ABORTION

Claire Foster © 2006

The Ethical Dimension

No one thinks having an abortion is a good thing to do.  The question is, is it always wrong or are there circumstances when it is the better course of action?  The following paragraphs explain what happens at the beginning of a human life and asks some questions.

 

Development of the embryo/fetus

At conception, when the egg is fertilised, the unique genetic code (genome) is fixed which determines the characteristics of the human being the embryo is to become.  At that stage it isn’t known whether the embryo will become one or more people.  At about the eighth cell division (four or five days after conception), if there are two embryos, each will have its own placenta by now.  They will become twins.  At 14 days, when the embryo has travelled up the fallopian tube and is implanting in the womb wall, the single embryo may divide.  If that happens, two fetuses share one placenta, and become identical twins because their genome is identical.  If the division of the embryo happens at around day 12, the twins will share the same amniotic sac (the fluid in which the fetus grows) and these may become conjoined (‘siamese’) twins.

 

Once the embryo is implanted in the womb wall it starts to grow rapidly.  At 10 weeks, the central nervous system starts to develop which means that the fetus can feel pain.

 

When does an egg/sperm/embryo become a human being?

 

Viability as the deciding factor in abortion

The Infant Life (Preservation) Act 1927 made it a criminal offence to destroy the life of any child capable of being born alive, setting the limits of viability at 28 weeks.  The Abortion Act (1967) upheld this.  In 1990, when the Human Fertilisation and Embryology Act was passed (see below) this limit was reduced to 24 weeks, since it was by then possible for doctors to keep a fetus born at that stage alive.

 

Does the ability to survive outside the womb make you a human being with equal rights to other living human beings?

 

Presence of the primitive streak as the deciding factor in embryo research

The Human Fertilisation and Embryology Act (1990) put a 14 day limit on embryos being used for research purposes.  No embryo is permitted to be kept alive after that stage, except for those which are cryopreserved for couples’ future children.  The idea was that up until that point the embryo might divide into two, and was not, therefore, a person in any meaningful sense, including in potential.  We don’t say that identical twins are actually one person.  So until the embryo ‘knows’ if it is one or two people, arguably it isn’t really a person at all.

 

Does the definite appearance of one or two embryos with their unique genetic code mean a human being now exists?  Does it have the same rights as human beings living outside the womb?

 

The Abortion Act 1967

The prevailing idea behind the Abortion Act was not to defend women’s rights over their own bodies.  Nor was it to devalue the fetus.  Rather it sought to decriminalise the actions of doctors who, on compassionate grounds, gave women abortions because they really believed that was the right thing to do.  The case that led to the Act was one of a girl in her early teens who was raped by a group of Guardsmen and fell pregnant.  Public opinion was outraged at the idea that her procurement of an abortion should be a criminal offence.  The other factor weighing in the balance was that many women were (and always have been) procuring abortions illegally (‘back street abortions’), and these abortions, subject to no regulatory framework, were serious threats to the health of the women going through with them.

 

In order to procure an abortion in this country, a woman has to obtain the permission of two doctors.  The doctors have to sign a form stating that they are satisfied that the woman’s pregnancy would be of significant risk to her physical or mental health.

 

The vast majority of General Practitioners will sign this form if a woman wants them to, without regard to serious questions of health or morality.  The loophole in the law is that a woman’s distress at having an unwanted pregnancy could in every event damage her mental health. 

 

GPs and surgeons who, on grounds of conscience, do not wish to have anything to do with abortion are within their rights to refuse to sign forms or perform abortions.  GPs who do not sign abortion forms may refer their patients to a colleague who would sign.

 

If abortion is wrong, is it morally as bad to refer your patient to someone who will procure the abortion for her as to sign the form yourself?

 

Surgeons generally reckon that performing abortions is among the worst of their surgical duties.  Nobody likes doing it or thinks it’s particularly right or good.  Are those surgeons who refuse to perform abortions on grounds of moral conscience merely leaving the dirty work to their colleagues and copping out?

 

The feminist perspective

A driving force behind the abortion issue is the women’s movement.  This movement sees a historical subservience of women to men in which the woman’s role as childbearer has played a major part.  Because the woman has to bear the children, her place is at home and her freedom is severely restricted.  The children were of the mother and father, and the woman did not have sole rights over them.  Hence children tied a woman to her man and her home.  With the advent of contraception the woman gained considerable control over her child bearing potential.  The Abortion Act demands that two doctors’ permissions be sought for an abortion to be lawful.

 

Given that the fetus while in the womb is part of a woman’s body, is it her right to determine what should happen to that fetus?  Why should she seek permission from doctors for it to be destroyed?  Or does the wider society have a say as well? 

 

Welfare of the fetus

There are goal-based or utilitarian arguments to justify abortion.  They are related to the welfare of the potential child.  If a fetus is disabled or has genetic abnormalities that will cause disabilities in later life, it could be argued that it would be better for that child never to have been born.

 

Is it better to live with disability than not to live at all?

 

If the disability involves significant pain and suffering, does that strengthen the argument in favour of aborting fetuses on the grounds of disability?

 

Is it ever justified for parents to seek abortion on the grounds that they don’t think they can cope with a disabled child?

 

Welfare of the mother

Sometimes the mother’s life is endangered by a pregnancy.  Sometimes the pregnancy is caused by rape.

 

When should the welfare of the mother take precedence over the welfare of the child?