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Deadly Questions - on abortion |
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'Be prepared to give an answer... with gentleness and respect.' (1 Pet 3:15)
Have you ever been stuck for words when quizzed on ethical issues? This new series of articles looks at Christian answers to vexing problems. Given the recent 30th anniversary of the passing of the Abortion Act, we start with common questions on abortion.
1. Isn't the fetus only a potential human being?
This is the key issue. Biologically the fetus is undoubtedly human; it has human chromosomes derived from human gametes. It is also alive, exhibiting movement, respiration, sensitivity, growth, reproduction, excretion and nutrition. It is therefore more accurate to speak of it as a human being with potential, a human being in an early stage of development or a potential adult rather than a potential human being. Any biology text book tells us that human development is a continuous process beginning with fertilisation; essentially the only differences between zygote and full term baby are nutrition and time.
The Bible makes many specific references to life before birth. Psalm 139[1] affirms God's creation of and communion with the unborn child. It also implies the continuity between life before and after birth:
'For you created my inmost being; you knit me together in my mother's womb... My frame was not hidden from you when I was made...your eyes saw my unformed body.'
God called Isaiah and Jeremiah before birth[2] and formed Job 'in the womb' as well as bringing him out of it.[3] Furthermore we have the Holy Spirit's own testimony[4] that Christ was present in Mary's womb at about 14 days gestation.[5] Many other verses in the Bible reinforce these principles[6] and there are over 60 references that mention conception specifically.
Biologically and biblically, the fetus is a human being.
2. How can a non-sentient being have value?
Peter Singer, editor of the Bioethics Journal, puts the secular view of humanity in a nutshell: 'Once the religious mumbo-jumbo surrounding the term "human" has been stripped away... we will not regard as sacrosanct the life of every member of our species, no matter how limited its capacity for intelligent or even conscious life may be'.[7] To Singer and many influential thinkers like him, man is nothing but the product of matter, chance and time in a godless universe; merely a highly specialised animal. The value of an individual human being is determined by his level of rationality, self-consciousness, physical attributes or capacity for relationships. Human life that has fewer of these qualities is of less value and can be disposed of. This Darwinian ethic with its aim of 'survival of the fittest' puts the demented, mentally handicapped, brain-injured and unborn in great danger.
By contrast, the Christian view is that all human beings are made in God's image.[8] If they lack the means to feel, think or form relationships as we do, they still have dignity by virtue of the fact that they are made and known by God. Biblical morality dictates that the weak deserve special protection.[9] In God's economy the strong lay down their lives for the weak.[10] After all, protecting the vulnerable is what 'knowing God' is all about.[11] Even if it could be established that fetuses feel nothing, should it really make a difference to the way we treat them? Does anaesthesia legitimise killing?
Having said this, we do not even know that the fetus is 'non-sentient'. We do know that brain function, as measured by EEG, is present in the fetus about six weeks after conception[12] and that responses to tactile sensation (skin tightening, bending, fist forming) can be observed at seven to eight weeks' gestation. At nine to ten weeks the fetus squints and swallows; breathing movements begin at eleven to twelve weeks. By 16 weeks he will respond violently to stimuli that you or I would find painful. Pain is a peculiarly personal and subjective experience: there is no biochemical or physiological test we can do to tell us if fetuses (or other people) experience it. By the same token we lack any proof that animals feel pain but judging by their responses, it seems charitable to assume that they do. No-one would dare suggest dismembering newborn kittens (which ironically are born blind, deaf and helpless at nine weeks' gestation!)
3. Don't women have a right to choose?
Any woman with an unplanned pregnancy will understandably feel under pressure, especially if the father of the child is not supportive. Whether she opts for abortion, adoption or keeping the baby, her decision will change her life forever. She needs to know that the fetus is not just 'part of her body'. It is a genetically distinct and vulnerable human being that has come into existence, almost always, because of choices she and her partner have made.
Some argue that only women can decide about abortion because only women understand what it is like to be pregnant. While this has a certain validity it also has shortcomings. It is rather like arguing that only drivers should be able to decide about road rules because only drivers understand the pressures of driving. However, the actions of motorists can have profound effects on passengers, bystanders and the drivers of other cars as well. In the same way there is a 'passenger' in the womb and other parties outside it to consider.
No man (or woman) is an island. We all value the opportunity of living in a free society but also recognise that personal autonomy has its limits. Rights need protection but they are not absolute. They must be balanced against responsibilities. We are not free to do things which limit or violate the reasonable freedoms of others. In human community abortion is not simply a matter between a woman and her doctor. There are others to consider: the father, any other citizens who may be affected by the decision and, not least, the unborn child herself.
