abortion morally wrong essay

Ethics and Morality

Ethics and abortion, two opposing arguments on the morality of abortion..

Posted June 7, 2019 | Reviewed by Jessica Schrader

Abortion is, once again, center stage in our political debates. According to the Guttmacher Institute, over 350 pieces of legislation restricting abortion have been introduced. Ten states have signed bans of some sort, but these are all being challenged. None of these, including "heartbeat" laws, are currently in effect. 1

Much has been written about abortion from a philosophical perspective. Here, I'd like to summarize what I believe to be the best argument on each side of the abortion debate. To be clear, I'm not advocating either position here; I'm simply trying to bring some clarity to the issues. The focus of these arguments is on the morality of abortion, not its constitutional or legal status. This is important. One might believe, as many do, that at least some abortions are immoral but that the law should not restrict choice in this realm of life. Others, of course, argue that abortion is immoral and should be illegal in most or all cases.

"Personhood"

Personhood refers to the moral status of an entity. If an entity is a person , in this particular sense, it has full moral status . A person, then, has rights , and we have obligations to that person. This includes the right to life. Both of the arguments I summarize here focus on the question of whether or not the fetus is a person, or whether or not it is the type of entity that has the right to life. This is an important aspect to focus on, because what a thing is determines how we should treat it, morally speaking. For example, if I break a leg off of a table, I haven't done anything wrong. But if I break a puppy's leg, I surely have done something wrong. I have obligations to the puppy, given what kind of creature it is, that I don't have to a table, or any other inanimate object. The issue, then, is what kind of thing a fetus is, and what that entails for how we ought to treat it.

A Pro-Choice Argument

I believe that the best type of pro-choice argument focuses on the personhood of the fetus. Mary Ann Warren has argued that fetuses are not persons; they do not have the right to life. 2 Therefore, abortion is morally permissible throughout the entire pregnancy . To see why, Warren argues that persons have the following traits:

Consciousness: awareness of oneself, the external world, the ability to feel pain.
Reasoning: a developed ability to solve fairly complex problems.
Ability to communicate: on a variety of topics, with some depth.
Self-motivated activity: ability to choose what to do (or not to do) in a way that is not determined by genetics or the environment .
Self-concept : see themselves as _____; e.g. Kenyan, female, athlete , Muslim, Christian, atheist, etc.

The key point for Warren is that fetuses do not have any of these traits. Therefore, they are not persons. They do not have a right to life, and abortion is morally permissible. You and I do have these traits, therefore we are persons. We do have rights, including the right to life.

One problem with this argument is that we now know that fetuses are conscious at roughly the midpoint of a pregnancy, given the development timeline of fetal brain activity. Given this, some have modified Warren's argument so that it only applies to the first half of a pregnancy. This still covers the vast majority of abortions that occur in the United States, however.

A Pro-Life Argument

The following pro-life argument shares the same approach, focusing on the personhood of the fetus. However, this argument contends that fetuses are persons because in an important sense they possess all of the traits Warren lists. 3

At first glance, this sounds ridiculous. At 12 weeks, for example, fetuses are not able to engage in reasoning, they don't have a self-concept, nor are they conscious. In fact, they don't possess any of these traits.

Or do they?

In one sense, they do. To see how, consider an important distinction, the distinction between latent capacities vs. actualized capacities. Right now, I have the actualized capacity to communicate in English about the ethics of abortion. I'm demonstrating that capacity right now. I do not, however, have the actualized capacity to communicate in Spanish on this issue. I do, however, have the latent capacity to do so. If I studied Spanish, practiced it with others, or even lived in a Spanish-speaking nation for a while, I would likely be able to do so. The latent capacity I have now to communicate in Spanish would become actualized.

Here is the key point for this argument: Given the type of entities that human fetuses are, they have all of the traits of persons laid out by Mary Anne Warren. They do not possess these traits in their actualized form. But they have them in their latent form, because of their human nature. Proponents of this argument claim that possessing the traits of personhood, in their latent form, is sufficient for being a person, for having full moral status, including the right to life. They say that fetuses are not potential persons, but persons with potential. In contrast to this, Warren and others maintain that the capacities must be actualized before one is person.

The Abortion Debate

There is much confusion in the abortion debate. The existence of a heartbeat is not enough, on its own, to confer a right to life. On this, I believe many pro-lifers are mistaken. But on the pro-choice side, is it ethical to abort fetuses as a way to select the gender of one's child, for instance?

We should not focus solely on the fetus, of course, but also on the interests of the mother, father, and society as a whole. Many believe that in order to achieve this goal, we need to provide much greater support to women who may want to give birth and raise their children, but choose not to for financial, psychological, health, or relationship reasons; that adoption should be much less expensive, so that it is a live option for more qualified parents; and that quality health care should be accessible to all.

I fear , however, that one thing that gets lost in all of the dialogue, debate, and rhetoric surrounding the abortion issue is the nature of the human fetus. This is certainly not the only issue. But it is crucial to determining the morality of abortion, one way or the other. People on both sides of the debate would do well to build their views with this in mind.

https://abcnews.go.com/US/state-abortion-bans-2019-signed-effect/story?id=63172532

Mary Ann Warren, "On the Moral and Legal Status of Abortion," originally in Monist 57:1 (1973), pp. 43-61. Widely anthologized.

This is a synthesis of several pro-life arguments. For more, see the work of Robert George and Francis Beckwith on these issues.

Michael W. Austin, Ph.D. , is a professor of philosophy at Eastern Kentucky University.

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The Ethical and Moral Argument Against Abortion

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So Why is Abortion Wrong?

If you paid any attention to the title of this piece, you would have known what the essay was going to be about before even reading the paper. In “Abortion is Morally Wrong,” John T. Noonan Jr. defends the idea that an entity becomes a person at the time of conception and that abortion is morally wrong. The only exception to his belief is if the mother’s life is at stake (Noonan Jr. 353) Throughout his writing, Noonan Jr. presents oppositions from the opposing stance that abortion is morally right, and then refutes it. He attempts to answer the question: “How do you determine the humanity of a being?” He introduces several opposing viewpoints and promptly refutes them. The two that will be primarily focused on are the ideas of the dependence on the mother and the unborn child’s lack of experience.

The first opposition that he presents is the idea that the lack of experience makes the child less human. He rejects the claim that “a being who has had experiences, has lived and suffered, who possesses memories, is more human than one who has not” (Noonan Jr. 354). The opposition claims that because the child has never yet experienced anything (i.e. happiness, sadness, pain, etc.), it is not qualified to be a human. He rejects this idea by emphasizing “the embryo is responsive to touch after eight weeks and at least at that point is experiencing” (Noonan Jr. 354). Even if humanity were determined by experience, babies experience things while in the womb even before birth. It was found that unborn children could differentiate touch from pain in the womb at several weeks into pregnancy and maybe even before then (Ertelt). Therefore, the idea that the unborn child does not experience anything while in the womb is inaccurate. However, the question is: Is the level of experience an accurate way of measuring how human a person is? Would older people be more human than young people? Older adults have been through and experienced more than small toddlers. So according to the objection, the older adults would be more human than the toddlers. The age of the person has no correlation with how human a person is. Therefore, the unborn child in the mother’s womb should not be considered less human than an adult on the basis that experience determines humanity.

The second opposing view that he presents is the idea that because the child is dependent on the mother during early pregnancy, the child is not a “human.” The objection explains, “this dependence is made on the basis of denying recognition to [the unborn child’s] humanity” (Noonan Jr. 353). However, Noonan Jr. asserts that this distinction is not fully valid because “artificial incubation may make the fetus viable at any time” (Noonan Jr. 353). Nowadays, there is more technology to provide a chance for premature babies to survive without fully developing in the mother’s womb. He mainly argues against this opposition by asserting that the dependency of the child does not end after birth. He claims that “ the fetus is still absolutely dependent on someone care in order to continue existence” (Noonan Jr. 354). After the birth of the child, do the parents just let the child grow on its own without any assistance? Of course not, that would be child neglect; if this were the case, no one would be alive today. The notion that a child’s dependency on the mother to live determines how human it is not valid. Babies and even small children are completely dependent on others to live. Since they cannot fend for themselves, they rely on others entirely.

Noonan Jr. compelling argument against abortion provides great retribution for the opposition’s arguments. An unborn child is no less human than a person who has had more experience or is “less dependent” on the mother. The child has the potential to grow up and become someone but abortion takes that away in a matter of minutes. Despite others attempts to define humanity, an unborn child is human regardless simply because it has the potential to become an experienced and independent human being.

Works Cited

Ertelt, Steven. “Study: Unborn Babies Can Differentiate Touch, Pain in Womb.” LifeNews.com . N.p., 09 Sept. 2011. Web. 08 Nov. 2014.

Noonan Jr., John T. “Abortion is Morally Wrong.” Famine, Affluence, and Morality. N.p. 353-357. Print.

4 responses to “ So Why is Abortion Wrong? ”

Is Abortion Sacred?

By Jia Tolentino

The silhouettes of two women made from the negative space of a rosary.

Twenty years ago, when I was thirteen, I wrote an entry in my journal about abortion, which began, “I have this huge thing weighing on me.” That morning, in Bible class, which I’d attended every day since the first grade at an evangelical school, in Houston, my teacher had led us in an exercise called Agree/Disagree. He presented us with moral propositions, and we stood up and physically chose sides. “Abortion is always wrong,” he offered, and there was no disagreement. We all walked to the wall that meant “agree.”

Then I raised my hand and, according to my journal, said, “I think it is always morally wrong and absolutely murder, but if a woman is raped, I respect her right to get an abortion.” Also, I said, if a woman knew the child would face a terrible life, the child might be better off. “Dead?” the teacher asked. My classmates said I needed to go to the other side, and I did. “I felt guilty and guilty and guilty,” I wrote in my journal. “I didn’t feel like a Christian when I was on that side of the room. I felt terrible, actually. . . . But I still have that thought that if a woman was raped, she has her right. But that’s so strange—she has a right to kill what would one day be her child? That issue is irresolved in my mind and it will eat at me until I sort it out.”

I had always thought of abortion as it had been taught to me in school: it was a sin that irresponsible women committed to cover up another sin, having sex in a non-Christian manner. The moral universe was a stark battle of virtue and depravity, in which the only meaningful question about any possible action was whether or not it would be sanctioned in the eyes of God. Men were sinful, and the goodness of women was the essential bulwark against the corruption of the world. There was suffering built into this framework, but suffering was noble; justice would prevail, in the end, because God always provided for the faithful. It was these last tenets, prosperity-gospel principles that neatly erase the material causes of suffering in our history and our social policies—not only regarding abortion but so much else—which toppled for me first. By the time I went to college, I understood that I was pro-choice.

America is, in many ways, a deeply religious country—the only wealthy Western democracy in which more than half of the population claims to pray every day. (In Europe, the figure is twenty-two per cent.) Although seven out of ten American women who get abortions identify as Christian, the fight to make the procedure illegal is an almost entirely Christian phenomenon. Two-thirds of the national population and nearly ninety per cent of Congress affirm a tradition in which a teen-age girl continuing an unplanned pregnancy allowed for the salvation of the world, in which a corrupt government leader who demanded a Massacre of the Innocents almost killed the baby Jesus and damned us all in the process, and in which the Son of God entered the world as what the godless dare to call a “clump of cells.”

For centuries, most Christians believed that human personhood began months into the long course of pregnancy. It was only in the twentieth century that a dogmatic narrative, in which every pregnancy is an iteration of the same static story of creation, began both to shape American public policy and to occlude the reality of pregnancy as volatile and ambiguous—as a process in which creation and destruction run in tandem. This newer narrative helped to erase an instinctive, long-held understanding that pregnancy does not begin with the presence of a child, and only sometimes ends with one. Even within the course of the same pregnancy, a person and the fetus she carries can shift between the roles of lover and beloved, host and parasite, vessel and divinity, victim and murderer; each body is capable of extinguishing the other, although one cannot survive alone. There is no human relationship more complex, more morally unstable than this.

The idea that a fetus is not just a full human but a superior and kinglike one—a being whose survival is so paramount that another person can be legally compelled to accept harm, ruin, or death to insure it—is a recent invention. For most of history, women ended unwanted pregnancies as they needed to, taking herbal or plant-derived preparations on their own or with the help of female healers and midwives, who presided over all forms of treatment and care connected with pregnancy. They were likely enough to think that they were simply restoring their menstruation, treating a blockage of blood. Pregnancy was not confirmed until “quickening,” the point at which the pregnant person could feel fetal movement, a measurement that relied on her testimony. Then as now, there was often nothing that distinguished the result of an abortion—the body expelling fetal tissue—from a miscarriage.

Ancient records of abortifacient medicine are plentiful; ancient attempts to regulate abortion are rare. What regulations existed reflect concern with women’s behavior and marital propriety, not with fetal life. The Code of the Assura, from the eleventh century B.C.E., mandated death for married women who got abortions without consulting their husbands; when husbands beat their wives hard enough to make them miscarry, the punishment was a fine. The first known Roman prohibition on abortion dates to the second century and prescribes exile for a woman who ends her pregnancy, because “it might appear scandalous that she should be able to deny her husband of children without being punished.” Likewise, the early Christian Church opposed abortion not as an act of murder but because of its association with sexual sin. (The Bible offers ambiguous guidance on the question of when life begins: Genesis 2:7 arguably implies that it begins at first breath; Exodus 21:22-24 suggests that, in Old Testament law, a fetus was not considered a person; Jeremiah 1:5 describes God’s hand in creation even “before I formed you in the womb.” Nowhere does the Bible clearly and directly address abortion.) Augustine, in the fourth century, favored the idea that God endowed a fetus with a soul only after its body was formed—a point that Augustine placed, in line with Aristotelian tradition, somewhere between forty and eighty days into its development. “There cannot yet be a live soul in a body that lacks sensation when it is not formed in flesh, and so not yet endowed with sense,” he wrote. This was more or less the Church’s official position; it was affirmed eight centuries later by Thomas Aquinas.

