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Answering Three Common Arguments for Abortion

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Filed under Morality

Pregnancy

NOTE: The following post, the second of two from Trent Horn, is excerpted from a new book he will publish in September defending the pro-life position. Read the first post here.


 
In Part 1 of this short series, we saw that there isn’t a way to consistently define what a “person” is that includes newborns but excludes fetuses and non-human animals. In this post I will examine “body-rights” arguments for abortion that take advantage of the difference between newborns and the unborn in terms of the use of the mother’s body during pregnancy. These arguments either admit the unborn are persons or say the question doesn’t matter and merely assume the unborn are persons for the sake of the argument.

There are really two arguments in this vein and I believe neither works.

The “Sovereign Zone” Argument

 

“Women have the right to have an abortion because women (and men) have the right to do whatever they want with their bodies, or at least, do whatever they want to whatever is inside of their bodies.”

The problem with this argument is that the premise (complete bodily autonomy) is more controversial than the conclusion (abortion should be legal). How do we know we have complete bodily autonomy? This argument is on par with saying, “Slavery is moral because is have the right to own anything I want.” Just as we should be skeptical of the premise “I can own anything” we should be skeptical of the premise “I have the right to do whatever I want with my body.”

The pro-choice philosopher Mary Anne Warren writes,

“The appeal to the right to control one’s body, which is generally construed as a property right, is at best a rather feeble argument for the permissibility of abortion. Mere ownership does not give me the right to kill innocent people whom I find on my property, and indeed I am apt to be held responsible if such people injure themselves while on my property. It is equally unclear that I have any moral right to expel an innocent person from my property when I know that doing so will result in his death.”1

The U.S. Supreme Court even rejected this argument in Roe v Wade. Justice Blackmun wrote,

“In fact, it is not clear to us that the claim asserted by some amici that one has an unlimited right to do with one’s body as one pleases bears a close relationship to the right of privacy previously articulated in the Court’s decisions. The Court has refused to recognize an unlimited right of this kind in the past.”2

I can’t think of any other right that is absolute in the way that defenders of the sovereign zone argument claim the right to control one’s body is absolute. No one has an absolute right to free speech; we ban shouting “Fire!” in a crowded building when there is no fire. No one has the absolute right to engage in illegal religious activities under the guise of “freedom of religion.” Laws against illicit drug use, prostitution, selling organs, public urination, and indecent exposure show there is no absolute right to do anything we want with our bodies.

In fact, all it takes to refute this argument is one example that shows we cannot do whatever we want with our bodies. If that principle is refuted, then so is the sovereign zone argument. Here’s one thought experiment that I think shows we do not have unlimited bodily autonomy over that which lives inside of us.

If it is possible to remove a late-term fetus and keep him alive in an incubator, then, theoretically, if the technology existed, one could take a premature infant from an incubator and transfer him into a woman’s uterus. Nearly everyone agrees that it would be wrong to kill the child in the incubator. But according to the sovereign zone argument, it would not be wrong to kill that child after he was transferred back into the sovereign zone of the womb. It is ridiculous that an infant could be treated like a human being in one location (the incubator) and like disposable property in another (the uterus).

Finally, the argument admits that the fetus is a person who, by the argument’s own logic, has a right to bodily autonomy. If we would respect the bodily autonomy of a sleeping or unconscious born person by not killing him, then wouldn’t we bound to treat an unborn child in the same way because they too, as a person, have a right to “bodily autonomy?”

Regardless of the status of unlimited bodily autonomy, the sovereign zone version of the bodily rights argument fails to support legal abortion.

The “Right-to-Refuse” Argument

 
This version of the argument says that maybe you can’t do anything you want with your body, but you have the right to not let your body be used as life support in order to keep another person alive (such as the refusal to donate bone marrow to save a dying person).

The biggest problem with this kind of argument is what’s called the responsibility objection. In the case of a stranger who will die unless I donate blood or bone marrow, I am not obligated to help him, because I was not involved in how he became ill. But if I caused another person to become dependent on me, then I would owe him assistance.

Here’s an analogy that might help illustrate what I mean. Imagine a replicator machine that can create any kind of object. If I activate the replicator, there is a high chance that the machine will dispense $10,000. There is also a chance that along with the money the machine will dispense a healthy newborn infant.3 If you could find no one else to care for this child, you would become the guardian or “parent.”

Why? Because you engaged in an act that you knew could create a helpless human being, and now that human being stands in need of your assistance. Abandoning this infant to die would simply never be tolerated. Michael Tooley argues in his book defending the morality of both abortion and infanticide:

". . . the anti-abortionist can argue that although people in general may be under no moral obligation to allow the fetus the use of their bodies, even when it is necessary if the other individual is to survive, a pregnant woman is, in general, under a moral obligation to allow the fetus the use of her body, since she is morally responsible for there being a fetus that stands in need of a life support system.”4

While the replicator is a science fiction example, we can also use the rare though real example of women who do not know they are pregnant until they give birth. If the autonomist believes that we have no obligation to the children we create, then there is no reason a mother who unexpectedly gives birth to a child in a field could not simply leave the child there.

Suppose a woman lived in a country where abortion was illegal or she could not afford to pay for an abortion. Upon giving birth at home could she simply abandon the child or “refuse to provide life-giving bodily aid” in the form of breast milk? If this woman does have a responsibility to care for this child because she was responsible for his existence, then it follows she would be responsible for that same child when it came into existence at conception and abortion would be morally wrong.

I’ve heard arguments in response to this objection that say engaging in sex doesn’t “cause” pregnancy because not everyone who has sex becomes pregnant. The critic also says that there are many factors outside of a woman’s control that influence whether she becomes pregnant so we can’t say she “caused” a child to come into existence that needs her help when she chose to have sex.

But that is like saying that drinking large quantities of alcohol and driving doesn’t cause pedestrians to be hit by drunk drivers because some people drink and drive and no one gets hurt. Furthermore, there are also factors outside of the driver’s control that affect whether a person gets hit (like whether other people are on the road or not). Therefore, we can’t say drunk drivers cause drunk driving fatalities.

Hogwash.

Drinking alcohol impairs a person and initiates a chain of events that is likely to lead to traffic fatalities. Even if the person took measures to avoid getting into an accident (e.g. playing the music loudly, rolling the window down) he or she is still responsible for the fatality that was caused.

Finally, this response would make it futile to collect child support from deadbeat dads since they could always claim that they aren’t truly “responsible” for the children they sired since they didn’t intend to have those children when they chose to have sex. If we expect men to be responsible for children they create (intentionally or unintentionally) through intercourse, then shouldn’t women be held responsible for the children they create through intercourse as well?

The Organ Use Objection

 
“But,” says the critic, “What if the traffic victim needs your blood, or your own child needs a bone marrow transplant that you knew would be required before they were conceived? Are you obligated to donate your body in those cases?”

Here is where another important difference arises between pregnancy and these cases. In organ donation cases, I use a part of my body that was not made for the sick person in order to keep him alive. I am resorting to extraordinary means to save him, since the purpose of my kidneys, for example, is to filter my own blood and not anyone else’s. By my withholding the use of my kidneys, the sick person dies. But I am not the cause of his death; I have merely chosen not to save him. Is abortion a similar act of withholding an extraordinary use of an organ?

Even in a nonreligious framework it makes sense to say things like, “The purpose of the heart is to pump blood” or “The purpose of the lungs is to absorb oxygen.” Some people may deny that our organs have any “purpose” or are “for” anything, but I don’t think they would hold that attitude should their own organs become damaged or infected. In order to say an organ isn’t working properly would seem to imply that the organ has a proper way of functioning, or a “purpose” or “end” in its operations that is not being achieved.
 The uterus’s purpose seems clear: to support the life of an unborn child. Otherwise, why is it even inside the body at all? If the uterus is designed to sustain an unborn child’s life, don’t unborn children have a right to receive nutrition and shelter through the one organ designed to provide them with that ordinary care?5

Unlike in the organ donation cases, where I fail to save someone who is dying, abortion involves separating a healthy child from what it requires to live. Abortion is not an act of “failing to save” but is an act of killing that deprives a child of its right to live safely.6 It is on par with putting your infant out in a snowstorm that directly kills him and does not “fail to save (him) from an environment in which (he) cannot survive.”

