Abortion. Who Suffers?

00161 Who Suffers

The Scottish Cardinal Keith O’Brien gave a sermon in 2007 to mark the fortieth anniversary of the passing of the Abortion Act.  In it he described abortion as an “unspeakable crime.”  So unspeakable did he find it that he compared it to the massacre of schoolchildren that took place at Dunblane.  He justified his position by saying, “I can’t change the Ten Commandments. Thou shalt not Kill.” Shortly afterwards, despite his longstanding membership, he also resigned from Amnesty International “for its decision to support the decriminalisation of abortions” in cases of rape, sexual assault, incest, and where the pregnancy threatens the woman’s life.”

This approach is not new. His predecessor Cardinal Thomas Winning drew a parallel between the abortions now carried out in this country with the millions slaughtered in the Nazi Holocaust.  Dr Jack Scarisbrick, the founder of Life, who is not medical but a retired History professor, agreed and supported him saying that he saw “no moral distinction between killing adults and killing unborn children.”  Finally and most recently in 2007 there was an attempt in the House of Lords by Susan Cunliffe-Lister, Baroness Masham, to get part of the Abortion Act revoked. Baroness Masham is a life peer, campaigner for the handicapped, convert to Roman Catholicism and a wheel-chair user. Her aim (which failed in the Lords but will be fought again in the Commons) is to stop the small number of late abortions (less than 2%) carried out each year.  The law allows this in cases where the foetus has been diagnosed as having “severe mental or physical abnormalities.”

If she and her supporters succeed the consequence would be that a mother who knew she was bearing a severely handicapped foetus would be forced to go through with the pregnancy.  This all adds up to a pretty extreme position, yet it is being advocated with passion by people who are not without intelligence, people who seem convinced they occupy the moral high ground.  While I respect their dedication, having looked carefully at the case they make, I am quite unconvinced.

The present Catholic position is based on a simple line of argument promulgated by Pius XI in his 1930 encyclical Casti Connubii.  This is that from the moment a human sperm fertilizes a human ovum the fertilised cell becomes a unique new being and the bearer of an immortal human soul. Before that, while the Church always counselled against abortion, its position, as taught by St Thomas Aquinas and others, was that the foetus was only considered to have received a human soul on quickening, i.e. when the mother could feel it move at about five months.  The position Pius XI took and Pope Benedict has repeated is that the foetus is a person in the eyes of God from the moment of conception.  Thus it follows they regard the deliberate destruction of a fertilised ovum at any stage as being morally, if not legally, an act of murder – regardless of the circumstances.

Obviously this argument is based on faith.  As Pope Benedict has recognised, “No experimental datum can be in itself sufficient to bring us to the recognition of a spiritual soul.” (HULT p 6) This means it is not based on what can be known from scientific study and reasoned reflection, but on accepting the official church position as a divine revelation, as interpreted – is it claimed infallibly? – by Pius XI and Joseph Ratzinger – Pope Benedict XVI. (Other Christians who reject abortion, particularly Evangelicals, base their view on their understanding of Gen 1:27, “God created man in his own image.”)

Starting however from a careful ethical reflection on the findings of medical science rather than on any position based on the acceptance of the divine inspiration of any scripture or ecclesiastical authority, I would suggest there are good reasons for considering the “pro-life” position on abortion hard to justify.

The pro-lifers call abortion murder, the killing of a person.  The question is, can a freshly fertilised ovum consisting of a small number of rapidly dividing and growing cells the size of a pin head accurately be described as a person?  Is not a person really much more than that?  Then to take things on to full term, is it accurate to describe the developed foetus approaching birth as a person or is full human personhood much more than that? Are there not good reasons for considering full human personhood is something which can only blossom and express itself after birth?   What these questions add up to is this.  Is being a person something which is established in an instant, or is it something which grows in stages and comes to fruition after birth?

I would suggest that the argument that the foetus before birth is a person is not based upon the evidence.  Rather if we look at what we know about the growth in the womb of the unborn child we can see that becoming a person is a process which unfolds organically in a series of stages as body and brain develop.  It is not a single event. If this is the case then surely it is more accurate to speak of the unborn child as being a potential person, a potential person which does not have any self-awareness or memory of its condition before, during or immediately after birth.