In the early modern era, European attitudes began to change. The Black Death had dramatically lowered the continent’s population, and dealt a blow to most forms of economic activity; the Reformation had weakened the Church’s position as the essential intermediary between the layman and God. The social scientist Silvia Federici has argued, in her book “ Caliban and the Witch ,” that church and state waged deliberate campaigns to force women to give birth, in service of the emerging capitalist economy. “Starting in the mid-16th century, while Portuguese ships were returning from Africa with their first human cargoes, all the European governments began to impose the severest penalties against contraception, abortion, and infanticide,” Federici notes. Midwives and “wise women” were prosecuted for witchcraft, a catchall crime for deviancy from procreative sex. For the first time, male doctors began to control labor and delivery, and, Federici writes, “in the case of a medical emergency” they “prioritized the life of the fetus over that of the mother.” She goes on: “While in the Middle Ages women had been able to use various forms of contraceptives, and had exercised an undisputed control over the birthing process, from now on their wombs became public territory, controlled by men and the state.”

Martin Luther and John Calvin, the most influential figures of the Reformation, did not address abortion at any length. But Catholic doctrine started to shift, albeit slowly. In 1588, Pope Sixtus V labelled both abortion and contraception as homicide. This pronouncement was reversed three years later, by Pope Gregory XIV, who declared that abortion was only homicide if it took place after ensoulment, which he identified as occurring around twenty-four weeks into a pregnancy. Still, theologians continued to push the idea of embryonic humanity; in 1621, the physician Paolo Zacchia, an adviser to the Vatican, proclaimed that the soul was present from the moment of conception. Still, it was not until 1869 that Pope Pius IX affirmed this doctrine, proclaiming abortion at any point in pregnancy to be a sin punishable by excommunication.

When I found out I was pregnant, at the beginning of 2020, I wondered how the experience would change my understanding of life, of fetal personhood, of the morality of reproduction. It’s been years since I traded the echo chamber of evangelical Texas for the echo chamber of progressive Brooklyn, but I can still sometimes feel the old world view flickering, a photographic negative underneath my vision. I have come to believe that abortion should be universally accessible, regulated only by medical codes and ethics, and not by the criminal-justice system. Still, in passing moments, I can imagine upholding the idea that our sole task when it comes to protecting life is to end the practice of abortion; I can imagine that seeming profoundly moral and unbelievably urgent. I would only need to think of the fetus in total isolation—to imagine that it were not formed and contained by another body, and that body not formed and contained by a family, or a society, or a world.

As happens to many women, though, I became, if possible, more militant about the right to an abortion in the process of pregnancy, childbirth, and caregiving. It wasn’t just the difficult things that had this effect—the paralyzing back spasms, the ragged desperation of sleeplessness, the thundering doom that pervaded every cell in my body when I weaned my child. And it wasn’t just my newly visceral understanding of the anguish embedded in the facts of American family life. (A third of parents in one of the richest countries in the world struggle to afford diapers ; in the first few months of the pandemic , as Jeff Bezos’s net worth rose by forty-eight billion dollars, sixteen per cent of households with children did not have enough to eat.) What multiplied my commitment to abortion were the beautiful things about motherhood: in particular, the way I felt able to love my baby fully and singularly because I had chosen to give my body and life over to her. I had not been forced by law to make another person with my flesh, or to tear that flesh open to bring her into the world; I hadn’t been driven by need to give that new person away to a stranger in the hope that she would never go to bed hungry. I had been able to choose this permanent rearrangement of my existence. That volition felt sacred.

Abortion is often talked about as a grave act that requires justification, but bringing a new life into the world felt, to me, like the decision that more clearly risked being a moral mistake. The debate about abortion in America is “rooted in the largely unacknowledged premise that continuing a pregnancy is a prima facie moral good,” the pro-choice Presbyterian minister Rebecca Todd Peters writes . But childbearing, Peters notes, is a morally weighted act, one that takes place in a world of limited and unequally distributed resources. Many people who get abortions—the majority of whom are poor women who already have children—understand this perfectly well. “We ought to take the decision to continue a pregnancy far more seriously than we do,” Peters writes.

I gave birth in the middle of a pandemic that previewed a future of cross-species viral transmission exacerbated by global warming, and during a summer when ten million acres on the West Coast burned . I knew that my child would not only live in this degrading world but contribute to that degradation. (“Every year, the average American emits enough carbon to melt ten thousand tons of ice in the Antarctic ice sheets,” David Wallace-Wells writes in his book “ The Uninhabitable Earth .”) Just before COVID arrived, the science writer Meehan Crist published an essay in the London Review of Books titled “Is it OK to have a child?” (The title alludes to a question that Alexandria Ocasio-Cortez once asked in a live stream, on Instagram.) Crist details the environmental damage that we are doing, and the costs for the planet and for us and for those who will come after. Then she turns the question on its head. The idea of choosing whether or not to have a child, she writes, is predicated on a fantasy of control that “quickly begins to dissipate when we acknowledge that the conditions for human flourishing are distributed so unevenly, and that, in an age of ecological catastrophe, we face a range of possible futures in which these conditions no longer reliably exist.”

In late 2021, as Omicron brought New York to another COVID peak, a Gen Z boy in a hoodie uploaded a TikTok , captioned “yall better delete them baby names out ya notes its 60 degrees in december.” By then, my baby had become a toddler. Every night, as I set her in the crib, she chirped good night to the elephants, koalas, and tigers on the wall, and I tried not to think about extinction. My decision to have her risked, or guaranteed, additional human suffering; it opened up new chances for joy and meaning. There is unknowability in every reproductive choice.

As the German historian Barbara Duden writes in her book “ Disembodying Women ,” the early Christians believed that both the bodies that created life and the world that sustained it were proof of the “continual creative activity of God.” Women and nature were aligned, in this view, as the material sources of God’s plan. “The word nature is derived from nascitura , which means ‘birthing,’ and nature is imagined and felt to be like a pregnant womb, a matrix, a mother,” Duden writes. But, in recent decades, she notes, the natural world has begun to show its irreparable damage. The fetus has been left as a singular totem of life and divinity, to be protected, no matter the costs, even if everything else might fall.

The scholar Katie Gentile argues that, in times of cultural crisis and upheaval, the fetus functions as a “site of projected and displaced anxieties,” a “fantasy of wholeness in the face of overwhelming anxiety and an inability to have faith in a progressive, better future.” The more degraded actual life becomes on earth, the more fervently conservatives will fight to protect potential life in utero. We are locked into the destruction of the world that birthed all of us; we turn our attention, now, to the worlds—the wombs—we think we can still control.

By the time that the Catholic Church decided that abortion at any point, for any reason, was a sin, scientists had identified the biological mechanism behind human reproduction, in which a fetus develops from an embryo that develops from a zygote, the single-celled organism created by the union of egg and sperm. With this discovery, in the mid-nineteenth century, women lost the most crucial point of authority over the stories of their pregnancies. Other people would be the ones to tell us, from then on, when life began.

At the time, abortion was largely unregulated in the United States, a country founded and largely populated by Protestants. But American physicians, through the then newly formed American Medical Association, mounted a campaign to criminalize it, led by a gynecologist named Horatio Storer, who once described the typical abortion patient as a “wretch whose account with the Almighty is heaviest with guilt.” (Storer was raised Unitarian but later converted to Catholicism.) The scholars Paul Saurette and Kelly Gordon have argued that these doctors, whose profession was not as widely respected as it would later become, used abortion “as a wedge issue,” one that helped them portray their work “as morally and professionally superior to the practice of midwifery.” By 1910, abortion was illegal in every state, with exceptions only to save the life of “the mother.” (The wording of such provisions referred to all pregnant people as mothers, whether or not they had children, thus quietly inserting a presumption of fetal personhood.) A series of acts known as the Comstock laws had rendered contraception, abortifacient medicine, and information about reproductive control widely inaccessible, by criminalizing their distribution via the U.S. Postal Service. People still sought abortions, of course: in the early years of the Great Depression, there were as many as seven hundred thousand abortions annually. These underground procedures were dangerous; several thousand women died from abortions every year.

This is when the contemporary movements for and against the right to abortion took shape. Those who favored legal abortion did not, in these years, emphasize “choice,” Daniel K. Williams notes in his book “ Defenders of the Unborn .” They emphasized protecting the health of women, protecting doctors, and preventing the births of unwanted children. Anti-abortion activists, meanwhile, argued, as their successors do, that they were defending human life and human rights. The horrors of the Second World War gave the movement a lasting analogy: “Logic would lead us from abortion to the gas chamber,” a Catholic clergyman wrote, in October, 1962.

Ultrasound imaging, invented in the nineteen-fifties, completed the transformation of pregnancy into a story that, by default, was narrated to women by other people—doctors, politicians, activists. In 1965, Life magazine published a photo essay by Lennart Nilsson called “ Drama of Life Before Birth ,” and put the image of a fetus at eighteen weeks on its cover. The photos produced an indelible, deceptive image of the fetus as an isolated being—a “spaceman,” as Nilsson wrote, floating in a void, entirely independent from the person whose body creates it. They became totems of the anti-abortion movement; Life had not disclosed that all but one had been taken of aborted fetuses, and that Nilsson had lit and posed their bodies to give the impression that they were alive.

In 1967, Colorado became the first state to allow abortion for reasons other than rape, incest, or medical emergency. A group of Protestant ministers and Jewish rabbis began operating an abortion-referral service led by the pastor of Judson Memorial Church, in Manhattan; the resulting network of pro-choice clerics eventually spanned the country, and referred an estimated four hundred and fifty thousand women to safe abortions. The evangelical magazine Christianity Today held a symposium of prominent theologians, in 1968, which resulted in a striking statement: “Whether or not the performance of an induced abortion is sinful we are not agreed, but about the necessity and permissibility for it under certain circumstances we are in accord.” Meanwhile, the priest James McHugh became the director of the National Right to Life Committee, and equated fetuses to the other vulnerable people whom faithful Christians were commanded to protect: the old, the sick, the poor. As states began to liberalize their abortion laws, the anti-abortion movement attracted followers—many of them antiwar, pro-welfare Catholics—using the language of civil rights, and adopted the label “pro-life.”

W. A. Criswell, a Dallas pastor who served as president of the Southern Baptist Convention from 1968 to 1970, said, shortly after the Supreme Court issued its decision in Roe v. Wade , that “it was only after a child was born and had life separate from his mother that it became an individual person,” and that “it has always, therefore, seemed to me that what is best for the mother and the future should be allowed.” But the Court’s decision accelerated a political and theological transformation that was already under way: by 1979, Criswell, like the S.B.C., had endorsed a hard-line anti-abortion stance. Evangelical leadership, represented by such groups as Jerry Falwell’s Moral Majority , joined with Catholics to oppose the secularization of popular culture, becoming firmly conservative—and a powerful force in Republican politics. Bible verses that express the idea of divine creation, such as Psalm 139 (“For you created my innermost being; you knit me together in my mother’s womb,” in the New International Version’s translation), became policy explanations for prohibiting abortion.

In 1984, scientists used ultrasound to detect fetal cardiac activity at around six weeks’ gestation—a discovery that has been termed a “fetal heartbeat” by the anti-abortion movement, though a six-week-old fetus hasn’t yet formed a heart, and the electrical pulses are coming from cell clusters that can be replicated in a petri dish. At six weeks, in fact, medical associations still call the fetus an embryo; as I found out in 2020, you generally can’t even schedule a doctor’s visit to confirm your condition until you’re eight weeks along.

So many things that now shape the cultural experience of pregnancy in America accept and reinforce the terms of the anti-abortion movement, often with the implicit goal of making pregnant women feel special, or encouraging them to buy things. “Your baby,” every app and article whispered to me sweetly, wrongly, many months before I intuited personhood in the being inside me, or felt that the life I was forming had moved out of a liminal realm.

I tried to learn from that liminality. Hope was always predicated on uncertainty; there would be no guarantees of safety in this or any other part of life. Pregnancy did not feel like soft blankets and stuffed bunnies—it felt cosmic and elemental, like volcanic rocks grinding, or a wild plant straining toward the sun. It was violent even as I loved it. “Even with the help of modern medicine, pregnancy still kills about 800 women every day worldwide,” the evolutionary biologist Suzanne Sadedin points out in an essay titled “War in the womb.” Many of the genes that activate during embryonic development also activate when a body has been invaded by cancer, Sadedin notes; in ectopic pregnancies, which are unviable by definition and make up one to two per cent of all pregnancies, embryos become implanted in the fallopian tube rather than the uterus, and “tunnel ferociously toward the richest nutrient source they can find.” The result, Sadedin writes, “is often a bloodbath.”