A critic may object that pregnancy is not “ordinary care” because it causes the woman’s body to undergo extraordinary and uncomfortable transformation. But it is a transformation toward which women’s bodies are naturally ordered. Puberty also involves large-scale and uncomfortable changes to the body, but no one says puberty is an “extraordinary” event on par with organ donation (indeed, it would be extraordinary if it did not happen).

Likewise, throughout all of human history, fertility and pregnancy were considered ordinary events, and anyone reading this page was involved in such an event. Providing shelter and nutrition in the womb is simply an ordinary amount of care (even if at times it can be painful or uncomfortable) that we expect parents to provide to their unborn children.

Conclusion

 
I think I’ve shown that there are no morally relevant differences between humans before they are born or can survive outside of the womb and humans just after they are born. As one child development book puts it, “The fourth trimester [the three months after birth] has more in common with the nine months that came before than with the lifetime that follows.”7

We therefore should either treat newborns like fetuses and make it legal to kill them simply because they are unwanted, or we should treat fetuses like newborns and make it illegal to directly kill them because they are unwanted.
 
 
(Image credit: Tribune News)

Notes:

  1. Mary Anne Warren, “On the Moral and Legal Status of Abortion” The Monist, 57, no. 4, 1973.
  2. As examples of this refusal Blackmun lists Jacobson v. Massachusetts, 197 U.S. 11 (1905) (vaccination) and Buck v. Bell, 274 U.S. 200 (1927) (sterilization).”Roe v Wade 410 U.S.113 Section VIII.
  3. Scott Klusendorf, The Case for Life (Wheaton, IL: Crossway Books, 2009), 195. Keep in mind that I don’t use this illustration to mean that women are just “baby-making machines.” It’s an analogy.
  4. Michael Tooley. Abortion and Infanticide (Oxford: Oxford University Press, 1983) 45.
  5. See also Stephanie Gray, “A Kidney versus the Uterus” Ethics & Medics 34 no. 10 (October 2009).
  6. This is also known as the “killing vs. letting die” objection, which I have subsumed into the “organ use objection.” Under my view, denying someone the extraordinary use of an organ in order to keep them from dying from an unrelated ailment is a moral case of “letting die” while denying someone the ordinary use of an organ they need to survive is an immoral case of killing.
  7. Susan Brink. The Fourth Trimester: Understanding, Protecting, and Nurturing and Infant through the First Three Months. (Berkeley: University of California Press, 2013).
Trent Horn

Written by

Trent Horn holds a Master’s degree in Theology from the Franciscan University of Steubenville and is currently an apologist and speaker for Catholic Answers. He specializes in training pro-lifers to intelligently and compassionately engage pro-choice advocates in genuine dialogue. He recently released his first book, titled Answering Atheism: How to Make the Case for God with Logic and Charity. Follow Trent at his blog, TrentHorn.com.

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  • Chee Chak

    Right to refuse argument.This version of the argument says that maybe you can’t do anything you want with your body, but you have the right to not let your body be used as life support in order to keep another person alive.

    In principle I don't think anyone can seriously argue that the law should be allowed to compel anyone to cede their rights in this matter. Trent has come up with all sorts of imaginative hypothetical scenarios and what if's, that only manage to obfuscate and cloud the discussion of the main issue. The issue essentially being what rights under law should a foetus have. That is what society, bioethicists and the law have to come to terms with.When the law grants the same human rights as anyone else, to an embryo or foetus under international law then I for one will be opposed to abortion as the law stands, except in only the most extreme cases where one or both "persons" are in imminent danger of extreme health risk or death.

    • David Nickol

      As your imply, when arguing about abortion, two aspects—the moral and the legal—are often intermingled. I think it is perfectly possible to consider abortion immoral and still maintain it should be legal. No one has ever seriously argued that everything immoral should be illegal.

      • "No one has ever seriously argued that everything immoral should be illegal."

        I agree. And I think most people, outside of extreme proponents of theocracy, would agree.

        "I think it is perfectly possible to consider abortion immoral and still maintain it should be legal."

        That depends on what abortion is. If abortion is simply the removal of impersonal cells, then sure. But if abortion involves the intentional murder of a human person, then we can't just say, "I think it's immoral but should also be legal."

        The purpose of law is to ensure the life, liberty, and flourishing of its citizens. Abortion directly undermines that if, as Trent and millions of others propose, it involves killing an innocent child.

        Correct me if I'm wrong, but I don't think you'd agree to any of these statements:

        "I think it is perfectly possible to consider rape immoral and still maintain it should be legal."

        "I think it is perfectly possible to consider torturing children for fun immoral and still maintain it should be legal."

        "I think it is perfectly possible to consider immoral and still maintain it should be legal."

        But why not? Where do you draw the line of legal permissibility, and why should abortion fall on one side but not the other?

        • David Nickol

          That depends on what abortion is. If abortion is simply the removal of impersonal cells, then sure. But if abortion involves the intentional murder of a human person, then we can't just say, "I think it's immoral but should also be legal."

          I almost agree with what you say here, but the point is that I don't think it can be said with certainty that abortion is the intentional murder of a human person. As I have noted, Judaism does not consider abortion to be equivalent to murder, because full personhood begins at birth, not at conception. And of course many people would say, based on philosophical arguments, that before a certain stage of development, an unborn child is not a person and therefore cannot be "murdered."

          So the question becomes whether, in a pluralistic society, it is acceptable to legally define conception as the moment when personhood begins when doing so is essentially using religion (or philosophy) to bind all by the beliefs of only some.

          Of course, I am reasonably certain that even if Roe v. Wade is overturned, no state will pass a law prohibiting abortion on the grounds that it is equivalent to murder. I believe six states currently have "trigger laws," intended to go into effect the moment Roe is overturned, that criminalize abortion, and none of them classify abortion as homicide.

          It is hypocritical, in my opinion, for pro-life advocates to claim that abortion is murder and yet insist that women should not be held legally responsible for procuring abortions. Mother Teresa said, "But I feel that the greatest destroyer of peace today is abortion, because it is a war against the child, a direct killing of the innocent child, murder by the mother herself. And if we accept that a mother can kill even her own child, how can we tell other people not to kill one another?" A law criminalizing abortion as murder that did not hold the mother responsible in some way for procuring and abortion would tell a mother that although abortion is murder, she is free to murder her own children and pay no penalty for it. All society wants to do is make it difficult for her to find someone to perform the abortion.

          If people want to argue that abortion is murder, they should have the guts to deal with it as murder, and that means holding women who procure abortions just as legally responsible as women who arrange and pay for the murder of their "post-born" children. There may, in certain cases, be such extenuating circumstances that a woman who procures an abortion should not be punished for murder, but that is the kind of thing that—if abortion really is murder—should be decided by juries.

          • "I almost agree with what you say here, but the point is that I don't think it can be said with certainty that abortion is the intentional murder of a human person."

            Why not? If a human person isn't created at the moment of conception, when do you believe it happens?

            If you're answer is, "I don't know", then wouldn't you agree we should err on the side of caution? If we're hunting deer in the forest and hear a rustling behind a bush, do we shoot or do we wait until we know for sure we're not targeting a human?

            If we don't know when a human person comes into existence (but we know it happens sometime between conception and birth), shouldn't we prevent abortions throughout that entire stage?

            "As I have noted, Judaism does not consider abortion to be equivalent to murder, because full personhood begins at birth, not at conception."

            What Judaism teaches about abortion is irrelevant to the general question of when life begins. U.S. law should be religiously agnostic where possible, wouldn't you agree? Especially in the case of human personhood, which is not a religious question (evident by the many atheists and agnostics who hold views in this area.)

            "And of course many people would say, based on philosophical arguments, that before a certain stage of development, an unborn child is not a person and therefore cannot be "murdered.""

            What does this show? Is personhood decided by majority vote? Trent has argued, clearly and strongly, why these "many people" would be wrong--or that they would be hypocritical if they didn't also agree to terminate undesired infants.

            "So the question becomes whether, in a pluralistic society, it is acceptable to legally define conception as the moment when personhood begins when doing so is essentially using religion (or philosophy) to bind all by the beliefs of only some."

            Again, the view that human life and personhood begins at conception is not a religious view, nor based on divine revelation or any religious arguments. I'm not sure what gives you that idea.

            "It is hypocritical, in my opinion, for pro-life advocates to claim that abortion is murder and yet insist that women should not be held legally responsible for procuring abortions."