I would however agree that the destruction or killing of a potential person becomes an increasingly serious and difficult step for a woman to take as a pregnancy progresses and she identifies with her unborn baby.   Abortion, except possibly in the first few days when the “morning after” pill has been used (again something the “pro-lifers” condemn as murder) is never a simple or easy option or one which should ever be taken lightly. It may result in serious if unforeseen physical and psychological consequences.  Nevertheless according to the evidence collected by the Royal College of Obstetricians and Gynaecologists the stillborn and the terminated do not suffer.  This is because the foetus has not yet developed the neural pathways or sufficient awareness to know it is suffering and in the case of the late abortions of the seriously abnormal the foetus is anesthetised prior to the procedure as a precaution.  To pretend the foetus has the capacity to suffer at a late – or even at an early stage – as much pro-life propaganda showing foetal images does – is to indulge at best in self-delusion, if not in dishonesty. It seems to me, therefore, that since the unborn child is not self-aware – however energetic its movements are as its body and brain prepare for birth – if it dies it suffers no more than if an adult dies unexpectedly while sleeping or under anaesthetic.

The really important point surely is that there is a huge difference between a death in the womb (be it a stillbirth or an abortion) and the death of a self-aware child and it is this difference which the supporters of the “pro-life” stance seem to ignore.

A death in the womb is the death of a potential human life, a life unexposed to experience, a life still incapable of reflection, a life where the brain in its early forms is incomplete and even in its final stages has yet to develop through interaction with the outside environment and with other minds the capacities which are needed to trigger that full functioning which leads to self-awareness.  Of course as with stillbirths, this death can cause great sadness, pain and a sense of loss to the parents and close relatives who have identified with it, particularly if it happens late in the pregnancy.

Nevertheless such a death in the womb should not be confused with the death of a child or adult who dies self-aware.  Such a death is simply of quite a different order.  The child or adult, like the victims of the Holocaust or Dunblane, dies a subject of pleasure, pain, joy and sorrow, the bearer of a self-conscious mind and imagination, able to choose, to love, fear and suffer.  The terminated foetus and the stillborn simply cease functioning and die without suffering.

Surely then we need to conclude that there is something crude and very misleading about treating a newly fertilised ovum as having the same value and status in the eyes of man and of any God there may be as the developed mind and personality of the mother who carries it.

We also need to ask what is it about human life that makes it so important we respect it?  Is it simply our membership of a particular species? Surely not. Is it dependent on our believing as a matter of “faith” that “we are made in the image of God” or is it due to something special that perhaps that text alludes to, something we can all see, recognise and know – be we “believer” or “unbeliever” ? I would suggest this is so and our respect for human life is based on our recognition that the most amazing and awe-inspiring phenomenon we encounter is the flowering of human consciousness and our development after birth into thinking, morally responsible, self-aware persons.

If we recognise this then to equate the deaths of the unborn with the sufferings of Holocaust victims is a ghastly mistake.  It is like saying there is no difference between the ending of a foetal life and a man being crucified.

Unfortunately the “pro-lifers” within and outside the Roman Catholic Church consider it is not enough to say that they personally would never resort to having an abortion, and that they would never expect or pressure anyone they knew to have one. That is a position I respect, as I would respect moves to define more clearly the abnormalities that should be accepted as providing grounds for late abortions. Rather the “pro-lifers” wish to criminalise anyone who has an abortion however early, and anyone in the medical field who helps them to have one safely, and to force every woman who becomes pregnant – regardless of their circumstances or the prognosis for the infant – to take the pregnancy to term.

True respect for human life is surely a respect for self-aware persons, and there can be no respect for persons if a woman is denied the right to choose in such a crucial area as taking on the responsibility of being a parent. What is more those who make no distinction between the suffering of conscious, self-aware people and the destruction of newly fertilised cells need to ask themselves if they have not become the victims of a faith induced blindness, a blindness which has led them to show a frightening moral insensitivity.

John Baxter  2008.   E mail your comments to john@nulljohnbaxter.org  Read also the full treatment of my views in Abortion. Murder by Another Name? I read Theology at Rhodes and Oxford, have an M.Ed in the Philosophy of Education from Bristol and taught Religious Studies in Bristol and Devon.  That does not make me right of course, but I do try to consider issues carefully.