The Book of Genesis tells us that the pain of childbearing is part of the punishment women have inherited from Eve. The other part is subjugation to men: “Your desire will be for your husband and he will rule over you,” God tells Eve. Tertullian, a second-century theologian, told women, “You are the devil’s gateway: you are the unsealer of the (forbidden) tree: you are the first deserter of the divine law: you are she who persuaded him whom the devil was not valiant enough to attack.” The idea that guilt inheres in female identity persists in anti-abortion logic: anything a woman, or a girl, does with her body can justify the punishment of undesired pregnancy, including simply existing.

If I had become pregnant when I was a thirteen-year-old Texan , I would have believed that abortion was wrong, but I am sure that I would have got an abortion. For one thing, my Christian school did not allow students to be pregnant. I was aware of this, and had, even then, a faint sense that the people around me grasped, in some way, the necessity of abortion—that, even if they believed that abortion meant taking a life, they understood that it could preserve a life, too.

One need not reject the idea that life in the womb exists or that fetal life has meaning in order to favor the right to abortion; one must simply allow that everything, not just abortion, has a moral dimension, and that each pregnancy occurs in such an intricate web of systemic and individual circumstances that only the person who is pregnant could hope to evaluate the situation and make a moral decision among the options at hand. A recent survey found that one-third of Americans believe life begins at conception but also that abortion should be legal. This is the position overwhelmingly held by American Buddhists, whose religious tradition casts abortion as the taking of a human life and regards all forms of life as sacred but also warns adherents against absolutism and urges them to consider the complexity of decreasing suffering, compelling them toward compassion and respect.

There is a Buddhist ritual practiced primarily in Japan, where it is called mizuko kuyo : a ceremony of mourning for miscarriages, stillbirths, and aborted fetuses. The ritual is possibly ersatz; critics say that it fosters and preys upon women’s feelings of guilt. But the scholar William LaFleur argues, in his book “ Liquid Life ,” that it is rooted in a medieval Japanese understanding of the way the unseen world interfaces with the world of humans—in which being born and dying are both “processes rather than fixed points.” An infant was believed to have entered the human world from the realm of the gods, and move clockwise around a wheel as she grew older, eventually passing back into the spirit realm on the other side. But some infants were mizuko , or water babies: floating in fluids, ontologically unstable. These were the babies who were never born. A mizuko , whether miscarried or aborted—and the two words were similar: kaeru , to go back, and kaesu , to cause to go back—slipped back, counterclockwise, across the border to the realm of the gods.

There is a loss, I think, entailed in abortion—as there is in miscarriage, whether it occurs at eight or twelve or twenty-nine weeks. I locate this loss in the irreducible complexity of life itself, in the terrible violence and magnificence of reproduction, in the death that shimmered at the edges of my consciousness in the shattering moment that my daughter was born. This understanding might be rooted in my religious upbringing—I am sure that it is. But I wonder, now, how I would square this: that fetuses were the most precious lives in existence, and that God, in His vision, already chooses to end a quarter of them. The fact that a quarter of women, regardless of their beliefs, also decide to end pregnancies at some point in their lifetimes: are they not acting in accordance with God’s plan for them, too? ♦

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Agree to Disagree: The Morality of Abortion and the Dobbs Decision
All Stories

Colgate students and professors gathered at Donovan’s Pub on Oct. 17 to hear faculty and staff opinions related to the recent controversial Dobbs v. Jackson Women’s Health Organization Supreme Court decision. The decision upholds that the Constitution of the United States does not grant citizens a right to abortion, famously overturning Roe v. Wade.

Panelists discussed the morality and justifications of abortion in the United States as well as the modern world as a whole. Titled “Agree to Disagree: The Morality of Abortion and the Dobbs Decision,” the panel discussion was moderated by Spencer Kelly, Hurley Family Chair and Professor of psychology and brain sciences, and sponsored by the Forum on Philosophy and Religion, the Center for Freedom and Western Civilization, Dart Colegrove Commons, and Hancock Commons.

Panel members included David Dudrick, George Carleton Jr. Professor of philosophy; Jenna Reinbold, associate professor of religion; and Renee Madison, vice president for equity and inclusion.

Before the panelists began introductions and stating their respective positions on the topic, Kelly emphasized that, rather than debating, the panelists would talk about their individual perspectives and attempt to understand one another.

“My moral position is tied very closely to certain kinds of discomforts I have with our political system, our legal system, and who makes laws and policies in our country,” Reinbold said. “I agree with one aspect of [the Dobbs decision] in the sense that it is a situation in which it involves two lives, and it is a great tragedy in the discourse around abortion that it has become politically difficult to talk about and acknowledge these two lives that are at stake here. I also agree with part of the dissent in that decision, that people who can get pregnant must be given a substantial amount of choice in how they navigate their situation.”

Coming from a law background in law, Madison shared her thoughts on the subject. “I look at it in terms of oppressive restriction and control over the right to liberty. With the opinion that abortion should be a state’s choice, my concern is that we are not well represented in Congress. [Women] are only about 27%, speaking in binary terms of folks who identify as women in Congress. A disproportionate representation of half of the population is significantly outnumbered; we are asking folks to make decisions on things they can never experience.”

Lastly, Professor Dudrick defended a pro-life standpoint. “It is morally wrong to intentionally kill innocent human beings. The second premise is that abortion is the intentional killing of an innocent human being and therefore, abortion is morally wrong. This argument is what philosophers call ‘valid,’ which means that if the premises are true then the conclusion has to be true.”

Having discourse across differences is really important, Dudrick added. “We who have the privilege to be at universities have, I think, the duty to engage in reasoned discourse about difficult topics, and to do so in a spirit of genuine curiosity and truth-seeking.”

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About the Survey

Religious and Moral Influence on the Debate

One-third of Americans (32%) say their religious beliefs are the primary influence on their attitudes toward abortion. Roughly one-in-five cite their education (21%), and one-in-seven point to their personal experience (14%). Fewer say the views of their family and friends (6%) or what they have seen or read in the media (5%) are the main influences on their opinion about abortion, but a sizable proportion (21%) say there is something else that most informs their view.

Religious beliefs hold much stronger sway over those who oppose abortion than over those on the pro-choice side of the abortion issue. More than half of those who say abortion should be illegal (53%) cite religious beliefs as the primary influence on their views, compared with only 11% among supporters of legal abortion. Instead of religion, supporters of legal abortion are much more likely to cite their education (30%) or a personal experience (20%) as the primary influence on their views on abortion.

Women are more apt than men to say that their religious beliefs have the most influence on their views about abortion (36% vs. 28%), and Americans 65 and older are much more likely than young adults to say this (44% among those 65 and older vs. 25% among those under age 30).

Among political groups, 53% of conservative Republicans say their attitudes are based primarily on their religious beliefs, compared with just 22% of moderate or liberal Republicans. More than a third of conservative or moderate Democrats (36%) and 17% of liberal Democrats single out the influence of their religious beliefs.

A majority of white evangelical Protestants (58%) say their religious beliefs drive their views on abortion. This figure approaches seven-in-ten (68%) among white evangelicals who attend services at least weekly. Mainline Protestants are much less likely to cite their religious beliefs (22%), but there is still a strong divide between white mainline Protestants who attend church at least weekly (41%) and those who attend less often (14%). White, non-Hispanic Catholics are similarly divided on the issue, with 60% of those who attend weekly services saying their religious beliefs are the main influence on their abortion views, compared with just 19% of those who attend less regularly. More than one-quarter of religiously unaffiliated Americans (28%) rely most on their education in formulating their opinion on abortion.

Half Say Abortion Is Morally Wrong

A slight majority of Americans (52%) say having an abortion is morally wrong. One quarter says it is not a moral issue, and just 10% say it is morally acceptable. (The remaining 12% say that the morality of abortion depends on the situation or refuse to express an opinion.)

There is a strong connection between views on whether abortion should be legal and views on the morality of having an abortion. Most opponents of legal abortion (80%) say having an abortion is morally wrong. Most supporters of legal abortion, on the other hand, say abortion is morally acceptable (18%) or that it is not a moral issue (42%). But more than a quarter of those who say abortion should be legal (28%) say it is morally wrong to have an abortion.

Consistent with this, the most pro-life groups more often say that abortion is morally wrong. Three-quarters of conservative Republicans say this, as do slight majorities of moderate or liberal Republicans (51%) and conservative or moderate Democrats (55%). Nearly a third of liberal Democrats (31%) say abortion is morally wrong, with 40% saying it is not a moral issue.

White evangelical Protestants are very likely to say abortion is morally wrong (74%). Majorities of black Protestants (58%) and Catholics (58%) also say this. Fewer than half of white mainline Protestants (40%) say that abortion is morally wrong. Among the unaffiliated, 30% say having an abortion is morally wrong, but 43% say it is not a moral issue. Attendance at worship services also plays a role, with those who attend most frequently being twice as likely as those who attend least often to say abortion is morally wrong (67% vs. 35%).

Influence of Religious and Moral Beliefs

Religious beliefs, when cited as the main source of thinking on abortion, are much more likely to influence adherents in a pro-life direction than in a pro-choice direction. Among those who say their religious beliefs have the most influence on their thinking about abortion, an overwhelming majority (82%) say abortion should be illegal. Less than one-in-five (18%) say it should be legal.

The opposite is true, however, among those who cite education or personal experience as their main influence. Strong majorities of these groups identify with a pro-choice viewpoint (72% among those saying education, 70% among those saying personal experience).

A similar though less-pronounced pattern is seen on the question of whether the country should find a middle ground on abortion. Those who cite religious beliefs as the primary influence on their abortion views and those who say abortion is morally wrong are considerably more likely than others to say that there is no room for compromise on the issue of abortion.

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Support for legal abortion is widespread in many places, especially in europe, public opinion on abortion, americans overwhelmingly say access to ivf is a good thing, broad public support for legal abortion persists 2 years after dobbs, most popular, report materials.

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Introduction

Access to safe abortion has been labelled as a fundamental human right by the International Women's Health Coalition, who stated that:

A woman should have the choice to carry a pregnancy to term or not;

Abortion services should be part of a comprehensive sexual health programme;

Lack of funding and illegality do not reduce the number of abortions, they only serve to put the woman's health in danger. 1

In the USA, certain states have introduced laws requiring women to listen to fetal heart beat monitors or to undergo a transvaginal ultrasound scan before being permitted to proceed with an abortion, with the thinly-veiled intent to discourage them.

Recently in the UK, MP Nadine Dorries proposed an amendment to abortion legislation that would have prevented abortion providers, such as Marie Stopes International and the British Pregnancy Advisory Service, from offering pre-abortion counselling to women on the basis that their advice was ‘not independent’. They would instead be directed to ‘Crisis Pregnancy Centres’ for supposedly independent counselling. However, many of these centres are run and funded by religious groups with prominent anti-abortion agendas. 2

The amendment was withdrawn due both to lack of support and to a national campaign against it. But the motives behind the amendment, and the more extreme pieces of legislation being passed in the USA, call for the arguments of legality, morality and access to be re-evaluated.

Traditional arguments

Against abortion.

A common argument against abortion is that it is equivalent to murder – specifically infanticide – and in this way it is immoral and unjustifiable.

One of the best known philosophical arguments to this effect is that of Don Marquis, who claimed that murder is illegal because …

Funding None.

Competing interests None.

Provenance and peer review Not commissioned; externally peer reviewed.

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Highlights from this issue In this issue British Medical Journal Publishing Group BMJ Sexual & Reproductive Health 2013; 39 1-1 Published Online First: 07 Jan 2013. doi: 10.1136/jfprhc-2012-100558

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The Scourges: Why Abortion Is Even More Morally Serious than Miscarriage

Calum miller.

University of Oxford, Oxford, UK

Several recent papers have suggested that the pro-life view entails a radical, implausible thesis: that miscarriage is the biggest public health crisis in the history of our species and requires radical diversion of funds to combat. In this paper, I clarify the extent of the problem, showing that the number of miscarriages about which we can do anything morally significant is plausibly much lower than previously thought, then describing some of the work already being done on this topic. I then briefly survey a range of reasons why abortion might be thought more serious and more worthy of prevention than miscarriage. Finally, I lay out my central argument: that reflection on the wrongness of killing reveals that the norms for ending life and failing to save life are different, in such a way that could justify the prioritization of anti-abortion advocacy over anti-miscarriage efforts. Such an account can also respond to similar problems posed to the pro-lifer, such as the question of whom to save in a “burning lab” type scenario.

I. INTRODUCTION

In recent years, pro-lifers have been criticized for focusing disproportionately on the issue of abortion, while at the same time neglecting the apparently much greater number of deaths from spontaneous abortion ( Ord, 2008 ; Berg, 2017 ; Simkulet, 2017 ). A similar problem is suggested by the scenario which asks us to consider whether we would save multiple embryos or a single child in a burning laboratory—the intuition commonly being that we should save the single child. 1 Different implications might be drawn from this, including that pro-lifers do not really believe that embryos are human beings with a right to life, 2 or that pro-lifers are more interested in limiting women’s autonomy, or both. In this paper, I marshal a series of arguments to explain why these conclusions are unwarranted. In particular, I suggest that reflection on the wrongness of killing shows that it is largely unrelated to consequences, and even largely unrelated to the badness of death. This furnishes the pro-lifer with a reason to seek the prevention of abortion more urgently than the prevention of miscarriage, and indeed for pro-lifers to preferentially rescue older children over embryos. But, it also supplies a more general reason to think that the distinction between killing and letting die is relevant, and for thinking that the norms shaping behavior in those situations differ.

