Medical Ethics is an area of great concern in the modern age, though several of the issues have been of concern for centuries. Abortion and euthanasia are not new issues, for they were known in ancient times. An early Christian writing, the Didache a text written in 54 CE, condemns it. However, issues pertaining to embryo research are new, as are those concerning transplants. New technology tends to throw up new ethical problems, as human power extends into areas where it was once absent. The central moral question is basically: if I am able to perform an action, why can I not perform it? In the modern world this question might take the specific form of whether or not any advance in technology is morally legitimate. Does the fact that a new technology is developed automatically confer legitimacy on its use?
The answer to the questions above must be in the negative. For example, the atomic bomb was a skilful technology, but it produced great evil and suffering. German firms produced gas chambers for the Nazis, but we would not applaud them for the quality of their technology, however effective or advanced for the time it was. There is no escape from these examples by saying that they are extreme cases; they are, but they clearly exemplify a general principle that developments in technology are not necessarily or per se morally legitimate. Thus it is essential that any kind of technology be evaluated to ascertain whether its use is morally acceptable.
When discussing the question of abortion from the standpoint of religious ethics it is important to emphasise that several moral claims must be taken into account:
1. The mother of the child (and also the father)
2. The child
3. The deity or ultimate reality, however he/she be conceived.
For religious people all life is lived in and under God. Even for Buddhists, who accept no transcendent creator God, there is a moral teaching that leads to a transcendent goal, nirvana, under which all humans are advised to live. Thus at the very beginning of the debate on abortion religious ethics diverges from non-religious ethics, which accepts no supreme deity or transcendent being of any kind. Furthermore, religious ethics believes that the supreme being is not merely one partner in the calculation, but the dominant factor whose wisdom is greater than the wisdom of all others and whose will is more significant than the will of any mere mortal. Hence determining God’s will is the matter of greatest significance in all ethical matters, abortion included.
Religious ethics disagrees with some forms of secular ethics as they are now understood and practised. Currently in secular discourse there is a tendency to reduce questions as to whether to abort or not to “how you feel at the time.” Religious ethics regards this reduction of such significant issues to questions of how someone feels as an inadequate way of looking at the issue. Feelings are fluid and unreliable and as we do not rely on feelings alone in other ethical matters, there is no reason to let them be the sole arbiter of questions on abortion. Religious ethics is apt to operate on clearly understood principles, from whatever source a religion derives them.
Religious ethics will therefore try to ascertain the view of the deity on the question of whether or not abortion is legitimate, or indeed if they believe that there is no personal God they would need to ascertain how abortion fitted in with the overall scheme of life under the supreme reality. For example, a Buddhist would need to determine how the individual’s path to nirvana would be aided or hindered by an abortion, whereas a Christian would want to know how abortion was in God’s eyes. Some religions believe that ethics is derived from God but is somehow inbuilt into the world or into reason. These ethical systems would take a deontological approach and try to examine when the foetus becomes a person and what is its significance before or after that time. Yet they will not rely on a purely secular approach, as Kantian ethics does, because they may draw on religious revelations that are not appropriate within secular ethics.
Activity 54: Consider the following issue. The humanist Ronald Dworkin, an American Liberal professor well-known for his concern over human rights, attempted to resolve the debate about abortion that is ripping through America by proposing the following scheme. He divided a pregnancy into three semesters:
1. The first three months, when there is no great commitment of emotion, time and bodily resources that has gone into a child; during this time abortion is permissible.
1. The second three months, when there may have been some commitment; during this time the legitimacy of abortion depends on the mother.
1. The final three months, when much commitment of time, energy and bodily resources has gone into pregnancy; during this period abortion should be in most cases illegal.
He was attempting to find a common ground on which religious and secular people could agree. Did he succeed? Can religious and secular people ever fully agree on the question of abortion?