I spent copies of this to many MPs before the debate in 2009 to make late abortions illegal.   The motion to do this was overwhelmingly rejected after an excellent debate in the Commons, however the pro-lifers will never give up and have continued to hound the abortion clinics and have tried to make themgive “independent” ie pro-life counselling and to argue again for reducing the time allowed for late abortions. Since this only applies to those pregnancies where a severe abnormality has been diagnosed, the abolition of this right to a termination would be the cruelest action of all.  As it is modern medicine results in far more really seriously handicapped babies being born than ever before with many horrendous unintended consequences.

Post Script

This download from the Pro-choice Forum deals with the issue of “fetal pain.”

The Implications for Abortion Procedure

Fetal pain is obviously an important issue for those carrying out fetal operations and other invasive practices, but it is also of interest for those involved in abortion procedure and for those motivated to restrict the current abortion legislation. The broadly accepted conclusion that recorded responses to noxious stimulation prior to 26 weeks gestation are reflex responses, not dependent on conscious appreciation, is important as it eliminates much of the generated concern regarding abortion. In 1994 just 94 abortions, out of more than 160,000 carried out in the UK, were later than 24 weeks (37). If it is accepted that consciousness is essential to the pain experience, and that consciousness is contingent upon psychological development, it would follow that even after 24 weeks gestation it would be more appropriate to describe fetal reaction to stimuli as reflex responses than as pain.

Guidelines on the termination of pregnancy for fetal abnormality issued by the UK Royal College of Obstetricians and Gynaecologists (RCOG) draws on the work of Fitzgerald (1995) which suggests strongly that the immaturity of the fetal nervous system prevents conscious awareness of pain before 26 weeks gestation. The document argues that ‘it follows that up to this gestation the method of abortion should be selected to minimise the physical and emotional trauma to the woman’ (38).

Regardless of one’s own views on whether late term induced abortions may cause pain to the fetus, the issue warrants special attention because almost all late terminations are of wanted pregnancies where the putative parents may be emotionally vulnerable. Often, during counselling, they express concern about what the fetus may ‘feel’ during an abortion. In these circumstances it is common for the putative parents to think of the fetus as a ‘baby’ and to attribute to it the qualities that they anticipated their child would have were it to be born. In such cases good sympathetic clinical practice would require steps to be taken to reduce the concerns of the woman.

In the UK, the RCOG recommends that measures to stop the fetal heart should be taken in all terminations after 21 weeks gestation. This is to ensure that there is no possibility of the abortion resulting in a live birth. After 26 weeks the guidelines suggest that it is not possible to know the extent to which the fetus is aware and so after this gestation it is suggested that ‘methods used during abortion to stop the fetal heart should be swift and involve a minimum of injury to fetal tissue.’ Even if the fetus is not aware, as we suggest, these guidelines would be appropriate to avoid unnecessary distress to the woman.

The paramount interests of the woman in abortion procedures is an important principle. Arguments that with viability the fetus becomes a patient and the doctors’ responsibilities towards the woman need to be balanced against those of the fetal patient remain controversial (39)(40). The view that the pregnant woman is the patient while the fetus is cared for on behalf of the woman endures among many clinicians and is in my view the ethical stance (41)(42).

Concern about fetal suffering is raised by those who oppose abortion in principle as a reason to restrict some methods of abortion. In both the US and the UK legislative changes have been proposed which would outlaw a late abortion procedure known by gynaecologists as intact dilation and evacuation and by opponents of abortion as ‘partial-birth abortion’. In both countries the method was defended by the medical establishment on the grounds that there may be circumstances when such practice was in the interests of the woman. It was for this reason that President Clinton exercised his right of presidential veto in respect of the Partial Birth Abortion Ban Bill of 1995 (H.R. 1833/S 939) which had been approved by Congress. Clinton correctly stated that: ‘By refusing to permit women in reliance on their doctors’ best medical judgement, to use this procedure when their lives are threatened or when their health is put in serious jeopardy, Congress has fashioned a Bill that is neither consistent with the Constitution nor with sound public policy’ (43).