II. HOW MANY INDUCED ABORTIONS AND MISCARRIAGES ARE THERE?

It is worth briefly reviewing the evidence regarding induced abortion and miscarriage. This does not make a great difference to my central argument, but most authors have noted that even if there are clear reasons to prioritize tackling a lesser number of abortions over a greater number of miscarriages, there is some residual (indeed, substantial) reason for pro-lifers to address those miscarriages which do occur, which undoubtedly number many millions. Let me say something about this.

Estimates for the number of miscarriages vary, although it appears likely that most are exaggerated. Berg suggests up to 89% of all pregnancies, while Ord suggests that there are 226 million worldwide every year. These are almost certainly vast overestimates. In a recent comprehensive review, Jarvis (2017) proposes somewhere between 40% and 60% of all pregnancies end in miscarriage, noting that higher figures are implausibly excessive. Around 10%–35% of embryos are lost before implantation, a further 10%–20% before clinical recognition of pregnancy, and 5%–15% between clinical recognition and birth. We note in particular the large range for embryo loss before implantation: the relevant events are extremely difficult to measure, and so we have very low confidence in our estimates.

Globally, there are around 140 million births a year ( Our World in Data, 2020 ). If around half of the pregnancies are ended prematurely (the midpoint of 40%–60%), then there are around 140 million spontaneous abortions a year. This is obviously a very large number—far exceeding the number of induced abortions, even. That said, it is still 80 million or so less than Ord’s estimate.

This does not, of course, take into account induced abortions. Some pregnancies end neither in birth nor spontaneous abortion, and this will affect the estimate of spontaneous abortions (if there are more total pregnancies, then there are likely more spontaneous abortions, although some of these will result in induced abortions before a miscarriage occurs). This does not affect the estimate by a very great deal, relatively speaking. Very likely, the number is somewhere between 100 and 200 million, which is enough for the argument to get going. Ord and Berg have likely overestimated it by quite some way, however, which reduces considerably the ostensible disproportion with which they allege pro-lifers to act.

Blackshaw and Rodger (2019) note that about a third of spontaneous abortions are anembryonic pregnancies, where the embryo proper does not actually form (or forms briefly, and then disappears). If the embryo never forms, then according to the standard pro-life view, there is no organism and hence, no life is lost. This would reduce the salience of spontaneous abortion for pro-lifers. However, the events in early pregnancy are too poorly understood (at least in frequency) to know how many anembryonic pregnancies involve embryos that formed and then were destroyed, which would presumably still count as deaths. Although there are other “pregnancies” where a human being likely does not form, 3 I shall ignore these and take the estimate of 140 million lives lost as broadly correct—my argument is precisely intended to explain how pro-lifers are justified in paying more attention to a more limited number of lives.

Although Ord and Berg overestimate the number of miscarriages, the number of abortions is also likely to be substantially lower than some of their pro-life respondents (and authorities such as the WHO) have suggested. Blackshaw and Rodger cite a study from the Guttmacher Institute which estimates around 56 million abortions a year. ( Sedgh et al., 2016 ) Although details of the data used in the Guttmacher study are sparse, it seems reasonable to believe they have relied at least in part on previous Guttmacher studies that overestimate the number of illegal abortions by an order of magnitude in many countries. For example, Koch, Bravo et al. (2012) have provided powerful arguments that the Guttmacher Institute overestimates the number of abortions in Colombia by around 10-fold. In Mexico, a Guttmacher study estimated 137–194,000 abortions per annum for Mexico’s Federal District. After abortion was legalized in this region (the only region in the country), however, the subsequent 5 years yielded only 78,544 abortions across the entire period ( Koch, Aracena et al., 2012 ). 4 Given how prone to radical overestimates abortion statistics are, 56 million may be a large overestimate—although there are certainly many millions every year. 5 Probably, the total number of spontaneous abortions still exceeds the number of induced abortions by several times. For Colgrove (2021) and Blackshaw and Rodger (2019) , this does affect the argument, although not by a great deal and likewise for my own argument.

III. CAUSES OF MISCARRIAGE

As Colgrove describes at length, “spontaneous abortion” or “miscarriage” (used interchangeably here) is not a cause of death in itself: it is just the phenomenon of natural deaths in utero (prior to viability, after which point the terminology used is “stillbirth”). So, saying that spontaneous abortion is responsible for more deaths than induced abortion is like saying that natural death is responsible for more deaths than homicide or genocide. This is evidently not a very persuasive argument for not paying significant attention to homicide and genocide, nor is it very informative about the causes of death.

Spontaneous abortion is made up of a variety of different causes, as helpfully summarized by Blackshaw and Rodger. They note that around 60% are due to aneuploidies, where an embryo has an anomalous number of chromosomes in each cell (as in Down Syndrome). 6 We can also add to these euploid genetic causes ( Colley et al., 2019 ), and hence, the number of miscarriages due to genetic causes is greater—though we are unsure by how much—than simply the proportion due to aneuploidies. Other causes include immunological conditions, thrombophilias, endocrinological causes, uterine malformations, and acute maternal infections. Certain lifestyle factors (e.g., smoking), chronic conditions (e.g., diabetes), and non-modifiable risk factors (e.g., increasing age) also appear to contribute.

Blackshaw and Rodger use this analysis to argue that induced abortion is actually one of the largest causes of prenatal death: on their analysis, 44% are due to aneuploidies, 27% due to induced abortion, and 29% due to other causes. 7 They note, further, that treating aneuploidies is very difficult since we have no treatment and, since they usually occur before detection of pregnancy, prevention is likewise difficult. Ord rightly objects that this does not rule out research. For example, Alzheimer’s is largely unpreventable, and so we invest instead primarily in research. Ord also suggests sperm sorting to prevent the anomalies in the first place. Blackshaw and Rodger respond to the suggestion of research by noting that most such research is likely to be ethically problematic if, for example, it involves research on embryos. But, in Ord’s defence, it is not entirely clear that this is the case: aneuploidy and spontaneous abortion both occur in animals, and animal models may shed considerable light on the causes and possible prevention. Blackshaw and Rodger note also that keeping human beings with fatal chromosomal defects alive for an inevitably short period is not necessarily an overriding moral obligation: this is true, but if those fatal chromosomal defects are themselves remediable in principle, then this response will not work, since we would have at least some obligation (even if not overriding) to extend their lives.

There is a bit more we can say about the relevance of chromosomal anomalies, however. First, the aneuploidies are themselves quite varied: Hassold et al. (1980) report that about a quarter are due to Turner Syndrome (only one sex chromosome, X), nearly half due to trisomies (such as Down, Patau, and Edwards Syndrome), and nearly a quarter triploidy and tetraploidy (one or two extra copies of each chromosome), inter alia.

Here is one pro-life response: just as “miscarriage” is an artificially large group, so too is “aneuploidy”: it groups together a wide range of conditions (from Down Syndrome to Turner Syndrome, to tetraploidy), which do not really constitute a single cause of death. The largest cause of death is Turner Syndrome, responsible for, we suppose, 15% of spontaneous abortions, so perhaps 20,000,000 lives lost a year. This may be equal to, or even fewer than, the number of induced abortions (certainly considerably less according to the Guttmacher and WHO estimates). 8

That the causes may be split up into specific conditions may not affect the argument significantly. After all, if we suppose that resources should be apportioned relative to the burden of mortality, Ord and Berg still have an argument that the total expenditure on chromosomal anomalies ought to exceed spending on induced abortion when added altogether, and clearly pro-lifers do not expend as many resources on chromosomal anomalies as on induced abortion. That said, there being a wider variety of conditions may affect the efficiency of the research and hence, could justify more spending on abortion: if miscarriages had 140,000,000 different causes, it is plausible that the cost to find a treatment for 50,000,000 spontaneous abortions is likely to be higher than the cost of preventing 50,000,000 induced abortions. So, a significant amount may depend on the extent to which the disparate causes of spontaneous abortion are likely to have treatments derived through similar or the same research. Berg and Ord may have a point that pro-lifers, on the whole, have not even attempted this calculation (difficult though it surely is): they may be right that the pro-life community as a whole has a moderate duty to at least attempt a calculation of this sort before deciding that preventing abortion is most cost-efficient.

However, there is a much more powerful reason why the proportion of deaths caused by genetic anomalies (chromosomal or otherwise) and the careful distinction of these genetic anomalies may be important. The reason is that some genetic anomalies—especially those in question here—may be so radical as to prevent the creation of a human organism or, more plausibly, that changes to certain genetic constitutions may not be identity preserving.

We clearly do not want to say that any chromosomal anomaly prevents the entity constituting an organism. People with Turner Syndrome and Down Syndrome are clearly human beings and moral equals. 9 What about those with tetraploidy? That seems less clear. I suspect we do not know enough about genetics at this point to be able to judge whether most entities with extreme chromosomal anomalies are human organisms. 10 My own view is that most or all are. In any case, perhaps even uncertainty should make us err on the side of caution, granting them personhood unless we have clear evidence that they are not organisms. So, this response will not do a great deal.

What seems much more plausible is that large changes in genetic constitution may not be identity-preserving. I have previously defended this view ( Miller and Pruss, 2017 ), noting that even some relatively small genetic changes (such as in Tay–Sachs disease, which can be caused by mutation of a single base pair) may not be identity-preserving. Would I be the same person if I had Tay–Sachs or Turner Syndrome? Or if I had the opposite assortment of sex chromosomes? It is very plausible that I would not be. If so, then it seems like most aneuploidies—and hence, a very large proportion of spontaneous abortions—result in a different human being to the human being they would have formed if the anomaly had not occurred.

If substantial genetic changes are not identity-preserving, then many genetic anomalies are not treatable. This is not for technical inability—which could be solved with enough research—but because it is metaphysically impossible to treat the genetic anomaly without altering the identity of the individual. Hence, these deaths are unpreventable in a way that cannot be solved by research, and so it is difficult to see how any resources could be devoted to them.

On a certain view—which I suspect most pro-lifers would endorse—this matters a great deal. On this view, it is not necessarily wrong—and certainly not comparable to murder—to bring into existence a genetically anomalous child, even if one could have acted differently and brought into existence a healthy child. 11 Indeed, intuitively, the main reason why it might be wrong to bring into existence a severely disabled child is the suffering that the child would bear. This reason is nullified in the case of a child who will not suffer because they die before their nervous system is sufficiently developed, or if the particular kind of suffering would only occur at a later point after the spontaneous abortion (e.g., from hypoxia due to inadequate ventilation). In short, it is not comparable to murder to bring into existence a child with, say, trisomy 2, who will die before birth.

This is important because Ord and others suggest that these deaths are preventable by preventing that particular conception, with that genetic constitution, from occurring. But, preventing a person from ever existing is hardly morally equivalent to saving their life, even though both are spared death (in different senses). A person with trisomy 2 is not benefitted by being prevented from ever existing in the first place. Conversely, they are not harmed by being brought into existence for a very short time. Thus, it makes no sense to say that these are preventable deaths, or to say that pro-lifers have a duty to prevent these conceptions taking place. They are preventable deaths only in the sense that they stop someone from ever existing in the first place: by that measure, every death is preventable. Clearly, this is implausible and should not have a significant impact on policy—preventing deaths in the sense of preventing people with a short life expectancy from existing is simply not a duty, certainly not a duty comparable to preventing homicides. At the very least, we can say that bringing into existence persons who will die shortly after their conception, and thereby in some sense causing those persons’ death, is obviously not equivalent to murder. Arguably, it is not wrong at all. Hence, there is no argument for thinking that pro-lifers should seek to prevent these deaths over the deaths caused by induced abortion. 12

I said earlier that the distinction of specific genetic anomalies may be important for this response. Some genetic changes are plausibly identity-preserving, while others are not, and so pro-lifers may have some reason to research gene therapy for some individuals as a way to save lives. But, that number of individuals will probably be a much smaller number than the number of lives lost to aneuploidy. It is certainly plausible that many aneuploid individuals are literally untreatable—treating them is not even metaphysically possible. And so the number of preventable miscarriages is plausibly much lower than 140 million.

If I am right that the number of induced abortions is vastly lower than 56 million, these points will still not suffice. For, even if we exclude all those cases of “essential” aneuploidy (and other genetic anomalies which are literally untreatable), the number of spontaneous abortions with preventable causes may well still exceed the number of induced abortions, and so still generate a potential inconsistency for the pro-lifer.

Still, everyone in the debate is agreed that pro-lifers should ensure that something is being done to save lives lost in miscarriages. We should also agree that the loss of life due to miscarriage is seriously regrettable—this is far from unintuitive, however. Indeed, it is difficult to give an account of the badness of death that does not have the implication that spontaneous abortion is a very bad thing, not to mention the grief women suffer from miscarriage—enough for the UK’s leading abortion provider to refer to it as “The inconceivable grief of baby loss” ( British Pregnancy Advisory Service, 2020 ).

