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Buddhism and Abortion

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Buddhism and Abortion 424 Book reviews J Med Ethics: first published as 10.1136/jme.25.5.424 on 1 October 1999. Downloaded from of the unborn patient is the phrase Postgraduate Medical Dean, University of abortion rate in Korea is very high used here to describe the introduction Bristol and General Secretary, Institute of (partly driven there by son prefer- of treatment primarily directed at the Medical Ethics ence). Moreover the rate among Ko- fetus. rean Buddhists is as high or higher Early in the book the author states: than that of the rest of the population. "it is a key goal ofthis book to reframe Buddhism and However, only rather recently have fetal surgery as a women's health issue Abortion Korean Buddhists begun to express a and to re-situate fetal personhood concern for aborted fetuses and de- within the specific relationships in and mand Edited by Damien Keown, London, memorial services for them, by which it is produced". This per- though of a distinctively Korean form. Macmillan, 1998, 222 pages, spective results in questioning much £45. Part three begins with a review by of the practice of fetal surgery, but McDermott of This interdisciplinary collection James the ancient Pali whether this perspective is shared by of textual sources on nine essays is a welcome and abortion, which expectant mothers is debatable. pioneer- it for as a ing attempt to explore the abortion regard (especially monastics) The book documents the period serious breach of the Buddhist precept from the start of intrauterine transfu- question from a number of Buddhist life. ethical and cultural perspectives. The against taking James Hughes's sions for Rhesus disease in 1963 succeeding essay, however, suggests through to the present, describing new book is divided into three parts. Parts that modern Western Buddhists do one and two are developments in intrauterine surgery area studies focused, not need to follow these ancient texts and respectively, on Thailand and other therapies given to the Japan/ slavishly. Instead Hughes favours a mother but designed to benefit the Korea. Part three is concerned with Buddhist blend of utilitarian and fetus in textual and utero. normative issues. virtue ethics, a "paradoxical unity of Describing in utero procedures, the The first chapter, by Robert compassion and wisdom", which author uses powerful language. Exam- Florida, provides a very useful intro- would allow abortion where the inten- ples include: "the new practice fasci- duction both to some basic Buddhist tion is and the act nates and compassionate horrifies because it trans- ethical principles, including the tra- achieves the best outcome for all con- gresses a number of medical and ditional prohibition on taking life, and cerned. cultural boundaries".... "breaches to the the current legal situation in The concluding essay by Damien womb in new and copyright. unsettling ways".... Thailand, a Buddhist country with an Keown takes a more conservative line. "makes us rethink some of our most abortion rate 50% higher than the US cherished Keown is sceptical of claims that Bud- assumptions about life and figure for the equivalent number of dhism can the natural body"..."inspiring wonder offer a "middle way" on citizens. Cleo Odzer's succeeding abortion that steers a course between and concern about our capacity to chapter on Thai prostitutes, however, alter human destiny".... "This book "pro-choice" and "pro-life" extremes. surprisingly reveals that while married To this end he himself to the offers a critical social and cultural women in Thailand regularly seek helps analysis of this nascent yet significant dubious assumption that any such abortions, prostitutes do not. Pinit proposed Buddhist middle way must innovation in biomedicine" ..."foetal Ratanakul's chapter adds http://jme.bmj.com/ further be "distinctly or uniquely Buddhist" surgery is not by any means 'old stuff information on the Thai context especially in terms of its social and (page 202) before going on to make (including the increasing number of some conceptual heavy weather of political consequences. It is medicine abortions of HIV positive fetuses), without boundaries, cowboy surgery what the phrase "middle way" might advocating a Thai "middle way" mean here (surely just a position that on what is considered, at least for now, which acknowledges that sometimes the final frontier." gives full moral weight to both the abortion may be the lesser evil. value of choice and the value of life). The introduction of intrauterine Part two includes two essays on the transfusion in the Keown's central objection, however, is early 1960s was the Japanese practice of mizuko kuyo, a on September 28, 2021 by guest. Protected first direct intervention aimed at the that the Pali textual tradition, particu- Buddhist memorial service for larly its monastic code, unequivocally fetus, and the social and ethical issues aborted children. The first of these is