Abortion is the intentional destruction of the fetus in the womb, or any untimely delivery brought about with intend to cause the death of the fetus (Price, 1988). As is evident in the definition, it is the intention to terminate the life of a living being which has made abortion such a controversial issue. Hippocrates (c. 3rd century BC) wrote in his famous oath: ‘I will not give to a woman a pessary to cause abortion’ (Reiser et al. 1977, p.5). The history of abortion goes that far back, perhaps further. How can abortion which contradicts such basic imperatives of medical practice, like ‘Do not harm’ or ‘Respect human life’, be so deep rooted in the history of that practice? What made (and still makes) health professionals carry out abortions on such a wide scale?
Two principal kinds of indications have been defined for ‘termination of pregnancy’. The first, called ‘medical indications’, are: 1) That continuance of the pregnancy would put the life of the pregnant woman at risk, or put her physical or mental health or that of any existing children, at greater risk than if the pregnancy were terminated; 2) There is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously disabled.
The second kind of indications, the so-called ‘social indications’, are more complex and vary between cultures and epochs. Examples are: pregnancies resulting from extra-marital relations, from rape or incest, unwanted or unplanned pregnancies, pregnancies at too young or too old an age, expecting a baby of the ‘wrong’ sex - the information being provided by recent medical technology. We may note that it is primarily ‘social reasons’ of this sort that lead parents to seek abortion. The actual termination of pregnancies has been carried out either by health professionals or by some unqualified person, sometimes even by the pregnant woman herself.
Abortion has always been discussed by doctors, philosophers, lawyers and theologians from different perspectives. Here I shall go over some of these arguments, and try to come to a conclusion about the ethics of abortion. Actually, as Dunstan observes (1978, p.7S), we shall be considering the ethics of a practice already very widespread, and likely to become more so, in all regions of the world, developed and developing. At least fifty million abortions are carried out annually world-wide, and, for example in France and Japan, half of all pregnancies end in abortion (E.B., 1982, vol.2, plO69). One and half million abortions are performed in USA each year, one-third of them on teenagers between 12 and 17 years old (Poots & Diggory, 1983, p.287). Therefore, it is rather difficult to discuss the moral acceptability of something which has already been so widely accepted. A 1991 Harris poll showed 81% of adults in England in favour of a woman’s right to choose’ to have an abortion in the first three months of pregnancy (Cole, 1992, p.2) Mason (p.113) states that: ‘The significant feature is not so much the total number of abortions but, rather, the steady escalation in numbers over the years. The figures indicate that there must be an increasing public acceptance of abortion as a natural way of life’. Dunstan (1974, p.87) commenting on this fact writes: ‘Abortion is now being more widely legalized and practised because that is what people want - an indication for medical intervention for the destruction of life unknown in our ethics before’.
Writers on the abortion issue have concentrated most on two matters: first, the ‘rights’ of the fetus and the mother, in particularly the property right of the woman on her body; second, the question of the ‘personhood’ of the prenate (i.e. the unborn child). Judith Jarvis Thomson is one of the pioneers among writers who approach the issue from the perspective of the ‘rights’ of the fetus and the mother. She has no difficulty recognizing the ‘personhood’ of the fetus. She says every person has a right to life, so the fetus has a right to life. However, she believes that the mother has a right to decide what shall happen in and to her body (Dunstan, 1974, p.203).
The ‘personhood’ or legal, moral status of the prenate is a very involved legal, philosophical question which I have addressed elsewhere (see Aksoy, 1996).
People who have defined views on the issue generally take one of three positions: 1) abortion is always wrong and must never be performed at any time for any reason; 2) abortion may be carried out at any time for any reason; and 3) abortion should only be allowed up to a certain stage of pregnancy, after which it should not be allowed except under certain special conditions.
The people in the first group are not very many. They follow the Roman Catholic teaching. which maintains:
‘We cannot be absolutely certain when animation takes place, or when the conceptus or the fetus is a human person; but it may well be precisely at the moment of conception. This being so, it would be seriously wrong to destroy the fertilized ovum even then, because one might be killing a human person’ (Mahoney, 1984, p.69). According to this strict line, abortion is impermissible even when the mother’s life is in danger or the pregnancy is the result of an indecent event, like rape or incest.
The second position is held by those who advance the ‘personhood’ argument. Harris (1990) is one of those writers who suggest that: ‘A person is a creature capable of valuing its own existence. And non-persons or potential persons cannot be wronged in this way because death does not deprive them of anything they can value. If they cannot wish to live, they cannot have that wish frustrated by being killed.’