            Of course, this is completely irrelevant to the question of whether abortion is murder. It's a red herring. Yet still, I think women *should* be held legally responsible for procuring an abortion, to the extent they understand what they are doing. This could be the difference between intentional murder or misguided homicide.

          • David Nickol

            If you're answer is, "I don't know", then wouldn't you agree we should err on the side of caution?

            When a pregnancy seriously threatens the life of the mother, you have to balance the uncertainty of not being sure when personhood of the unborn begins with the absolute certainty (under usual conditions) that the mother whose life is in danger is a person.

            If we don't know when a human person comes into existence (but we know it happens sometime between conception and birth), shouldn't we prevent abortions throughout that entire stage?

            It is not necessary to be able to draw a sharp line to conclude that an embryo that has not developed a brain or nervous system is not a person, but a 24-week fetus that would survive if born is a person. You don't have to be able to pinpoint the moment personhood begins to say conclude that in the very earliest stages of pregnancy, there is no person, but in the very latest stages, there is a person.

            What Judaism teaches about abortion is irrelevant to the general question of when life begins. U.S. law should be religiously agnostic where possible, wouldn't you agree?

            What Judaism and Catholicism both teach are relevant to what the law ought to be when both Jews and Catholics will be expected to obey the law. Although there are some non-religious people in the right-to-life movement, it is almost exclusively a Christian movement. The law at the moment is "religiously agnostic." It takes neither the Christian nor the Jewish view. Those who want abortions may procure them. Those who do not want abortions do not have to have them. Those who object to abortion are exempted from participating in them even when it might normally be part of their job duties. The law simply does not say when "moral" personhood begins. It is the right-to-life movement that would like to change hundreds of years of legal tradition through such things as "personhood amendments."

            Of course, this is completely irrelevant to the question of whether abortion is murder. It's a red herring.

            It is totally relevant. To quote again, Mother Teresa said:

            But I feel that the greatest destroyer of peace today is abortion, because it is a war against the child, a direct killing of the innocent child, murder by the mother herself. And if we accept that a mother can kill even her own child, how can we tell other people not to kill one another?

            If a group believes that abortion is murder, then that group ought to advocate that abortion be treated as murder. If I declare myself in favor of the death penalty for black and hispanic murderers on the grounds that any person who takes an innocent human life forfeits his or her own life, but I do not advocate the death penalty for white murderers, how would that strike you? If you said to me, "But why don't you advocate the death penalty for white murderers?" would you really accept an answer that that is a red herring? I might argue, "I am saying that black and hispanic murderers deserve the death penalty. Don't try to change the subject. Either they do or they don't. Your bringing white murderers into this discussion is just a red herring to to draw attention away from my argument that black and hispanic murderers deserve the death penalty."

            If people equate abortion and murder, then their position may be questioned if they do not advocate that abortion be dealt with as murder.

          • "When a pregnancy seriously threatens the life of the mother, you have to balance the uncertainty of not being sure when personhood of the unborn begins with the absolute certainty (under usual conditions) that the mother whose life is in danger is a person."

            Besides the fact that this is an extremely rare case, classical moral theory allows for procedures that save the life of the mother even if that procedure unintentionally results in the death of the unborn child. The difference between that situation and an abortion is subtle, but substantial. In the first case, your primary aim is to save the life of the mother. In the second case, your aim is to terminate the unborn child.

            Yet again this is extremely rare. Bringing it up in this discussion therefore teeters on the line of another red herring.

            Perhaps we can move by it by answering this question: would you be in favor of banning abortion in all cases except when the life of the mother is in jeopardy?

            "It is not necessary to be able to draw a sharp line to conclude that an embryo that has not developed a brain or nervous system is not a person, but a 24-week fetus that would survive if born is a person."

            Ironically, you just drew the line--actually multiple lines. In just one paragraph you suggest that personhood begins either 1) when a child develops a brain (what constitutes a "developed" brain?) or 2) when it develops a nervous system (at what moment is the nervous system adequately "developed"?) or 3) once it is able to survive outside the womb (but this is extremely contextual--does a child become a person at different times depending on the surrounding medical technology?).

            Although failing to admit it, this paragraph exposes the confusion I pointed out earlier. I don't think there's any confusion; personhood begins at conception. But if you were confused about when life begins, as you seem to be, wouldn't you agree the law should err on the side of caution so we don't accidentally kill a human person (or millions of them)?

            "You don't have to be able to pinpoint the moment personhood begins to say conclude that in the very earliest stages of pregnancy, there is no person, but in the very latest stages, there is a person."

            You do if you want to avoid being arbitrary. And you do if you're concerned with law. Laws are precise. They require specific boundaries. A law can't say, "Do not kill people, but we're not really sure when people begin to exist." That's not a law. That's a confusion.

            "What Judaism and Catholicism both teach are relevant to what the law ought to be when both Jews and Catholics will be expected to obey the law."

            This is simply not true. General laws in a pluralistic society do not, and should not, consider the specific tenants of any particular religion. I find it odd that you keep trying to make this a religious debate--it's not. It's a biological and philosophical discussion.

            "If people equate abortion and murder, then their position may be questioned if they do not advocate that abortion be dealt with as murder."

            This is, again, false. The sincerity or consistency of their position might be questioned--this is, in fact, what Trent is doing in regards to atheists--but not the truth of that position (i.e., not the position itself.)

            That's why even if pro-life advocates were hypocritical in this regard (though I personally don't know any abortion opponents who champion other sorts of murder) that would say nothing about the main questions at hand: 1) when does human personhood begin and 2) should the law protect persons at all ages, locations, and stages of development.

          • David Nickol

            Besides the fact that this is an extremely rare case, classical moral theory allows for procedures that save the life of the mother even if that procedure unintentionally results in the death of the unborn child.

            Apparently not in the Diocese of Phoenix, or do you think Bishop Olmsted is wrong?

            Yet again this is extremely rare. Bringing it up in this discussion therefore teeters on the line of another red herring.

            I think it is uncharitable to accuse people of introducing red herrings (or straw men) into discussions. The implication is that the accused commenter is deliberately trying to throw the discussion off track. I am not making an argument that all abortions should be legal (or are morally permissible) because abortion is sometimes necessary to save a pregnant woman's life. And no matter how rare it is that a woman's life may be saved by abortion, it still happens.

            General laws in a pluralistic society do not, and should not, consider the specific tenants of any particular religion.

            Then why are so many Catholic institutions fighting the contraceptive mandate? And why were the American bishops lobbying for (unnecessary) provisions in ACA about abortion? How do you feel about laws prohibiting the circumcision of male newborns?

            This is, again, false. The sincerity or consistency of their position might be questioned--this is, in fact, what Trent is doing in regards to atheists--but not the truth of that position (i.e., not the position itself.)

            I am bewildered as to why it is legitimate for Trent Horn to question at great length the consistency of abortion advocates, but it is illegitimate for me to question the consistency of abortion opponents.

          • Once again, you are not being accurate. What happened at St. Joseph's was NOT an indirect abortion, which IS permissible under Catholic moral law. Bishop Olmsted knows this and recognizes this.

            The problem is that the baby was intentionally, directly killed, which makes the procedure a direct abortion. They hospital did not attempt to induce labor in hopes of expelling the placenta (the organ causing the pathology) with the foreseen but tragic side effect of killing the baby. Nor did they perform a C-section to remove the placenta and/or uterus with the foreseen but tragic side effect of killing the baby. They killed the baby, directly, and removed his/her body from the mother's body (if the method of killing was a D&C or a D&E, s/he was essentially dismembered within the womb). That is a direct abortion and an intrinsic evil, and we may never do evil so that good may result. Again, please read the following: https://www.osv.com/TheChurch/Mary/Article/TabId/660/ArtMID/13700/ArticleID/8871/Sisters-abortion-approval-draws-automatic-excommunication.aspx

          • Jonathan Brumley

            My understanding about the Diocese of Phoenix / Margaret McBride case is that the procedure in question was a _direct_ abortion, probably a suction or D&C abortion, and, as such, the nature of the procedure violated the principle of double effect because it intended to remove the child from the womb by first tearing the child into pieces.

            The key questions to ask are two:

            1. Did the procedure directly intend to kill the child, and through the child's death achieve removing the child from the mother's womb? If so, then the procedure violated the principle of double effect. Or, did the procedure intend to remove the child from the womb while not intending, but foreseeing the child's death (e.g., an induced abortion)?