The vital question for any discussion of abortion is when does the foetus become a person. At this moment it becomes morally protected from harm and cannot be intentionally killed or harmed. Humanists often determine this moment by reference to viability, the time at which a foetus becomes capable of surviving alone outside the womb. Religious believers argue that the vital moment is ensoulment, when the foetus acquires the soul, the spiritual centre of the self that makes us who we are. This moment cannot be determined with ease, and believers may have to accept that there is no one specific moment at which this occurs in every pregnancy. Even if law specifies a moment of viability, nature may do otherwise. We should only look for so much precision as nature allows, according to Aristotle and, although he was not speaking of abortion, his statement can be usefully applied to the issue.
Views on ensoulment vary. The strictest position is taken by the Roman Catholic Church, which argues that a foetus is ensouled from the moment of conception and that therefore any abortion is killing a person. This was not always the view of the church, because until the nineteenth century many Christians believed that ensoulment took place at quickening, the time when the baby in the womb began to move. The problem with stating that a foetus is ensouled at the moment of conception is that it is impossible to say whether this moment is when the sperm and egg come together or when the embryo implants. Determining the answer to this question matters enormously, as it bears on the question of embryo research. If ensoulment occurs at implantation, the embryo that is not implanted is not a person and can be subject to some experimentation. If it is ensouled from the moment of sperm and egg coming into contact, it is a person and therefore not a proper subject of experimentation of any kind.
Deciding that a foetus at a certain stage is not a person will not necessarily make abortion legitimate, because we still have the problem of determining whether it is legitimate to kill a being that will certainly become a person. We might call these beings potential persons, because we know that if they are left to be born they will live human lives. Whatever the legality of abortion, a human life is being prevented. Preventing a human life from happening is what abortion is about. Secular ethics works on the legal assumption that the moment at which a being becomes a person is the moment at which abortion becomes in most cases immoral. The assumption behind this belief is that abortion is a matter of law. Some religious believers may see the question as a matter of divine law, for example Jews, Christians and Muslims, who have well-developed systems of religious law.
Christianity, however, argues that law is merely a lower stage in religious ethics and that Jesus came to lead humans beyond the law into a life of love. While Christians would therefore have to ask what God’s law requires, they would need to determine the issue of abortion by asking what does love of God and neighbour require of us. The love required of a Christian is not sentimental love, but a way of living one’s life in full recognition of the importance of others. It is a way of directing your life in a selfless manner, going beyond the self into a state when the other becomes fully significant to you. Love, of course, is a general principle, so it must be put into practice in specific circumstances, and it is not always possible to derive absolute rules of conduct from it, but it requires anyone participating in a decision on abortion to ask what love requires of them.
Activity 55: Can an abortion ever be a loving act?
Activity 56: Have fathers any claim in decisions about abortion?
The problems of abortion become quite serious when we are dealing with certain problem cases:
1. Health of mother cases
2. Handicapped foetuses
3. Rape cases.
These cases are problematic because they deal with matters that cannot be reduced to respect for persons and because they deal with situations that are hard to handle and in which only a narrow range of options may be available to us.
1. Health of mother cases
In the extreme scenario we are dealing with a situation in which we have two lives, only one of which can survive. The situation is rarely this extreme, because generally we are dealing with risk to the mother rather than certainty of death. Respect for persons does not provide an easy or straightforward answer here. What is to be done? Secular Ethics is quite clear that the foetus should be aborted so that the mother can be saved. Religious Ethics differs in some cases. Most religions accept abortion if the life of the mother is to be saved, because to ignore her life is to deny her basic rights as a person.
It may also be detrimental to the well being of her other children, should she have any. The Roman Catholic Church argues that a serious attempt should be made to save both lives and that the option that provides the best possible route to this goal should be taken. Christianity has also been known to apply the principle of double effect, developed by the Mediaeval Scholastics and generally accepted in ethics today. This is as follows: if an action has two effects, one good, one bad, you may perform it if your intention is to achieve the good effect, and the good effect outweighs the bad one. In health of mother cases this principle might operate as follows: a pregnant woman finds that she has cancer of the uterus. The uterus must be extracted to save her life, even though the foetus inside will die. The double effect principle is generally taken to indicate that she should have the operation. However, if the child survives there should be reasonable attempts to save its life.