As it turns out, much is already being done to try and prevent miscarriages: a great deal of research, involving many millions of pounds, is already being done on the causes of miscarriage. Even in 2005, over $2.9 billion was spent globally on genetics research ( Pohlhaus and Cook-Deegan, 2008 ), while the fertility business makes an estimated $25 billion a year in sales, much of which presumably goes into research on helping pregnancies come to term ( The Economist, 2019 ). Sometimes this research is carried out specifically by pro-life or Catholic organizations (see NaProTechnology, 2020 ). It goes without saying that there is already enormous global expenditure on public health campaigns trying to stop smoking, on research on chronic conditions contributing to miscarriage like diabetes, and so on. Even recurrent miscarriage is the subject of a great deal of research. There is no large research budget for “miscarriage” generally because it has a wide variety of causes. But, for those individual causes, there are enormous research budgets. While a quantitative analysis is beyond the scope of this paper, it seems plausible that money spent on research helping to prevent miscarriages vastly exceeds money spent on preventing abortion, even when controlling for the numbers of miscarriages and abortions. 13 If so, it is hardly clear what pro-lifers are expected to do. We do not expect researchers in non-malignant thyroid disease to spend any time, let alone a large majority of it, on researching cancer, despite the far greater mortality of the latter. Why? Because other people are already doing it, disproportionately, even. Likewise, given the relatively meager budgets of pro-life organizations, it is hard to see why they should spend it on miscarriage research, given the vastly greater sums of money already being spent on such research. 14

IV. OTHER REASONS FOR PRIORITIZING ANTI-ABORTION ADVOCACY

Before turning to the argument that I wish to develop in detail, it is worth briefly summarizing just a few reasons (in addition to the considerations above) why pro-lifers might reasonably consider abortion to be more worth preventing than miscarriage. These will be of relevance to my central argument, as we shall see. We begin with a series of reasons why abortion is more degrading than miscarriage:

1) Methods of abortion are often degrading. In England and Wales, for example, around 10,000 abortions every year involve dismembering the live fetus, a fetus at around 14 weeks’ gestation or more ( Department of Health and Social Care, 2020 ). In some other countries, surgical abortions (of which those at later gestations involve dismemberment) are more common still ( Guttmacher Institute, 2019 ; Popinchalk and Sedgh, 2019 ). Public opinion in the U.S. shifted significantly toward the pro-life position in the mid-1990s ( Gallup, 2020 ) around the time partial-birth abortion began to be publicized, eventually leading to a federal prohibition. Partial birth abortion was normally performed on healthy babies in healthy mothers ( New York Times, 1997 ) and involved delivering a living child all except for the head, at which point “blunt scissors” are forced into the baby’s skull so that the “skull contents” (i.e., the brain) can be suctioned out ( Haskell, 1992 ). One nurse testified:

Dr. Haskell went in with forceps and grabbed the baby’s legs and pulled them down into the birth canal. Then he delivered the baby’s body and the arms—everything but the head. The doctor kept the head right inside the uterus … The baby’s little fingers were clasping and unclasping, and his little feet were kicking. Then the doctor stuck the scissors in the back of his head, and the baby’s arms jerked out, like a startle reaction, like a flinch, like a baby does when he thinks he is going to fall. The doctor opened up the scissors, stuck a high-powered suction tube into the opening, and sucked the baby’s brains out. Now the baby went completely limp … He cut the umbilical cord and delivered the placenta. He threw the baby in a pan, along with the placenta and the instruments he had just used. ( Supreme Court of the United States, Gonzales v. Carhart , 550 U.S. 124 (2007) , 8)

In my experience, those hearing this description have described it as straightforward murder, if not a crime against humanity, regardless of their general position on abortion. In any case, it is not difficult to see why someone would regard this, other things being equal, as worse than a miscarriage, even than a stillbirth of the same gestation. It is worth noting that recent research suggests fetal pain from 12 weeks is distinctly possible—and certainly at later stages ( Derbyshire and Bockmann, 2020 ).
A ban on this procedure was vetoed by President Clinton, opposed by the majority of House and Senate Democrats, and even declared unconstitutional by four Supreme Court judges. 15 Although partial birth abortions constituted only a small proportion of abortions, it was responsible for an estimated 3,000–5,000 abortions a year, 500–750 of which were after 7 months’ gestation ( Johnston, 2007 ). By contrast, Presidential candidate Elizabeth Warren (2019) described children dying by gun violence in the US as a “national health emergency,” responsible for around the same number of deaths ( Cunningham et al., 2018 ). Partial birth abortions alone counted only for a very small proportion of surgical abortions in the US. This is relevant because a major political party in the most powerful country in the world supporting this kind of degradation—while claiming that the same number of deaths from another cause is a “national health emergency”—adds a further level of systemic institutional degradation against human beings in the womb.
2) Abortion, on the pro-life view, involves a violent attack within the family—hence, many early Christian writers referred to it as “parricide.” As well as parricide being particularly destructive within a family, widespread parricide plausibly results in a more general destruction of the family by the normalization of the dispensability of children and the erosion of the appreciation for motherhood. Since, according to the Universal Declaration of Human Rights Article 16, the family is the “natural and fundamental group unit of society and is entitled to protection by society and the State,” 16 the widespread breakdown of the family is plausibly a unique and serious evil to be prevented at any cost, in contrast to miscarriage which—while causing families much grief—does not involve the same kind of relational fracturing. Relatedly, abortion contributes to a widespread culture of the dispensability of children, which plausibly contributes in the same way to more general societal harms. Along similar lines, pro-lifers often think that abortion contributes to a sexual culture that is likewise destructive to human flourishing (and disproportionately so for women and the poor) by severing the link between sex and procreation ( Alvaré, 2011 ).
3) Abortion involves the systematic and state-sponsored violence against a particular class of people, which most of us would regard as worse than the natural death of the same number of people. One reason we are appalled at the Holocaust, the Rwandan genocide, the Armenian genocide, and so on, is because of the systematic and state-sponsored violence specifically impacting (and even targeted toward) a vulnerable demographic group on a large scale. There are multiple elements here, all of which no doubt contribute to the horror of these genocides, and all of which seem on initial inspection to justify greater attention than the equivalent number of deaths by natural causes. Even on much smaller scales, many of us think that it is reasonable to take radical action over violence against vulnerable groups, exceeding our response to natural deaths among those groups. Perhaps the most salient example is from the Black Lives Matter movement. The Guardian reports that in 2016, 39 unarmed black men were killed by US police. Compared to other causes of death, this is a relatively small number. Yet, we rightly realize that it is much more salient than 39 deaths from natural causes, justifying a much more significant public response. As Colgrove puts it, “BLM has a particular target. It is not solely fixated on saving as many lives as possible. It is aimed at revealing (and undoing) systematic injustice that is directed toward certain people” ( Colgrove, 2021 ).
4) Abortion involves the systematic dehumanization of a class of people. One of the most basic rights of human beings is to be recognized as a person, 17 and it seems clear that the dehumanization of certain classes of people (whether Jews, black slaves, Tutsis, disabled people, or others) is a serious aggravating factor to many crimes, especially genocides. This raises a particularly salient point: as well as dehumanization being an aggravating element of mass killing, working to oppose dehumanization constitutes the bulk of pro-life work in many countries. It may even be that humanizing the fetus is the best way to garner public support for putting resources into preventing miscarriage, and that discussion of abortion is one of the best ways to demonstrate the humanity of the fetus (the Partial Birth Abortion Ban Act and its effect on public opinion suggest this may be the case). 18
5) In the case of abortion, tens to hundreds of millions of dollars are spent advocating for abortion all over the world as a basic human right and as a part of essential health care. There is not a similar movement promoting miscarriage. This means that the dehumanization involved in abortion is not only ideological: it is institutionalized in our economic system, with hundreds of millions of dollars invested into its propagation. 19
6) In the case of abortion, the killing and dehumanization receive the imprimatur of the state and the law (and institutions like the UN and the WHO, insofar as they are able to make pronouncements not reflecting international consensus). The expressive function of the law is powerful—we can see this by asking whether we would allow, for example, the state to declare that African Americans are not fully human, if for some reason it meant that they received better treatment. 20 People are divided on this question—which is enough, I think, to show that the expressive function of the law plausibly might outweigh a certain number of lost lives. It is one degradation to have a large number of the population dehumanize you: it is another level of degradation to have this enshrined in law, and in the major political institutions. Thus, the ideological and economic weight behind abortion is compounded by political weight; it is plausibly more degrading—and certainly more of a problem—for the dehumanization of a class of human beings to have the imprimatur of the ruling institutions. 21
7) If, as many prominent philosophers have thought, virtue is a constituent of well-being, then on the pro-life view abortion is also extremely harmful to those participating in abortion. More generally, if you think that our character is more important than our experiences, you would have a strong interest in preventing abortion that does not apply to miscarriage. There is also evidence linking abortion with increased suicide rates and increased mortality ( Fergusson et al., 2013 ; Karalis et al., 2017 ), suggesting more lives may be lost due to abortion (though of course, not enough to match those lost in miscarriage). While this does not necessarily make abortion more degrading for the primary victim, it is another reason to oppose more strongly than miscarriage. 22
8) One of the primary obstacles to generating substantial societal support for miscarriage and abortion prevention is the view that unborn human beings are not really human, or are not equally morally considerable. (Effective) anti-abortion advocacy helps to remove this obstacle for both causes, and perhaps more effectively than miscarriage prevention advocacy.

As a sense of what is at work here, imagine tens or hundreds of thousands of members of another vulnerable group were dismembered alive each year, with the social, legislative, and financial support of the most powerful governments around the world, as well as immensely powerful NGOs, the UN, and the WHO. Imagine this was just the tip of the iceberg for many millions more who were killed in less graphically violent ways. Now imagine there was already a great deal of research being put into saving these people from dying due to natural causes. It seems overwhelmingly likely to me that we would think we had a mandate to invest significantly more resources to stop the state-sponsored killing, compared to preventing the equivalent number of people dying from natural causes. We certainly could not rightly criticize human rights groups for paying significantly more attention to the former. The same situation is broadly what we have in the case of abortion, from the pro-life viewpoint. Indeed, comparisons to mass killings such as the Holocaust are perhaps the best way to understand the pro-life mindset for our purposes here , since such comparisons are the intuitive reason many pro-lifers offer for making abortion a central political and social priority.

I make no claims here about exactly to what extent the large numbers involved contribute to the horror of mass killings and systemic dehumanization. It might be that what made other mass killings so abhorrent is the large numbers. If so, then this only serves to make abortion more serious. In the case of abortion, we appear to have both factors: systemic violence and degradation, as well as enormous numbers.

Since my central argument is to do with the respect owed to victims of killing, all of the considerations here which pertain to the degradation and dehumanization involved in abortion will amplify the force of that argument, to which we now turn.

V. THE CENTRAL ARGUMENT

The suggestion that killing and letting die are morally inequivalent is hardly a new one, nor is its application in this context. Indeed, it is the obvious response to the argument: it is the most obvious difference between induced abortion and miscarriage. But perhaps it is undermotivated or ad hoc. Why think that they are morally distinct? Indeed, some philosophers have suggested that they are not distinct when all other things are equal ( Simkulet, 2019 ). Here, I propose an argument for thinking that they are distinct, and that this has significant implications for prioritizing the prevention of killing vis-à-vis the prevention of natural deaths.

My starting point is with the badness of death and the wrongness of killing. In the context of abortion, this has been heavily influenced by Marquis’ (1989) seminal work arguing that abortion (and killing more generally) are wrong because they deprive someone of a future life of value. This is a kind of deprivationist account of the wrongness of killing, and for many people it is an intuitive account of the wrongness of killing. Marquis’ paper is no doubt popular because it was one of the first major papers to be published for the pro-life position in the recent renaissance of pro-life philosophy. It is also an extremely simple and intuitive argument. As it happens, I think that the paper is largely correct, accounting for one reason why abortion is wrong. Marquis’ work deserves the attention it has received, including in recent discussions. 23

Now I do not, in fact, think that it is the central reason for the wrongness of abortion. To help explain my position, consider another feature of Marquis’ argument: it implies that the wrongness of killing is closely tied to the badness of death, which is widely variable. As Blackshaw and Rodger (2019) note, the badness of death differs a large amount between persons. But, if killing is wrong primarily because it deprives someone of a future life of value, then the wrongness of killing can vary from extremely wrong (in the case of embryos) to minimally, or perhaps not wrong at all (in the case of people killed near the end of their lives, or in the case of severely disabled people who are not able to enjoy much). The precise results in these cases depend on what is considered “valuable” about life, but it seems as though defenders of Marquis tend primarily to emphasize valuable experiences, rather than the inherent value of life itself.

It has been claimed that this kind of deprivationism is the standard view among pro-lifers. Indeed, Simkulet criticizes Friberg-Fernros’ defence of the significance of the distinction between killing and letting die by saying that “this view is at odds with the commonsense antiabortion position, grounding the wrongness of induced abortion not in the death of the fetus, but in the act of killing (or in disconnect cases, letting die)” ( Simkulet, 2019 ).

In fact, however, there are many reasons to think that the orthodox pro-life position is not based solely (or even primarily) on the badness of death. I would go further: it is actually intrinsic to the pro-life account that the wrongness of killing is not correlated with the badness of death. For example, pro-lifers are typically just as fiercely opposed to euthanasia or assisted suicide—even if the patient has almost no life of value remaining—as they are to abortion, which prevents many decades of valuable life. If killing is wrong because it deprives the victim of a future life of value, abortion should be considered orders of magnitude (if someone is killed by involuntary euthanasia a day before they were likely to die anyway, then abortion would be roughly 365 × 70 = roughly 25,000 times worse, or more if the euthanasia recipient is looking forward only to a day of misery) more wrong than euthanasia. But, pro-lifers tend to consider them roughly commensurate—or, at the very least, not as though one is 25,000 times more serious than the other. Pro-lifers object vehemently to the killing of people who are not likely to enjoy significant subjective goods in the future—for example, anencephalic children in the case of abortion, 24 or severely disabled or very elderly/terminally ill people in the case of euthanasia. The enormous effort to prevent the killing 25 of Terri Schiavo and the more recent case of Vincent Lambert are a testament to the seriousness with which pro-lifers take killing even in such cases. This is strong evidence that pro-lifers are not primarily pro-life because of potential future subjective goods to be experienced by the victim.