            2. If the procedure did not violate the principle of double effect, was the foreseen consequence of the child's death proportionate to the risk to the mother's life? It sounds like from the article that the hospital assessed a 100% risk to the mother's life - in which case, the foreseen consequence would have been proportionate, because doing nothing would have placed both mother and child at certain risk.

            Here is Jimmy Akin's article which analyzes the hospital's action and the bishop's decision:
            http://www.ncregister.com/blog/jimmy-akin/what_are_the_true_facts_regarding_the_abortion_approving_nun

          • David Nickol

            the nature of the procedure violated the principle of double effect because it intended to remove the child from the womb by first tearing the child into pieces.

            A procedure cannot intend. Only a person can intend.

            The target of the procedure performed (a D&C) was to remove the placenta. While there is a high risk that an 11-week fetus will be dismembered during a D&C, the procedure was performed with care so as to avoid dismemberment if at all possible.

            Let me reiterate that the controversy over the Phoenix abortion is due to the fact that there is more than one interpretation of what constitutes a direct abortion. The issues are explained here far better than I can explain them. however, at the risk of garbling or oversimplifying, I will say that as I understand it, even a suction abortion that would definitely have dismembered the fetus would, under these circumstances, would not have been a "direct" abortion, because the crucial issue is not what happens physically, but the intention of the person performing the procedure. What makes an abortion direct or indirect, according to the interpretation of those who disagree with Bishop Olmsted, is not whether the embryo or fetus is physically touched. It is the intention motivating the person who performs the procedure.

            Note the discussion in the paper I linked to of the procedure known as craniotomy. It is unnecessary where modern medicine is practiced, but under more primitive circumstances, it may be the only way to save a mother giving birth to a child whose head is too large for the baby to be delivered. In a craniotomy, instruments are inserted and the skull of the unborn fetus is crushed so that it will fit through the birth canal. To quote Germain Grisez:

            However, assuming the four conditions are met, the baby’s death need not be included in the proposal adopted in choosing to do a craniotomy. The proposal can be simply to alter the child’s physical dimensions and remove him or her, because, as a physical object, this body cannot remain where it is without ending in both the baby’s and the mother’s deaths. To understand this proposal, it helps to notice that the baby’s death contributes nothing to the objective sought; indeed, the procedure is exactly the same if the baby has already died. In adopting this proposal, the baby’s death need only be accepted as a side effect. Therefore, according to the analysis of action employed in this book, even craniotomy (and, a fortiori, other operations meeting the four stated conditions) need not be direct killing, and so, provided the death of the baby is not intended (which is possible but unnecessary), any operation in a situation meeting the four conditions could be morally acceptable. [Emphasis added.]

            I boldfaced the phrase "according to the analysis of action employed in this book" because it is no doubt an area of disagreement between those who agree with Bishop Olmsted and those who do not. I do not pretend to understand Grisez's position in any detail at all, but I believe it is based on the work of Elizabeth Anscombe

            It seems to me a simple rule of thumb (this is my own thought, so it may not be perfect) is that any procedure on a pregnant woman in which there is no intention to kill the embryo or fetus, and would be done in the same manner if the embryo or fetus had already died, is not a direct abortion or an intentional killing of the embryo or fetus.

            Another argument about the Phoenix abortion is that both the mother and her unborn child would have died if there had been no intervention. Consequently, it was not a case of taking one life to save another. The unborn child was going to die if nothing was done. It was simply a matter of saving one life rather than losing two.

            My point is that there is more than one view among Catholic ethicists about what constitutes a direct abortion. And with all due respect to Our Sunday Visitor and The National Catholic Register, they are not the best sources for information about complex issues of moral theology.

            The issue of whether Sister McBride excommunicated herself, it seems to me, rests simply on the issue of whether she believed what she and the other ethics committee members were authorizing was a direct abortion. What matters is not whether they were correct or not, but what their understanding of the issues were. If she and the others sincerely believed it was not a direct abortion, then they weren't excommunicating themselves.

          • Jonathan Brumley

            Hi David,

            I agree with almost all your points here.

            The article you linked tries to make the case that in this case, the placenta was a "diseased" organ, and that its removal could therefore be considered a morally good action (if other criteria are met).

            Removing a diseased organ can be a morally permissible act, if other criteria are met, according to this article from the National Catholic Center of Bioethics. It can be morally licit to evacuate the uterus in some situations when its contents become diseased, such as what happens when a uterus becomes infected due to rupture.

            However, it is suspect to consider a normally functioning placenta a "diseased organ", and I suspect many Catholic ethicists would disagree with the analysis given in the linked article.

            It seems to me a simple rule of thumb (this is my own thought, so it may not be perfect) is that any procedure on a pregnant woman in which there is no intention to kill the embryo or fetus, and would be done in the same manner if the embryo or fetus had already died.

            I think it's not that simple because there is a distinction between the "object" ("proximate" intent) and the "final" intent of the individual actions which make up a medical procedure. Not all procedures which achieve the same consequence are morally equal, even if the final intent is the same.

          • David Nickol

            If I have made it clear that the matter of what is and is not a direct abortion is not a simple matter, then I have achieved what I set out to do.

            As I understand him, Germain Grisez says that any abortion in which there is no intention to kill the unborn child is an indirect abortion. However, the circumstances in which even an indirect abortion is permissible are very rare.

            Why there would be any doubt that an organ threatening life, even if that organ (for example, a placenta) is functioning normally, should be removed (if possible) is beyond me. We do not hesitate to suppress or disable "normal" processes for overall health. For example, the immune system may be suppressed for recipients of organ transplants. Deliberate intoxication is considered sinful, but I personally have been rendered high as a kite for certain medical procedures. But that is another very complex discussion. I am happy just to leave it that some experts think it would be licit to target a healthy, normally functioning placenta in the case of threat to the life of the mother. Even the doctor in the Our Sunday Visitor article and JoAnna Wahlund claim it would be licit to induce abortion prior to viability to expel a placenta in a case like the Phoenix abortion. And Our Sunday Visitor would not publish it if it weren't infallibly true. :P

          • David Nickol

            This is, again, false. The sincerity or consistency of their position might be questioned--this is, in fact, what Trent is doing in regards to atheists--but not the truth of that position (i.e., not the position itself.)

            I think what Trent Horn is doing is attempting to show what he believes to be inconsistencies in various pro-abortion positions by making an argument along these lines: "You are in favor of abortion in the first trimester, but you say you oppose killing newborns. However, there is no moral difference between killing unborn babies in the first trimester and newborn babies. Given this fact, to be consistent, you must either oppose first-trimester abortions or accept the killing of newborns. Which is it?" If the argument is successful, the abortion proponent will be forced to say, "I can't bring myself to support infanticide, consequently I must give up my support for first-trimester abortion."

            Trent Horn is going further than merely pointing out inconsistency. He is attempting to persuade by saying, "You must accept the logical consequences of your position. If you can't accept infanticide, you must oppose abortion." Likewise, I am saying, if you insist that abortion is the murder of children by their own mothers, and you want to criminalize abortion, you must treat women who procure abortions as murderers.

            Pointing out inconsistency can indeed call into question the truth of a particular position. Trent Horn is in effect arguing that if you oppose infanticide but support abortion, you don't have a leg to stand on. You have to give up either your support for abortion or your opposition to infanticide. It is a mildly dangerous argument to make, since of course it invites abortion supporters to consider also supporting infanticide. But I think those who make such arguments know the likelihood of turning a significant number of people into supporters of infanticide is extraordinarily small.

          • Jonathan Brumley

            Likewise, I am saying, if you insist that abortion is the murder of children by their own mothers, and you want to criminalize abortion, you must treat women who procure abortions as murderers.

            Not necessarily. There may be good reasons not to criminalize women who procure abortion, even if the action is morally equivalent to murder.

          • David Nickol

            There may be good reasons not to criminalize women who procure abortion, even if the action is morally equivalent to murder.

            I have never heard any, quite frankly. If abortion is really morally equivalent to murder, why should not those morally responsible be punished as murderers?

            And of course even the Catholic Church adds the penalty of excommunication for procuring an abortion or materially cooperating in abortion, yet a woman who kills her own "post-born" children is not excommunicated. Why the extra penalty?

