 days for boys and 90 days for girls. or hominisation occurs, we must behave as though A traditional distinction has been that of it occurred at conception so as to prevent the “quickening”—the time at which the pregnant dreadful sin of killing an innocent ensouled human woman can feel her fetus move inside her (generally being or human person. There are two main prob- around 20–21 weeks in a first pregnancy, often sev- lems with this position—as with the Ford’s eral weeks earlier in subsequent pregnancies)— unorthodox Roman Catholic view that the human undoubtedly a time of great emotional significance person begins at 14 days: first why should we for the pregnant woman. believe that a single cell or a clump of cells is a per- Moving along the developmental spectrum, son, with the same level of moral importance as we “brain life” (the development of a functioning readily acknowledge each other to have? Second are brain),5 and the development of the ability to have we prepared to accept the implications of this experiences, including sensory experiences (sen- stance for medical practice—for example that we tience)6 have also been proposed as criteria for dif- should refuse to permit not just all abortions and all ferentiating the “fully fledged” human person with in vitro research on human embryos but also even full moral status from the developing human being postcoital contraception, since this works in part by that lacks a right to life. Estimates of the onset of a preventing a newly fertilised ovum from implanting capacity for sentience vary but 20–24 weeks are into the lining of the uterus? commonly proposed. Now sometimes the first objection is met by the A technological criterion favoured among many argument from potential. There are two versions of doctors working in neonatology and also in gynae- this. The first is what might be dubbed the ordinary cology is the concept of viability—the stage of fetal language version. According to this version, of development at which the fetus can survive course the newly fertilised ovum and early embryo independently of the pregnant woman, given does not have the attributes of a person—it can’t suitable intensive care.7 This seems to be a steadily think or reflect or imagine or experience, or do reducing period but is currently around 20–22 things for itself. But it has the potential do all those weeks. things, it has in short the potential to become the The legal criterion in most jurisdictions is birth,8 wonderful being that we fully fledged human beings when the human fetus becomes a legal person, and are. It should therefore be valued and respected for certainly this corresponds with an enormous that potential and be accorded the same moral sta- psychological change in all involved with the tus and protection that we accord each other. The http://jme.bmj.com/ newborn baby—here it is, a new human being join- problems with this version of the argument from ing the human community. potential is that we don’t normally, let alone neces- Finally some argue that even at birth a baby is not sarily, accord the same value to x which has the yet a person, that a necessary attribute for being a potential to be y as we accord to y itself.