Second, the “traditional” pro-life approach was to speak of the “sanctity” of life. This terminology fits very well with the sense of intrinsic value and respect in the account I describe, and not so well with the view that life is valuable because of the subjective goods that may be experienced. Third, it is a staple of the pro-life view that life is intrinsically valuable—this is at odds with a view that takes life to be valuable primarily because of experienced goods. Pro-lifers make an extremely large point of valuing all human life, including where the quality of life may be very low. Pro-lifers consistently focus on the value of those with severe disabilities, which is surprising if they think the value of life is primarily determined by experienced goods. Fourth, many pro-lifers are pro-life for religious reasons, and religious prohibitions on killing have rarely, if ever, spoken of future goods. On the contrary, the Christian tradition, at least, has expressly used terminology more suitable to the respect theory I describe. This is perhaps best exemplified by Lactantius’ comments on killing at the turn of the fourth century: “Therefore, with regard to this precept of God, there ought to be no exception at all; but that it is always unlawful to put to death a man, whom God willed to be a sacred animal” ( Divine Institutes, 6.20 ). Finally, as Friberg-Fernros (2019) points out, the intention is extremely important for the pro-life view, which is why pro-lifers allow the foreseen death of fetuses to save the mother’s life, without ever allowing the intended death of fetuses.

Pro-lifers probably come across as being deprivationists primarily because many of them hold that deprivation is an additional reason why abortion is wrong, and—within philosophy—because of the influence of Marquis’ article on the debate in recent decades. But, that is no reason to suppose that the majority of pro-lifers only or primarily rely on deprivationist arguments for their view on abortion.

What all this suggests is that pro-lifers do not think that the wrongness of killing and the badness of death are very closely related—at least, not if the “badness of death” is measured in terms of the deprivation of positive subjective experiences.

This is important for the following reason: the comparison between spontaneous abortion and induced abortion relies crucially on one specific similarity: they both involve the same deprivation to the individual. Both individuals lose the large majority of their lives, and this is supposed to be what makes spontaneous abortion as pressing for the pro-lifer as induced abortion (and more so, once the numbers are added). But, if the wrongness of killing is not very closely tied to the badness of death, then the fact that both are similarly deprived (and hence the badness of death is roughly the same for each) may be of negligible relevance. Simply put, my argument runs thus:

The main similarity between babies or fetuses killed by abortion and those whose lives are ended in miscarriage is that they are both deprived of the same subjective goods. 26
However, deprivation of subjective goods is not the primary determinant of the wrongness of killing.
If 1 and 2, then the main similarity between abortion and miscarriage has little to do with the wrongness of killing.
Hence, the main similarity between abortion and miscarriage has little to do with the wrongness of killing.

If this is right, then drawing attention to this similarity between abortion and miscarriage does little to persuade the pro-lifer that they should give both equal attention. But, it would help if we had (a) some motivation for premise 2 and (b) an alternative account of the wrongness of killing that pointed toward (even if not explicating precisely) the reason we may be more worried about killing by abortion than death by miscarriage.

McMahan (2002) , in his magisterial volume on the ethics of killing, offers pointers toward both of these.

VI. IS THE DEPRIVATION ACCOUNT TRUE?

McMahan calls this sort of account the Harm-Based Account—killing is wrong because of the harm inflicted on the individual, harm being conceived as the loss of future goods. McMahan thinks that a fatal flaw to this account is that it thinks identity is what matters. In fact, according to McMahan, it does not: what matters is prudential unity relations—psychological relations tying an individual’s psychological life together. Hence, McMahan talks of “time-relative interests,” where these are essentially ordinary interests, whose importance is augmented or discounted, depending on the strength of the psychological connections between an individual at different times. 27

McMahan goes on to suggest that the Time-Relative Interest Account of the wrongness of killing is likewise deficient, however, at least for persons. Why is this? McMahan says that both the Harm-Based Account and the Time-Relative Interest Account have the implication that killing can be more or less wrong depending on the quality of the victim’s life . 28 This, McMahan says,

profoundly offends our sense of the moral equality of persons…The common view, in short, is that the wrongness of killing persons does not vary with such factors such as the degree of harm caused to the victim, the age, intelligence, temperament, or social circumstances of the victim, whether the victim is well liked or generally despised, and so on. ( 2002 , 234–5)

McMahan dubs this the Equal Wrongness Thesis.

The Equal Wrongness Thesis is intuitively plausible. Human equality, and its relevance to fundamental inviolable rights, are popular ethical ideas, on which it seems reasonable to base ethical opinion in the absence of countervailing considerations. Note that if it is true, then premise 2 of the above argument is true: if all killings are in some sense equally wrong, 29 specifically if they are equally wrong regardless of the quality of the anticipated goods in an individual’s life, then the wrongness of killing cannot be dependent on the deprivation of one’s future. Pro-lifers do not need to prove the Equal Wrongness Thesis to respond to the arguments of Ord et al.—they just need to show that there is a plausible reason for their discrepant approaches toward abortion and miscarriage. The Equal Wrongness Thesis is certainly at least plausible.

VII. IS THERE AN ALTERNATIVE ACCOUNT OF THE WRONGNESS OF KILLING?

McMahan goes on to suggest an alternative account that can explain the pro-lifer’s discrepant attitudes, along with a number of other ethical difficulties. It is, therefore, a fruitful theory, and one that I believe accords very well with our intuitions. McMahan suggests the following:

If the killing of persons is always equally wrong, and if all persons are of equal worth, the wrongness of killing may be a function of the worth of the person (rather than of the value of the person’s subsequent life)…a person, a being of incalculable worth, demands the highest respect. To kill a person…is an egregious failure of respect for the person and his worth. It is to annihilate that which is irreplaceable, to show contempt for that which demands reverence…Killing is, in short, an offence against what might be called a requirement of respect for persons and their worth. ( 2002 , 242) 30

McMahan eventually settles on a Two-Tiered Account, according to which the killing of persons is wrong for these sorts of reasons, but for those below the threshold of personhood and the threshold of respect, the wrongness of killing is governed by the Time-Relative Interest Account.

Let us give a few clarifications on this account. First, on this account, “the worth of the victim is entirely independent of the value…of the contents of his possible life in the future” ( 2002 , 243). Hence, it supports premise 2 of my argument. Second, it supports the Equal Wrongness Thesis, since it says that all killings of persons are, in a basic sense, equally wrong.

Third, it does not say that, all things considered, all killings of persons are equally morally wrong, despite appearances. McMahan explains this more carefully: “Despite my choice of label, the Equal Wrongness Thesis does not imply that the wrongness of killing persons never varies. It is compatible with that thesis to recognize that the wrongness of killing can vary in ways that are consistent with the fundamental moral equality of persons” ( 2002 , 235). He goes on to describe a number of ways in which the wrongness of killing can vary: more people killed, worse motivation, intention rather than foresight, and so on. The crucial point of equality is, as I wrote above, that it does not vary according to the worth of the victim (since all victims are equally valuable) or the worth of the victim’s life (since this is irrelevant, on this account).

McMahan defends the respect account of the wrongness of killing at greater length, but let me add some additional motivations for this thesis:

First, as described, it is an account that best fits our intuitions about the fundamental moral equality of human beings, and the connection between the equality of human beings and their most basic rights.

Second, it explains why the right to life is inviolable, as opposed to being potentially expendable, depending on the potential benefits. The International Covenant on Civil and Political Rights 31 says that the right to life is not violable, even in time of public emergency threatening the life of the nation, for example. This, of course, fits with our intuitions regarding the impermissibility of killing, even if it were possible to save more lives (as with the innocent healthy person who is killed to save five lives with organ transplants). 32 Those of us who are opposed to capital punishment and torture (among other things) may find the generation of inviolable rights on the basis of respect especially intuitive as well. It connects these rights in a plausible way with the absolute or infinite worth of the individual.

Zylberman (2016) has a helpful discussion of the concept of human dignity and its connection to these rights. Zylberman first quotes Kant: “In the kingdom of ends everything has either a price or a dignity. What has a price can be replaced by something else as its equivalent; what on the other hand is raised above all price and therefore admits of no equivalent has a dignity” ( Zylberman, 2016 , 204).

Zylberman then describes some implications of this view: in particular, that human dignity can never be traded away, even for something else with dignity, and hence results in an absolute prohibition on certain kinds of conduct, such as torture. This means it can also explain the equal wrongness of killing. The respect account can plausibly claim that human life is priceless, or infinitely valuable, and hence that all human beings are equally valuable. If the wrongness of killing is tied to their value, it can explain the equal wrongness of killing.

Third, it takes seriously our special status as persons rather than just sentient beings, connecting this in a plausible way to our inviolable right to life.

Fourth, it has strong historical precedent (and therefore the intuitive support from the “democracy of the dead,” as Chesterton put it): the U.S. Declaration of Independence ties together our equality and the unalienable right to life, 33 and the Universal Declaration of Human Rights, in its opening line, reminds us that “recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world.” Article 7 gives: “All are equal before the law and are entitled without any discrimination to equal protection of the law.” Arguably, liberal democracy is founded on a concept like respect, along with its moral implications. As we saw earlier, the Christian tradition on which our conception of rights and equality is historically grounded ( Spencer, 2016 ; Holland, 2019 ) has generally emphasized the “sacredness”—the inviolability due to respect—of human life. 34

Fifth, it makes a great deal of sense to many wrong actions which do not seem to harm anyone in a way that is appreciable to the victim. There are many things which are wrong but from which no one necessarily consciously suffers as a result. 35 For example, desecrating someone’s grave, deliberately contradicting or desecrating your loving, caring mother’s dying wish, privately laughing at another’s misfortune, cheating on one’s partner, secretly putting pork in a devout Muslim’s meal, watching child pornography, cannibalism, necrophilia, consenting to sell oneself into slavery, and so on. 36 That these wrongs disrespect the victim rather than “harming” them seems the best explanation of their wrongness. 37

Sixth, it explains our intuitions about particularly aggravated killings: for example, racially motivated or particularly degrading killings.

Finally, it fits very naturally with the pro-life view, which in its standard form says that the right to life is inviolable. Since the allegation is that the pro-life view has an inconsistency, this is a helpful virtue for the pro-lifer.

VIII. DIFFERING NORMS FOR KILLING AND LETTING DIE

This account of killing has a lot to commend it. Now how does it affect our central question? In this next section, I suggest that as a result of this account of the wrongness of killing, there are different norms for killing and letting die.

Here, I largely set aside the question of the extent to which intention to harm is important. To go into the literature on intention would take us too far afield, but it is certainly possible that the intention to harm is part of what makes killing necessarily disrespectful. In that sense, intention may well be a substantial part of my argument here. If so, my argument would neatly integrate and explain why intention is so important to the distinction. If not, my argument still works.

All I add here, therefore, is to say that it is deeply intuitive that intention makes an enormous difference to the morality of an action. To take a very simple example: it is permissible to perform actions foreseeing the death of civilians in wartime, so long as the action taken fulfills certain other strict criteria. By contrast, intentionally targeting civilians is a war crime. Foreseeing the death of a person when adjusting a policy to save five others is OK. By contrast, killing someone to use their organs for transplants is not. Examples could be multiplied endlessly, but the intuition is strong. Since, as we see, the intention in performing an abortion and in allowing a miscarriage is (usually) very different, there is an obvious reason to treat them discrepantly. What I propose is that the respect theory of the wrongness of killing may channel the role of intuition in these cases—intentionally killing a fetus is inherently disrespectful, while foreseeing the death of the fetus is not necessarily disrespectful.

The argument at this point is, again, very simple. Killing is inherently disrespectful—a violation of human dignity. It is impossible to (intentionally) kill in a way that respects the value of the victim’s life, and hence there is an absolute prohibition on it. 38 Now failing to save is not inherently or necessarily disrespectful. There are many reasons why one might fail to save someone that do not necessarily represent a failure of respect for that individual. 39 Hence, there is no absolute prohibition on failing to save. Saving someone from natural death often is a duty for various reasons—indeed, sometimes the failure to do so is a failure of respect. But, it is not necessarily so. Hence, different norms apply to each: killing is always wrong, for the reason that it is necessarily a failure of respect. Failing to save may or may not be wrong, depending on the details of the individual case.

At this point, we can respond to an objection that has been raised by a number of writers. Simkulet, for example, argues that once scenarios involving killing and letting die are made similar in every other respect, there is no moral difference between the two. In response, note that even if true , this does nothing to damage my argument. For one of the relevant factors that need to be made similar for the two scenarios to be comparable is a failure of respect . Killing, I have said, necessarily involves this. Failing to save only contingently does so. Where failing to save does constitute the same kind of failure of respect, it may well be just as wrong as killing. 40 But, in cases where failing to save is not borne out of a failure of respect, it is not necessarily as wrong. This result is all that is needed for my overall argument to succeed. Where failing to save is not a failure of respect, clearly there are other norms that govern such situations—and these norms may be significantly different from the norms governing killing. 41

Let us motivate the idea that the respect account generates differing norms a little more. First, I highlighted earlier how many of the bad features of abortion emphasized by pro-lifers are bad specifically because they are degrading , or because they disrupt a respectable part of the natural order (such as the love between members of a family). This adds more weight to the idea that killing (particularly in abortion) involves a lack of respect, while spontaneous abortion lacks those same features.