Although there are exceptions, most unwanted pregnancies result from a conscious decision to engage in sexual intercourse by people who are equipped neither for pregnancy nor parenthood (67% of women having abortions in Britain have never been married).[13] It is only natural to regret wrong decisions made in the heat of the moment; however, killing an innocent human being to avert the consequences of choices we have made is never morally justifiable. The right to life is the most fundamental right of all.
Solo mothers will need support, and adoption even with its difficulties is always an option to consider. There are many childless couples spending thousands of pounds on infertility treatments because babies they could have provided a home for have been among the 4.8 million terminated in Britain since 1968.
4. Won't refusing abortion simply mean that women suffer?
A common myth is that women will not change their minds about having an abortion when offered practical help and given the facts about fetal development. Many do, and pregnancy counselling organisations like CARE for Life[14] have made a substantial contribution in helping women whose turning to abortion is simply a cry for help. Even women refused abortions do not necessarily seek them. An early Swedish study[15] of 4274 women refused abortion showed that 85.6% completed their pregnancies and only 10% sought an abortion elsewhere.[16] Another similar study followed up 249 such women for 7 to 10 years finding that 73% were satisfied with the way things had turned out; 69% were taking care of the child.[17] Most unwanted pregnancies, if not aborted, result in wanted children. Conversely most abused children come from wanted pregnancies. Since the Abortion Act came into force in Britain in 1968 the incidence of child abuse has doubled.[18]
Many believe that women refused abortion are at risk of mental illness. However, representatives of the Royal College of Psychiatry giving evidence to the Rawlinson Commission[19] have stated that there are no psychiatric grounds for abortion. This is in spite of the fact that most abortions are carried out on alleged grounds of damage to the mother's mental health. In fact, for suicidal pregnant women, abortion will increase depression and the risk of post-abortion psychosis.[20] What they really need is proper psychiatric treatment. As a general rule pregnancy enhances rather than damages mental health; the incidence of suicide in non-pregnant women of childbearing age is 18 times that in pregnant women.[21]
While first trimester abortions are usually physically safe (for the mother), complications do however occur: uterine perforation, haemorrhage, sepsis, cervical lacerations and retained placentae in the short term as well as chronic pelvic inflammatory disease, subfertility, cervical incompetence, rhesus isoimmunisation and menstrual disturbances in the long term. A prospective and joint RCGP/RCOG study showed that 10% of women had complications within three weeks of the procedure.[22] As complications are required to be reported by one week, and most occur after this time, the rate may well be higher. Women damaged by abortion are unlikely to return to the institution that damaged them simply to be counted.
Early psychiatric morbidity appears to be about 10%.[23] The long term sequelae are difficult to evaluate
as follow up rates are low for a variety of reasons, not least that many do not wish to be reminded of their
experience. In some patients post-abortion psychosis can be crippling and those who feel ambiguous about the decision
are particularly vulnerable.[24]
5. Surely we can't return to the days of back street abortionists and abortion tourism?
The argument that 'safe and legal' abortion is necessary to stop 'thousands of women' dying at the hands of back street abortionists is ill-founded. Claims about death rates have been wildly exaggerated; take for eample the pro-choice newspaper which claimed in 1989 that 600,000 Brazilian women died from illegal abortions each year.[25] A look at UN statistics reveals that there were only 2,507 maternal deaths in Brazil in 1988 - from all causes![26] Similarly the figure of 200,000 abortion deaths worldwide promoted by leading politicians (such as Baroness Chalker) has been acknowledged to be hugely exaggerated. The UNFPA Report 'The State of the World's Population', published in August 1994, put the figure at 60,000. Even this is a guestimate. Dr Bernard Nathanson, who was a major figure in the effort to legalise abortion in the US and presided over 60,000 abortions before having a change of heart, gives some insight into the reasons for the disparity between the real and the claimed:
'...we emphasised the frame of the individual case, not the mass statistics, but when we spoke of the latter it was always "5,000 to 10,000 deaths a year". I confess that I knew the figures were totally false... but the overriding concern was to get the laws eliminated, and anything within reason that had to be done was permissible.'[27]
The truth is that, throughout the world, abortion deaths have fallen steeply in line with maternal deaths, owing to advances in medical science. According to WHO figures this trend has occurred regardless of whether abortion is legal or illegal in particular countries[28]. Ireland, which has maintained an absolute law against abortion, has the lowest maternal mortality rate in the world.[29] Prior to the Abortion Act mortality from criminal abortion in Britain was very low (approx 20 per year); compared with the 180,000 unborn children who now die annually. This was because many so-called back street abortions were performed (albeit illegally) by doctors in relatively 'safe' circumstances.[30]
It's also claimed, by pro-choice law 'reformers', that women denied abortions at home will simply travel to other countries to obtain them. While this did happen to a limited extent in the past, it was never in numbers approaching those in countries where abortion is legal. Legalisation has increased abortion rates dramatically, to the extent that deaths (of unborn children) from abortion worldwide now number 55 million per year.[31] Abortion rates among Irish women (who can easily travel) are still only a third that of British women.