are discussed. From this beginning, commits Buddhism to an exception- an excerpt from William LaFleur's less pro-life position (his evidence for the number of intrauterine interven- acclaimed 1992 book, Liquid Life, tions that can be carried out has the textual claim is not presented here, commending this Japanese response but in his 1995 book, Buddhism and markedly increased, and in specialist as one from which the West might centres operations may be performed Bioethics). Hence the only viable Bud- learn. LaFleur suggests it is an inter- dhist middle way on the issue is one on the fetus which is then returned to esting exemplar of the way in which the womb. Inevitably, such procedures between the extremes of vitalism (the Japanese "societal pragmatism" has doctrine that life is an absolute value have a profound effect on the mother, achieved a consensus on abortion, when the direct benefit (if achieved) is to be preserved at all costs) and "qual- forefronting the need for a solution ity of life" utilitarianism. It is notewor- to the fetus. However, most mothers without tearing the social fabric apart. would probably want such surgery to thy how far Keown's fundamentalist The second essay, by Elizabeth Harri- understanding of the authentic Bud- be undertaken. son, presents some of her research on The author provides an interesting dhist position on abortion is from that lay participants' perceptions of the of so many modern Asians and and partisan review of the develop- ritual and the way in which it fulfils a ment of intrauterine interventions to Westerners who count themselves number of important social and psy- Buddhists, including some ofthe other aid the fetus, and draws attention to chological functions for Japanese new ethical situations. These will need contributors to this volume. women. In the third essay in this Although all of the essays included thoughtful analysis and debate in the section Frank Tedesco a years to come. provides in the volume are interesting and good deal of new information about informative, there are obvious lacu- RICHARD WEST the situation in Korea. As in Japan, the nae. Indeed the editor himself disarm- Book reviews 425 J Med Ethics: first published as 10.1136/jme.25.5.424 on 1 October 1999. Downloaded from ingly admits some of these (page 8): concerns which affect the CAM rela- Weitzman, in his chapter on insur- nothing on Tibet, nor on the Therava- tionship, which is essentially subjec- ance coverage, by way of contrast, din tradition in Sri Lanka or Burma, tive, holistic and intuitive, are very dif- takes as his starting point the much nor on Cambodia, Vietnam or China, ferent from those arising in an quoted findings from a 1993 survey nor on feminism. However, his de- orthodox relationship which is, char- that nearly one in three of the popula- fence of these shortcomings is weak: acteristically objective, symptom- tion in the US used some form or namely, that these just reflect the lack based and rational. When considering other of CAM therapy, spending of research to date into these areas. In beneficence, for example, "healing" in $13.7 billion out of their own pockets fact there already exists published the CAM sense takes on a much for services not covered by health work on Tibetan perspectives that broader definition, referring to im- could have been reprinted, and further plans. Patel's chapter, "Understanding provements which can occur on an the integration of alternative modali- work on all of these areas presumably emotional, psychological or spiritual could have been commissioned. Fur- level, without the patient necessarily ties into an emerging healthcare thermore, as Keown does not specifi- being cured of specific disease symp- model in the United States", provides cally acknowledge, the volume is also toms. a thoughtful analysis of what integra- weak on philosophy. Obviously, there Alternative Medicine and Ethics is tion might mean in practice and what already exists in the West a very large certainly a useful starting point for might be lost by forcing CAM thera- body of rigorous philosophical discus- debate. This multi-authored text in- pies, which traditionally offer a com- sion on the issue of abortion, critically cludes thought-provoking chapters on passionate, caring and humane ap- examining the rationality of the moral orthodox practitioners as gatekeepers proach, into the environs of orthodox and non-moral judgments that sup- to CAM, insurance coverage for medicine. In doing so, he poses critical posedly justify various stands on the CAM, and ethical and legal dilemmas questions about how the Cartesian/ matter. It is regrettable that this surrounding prayer as a method of Newtonian biomedical model can be volume includes no sustained attempt alternative healing for children. Al- reconciled with the mind-body phi- to engage with Buddhist views on though written from an American losophies underpinning CAM thera- abortion from that disciplinary per- perspective, the issues are extremely pies.
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