            But if you can make an argument that the women who hire abortionists and deliver their children into the abortionists' hands to be killed should not necessarily be held legally responsible, I suppose you could say there may be good reasons not to necessarily treat abortionists as criminals, either.

            In any case, in actual fact, British and American law never did treat abortion as murder, and even if Roe v. Wade is overturned, it is unlikely that any state will. I say this based on the existing "trigger laws" ready in some states to outlaw abortion the second Roe is overturned (if it ever is). They do not treat abortion as murder.

          • HelloThere777

            I mostly agree with your logic of trying non-repentant, non-traumatized women who have abortions as murderers and have always felt that way. But I think it would be more accurate to be some lesser degree of murder, or perhaps manslaughter, since everyone's been so thoroughly mind wiped by feminist propaganda for over a half a century that even the feminists from the days of yore are started to be horrified at the fruits of their labor.

          • Doug Shaver

            "And of course many people would say, based on philosophical arguments, that before a certain stage of development, an unborn child is not a person and therefore cannot be "murdered.""

            What does this show?

            It shows that you haven't won the debate yet.

            Again, the view that human life and personhood begins at conception is not a religious view, nor based on divine revelation or any religious arguments.

            Oh, come on. It is not only a religious view, but secular opposition to abortion is negligible wherever I look.

            At least in the United States, the public debate is carried out mostly in the political arena, and of course most people don't dare use religious arguments in that venue. But that doesn't mean one side isn't just using secular arguments as covering for what they'd really like to be saying: "God says don't do it."

          • Joseph R.

            Oh, come on. It is not only a religious view, but secular opposition to abortion is negligible wherever I look

            https://www.facebook.com/AtheistsAgainstAbortion

            A wise old cartoon baboon named Rafiki once said, "Look harder..." [https://www.youtube.com/watch?v=maARmxjj3f0 : scroll to the 40 second mark]

          • Doug Shaver

            A wise old cartoon baboon named Rafiki once said, "Look harder..."

            I didn't say nonexistent. I said negligible.

          • Joseph R.

            Agreed. You didn't say secular opposition was nonexistent, but you did say opposition to abortion was, "...only a religious view."

            So while the group of people comprising the Atheists Against Abortion are considered negligible to you, it happens that their very existence is irrefutable evidence which contradicts claims that opposition to abortion is only a religious view.

          • Doug Shaver

            but you did say opposition to abortion was, "...only a religious view."

            You omitted the "not" before the "only" when you pasted that snippet.

          • Joseph R.

            When Brandon said, "...the view that human life and personhood begins at conception is not a religious view...," and you plead, "Oh, come on," I thought you were disagreeing with him on that point. Please accept my apologies for misunderstanding your position.

          • Doug Shaver

            Apology accepted. No problem.

        • Doug Shaver

          Correct me if I'm wrong, but I don't think you'd agree to any of these statements:

          "I think it is perfectly possible to consider rape immoral and still maintain it should be legal."

          "I think it is perfectly possible to consider torturing children for fun immoral and still maintain it should be legal."

          I don't care how possible it might be for someone to think that way. I believe otherwise for what for what seem to me good enough reasons.

          And if anyone actually wants to advocate the legalization of rape, I think they should given a hearing. If it really is as unequivocally impermissible as we all think it is, we have nothing to fear from such a debate.

  • jakael02

    Maybe a good definition of "person" is membership in the human species? That away we don't discriminate based upon development, size, age, skill, mental capacity (IQ), awake or comatose.

    • David Nickol

      Maybe a good definition of "person" is membership in the human species?

      These may be trivial examples, but they will show the problem with your proposal. In New York City where I live (and presumably most other places as well), there are signs in elevators limiting the number of persons who may lawfully occupy the elevator at the same time. This is true also for various public places like restaurants. Would we seriously count pregnant women as two persons in such cases? If no one under 17 is permitted to be admitted to a certain movie, does that exclude pregnant women? Are pregnant women who drink alcohol serving it to minors? Should the unborn have passports to enter the country?

      If you want to define person as a member of the human species, from conception to death, you are going to have to enumerate all the rights unborn persons do and don't have. Matters of inheritance could be changed quite dramatically in certain cases if the moment a baby is conceived, it has the same rights as "post-born" children. There are very good reasons why birth, and not conception, is used as the beginning of legal personhood. Should citizenship be determined by where a person is conceived rather than where he or she is born? Should the unborn have a right to a mother who does not smoke, drink, use possibly harmful drugs, or engage in risky behavior?

      • Trent Horn

        "If no one under 17 is permitted to be admitted to a certain movie, does that exclude pregnant women?"

        If it's rated R, then as long as the woman is an adult, no problem! jk

        Acknowledging a thing is a person doesn't mean it gets the same rights as every other human, just the same basic rights. Same with being a citizen. There are 11 million non-citizens who live in this country who don't have the same legal rights you and I possess, but they still have basic rights like the right to live.

        I do believe that the unborn do have a right to a mother that doesn't poison them with alcohol or drugs. Wouldn't you agree that a mother who drinks enough to cause a baby to be born with fetal alcohol syndrome has harmed that baby? Should that woman be punished or should the baby be able later to sue the mother for causing her to have this condition?

        • David Nickol

          I do believe that the unborn do have a right to a mother that doesn't poison them with alcohol or drugs.

          Here is the problem. If a pregnant woman is fully a person (which I will concede!), and her unborn child is fully a person, to what extend does society have a legal right to regulate the behavior of the pregnant woman and coerce her into certain actions and prohibit her from engaging in other actions?

          Wouldn't you agree that a mother who drinks enough to cause a baby to be born with fetal alcohol syndrome has harmed that baby?

          Obviously so. But should pregnant women be legally restricted from drinking, or should a legal limit be placed on how much a pregnant woman can drink? We know that smoking is also harmful to a developing embryo or fetus. Should smoking be outlawed for pregnant women?

          If you are going to legally prohibit a woman from aborting on the theory that an unborn child has rights, what are you going to do to guarantee the rights of the unborn to develop in a safe and healthy environment?

          Should that woman be punished or should the baby be able later to sue the mother for causing her to have this condition?

          As best I know, a child can sue its mother for harm caused by the behavior of the mother during pregnancy, but (also as best I know) a woman cannot be held criminally responsible for negligent behavior during pregnancy.

          • Trent Horn

            I agree the issue can be complicated. Most fetal alcohol syndrome is caused by being an alcoholic, not casual drinking. But lawsuits have been filed due to reckless actions undergone by pregnant women (http://www.leagle.com/decision/1992422136NH286_1377.xml/BONTE%20v.%20BONTE) - that was for a pregnant woman who was struck by a car while jaywalking.

            If such lawsuits can occur then suppose I own a bar and a visibly pregnant woman wants to order a drink for herself. Could I be sued later if the baby has FAS? Could I also be sued for discriminating against women if I don't serve her. Damned if you do, damned if you don't.

          • herewegokids

            What about 'born' children whose parents smoke? It's been shown 2nd hand smoke is harmful.... doesn't the child have the right to clean air?

      • jakael02

        I see what your saying. That "persons" is used instinctively, culturally, and legally in everyday usage in a manner that seems contrary to the definition I proposed. I admit, I agree with you. Yet, my definition is how it should be defined; but not a definition of how it's being used in our culture today.

        The Q's you proposed would have to be handled individually. Thank you for your thoughts.

  • David Nickol

    If the uterus is designed to sustain an unborn child’s life, don’t unborn children have a right to receive nutrition and shelter through the one organ designed to provide them with that ordinary care?

    I would say almost certainly not if the pregnancy is a threat to the life of the mother. In the "famous violinist" scenario, where an ordinary person awakes to find himself attached, as a kind of life-support system, to a famous violinist who would die if the attachment is broken, it is assumed (as I recall the argument) that the connection between the two is a violation of the ordinary person's autonomy. But it becomes a different matter altogether if the connection between the two individuals seriously threatens the ordinary person's life.

    Admittedly, life-threateing pregnancies requiring abortions are rare, but of course no matter how rare they are, if you are a woman faced with a life-threatening pregnancy, it is of little or no interest to you how many or how few others are faced with the same situation.

    The "Phoenix abortion" was just such a case, in which Sister Margaret McBride was excommunicated by Bishop Thomas Olmsted for approving the abortion as the head of the hospital ethics committee. It is not necessary to go into the argument here, but the hospital had a rationale justifying the abortion by the principle of double effect, saying it was the placenta (which is neither the unborn child nor a part of the mother's body) that was the target of the abortion as the life-threatening organ.