Second, the general reason we fail to save people is clearly not a lack of respect; it is a lack of resources. Indeed, it is impossible to save everyone. This creates a clear asymmetry with killing: it is entirely possible never intentionally to kill anyone, yet it is completely impossible to save everyone. If it is impossible to save everyone, then it is wildly implausible to claim that failing to save someone necessarily involves a failure of respect.

Third, the infinite value of human life easily translates into a principle on killing: do not kill. What is the equivalent principle of saving life? Because it is not possible to save everyone, it is difficult to see what this could be. Certainly, it is difficult to see what plausible principle this could involve. Put another way: it is possible for us to achieve infinite utility in the realm of killing: simply by not killing at all. But, it is harder to understand what infinite utility would look like when it comes to saving lives.

Fourth, further intuition supports different norms for the two cases. We would potentially kill in order to prevent a murder or genocide. This seems to be broadly the only situation killing would gain widespread support. 42 However, we would not at all countenance the thought of killing one person to save more people from another disease (as in the transplant case). This suggests that there are different norms for the two situations.

Fifth, it is almost universally agreed that killing and letting die are morally different. This is clear in Anglo-American law and international law, among many other (perhaps all) jurisprudential systems. Hence, there are many reasons to think that the norms governing each situation are distinct.

What norms could govern failing to save? I do not aim to set out a comprehensive algorithm: just to list some of the possibilities and their plausibility. First, of course, a failure to save can be a failure of respect, which would make that failure prohibited. Aside from this, we could be guided by many considerations:

How much such persons might be able to contribute to the rest of society (e.g., if they have the cure for cancer).
How many expected years of life that person has remaining.
How many vulnerable people that person has depending on them (including if they are pregnant).
Whether that person belongs to a protected class of human beings disproportionately affected by systemic injustice.
How likely the person is to survive the intervention.
Prudential unity considerations (i.e., the time-relative interest account).
Whether that person would prefer to live or die.
Other competing goods—not just saving lives, but other cultural goods and other sources of human flourishing, and the prevention of harm and/or misery.
The proximity of the person.
Special relationships we might have with the person.
The circumstances and cause of death: including whether the person is being killed by another person or by natural disease, and the reason for their being killed (if homicide).

Most of us already believe that at least some of these are relevant to whether we have a duty to save someone’s life, and if so, which lives we should save (given limited resources). So, our intuitions already support this sort of reasoning— even though most of us agree that humans are equal and have equal rights. This supports the idea that an equal right to life is primarily a negative right, as described. Most people endorse an account like this: killing is equally wrong across all persons, but failing to save can be right or wrong depending on a wide variety of factors. As some examples of the above: most people agree that you should save someone who has a cure for cancer over someone who does not; the idea of spending limited resources to preserve as many years of life as possible (hence discriminating between persons) is not only widely accepted but built into the foundations of health economics and resource distribution; most people think you have a duty to save your child over someone else’s child, and so on.

We even tacitly grant that competing goods that can justify not saving someone’s life include goods that do not save the life of another person. Almost every country in the world, and almost every person in the developed world, at least, spends a large amount of money or other resources on things that do not save lives, when they could have contributed toward saving a life. 43 At the same time, we would still all grant that killing people in the developing world to make money for those same goods is clearly morally monstrous.

Almost everyone endorses policies that result in more deaths because they think that when it comes to saving lives, this can be weighed against other competing goods. As an example related to abortion: most people support delayed childbearing in order to improve equality between men and women, even though the subsequent delayed childbearing leads to increased maternal mortality ( Koch, 2012 ). 44

Likewise, it is uncontroversial that a central part of medicine is not only the preservation of life but also the alleviation of misery. Those in health care realize they could save more lives by shifting all the money from misery prevention into life preservation; almost no one thinks we should do so.

All that is needed for my argument is the theoretical result that some of these considerations can outweigh numbers alone. If it is permissible to save one young child over two 90-year-olds with terminal illnesses, then we have granted that equality and the equal wrongness of killing do not mean that we cannot discriminate on any other basis when it comes to saving lives. And, that is enough to generate the possibility that preventing abortion or curing cancer ought to be a bigger priority than preventing miscarriages. If it may be permissible to stop an ethnic genocide against 10,000 people over a disease killing 10,001, the principle is proven.

To use an example that may be more (though far from entirely) analogous to abortion, suppose a disease has been unleashed, and you can save only:

1) A group of ten young girls, deeply integrated into their local communities, whose death would be extremely painful and degrading, and would lead to much misery for both the victims and perennially for their families.
2) A disparate collection of eleven hermits with no social contact at all, who would be missed by no one, who are in comas, and who would die quickly and painlessly.

I am not going to adjudicate in this scenario; I do not need to. All I need is to show that the answer is not obvious , even for those of us completely committed to human equality. We would all be agreed that killing the hermits is absolutely wrong, no matter the benefit. But, we might reasonably think that allowing a greater number of hermits to die to save the tightly bonded community is permissible. And that is enough to show that numbers are not the only consideration when it comes to saving lives.

We have, then, a plausible theoretical explanation for why different norms governing the different situations apply. We also have a wide range of intuitions regarding practices mostly already adopted, that suggest we can discriminate when it comes to saving lives. We also firmly believe that this is compatible with our deep commitment to human equality. The view that different norms govern killing and letting die appears to have robust justification.

We are now in a position to respond to Ord’s pre-emption of this strategy. Ord says that the difference between killing and letting die does not matter; he can sidestep this question by directly comparing miscarriage to other natural conditions leading to many deaths, such as cancer. As we can now see, this move does not work. Not only does the difference between killing and letting die justify saving fewer lives from killing than from natural causes, a close examination of the wrongness of killing and the wrongness of failing to save reveals very different norms governing each case. Saving lives involves asking many questions other than simply: “how many lives?” Indeed, there are compelling arguments to show that sometimes saving fewer lives is reasonable. With this established in principle, it is not clear what argument Ord can make. He has to show not only that spontaneous abortion kills a large number of people, but that no reasonable overall assessment could justify spending more on other causes. That argument looks to be very difficult to make.

Essentially, there are two different questions. Why prioritize the prevention of abortion over the prevention of miscarriage? For all the reasons I have given throughout this paper. Ord suggests there is a second question: why prioritize the prevention of cancer, coronavirus, and so on, over the prevention of miscarriage? The answer is because the norms for killing and saving are different, and the norms for saving do not require treating every life saved as equivalent, nor do they require treating every life saved as being of overriding importance to other social concerns (such as the prevention of misery, the preservation of community, and so on). We are able to preserve the equality of human beings and the equal wrongness of killing, at the same time as triaging when it comes to saving lives on the basis of a wide range of other considerations.

We can also now respond to Simkulet’s (2019) allegation that pro-life responses appealing to discriminating factors between lives can justify abortion. This would perhaps be the case if abortion were merely a failure to save. However, since abortion is (at least typically) killing, 45 Simkulet’s response fails.

It is worth briefly responding to the anticipated objection that when it comes to pro-life lobbying, all work is rescuing, rather than refraining from killing. Pro-lifers are not just refraining from killing; they are rescuing people, even if from killing rather than from disease or misfortune. This is true, and it is important: after all, it follows that pro-lifers cannot save everyone from being killed, and for the reasons explained here they therefore have no infinitely strong obligation (as they do against murder) to try and save children from abortion. Failing to advocate against abortion is not necessarily a failure of respect (though it can be). However, this consideration does not impugn my argument. I have not argued that pro-lifers must advocate against abortion at the expense of anything else or that failing to do so necessarily results from a lack of respect tantamount to killing. Rather, I have claimed and argued that the reasons for saving lives from abortion are significantly stronger than the reasons for saving lives from miscarriage, and hence can justify a greater focus on the former. I make no argument here for how strong those reasons are in absolute terms, and whether they suffice to make abortion a pre-eminent social and political priority. 46

All that is needed for my argument to work, therefore, are the following claims:

1) The norms for killing and letting die are distinct.
2) Norms other than the equality and inviolability of persons (and numbers) are applicable in the case of letting die.
3) Some of these norms in the case of letting die can outweigh numerical considerations.

I submit that each of these is not only plausible, but widely believed. In this paper, I have sought to elucidate some of the theoretical and intuitive justification behind them. It might be that Ord, Berg, and Simkulet believe that pro-life efforts are still disproportionate when all these norms are taken into account: but that requires more than just a statement of the numbers involved. It takes even more to show that the typical pro-lifer’s priorities are unjustifiable . I suspect that this cannot be shown.

IX. IMPLICATIONS

As I have shown, this account of the wrongness of killing has significant implications for our moral interpretation of killing and failing to rescue, and hence for our prioritization of preventing killing and preventing natural death. The consequences of this are many, and not only limited to the abortion debate. Within the abortion debate, it gives the pro-lifer powerful resources for explaining why they prioritize the prevention of abortion over the prevention of miscarriage. It could also give powerful resources for explaining why a pro-lifer might save a young child over multiple frozen embryos in a “burning building” scenario. 47 It could help to explain part of the reason killing is much more morally serious than letting die, and hence, it could reinforce a significant disanalogy between abortion and Thomson’s violinist scenario. 48 It could explain the wrongness of abortion in cases of fatal fetal anomaly, where the child is not expected to enjoy significant positive conscious experience for a long period of time, and perhaps also the wrongness of euthanasia in general. Finally, it could explain the wrongness of early abortion, which many find counterintuitive. As we have seen, the respect account explains the wrongness of certain actions whose victim is never cognisant of the action or its consequences (such as using child pornography). If actions can be seriously wrong—as a violation of respect—without the victim ever experiencing that harm, then perhaps the primary objection to the plausibility of the pro-life view is dispatched, namely, that it is not plausible that a completely unconscious being is worthy of serious moral consideration.

More generally, this account of the wrongness of killing could be part of the reason why we almost universally treat killing as more serious than letting die and take more measures to rescue people from killing than from natural disease or misfortune . Since this distinction is a central element of much Anglo-American (and other) jurisprudence, it has considerable importance. The distinction between killing versus letting die is also, of course, relevant for all sorts of ethical debates, and does not need to be explained in detail here. The account can also assist us in prioritizing the prevention of deaths by killing and by natural causes. The distinction between killing and letting die remains respectable.

1 This appears to have been first published by Annas (1989) , who cites Leonard Glantz as the inspiration.

2 Berg and Ord seem to suggest this; Simkulet, by contrast, insists that pro-lifers must be unaware or simply morally monstrous.

3 Condic (2011) offers a fuller discussion.

4 See also Miller (2021) .

5 Around 9,000,000 are reported each year in China alone, for example—though for obvious reasons China is likely to have a higher abortion rate than average. See Johnston (2020) .

6 As opposed to “euploidy,” where the normal number of chromosomes is present.

7 These proportions may differ by country, depending on the extent to which malnutrition and poorer control of chronic conditions and infections may cause miscarriage. So it may be that—given that these estimates come largely from the developed world—the proportion due to aneuploidy globally is actually less than for induced abortion.

8 Even this is a bit simplistic: dying with a chromosomal anomaly does not mean dying from the anomaly. After all, some people with Turner Syndrome live long lives: it by no means entails intrauterine death.

9 At least, on the pro-life view. That they are moral equals is highly debatable on the common alternative view that our moral worth is grounded in our psychological capacities. See Miller (Forthcoming) .

10 I specify human organisms since it is even possible that genetic changes may be so radical as to constitute a separate species—after all, the genetic makeup of different species is largely quite similar. That said, I think it is plausible that the overwhelming majority of cases in question are human, and in many cases constitute organisms.

11 I say “necessarily,” because it may be wrong in some cases: if the intention is to cause suffering, for example. But, if there is a valid reason—for example, wanting to delay childbearing until a point that having a disabled child is very likely but not intended—then it is not inherently wrong.

12 Incidentally, it is also a reason pro-lifers have no significant duty to take particular measures to avoid genetic anomalies recommended by some authors, such as avoiding the rhythm method (which may—speculatively—lead to older and more genetically vulnerable gametes conceiving) or using sperm sorting. Bovens (2006) makes the former argument. Likewise, changing the timing of pregnancy is probably unhelpful from the perspective of preventing deaths, since changing the timing of pregnancy will likely result in a different child.

13 See the figure cited for genetics research here, and Colgrove’s (2021) estimate for money spent on fertility research.

14 Colgrove (2021) makes similar points, while Marino (2008) presents a summary of current research.

15 “The notion that the Partial-Birth Abortion Ban Act furthers any legitimate governmental interest is, quite simply, irrational” ( Supreme Court of the United States, Gonzales v. Carhart , 550 U.S. 124 (2007) , Ginsburg, J., dissenting, 24).

16 See also the International Covenant on Civil and Political Rights, Article 23.

17 See UDHR, Article 6; ICCPR, Article 16.

18 Colgrove (2021) makes this point independently.

19 One might also think that the money spent lobbying for abortion justifies higher spending on abortion insofar as more money is needed to create a “level playing field.” Intuitively, the more money invested in the transatlantic slave trade, the greater the necessity to spend money and resources fighting against it.

20 Advocates of the transatlantic slave trade claimed that keeping the trade legal was the best way to keep it “safe”—banning it would only lead to poorer conditions on the now unregulated ships. See Hague (2008) .

21 The same applies from the fifth point, namely, that more resources are needed to create a level playing field regardless of whether the political impetus behind abortion makes it more degrading.