The third position which may be defined as ‘moderate’ maintains that abortion should not be allowed after a certain stage of pregnancy and only if particular circumstances justify it. For instance, it is a very common view that abortion should be permitted in order to save the mother’s life. Some people believe that abortion is also morally permissible when pregnancy is the result of rape or incest, and when a severe fetal abnormality has been diagnosed. There are also writers who suggest that termination of pregnancy should be permissible if the potential mother is too young.
One exceptional circumstance which justifies abortion, on this view, is the diagnosis of severe abnormalities in the fetus. The argument is that it is wrong to bring avoidable suffering into the world and we are morally obliged to terminate the life of severely handicapped fetuses. One writer has explained that it is a misconception to regard this justification as ‘on behalf of’ the fetus (Mason, p.106). In reality the suffering being avoided is being avoided on behalf of the mother and other potential carers. We need to be clear about whether the termination due to disability is being considered in the supposed interest of the unborn child - that it is ‘better’ for that child not to live at all then to live with a foreseeable handicap - or in the ‘interest’ of those who would have the care and burden of that child’s life, including its suffering and pain (Dunstan, 1974, p.84). Williams (1987, p.297) is explicit that abortion on such grounds relates to the welfare of the parents, whose life may be blighted by having to rear a grossly defective child, with perhaps in the background such secondary considerations as costs to the public purse.
For all the debate, the suggestions and counter-suggestions and alternatives, it seems likely that abortion will remain the dilemma it has been for centuries. However, we must bear in mind the fundamental fact that abortion is termination of the life of a living creature. We must approach ending the life of a prenate as cautiously and sensitively as we would ending the life of any other living creature, and we should not end the life of any living being unnecessarily and without very good reason. On the question of the ‘personhood of the prenate, we can be sure only that we will never be sure about it, unless we discover some sort of ‘Turnasol Paper’ like indicator to decide the matter. As the moral status of the prenate is not something material, we need to refer to the authority of metaphysical and transcendental knowledge, and the religions are among these sources. As I have tried to show elsewhere (Aksoy, 1966), not only all religions but also many philosophers from Aristotle onwards have declared that a human being consists of body and soul. In the religious perspective, the earthly existence of a person ends when the soul departs the body. At the other end of this ‘silent journey’ (Aksoy, 1995), the human person begins when the soul joins the body. We do not know very much about the when and how of the soul’s departure, but there are clear statements in the Qur’an about the time and the process of ensoulment. There is also some information related to this in the Talmud, and some detailed explanation in Aquinas’s works.
All the scientific (anatomical and physiological) and metaphysical (religious and spiritual) arguments tell us that, if there is a time between conception and birth at which the prenate ‘enters humanity’, ‘becomes a person’, ‘becomes morally important’ or however we call it, it is most likely to be at some time in the eighth week (Aksoy, n.d.). In sum: even at the very beginning of its existence we owe respect to the unborn, but after eight weeks time to terminate its life should be defined as morally unacceptable.
It may be asked, if the prenate ‘becomes a real person’ after eight weeks, then how do we regard embryos? Donceel (1984, p. 15) suggests that, ‘Although a prehuman embryo cannot demand from us the absolute respect which we owe to the human person, it deserves a very great consideration, because it is a living being, endowed with a human finality, on its way to homonization. Therefore it seems to me that only very serious reasons should allow us to terminate its existence.’ Apparently, it is one thing to say that an entity lacks the dignity of being a person in the strict sense of ‘person’, and another thing to say that it does not have any value. The embryo may, in this respect, be regarded as similar to a human corpse. At the moment in question neither of them are existing human persons. The embryo will be one, as the dead body once was. And we owe respect to both. If we mutilate and disgrace a human corpse it is something immoral and shameful, even though not illegal. Similarly, if we destroy or terminate the life of an embryo, it is not an attack on an individual human being but still inhumane and undignified. However, sometimes it might be necessary to undertake an undignified and inhumane action to undo the signs of another ‘more’ undignified and inhumane action, like rape.
The way Dunstan has expressed the dilemma of abortion (1974, p. 85-6) gives a most helpful direction to our moral thinking on it; ‘We should pass from the question, what harm are we doing to the fetus by destroying it, to the question, what harm are we doing to ourselves, to humanity, when we do so?”