2. Handicapped foetuses
Currently British law allows the abortion of a foetus found to be handicapped up to birth, on the grounds that handicapped people live such unhappy lives that it is reasonable to let those who are responsible for them terminate their pregnancies. Another ground is that looking after handicapped children is very demanding on parents in terms of time and emotional energy to the level that some parents cannot cope. Some parents also fear what will happen to the child when they are gone and feel that it would be better were the child to die before they do.
No major system of religious ethics accepts widespread or easy abortion of the handicapped, because generally they regard the handicapped as having a place in the world. The Indian religions regard the conditions that befall a person in this life as the karmic consequences of actions in their previous life or lives, and as they believe that karma accrues to us all and has to be worked out until all karmic debts are settled, there is a problem with aborting a handicapped foetus, because it will still have to work out its karmic load at some time. Judaism is a religion which has long enjoyed a deep and intricate intellectual life, so a full account of Jewish views on this issue is not possible in this book. Some of the Jews who believe in reincarnation believe that handicapped people may be holy people who have come back to work out the final steps in their path to heaven. They may have returned to fulfil one commandment that they have not fulfilled enough.
On these grounds these Jews would reject the abortion of the handicapped. Christians and Muslims believe that all people have their place in the world, whether handicapped or not, and that each person has a role in God’s scheme or plan, even though we may not know what this role is. They might also argue that, while a handicapped person might find it hard to cope in the fast and demanding capitalist world order of today, this is the fault of the world order rather than the handicapped person, and that it would be right to reform the world so that the handicapped can find it easier to hold a place in it. A Christian view would be that in a world that was run on the principle of love of neighbour the handicapped would have no problems in fitting in, and that it is an injustice to the handicapped to abort them because they do not easily fit into an unjust world. Christians believe that every individual has within them the ability to give and receive love, and that this is the talent that truly matters. Therefore the handicapped are not as lacking in talent as we think they are.
3. Rape cases
It is interesting and significant to note that, while ethics can argue the legitimacy of killing in abortion, euthanasia, war etc, no one can ever think of a situation in which rape would be justifiable. It seems to be one act that can never be justified, and it always constitutes a serious injustice committed against the victim. If the victim becomes pregnant then she has to bear a burden that she did not choose, furthering the injustice.
As a general principle, no one is bound to bear unjust burdens or burdens imposed on them without lawful authority and without due recompense, so there seems to be a prima facie case for abortion. Secular ethics accepts this, and so do many followers of religious ethics. The moral complications will not go away, and we must ask the question of whether or not we are killing an ensouled foetus. In the day or two after rape when the morning after pill might be given it is unlikely that there is an ensouled foetus, so this problem does not arise, but it could arise later in pregnancy. Some thinkers argue that in aborting the child at such a stage you are making it pay for the misdeeds of its father, and that this constitutes an injustice against the child. Certainly, the Christian principle that every child has a place in the world and a part in God’s plan would indicate that an unjustifiable killing is going on, and this is used as an argument against abortion in cases of this kind.
Ultimately we come to the problem of a hierarchy of values and we must decide which is the higher of two values, the mother’s right to bodily integrity or the foetus’ right to life. The former would lead us to accept abortion in rape cases; the latter would not. In normal circumstances the right to life is considered to be amongst the most significant of all rights, because without it none of the other rights could be exercised. But we must ask whether it must take priority in all cases, and if so, in which cases does it fall in importance behind other rights? There does not seem to be a clear way of addressing the question.
If anyone does argue that the foetus’ right to life must always take priority in rape cases they are being consistent in their application of the principle that the right to life has ultimate priority. But they are left with serious residual problems, because the injustice to the mother must still be addressed. Prioritizing one principle does not entitle us to ignore other principles. (Conversely, prioritizing the mother’s right to choose an abortion does not make the foetus’ right to life go away or render it null.) If a society expected a woman to bear a child in such circumstances it must be committed to giving her full support financially and emotionally, and the culprit must take full financial and penal responsibility for his crimes.