6. What about abortion for rape?
If life before birth has the same status as life after birth then it follows that if we wouldn't approve of infanticide in a given situation, then neither should we approve of abortion. Would we sanction the destruction of a neonate who was grossly deformed, conceived as a result of rape or the child of a minor? Wouldn't we rather look for some way to make the best of a bad situation by using our medical skills, helping practically or financially, or perhaps by arranging adoption?
These difficult cases must be seen in this light. Rape is a very serious crime that itself was a capital offence in the Old Testament. However pregnancy arising from rape is extremely rare; and even alleged rape is a factor in less than 1% of abortions. In the USA in any one year, one in a thousand women report rape and of these a similar proportion become pregnant. Furthermore in the only major study of pregnant rape victims ever done, 75 to 85% chose against abortion.[32] This is because many women who have been raped believe that abortion is immoral, that the child is simply a second innocent victim, and that if they get through the pregnancy they will have conquered the rape. Giving birth in such circumstances is a display of courage, strength and honour. Abortion, by contrast, simply sacrifices a second innocent party to the crime.
I am forced to the conclusion that the Christian solution, difficult though that may be, is to care for the child at least until birth when adoption can be considered (especially if the mother is young). However one can not advocate this without at the same time realising that it puts every onus on us as Christians to do everything we can to help an equally innocent (and much sinned against) mother.
7. What about abortion for fetal handicap?
Abortions for fetal handicap make up only 1.1% of the total in Britain, but over 90 are performed on infants of viable age each year. This puts the issue in sharp perspective. Whereas profoundly handicapped 26 week old neonates are (quite rightly) given every chance of survival, older babies still in utero can be legally killed in Britain for less serious abnormalities. Many women will not now consider having a child with any form of handicap, so biochemical screens, preimplantation diagnosis, chorionic villous biopsy and amniocentesis are increasingly available. Apart from the small number of tests done in order to prepare parents in advance for the arrival of a child with special needs, or to identify surgically correctable anomalies, most screening is performed to identify handicapped fetuses so that they can be aborted. This is a form of discrimination that would not be tolerated in any other group apart from unborn children. While no one is denying the huge psychological and financial cost of raising a handicapped child, we would not use this as an excuse for killing in any other field of medicine. Our obligation is to do the very best with what we have to 'strengthen what remains'.
This is not to deny the often extreme hardship incurred by those who have to care for children with special needs. It's a responsibility that the community must share; but it is sheer nonsense to assert that people with spina bifida, Down's syndrome, or some worse anomaly cannot, with the right support, live useful and fulfilling lives. Even those whose anomalies are incompatible with life can make a valuable contribution to the world and to others; and they are undoubtedly precious in the eyes of God.[33]
8. What about abortion to save the life of the mother?
Usually when the mother's life is at risk, the baby is viable and so can be saved simply by bringing forward the time of delivery. On very rare occasions it may be necessary to terminate a mid-trimester pregnancy in an emergency in order to save the life of the mother. Here we are not saying that the baby's life is less important than that of the mother, but simply (since the baby will die regardless) that it is better to intervene to save one life rather than to stand by and watch two die. Even in these situations it is usually possible to deliver the baby in such a way that the parents can have some short time with it. In the UK only 0.013% of all abortions are performed 'to save the life of the mother' and it is even questionable whether many of these require such radical action. Ireland's leading obstetricians stated in 1992:
'... we affirm that there are no medical circumstances justifying direct abortion, that is, no circumstances in which the life of the mother may only be saved by directly terminating the life of her unborn child'.[34]
This was not unsubstantiated. The National Maternity Hospital in Dublin investigated in detail the 21 maternal deaths which occurred among the 74,317 pregnancies managed in 1970-1979. The conclusion was that abortion wouldn't have saved the mother's life in a single case.[35]
Alan Guttmacher, former President of the pro-abortion US Planned Parenthood Federation has said:
'Today it is possible for almost any patient to be brought through pregnancy alive, unless she suffers from a fatal illness such as cancer or leukemia, and if so, abortion would be unlikely to prolong, much less save life'.[36]
In fact, women with cancer will often forgo chemotherapy for the sake of the baby[37] and this brings us back
to our starting point. When we recognise how precious human life before birth really is, we begin to see the evil
of abortion in all its stark reality.
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