    I think it is extremely difficult to explain to anyone how it would be the right thing to do to allow a mother and her unborn child to die when the mother could be saved by an abortion. I think it can be reasonably argued based on Catholic principles that in such cases, the abortion is always "indirect," since the intention is never to kill the unborn child but to save the life of the mother.

    • Actually, you're mistaken about the Phoenix example. The hospital performed a direct abortion; that is, they intended to kill the child and that's exactly what they did. The example you cite, inducing labor to remove the placenta with the foreseen yet unintended consequence of causing the child's death, was what WOULD have been morally acceptable; however, that was NOT done (see here). Plus there are some questions about if the woman was truly in imminent danger or if any other treatments were attempted (for example, there is a doctor in Wisconsin who has had a 100% success rate in treating pregnant patients who had pulmonary hypertension).

      • David Nickol

        The hospital performed a direct abortion; that is, they intended to kill the child and that's exactly what they did.

        It is much more complicated than that. See here, for example. In any abortion to save the life of the mother, is it the intention to kill the unborn child? It depends on how you determine what the intention of an act is. I think a good argument can be made that no abortion to save the life of the mother is a direct abortion.

        The example you cite, inducing labor to remove the placenta with the foreseen yet unintended consequence of causing the child's death, was what WOULD have been morally acceptable; however, that was NOT done (see here).

        The woman in question was so close to death that they performed the procedure in her hospital room because they feared if they moved her to the operating room, she would die. I am not an obstetrician, but I feel it is safe to say that attempting to induce labor in a woman who is near death would simply kill her.

        Plus there are some questions about if the woman was truly in imminent danger or if any other treatments were attempted . . .

        Do we really want to second-guess the medical team that treated this patient? Full medical information on the case cannot be released because of privacy laws.

        • Moral philosophy recognizes a difference between killing the child as a means to an end, and having the child's death being a tragic if foreseen side effect of a treatment to save the mother's life.

          A key Christian moral principle is that we may never do evil so that good may result. In this case we may never do evil (directly attack and kill a child via abortion) so that good (saving the life of the mother) may result.

          Where do you get the info that the procedure was done in the mother's hospital room? I've never heard that (and I'd think that the hospital would be prevented from giving that info, as they have with so much other info, due to HIPAA laws). I'm in Phoenix, btw, so this was ALL over our local news when it happened. (I might add that it was the hospital that notified the press -- the diocese sent Sr. McBride a private message about the situation and she chose to make it public.)

          • David Nickol

            Where do you get the info that the procedure was done in the mother's hospital room?

            Here is one source:

            Last November, a 27-year-old woman was admitted to St. Joseph's Hospital and Medical Center in Phoenix. She was 11 weeks pregnant with her fifth child, and she was gravely ill. According to a hospital document, she had "right heart failure," and her doctors told her that if she continued with the pregnancy, her risk of mortality was "close to 100 percent."

            The patient, who was too ill to be moved to the operating room much less another hospital, agreed to an abortion. But there was a complication: She was at a Catholic hospital.

            I was very interested in the controversy, and at the time I searched the web for any coverage I could find. You may have had more access to local coverage than I did, but I do remember reading local coverage in the Phoenix newspapers that were available on the web.

            A key Christian moral principle is that we may never do evil so that good may result. In this case we may never do evil (directly attack and kill a child via abortion) so that good (saving the life of the mother) may result.

            Yes, but an indirect abortion is not evil. As I said, a case can be made, I think, that any abortion performed to save the life of the mother is an indirect abortion. In the Phoenix case, the death of the unborn child was not willed. The mother very much wanted the baby. Think of the placenta as analogous to the uterus in the case of the woman with a cancerous uterus. The uterus can be removed in order to remove the cancer. There is no way to remove a uterus without removing the baby inside it. In this case, there was no way to remove the placenta without removing the unborn baby as well.

            Making a full argument requires detailed definitions of intention and action which I am not well informed enough to do justice to. However, it seems to me that when the pregnant woman whose life is in danger wants the baby, and the medical team wants to save the baby, it is difficult to argue that the abortion is direct. There is no intentional killing of a human being in such a case.

            Are you familiar with the reasoning by which a salpingectomy is permitted in case of an ectopic pregnancy? Do you find it convincing?

          • Yes, I'm well aware of the principle of double effect and its moral ramifications. Here's the thing, though. If a procedure directly attacks the baby, it's a direct abortion. Doesn't matter if the intent is to save the life of the mother, doesn't matter if the parents and the medical team wish they could save the baby. The fact is that directly attacking and killing the baby is a direct abortion even if the intentions are good.

            An indirect abortion is when you attack the organ causing the pathology -- the placenta, the uterus, the fallopian tube -- and in the process of removing the organ causing the pathology, the baby unfortunately dies. S/he was not the targeted entity under attack, however, so his/her death is indirect.

            I really encourage you to read the article I linked above, as it explains the difference: https://www.osv.com/TheChurch/Mary/Article/TabId/660/ArtMID/13700/ArticleID/8871/Sisters-abortion-approval-draws-automatic-excommunication.aspx

            Seems odd that NPR apparently had access to HIPAA-privileged information while the Diocese of Phoenix did not. They don't say who their source is for that tidbit of info, and I didn't see it in any of the local news reports or press releases.

          • NPR probably has better journalistic practice than the Diocese of Phoenix, given that one is a news agency and the other is a religious group.

          • I didn't see that info in any of the press releases from St. Joseph's Hospital or in any of the stories done by the AZ Republic. Are you suggesting, Paul, that NPR obtained that information by nefarious means (i.e., from someone at St. Joe's who violated HIPAA to give that info?).

          • No, but maybe from legitimate but anonymous means (such as from the person that had the procedure). You could of course contact NPR and ask, but it's typically considered irresponsible for journalists to divulge their sources.

            EDIT TO ADD: I'm not sure, but it may be that a good journalist would be able to deduce the event from a series of non-protected facts, such as where certain doctors happened to be, or not be, at a given time.

          • What I find curious is that they don't even attribute that info to a source at all, anonymous or otherwise. They just state it as fact. Yet, as I said, I didn't see that info in any of the press releases from St. Joe's, or in any of the local news stories about it (e.g. the ones done by the AZ Republic).

          • David Nickol

            What makes you think that reporting where the procedure was done (the patient's room rather than the OR) is a violation of HIPAA? And what difference does it make in general if the patient was indeed moved from her hospital room to the OR for the procedure? We have quotes from hospital documents that doctors told her her chance of dying was close to 100% without the procedure. Given that fact, exactly where in the hospital the procedure was done is a trivial factoid.

          • Also, according to this article, Bp. Olmsted was in talks with hospital representatives for two months, and yet he remained unconvinced that an indirect abortion was performed as opposed to a direct abortion: http://www.azcentral.com/community/phoenix/articles/2010/12/15/20101215phoenix-bishop-st-josephs-hospital.html

          • David Nickol

            Bishop Olmsted is not a moral theologian. He has a masters in theology and a doctorate in Canon Law. As bishop, he has the authority to decide this issue for his diocese, but outside his diocese, his opinion on a complex issue of moral theology is the opinion of one bishop with no credentials as a moral theologian.

          • Why should I care what Thomas Olmsted thinks? Shouldn't it matter more what medical professionals think?

          • David Nickol

            I really encourage you to read the article I linked above, as it explains the difference . . .

            And I encourage you not to assume that an article in Our Sunday Visitor presents the definitive explanation of direct and indirect abortion. Read, for example, Is Abortion Always the Wrongful Killing of a Person? by Germain Grisez. Also, you might check out Grant Gallicho's reporting on the story in a blog post on Commonweal, which begins as follows:

            Last summer, Bishop Olmsted of Phoenix asked Catholic Healthcare West to provide a moral analysis of the case that started this controversy. So CHW secured the services of the moral theologian M. Therese Lysaught. Her analysis, sent to the bishop in October, was rejected by Olmsted last month. We have obtained Lysaught's cover letter to CHW along with her analysis.In her cover letter, Lysaught summarizes her conclusion: "The procedure performed at St. Joseph's Hospital and Medical Center on November 5, 2009, cannot properly be described as an abortion. The act, per its moral object, must accurately be described as saving the life of the mother. The death of the fetus was, at maximum, nondirect and praeter intentionem. More likely, the fetus was already dying due to the pathological situation prior to the intervention; as such, it is inaccurate to understand the death of the fetus as an accessory consequence to the intervention."Lysaught's analysis includes a detailed summary of the medical condition of the mother. In October 2009, the mother's doctor counseled her to terminate the pregnancy because the symptoms of her pulmonary hypertension were worsening. He estimated that, given the advanced state of her disease, she would have a 50-50 chance of surviving the pregnancy. . . .