Activity 57: Take one of the issues discussed above and weigh the case for and against abortion, making reference to religious and secular ethics.
The final problem with abortion is the difference between what is legally permissible and what is morally right. We often hear individuals demanding that this or that practice be banned, simply on the grounds that they do not believe in it. In effect they wish to have society run according to their conscience and no one else’s. This is a demand for privilege over others. In ideological societies, those run according to one set of values, one group of people has managed to impose its views on others. Liberal Democracies are pluralistic, because they allow an area in which people may live according to their consciences. In these societies coercion is only used to prevent one person’s freedom harming others. The question is whether abortion is a matter of private conscience in which no one may interfere, or whether the fact that it involves taking life renders it a public matter.
Take the following cases:
1. As a religious believer I go to church on Sunday. My neighbours do not. I do not feel that I have any right to coerce them to go to church, because church attendance should be a matter of private conscience.
1. On the other hand, we may encounter someone burning down houses inhabited by ethnic minorities. Even if he/she argues that their conscience tells them that they are entitled to perform this act, we still prevent them, because their conscience is directly impinging on the rights and freedoms of others, preventing ethnic minorities from living safely. This is a matter of public morality.
The question is, does abortion fit into one of these two categories mentioned above, and if not, how are we to categorize it. Might abortions fall between these categories, or might abortion in some cases fall into the one or the other?
One argument that treats abortion as a purely private matter is that the foetus can be regarded as the private property of the mother, to treat as she wishes, as the American feminist Judith Jarvis Thompson believes? This argument is at its root a form of the argument that abortion is a matter of private conscience, though phrased in a peculiar form. The property argument has certain difficulties about it. Firstly, Thompson is not making distinctions between owning an object and owning a living being. I can smash up my shed if I want to, as it has no mental life, but can a person torture their dog?
We would think not, because we cannot own an animal as we own an inanimate object. As a foetus is a living thing Thompson’s argument is problematic. Secondly, it applies an American understanding of property to an issue of worldwide significance. The notion of exclusively private property is a very capitalistic notion, and not everyone is so capitalistic. Not all societies regard property as a purely private matter, because they believe that much private property has a public dimension. For example, I own some land, but society obliges me to maintain it, and I certainly have no right to poison it. Thirdly, believers in God argue that God is the absolute owner of the world and all that is in it. Thus in religious ethics property claims can never overrule God’s rights or permit anything that he does not.
All claims that abortion is a purely private matter and therefore a matter of choice (e.g. a woman’s right to choose) rest on the belief that there is a certain area of life that is properly beyond the reach of the state. In this view the womb would be a private space belonging only to a woman. How do religious ethics regard this claim? Certainly there is a credible case to be made for the statement that the state’s reach is limited and that its laws cannot intrude beyond a certain point.
If there is to be any sense at all to the idea of freedom there must be areas of life beyond the proper scope of the state. Yet religious believers would also argue that God is above all rules and that there is no area of life that is not subject to him. The implications of this idea are that while the law of the state may be limited in its reach, the moral law is not. This might lead us to the conclusion that in some cases abortion may be permissible in law but not, according to religious ethics, moral. Religious believers would therefore have to ask themselves how far they could work to ban abortion. Might they not feel that at a certain point they must leave the matter to individual conscience? Some religious believers accept this position, but there are others who argue that abortion can never be a matter of private conscience because a life is being wrongly taken.
Activity 58: “Abortion is a matter of personal choice and no one ought to interfere with it. It is a matter of private conscience.”
“Abortion involves taking a life, so it can never be a purely private matter. Aborting a foetus is murder.”
“At a certain point in time abortion becomes murder and therefore a public matter, but until this point it is a matter of personal choice.”