            Commonweal gives links to the various documents, including M. Therese Lysaught's 24-page analysis of the patient's condition and the hospital's actions. I would urge you to take the time to read it and to pay particular attention to Lysaught's analysis of the work of Germain Grisez and Martin Rhonheimer.

            There are different viewpoints on how to define direct and indirect in reference to abortion, and the matter depends on technical definitions of intention and action. I do not pretend to be an expert in moral theology in any way, but I have read widely and deeply enough to know that there are differences of opinion among experts.

            I find it odd that the doctor quoted in OSV "wonders why the staff didn’t attempt to induce early labor with the goal of expelling the placenta, which produces a hormone that affects blood flow and may have been a significant factor in the woman’s condition." The woman was so seriously in danger of death that she could not be moved to another hospital or even to the operating room. I am not a doctor, but I will go out on a limb and say it is not a good idea to induce labor in a woman who is dying. We have the following:

            Phoenix ob-gyn William Chavira, a member of the diocesan medical ethics board, told Our Sunday Visitor he was unfamiliar with the specifics of the case, which are protected by patient privacy laws, but was surprised the woman’s doctors felt compelled to take such a drastic measure so early in the pregnancy.

            “Normally you don’t have huge increases in blood volume and cardiac output and major decreases in blood pressure at that gestational age,” he said. “What effect an 11-week-old baby is placing on the mother that early that would cause her to decompensate so rapidly is really — to be forthright about it — not a common situation or case.”

            Of course this was not a "common situation or case"! This was an extreme emergency involving a very sick woman who needed immediate treatment. I would suggest that it is unethical for "a member of the diocesan medical board" to speculate on what the physicians and ethicist actually working with the patient could have or should have done differently when having admitted that "he was unfamiliar with the specifics of the case."

            I would seriously doubt, by the way, that Bishop Olmsted and those who agree with his analysis of the Phoenix case would agree that inducing labor at 11 weeks is not a direct abortion. What is the moral difference between inducing labor at 11 weeks and removing the contents of the uterus by suction?

          • David Nickol

            I really encourage you to read the article I linked above, as it explains the difference . . .

            Note that in the article from OSV you recommended, the doctor claims that inducing labor at 11 weeks would have been licit. Note the following:

            ROME, October 8, 2013 (LifeSiteNews.com) – Inducing labor before a child can survive outside the womb is a form of abortion and can never be accepted as a “compromise” by the pro-life community, two leading British pro-life activists said recently.

            Anthony McCarthy, Education and Publications Manager for Britain’s Society for the Protection of Unborn Children, late last month speaking to an international audience of obstetricians in Rome affirmed that the Church has formally declared early inducement, even when it is intended as a life-saving measure for the mother, is never permissible. . . .

            How do you reconcile this article with the statement of the ob-gyn quoted in OSV that he was surprised the doctors in the Phoenix case didn't try to induce labor, which he said would be acceptable under the principle of double effect? The good doctor says, "The baby will probably [at 11 weeks!!] not survive given where science is in this day and age in preserving premature babies, but my intention is to treat the mother’s disease, not to kill the baby.”

          • I've clearly stated that indirect abortion IS morally permissible in Church teaching, which is what inducing labor to remove the placenta would be (regardless if it is pre- or post-viability). But, again, this is not what happened with the Phoenix case. That was a direct abortion (and Bp. Olmsted does know the difference -- it's not a difficult distinction even for laypeople [i.e., non-medical-professionals] to make).

          • David Nickol

            That was a direct abortion (and Bp. Olmsted does know the difference -- it's not a difficult distinction even for laypeople [i.e., non-medical-professionals] to make).

            If you are willing to look beyond Our Sunday Visitor, you will find that there are disagreements about what constitutes a direct abortion. I don't believe you have read any of the sources I have linked to, and of course that is your choice. But your statement on the issue of direct vs. indirect abortion, "it's not a difficult distinction even for laypeople [i.e., non-medical-professionals] to make)," is simply false.

            I've clearly stated that indirect abortion IS morally permissible in Church teaching, which is what inducing labor to remove the placenta would be (regardless if it is pre- or post-viability).

            I am having trouble finding a clear statement from an authoritative source that early induction of labor (before viability) is permissible. I have found this paper from the National Catholic Partnership on Disability, that lists the following as circumstances under which early induction of labor is permissible:

            1. The presence of serious infection [chorioamnionitis], e.g., following preterm premature rupture of membranes (PPROM).
            2. The presence of serious maternal illness deriving from pregnancy, e.g., preeclampsia, H.E.L.L.P. syndrome.

            But note what they say regarding the very situation that arose in the Phoenix case:

            3. Controversy exists as to whether a woman with severe heart disease, who may or may not be able to tolerate the added stress of increased blood volume and swelling from the pregnancy, may undergo early induction. Even though the placenta is causing the increased blood volume in the mother, this is a normal part of pregnancy, not a pathological condition per se. The pathology of her weakened heart is not directly remediated by early induction, so there is debate about whether the Principle of Double Effect might be validly applied in these circumstances. [Emphasis added.]

            The position of The National Catholic Bioethics Center appears to be that there would be no justification in inducing labor in a case of pulmonary hypertension because while the pregnancy (and the placenta) is making increased demands on the patient's weakened heart, the placenta itself is performing its natural function, is not a diseased organ, and therefore may not be targeted for removal. Hence, by their analysis, the doctor quoted in OSV is mistaken that Catholic medical ethics would permit labor to be induced prior to viability.

            I hope I have given reason to convince you that this is not a simple matter, that authorities disagree, and that even if you have a firm conviction yourself that it is clearcut what is an indirect abortion and what is not, there are authorities who would disagree with you. And by the way Germain Grisez and Martin Rohnheimer are both highly credentialed authorities in moral theology who are not "liberal dissenters" from the Magisterium.

          • Also, here: "As for the problem of specific medical treatments intended to preserve the health of the mother, it is necessary to make a strong distinction between two different situations: on the one hand, a procedure that directly causes the death of the fetus, sometimes inappropriately called “therapeutic” abortion, which can never be licit in that it is the direct killing of an innocent human being; on the other hand, a procedure not abortive in itself that can have, as a collateral consequence, the death of the child: «If, for example, saving the life of the future mother, independently of her condition of pregnancy, urgently required a surgical procedure or another therapeutic application, which would have as an accessory consequence, in no way desired or intended, but inevitable, the death of the fetus, such an action could not be called a direct attack on the innocent life. In these conditions, the operation can be considered licit, as can other similar medical procedures, always provided that a good of high value, like life, is at stake, and that it is not possible to postpone it until after the birth of the child, or to use any other effective remedy»" (Pius XII, Speech to the Fronte della Famiglia and the Associazione Famiglie numerose, November 27, 1951). (source: http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20090711_aborto-procurato_en.html)

            The above seems pretty clear to me.

          • David Nickol

            The above seems pretty clear to me.

            Are you still maintaining it would have been licit to induce labor at 11 weeks in the case of the Phoenix woman with pulmonary hypertension—that is, that induced labor would have been permissible (an indirect abortion) but a D&C would not have been?

          • David Nickol

            The above seems pretty clear to me.

            Forgive me in advance for this speculation, but I think it is quite possible that the issue seems clear to you because you have decided not to read from any of the sources I have linked to. Have you read Germain Grisez's article Is Abortion Always the Wrongful Killing of a Person? Have you read M. Therese Lysaught's 24-page analysis of the patient's condition and the hospital's actions?

          • I read both and found the arguments unconvincing. (Your link is broken in the Commonweal piece, by the way -- there are some extraneous characters before the "www.") In a nutshell, both pieces placed too much emphasis on intent and not enough on action. We may never DO evil (perform an action) so that another good action may result. Period. Even if our intentions are pure and good, it's still wrong.

            And neither piece brought up the fact that there actually is a treatment for pulmonary hypertension in pregnancy that has, so far, a 100% success rate -- yet there is no evidence that this treatment was attempted or offered as an alternative. http://www.wisn.com/Doctor-Gives-Hope-To-Pregnant-Women-With-Heart-Condition/8079188#!bvGqos

  • David Nickol

    Drinking alcohol impairs a person and initiates a chain of events that is likely to lead to traffic fatalities. Even if the person took measures to avoid getting into an accident (e.g. playing the music loudly, rolling the window down) he or she is still responsible for the fatality that was caused.

    This would be my opinion, I think, but Thomas Aquinas has a slightly different take:

    If a man becomes intoxicated without his fault, either because he does not know that what he drinks is intoxicating, or because he underestimates its strength, or because he is affected by the drink in a manner unusual and unexpected, he is not guilty of sin, and he is excused from the responsibility for any regrettable conduct which results from his intoxication. If, however, a person becomes intoxicated by his own fault, he is at least partially responsible for any evils that result from his excessive drinking, just as he is responsible for the intoxication itself.

    I personally feel very strongly about drunk driving and have occasionally wondered whether the penalty for driving drunk even when no harm results should not be the same as for driving drunk and causing fatalities. However, if we were to follow Thomas Aquinas, it appears to me that a person who gets drunk "accidentally" because he underestimates the strength of what he is drinking should not be held accountable if he or she causes something like a traffic fatality.

  • David Nickol

    A critic may object that pregnancy is not “ordinary care” because it causes the woman’s body to undergo extraordinary and uncomfortable transformation. But it is a transformation toward which women’s bodies are naturally ordered.

    A pregnancy that has a high probability of killing the mother is not "ordinary care." Just because pregnancy is a perfectly natural and totally necessary condition for the continuation of the human race does not mean that all pregnancies can be considered equal and good.

    The reasoning that permits early intervention in ectopic pregnancy, almost universally accepted among Catholic medical ethicists, is far less compelling (in my opinion) than the reasoning that permits abortions in cases of true threat to the life of the mother.

  • Thanks for the article. I'll respond to your objections in a future comment, although from a first reading of the article, it seems that we may be on mostly the same page concerning the three arguments you present.

    Where is Judith Jarvis Thomson's argument? I had mentioned it in the comments last post, and although it is related to the organ use objection and right-to-refuse argument, there are significant differences, differences that invalidate your objections to those arguments. Will you be talking about Thomson's argument in a future article?

    Will you also be talking about positions other than strict pro-life and strict pro-choice positions? More moderate positions in which some abortions are morally acceptable and others morally unacceptable?

  • With respect to the replicator/responsibility argument, no. We absolutely do not require anyone to take responsibility for the children they produce. A woman who chose to get pregnant is legally entitled to give the child up for adoption for any reason. When people do take responsibility for children we hold them to certain standards. But I am glad I don't live in a society with a "you had sex, (or were raped) it's your problem now, no matter how much you hate kids" approach to parenthood.

    I simply disagree with your view of purpose in human organs, but I recognize this is a theological division here. I do not agree that because humans have evolved reproductive organs, it means ending a pregnancy is immoral or should be illegal.

    Fundamentally, people's position on abortion seems to track closely with their empathy to the unborn at various stages, not arguments like those above. This is drawn out by how few people take the position that a pregnant woman should risk likely death, rather than end a pregnancy. But of course I realize Catholics do believe the the death of the mom is not as bad as ending the pregnancy. http://www.theguardian.com/world/2013/apr/08/abortion-refusal-death-ireland-hindu-woman

    I am pro choice but I have a lot of sympathy for those with a contrary view.

    But abortion happens, it has always happened. The legal battle has been lost in the US and pretty much every industrialized country. These courts are not going to reverse themselves and now find that they allowed baby murder for decades. At the very least keeping it legal and accessible is, I think very good for women's health.

    The best way to reduce the number of abortions would be to get over prudishness of sex and sex education and promote the informed use of contraception.

  • David Nickol

    I think I’ve shown that there are no morally relevant differences between humans before they are born or can survive outside of the womb and humans just after they are born.

    What about ectopic pregnancy?

    Regarding what should be legal and illegal, it is not only the moral status of the unborn vs. the "post-born" that should be taken into account, but the physical and practical differences between how a pregnant mother "cares for" her unborn child and the care that child requires after it is born. Much as pro-life advocates may want to minimize the fact, an unborn child is inside another person, and a "post-born" child is not. So it would be perfectly reasonable, in my opinion, for those who believe full personhood is not achieved until sometime during or after the "fourth trimester" to argue that while a newborn child has not met the criteria for being a person with a right to life, it nevertheless has value as a potential person, and since it is easily transferred from on person to another, its life should be legally protected.

    As I have noted before, there are arguments against abortion that do not depend on a belief that the unborn are persons from the moment of conception. In fact, abortion prior to Roe v. Wade was outlawed without legally defining the unborn as persons.

  • For the case of using one's body as a life support system against one's will…
    Pregnancy is a case where two human lives are physically intertwined. When forced to decide if one life should be killed (permanently) vs. another life to be pregnant (temporarily), the reasonable course of action based on priority is to spare the life, because the right to be alive is the derivation of all other human rights and thus would have the highest priority.

  • Dear Trent,

    The problem here:

    The biggest problem with this kind of argument is what’s called the responsibility objection. In the case of a stranger who will die unless I donate blood or bone marrow, I am not obligated to help him, because I was not involved in how he became ill. But if I caused another person to become dependent on me, then I would owe him assistance... Why? Because you engaged in an act that you knew could create a helpless human being...

    Is that you now argue in defence of abortion. In cases of rape and incest. The woman now pregnant isn't responsible for her rape, so she's not responsible for the results. She owes nothing to the child now alive inside of her, and need not continue supporting that child with her body. The woman may remove the child from her body. The child may well die. If the child dies, the responsibility for the child's death rests with the responsible party, namely, the rapist.

  • Mike

    I think the problem I have with this topic is that of human rights, and where they come from. I believe that all humans are endowed with certain rights. As a Catholic, I believe humanity has these rights because we are made in the image and likeness of God, but I don't see a reason why an atheist couldn't hold that all humans have certain rights. While theists and atheists may disagree with a list of rights, without a right to live, I can't see a purpose in having any others. I think that all human beings, defined as a living individual with complete set of human dna. I can't see a good scientific reason why I can't hold that this criteria is fulfilled at conception.

    I suppose I also take this topic personally, i.e. some decades ago my mother could have violated my human rights and "exercised" her right to choose.

    Furthermore I hold that all life is sacred. Many times I think Sen. Ted Kennedy said it best "While the deep concern of a woman bearing an unwanted child merits consideration and sympathy, it is my personal feeling that the legalization of abortion on demand is not in accordance with the value which our civilization places on human life. Wanted or unwanted, I believe that human life, even at its earliest stages, has certain rights which must be recognized – the right to be born, the right to love, the right to grow old. When history looks back at this era it should recognize this generation as one which cared about human beings enough to halt the practice of war, to provide a decent living for every family, and to fulfill its responsibility to its children from the very moment of conception."

  • NowHereThis

    "We therefore should either treat newborns like fetuses and make it legal to kill them simply because they are unwanted..."

    Or since it is no longer imposing upon the woman's body, simply allowing the woman to forfeit her parental rights and give up the child would suffice to relieve her of unwanted motherhood without killing the newborn.

    The same option does not exist if the woman refuses to allow her body to be used as an incubator in the middle of a pregnancy. Therefore, to vindicate her rights at that point rather than enslave her to her fetus (and all sides agree that she is a person with the right not to be enslaved among other rights, whenever they attach, whereas status of the fetus is controversial), the fetus must be removed.

    In a contest between an adult with rights that have already attached, and a fetus whose status is ambiguous, the adult wins.

  • You say that the sovereign zone argument admits the fetus is a person. I do not see this in the argument you elucidated. The responsibility objection it seems does not work for pregnancies conceived in rape, as the women was not responsible for conception. Do you think that a person who caused someone else's condition can be forced to donate blood or bone marrow? Because that's what would be the case here. I think that would be a very dangerous idea.

  • John M

    Fantastic article! Wonderful analogies that really help clarify the pro-life view. Bravo!

  • Volmire1

    As usual, Trent is incredibly clear in his thinking.