22 A reviewer points out that apathy toward miscarriage is also a moral wrong and could be seen the same way. But the pro-lifer under attack by Ord et al. need not be apathetic to miscarriage. They could think miscarriage is a bad thing and spend some resources trying to prevent it, while spending more opposing abortion.

23 For example, Christensen (2018) and subsequent correspondence.

24 A baby with anencephaly is not able to experience much value—she cannot experience higher pleasures than many animals, and experiences them for a much shorter time. And yet pro-lifers generally consider abortion of anencephalic children to be a very morally serious violation of their right to life, even if much more understandable and exculpable than abortion for, say, career reasons.

25 In the view of many pro-lifers, which is the relevant view in this case.

26 By which I mean, goods that are able to be apprehended and appreciated by the subject.

27 McMahan notes that the Harm-Based Account (and presumably the Time-Relative Interest Account by implication) is ordinarily associated with the denial of a moral distinction between killing and letting die—but it may be that other accounts of the wrongness of killing do permit such a distinction.

28 The latter clause is important—McMahan does not deny that some killings can be more or less wrong, but that any variation must depend on factors other than the value of the victim or her life—for example, number of killings, motivation, intention, and so on.

29 We explicate exactly what this could mean shortly.

30 This fits neatly with the conception of human dignity as a “rank” that requires respect—this rank could explain the equal wrongness of killing, among other things. Zylberman (2016) has a helpful summary of the issues raised here.

31 The legal codification of the civil and political rights declared in the Universal Declaration of Human Rights.

32 McMahan writes that it is “permissible to sacrifice an animal for the greater benefit of other animals or persons … In the case of persons, however, we believe that it is wrong to kill one person as a means of preventing the killing of a greater number of others” ( 2002 , 246–7).

33 “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” In his most famous speech during the Civil War to end slavery, the Gettysburg Address, Lincoln relies heavily on this theme.

34 The account also fits neatly with Kant’s account of human dignity and worth.

35 Clearly, it is possible (in many cases, likely) that someone is consciously harmed by these actions—but this is not necessarily so.

36 Rodger, Blackshaw, and Miller (2018) offer some further examples in the context of the beginning of life.

37 Jonathan Haidt’s The Righteous Mind is a good introduction to a kind of common sense, pluralist morality that admits questions of sacredness and respect even in the absence of harm; see Part II in particular. Haidt shows how these notions are endemic to our thinking whether or not we are religious—ideas of respect and sacredness are a part of everyday moral thought, even if increasingly by the former label.

38 A reviewer points out that assisted suicide or euthanasia might be thought compatible with respect. This helpfully demonstrates how the respect account of the wrongness of killing is precisely that to which pro-lifers subscribe: they typically believe that killing oneself or another person is wrong even when solicited. All I need is for this theory to be plausible on the pro-life view. Even if one supposes that suicide and euthanasia are not necessarily disrespectful, the premise could easily be modified: killing someone without their consent is necessarily a failure of respect.

39 The most obvious is that doing so is metaphysically impossible, which—as I have argued—may be the case for many miscarriages.

40 Just as, for example, intending to kill may be as serious as killing, even if one fails.

41 It goes without saying that pro-lifers do not typically fail to prevent miscarriages deliberately, or out of a lack of respect, but out of a lack of resources.

42 There are a few fringe cases, such as in Re A (conjoined twins) , which do not make a significant difference to this argument.

43 This is not to say that I condone the widespread greed that also characterizes many people in the developed world. I do think that we have a duty to give much more to save lives in the developing world than we currently give; I just do not think that duty necessarily overrides any duty or permission to spend resources on goods that do not save lives.

44 Again, of course, by contrast, killing a woman of the same age to promote equality of women is not permissible.

45 As Greasley (2017) has compellingly argued.

46 For full transparency, I have no hesitation in saying that I believe a relatively compelling argument can be given for this as well.

47 In short, because the norms on saving lives are governed by many factors other than human equality: and these other factors are present in such cases. This does not impugn the ultimate equality between the embryos and the child.

48 Greasley offers a comprehensive analysis of the significance of this distinction—while letting die is frequently permitted in many jurisdictions, killing has far more stringent restrictions. Hence, since abortion appears to be killing rather than letting die, the restrictions on it are far more stringent than they would be if abortion were merely a failure to rescue, as Thomson’s violinist experiment might imply.

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U.S. Supreme Court tosses out challenge to widely used abortion drug

The unanimous ruling said abortion opponents lacked the legal right to sue over the fda’s approval of mifepristone..

Boxes of the drug mifepristone sit on a shelf at the West Alabama Women's Center in...

By The Associated Press

9:39 AM on Jun 13, 2024 CDT — Updated at 10:05 AM on Jun 13, 2024 CDT

WASHINGTON — The Supreme Court on Thursday unanimously preserved access to a medication that was used in nearly two-thirds of all abortions in the U.S. last year, in the court’s first abortion decision since conservative justices overturned Roe v. Wade two years ago.

The justices ruled that abortion opponents lacked the legal right to sue over the federal Food and Drug Administration’s approval of the medication, mifepristone, and the FDA’s subsequent actions to ease access to it.

Related: Dallas woman tells Congress she had to leave Texas for medically necessary abortion

The case had threatened to restrict access to mifepristone across the country, including in states where abortion remains legal.

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Justice Brett Kavanaugh wrote for the court that “federal courts are the wrong forum for addressing the plaintiffs’ concerns about FDA’s actions.” Kavanaugh was part of the majority that overturned Roe .

The high court is separately considering another abortion case, about whether a federal law on emergency treatment at hospitals overrides state abortion bans in rare emergency cases in which a pregnant patient’s health is at serious risk.

More than 6 million people have used mifepristone since 2000. Mifepristone blocks the hormone progesterone and primes the uterus to respond to the contraction-causing effect of a second drug, misoprostol. The two-drug regimen has been used to end a pregnancy through 10 weeks gestation.

Health care providers have said that if mifepristone is no longer available or is too hard to obtain, they would switch to using only misoprostol, which is somewhat less effective in ending pregnancies.

Related: U.S. women stocking up on abortion pills, especially when there’s news about restrictions

President Joe Biden’s administration and drug manufacturers had warned that siding with abortion opponents in this case could undermine the FDA’s drug approval process beyond the abortion context by inviting judges to second-guess the agency’s scientific judgments. The Democratic administration and New York-based Danco Laboratories, which makes mifepristone, argued that the drug is among the safest the FDA has approved.

The decision “safeguards access to a drug that has decades of safe and effective use,” Danco spokeswoman Abigail Long said in a statement.

The abortion opponents argued in court papers that the FDA’s decisions in 2016 and 2021 to relax restrictions on getting the drug were unreasonable and “jeopardize women’s health across the nation.”

Kavanaugh acknowledged what he described as the opponents’ “sincere legal, moral, ideological, and policy objections to elective abortion and to FDA’s relaxed regulation of mifepristone.”

But he said they went to the wrong forum and should instead direct their energies to persuading lawmakers and regulators to make changes.

Those comments pointed to the stakes of the 2024 election and the possibility that an FDA commissioner appointed by Republican Donald Trump, if he wins the White House, could consider tightening access to mifepristone.

Related: Supreme Court appears poised to preserve access to abortion medication

The mifepristone case began five months after the Supreme Court overturned Roe. Abortion opponents initially won a sweeping ruling nearly a year ago from U.S. District Judge Matthew Kacsmaryk, a Trump nominee in Amarillo, that would have revoked the drug’s approval entirely. The 5th U.S. Circuit Court of Appeals left intact the FDA’s initial approval of mifepristone but reversed changes regulators made that eased some conditions for administering the drug.

The Supreme Court put the appeals court’s modified ruling on hold, then agreed to hear the case , though Justices Samuel Alito, the author of the decision overturning Roe, and Clarence Thomas would have allowed some restrictions to take effect while the case proceeded.

By MARK SHERMAN, The Associated Press

The Associated Press

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Unanimous Supreme Court preserves access to widely used abortion medication

The Supreme Court has preserved access to a medication that was used in nearly two-thirds of all abortions in the U.S. last year.

The U.S. Supreme Court has ruled unanimously to preserve access to the abortion pill mifepristone, a pill used in the most common way to end a pregnancy.

FILE - Boxes of the drug mifepristone sit on a shelf at the West Alabama Women’s Center in Tuscaloosa, Ala., on March 16, 2022. The Supreme Court on Thursday, June 13, 2024, unanimously preserved access to the medication that was used in nearly two-thirds of all abortions in the U.S. last year, in the court’s first abortion decision since conservative justices overturned Roe v. Wade two years ago. (AP Photo/Allen G. Breed, File)

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Anti-abortion protestors demonstrate outside the Supreme Court on Thursday, June 13, 2024, in Washington. The Supreme Court on Thursday unanimously preserved access to a medication that was used in nearly two-thirds of all abortions in the U.S. last year, in the court’s first abortion decision since conservative justices overturned Roe v. Wade two years ago. (AP Photo/Mark Schiefelbein)

FILE - The U.S. Supreme Court is seen, April 25, 2024, in Washington. (AP Photo/Mariam Zuhaib, File)

FILE - Supreme Court is seen on Capitol Hill in Washington, Monday, Oct. 23, 2023. (AP Photo/J. Scott Applewhite, File)

Highlights: Replay AP’s live coverage of the Supreme Court’s decision to preserve access to mifepristone .

WASHINGTON (AP) — The Supreme Court on Thursday unanimously preserved access to a medication that was used in nearly two-thirds of all abortions in the U.S. last year, in the court’s first abortion decision since conservative justices overturned Roe v. Wade two years ago.

The nine justices ruled that abortion opponents lacked the legal right to sue over the federal Food and Drug Administration’s approval of the medication, mifepristone , and the FDA’s subsequent actions to ease access to it. The case had threatened to restrict access to mifepristone across the country, including in states where abortion remains legal.

Abortion is banned at all stages of pregnancy in 14 states, and after about six weeks of pregnancy in three others, often before women realize they’re pregnant.

Justice Brett Kavanaugh, who was part of the majority to overturn Roe, wrote for the court on Thursday that “federal courts are the wrong forum for addressing the plaintiffs’ concerns about FDA’s actions.”

The opinion underscored the stakes of the 2024 election and the possibility that an FDA commissioner appointed by Republican Donald Trump, if he wins the White House, could consider tightening access to mifepristone, including prohibiting sending it through the mail.

The Supreme Court ruled Friday that a rifle fitted with a rapid-fire accessory known as a bump stock is not an illegal machine gun. (AP Graphic)

Kavanaugh’s opinion managed to unite a court deeply divided over abortion and many other divisive social issues by employing a minimalist approach that focused solely on the technical legal issue of standing and reached no judgment about the FDA’s actions. Kavanaugh’s seven “pro-life” references to abortion opponents may have been the only language in his opinion that revealed anything of his views on abortion.

While praising the decision, President Joe Biden signaled Democrats will continue to campaign heavily on abortion ahead of the November elections. “It does not change the fact that the right for a woman to get the treatment she needs is imperiled if not impossible in many states,” Biden said in a statement.

Marjorie Dannenfelser, president of SBA Pro-Life America, expressed disappointment with the ruling, but trained her fire on Democrats. “Joe Biden and the Democrats are hell-bent on forcing abortion on demand any time for any reason, including DIY mail-order abortions, on every state in the country,” Dannenfelser said.

About two-thirds of U.S. adults oppose banning the use of mifepristone, or medication abortion, nationwide, according to a KFF poll conducted in February . About one-third would support a nationwide ban.

AP AUDIO: Unanimous Supreme Court preserves access to widely used abortion medication

AP Washington correspondent Sagar Meghani reports the Supreme Court has unanimously approved access to a widely used abortion medication.

Jillian Phillips, of North Brookfield, Massachusetts, took mifepristone after she suffered a miscarriage eight years ago. She eventually passed the remains of her nine-week pregnancy, which she buried in a memorial garden.

“It should have never been something we had to win,” Phillips, a 42-year-old mother of three, said. “These are decisions that should be happening in a medical exam room, not courtrooms.”

Biden’s administration and drug manufacturers had warned that siding with abortion opponents in this case could undermine the FDA’s drug approval process beyond the abortion context by inviting judges to second-guess the agency’s scientific judgments. The Democratic administration and New York-based Danco Laboratories, which makes mifepristone, argued that the drug is among the safest the FDA has ever approved.

The decision “safeguards access to a drug that has decades of safe and effective use,” Danco spokeswoman Abigail Long said in a statement.

The plaintiffs in the mifepristone case, anti-abortion doctors and their organizations, argued in court papers that the FDA’s decisions in 2016 and 2021 to relax restrictions on getting the drug were unreasonable and “jeopardize women’s health across the nation.”

Kavanaugh acknowledged what he described as the opponents’ “sincere legal, moral, ideological, and policy objections to elective abortion and to FDA’s relaxed regulation of mifepristone.”

Federal laws already protect doctors from having to perform abortions, or give any other treatment that goes against their beliefs, Kavanaugh wrote. “The plaintiffs have not identified any instances where a doctor was required, notwithstanding conscience objections, to perform an abortion or to provide other abortion-related treatment that violated the doctor’s conscience since mifepristone’s 2000 approval,” he wrote.

In the end, Kavanaugh wrote, the anti-abortion doctors went to the wrong forum and should instead direct their energies to persuading lawmakers and regulators to make changes.

Abortion rights advocates mainly breathed a sigh of relief after the decision, but they echoed Biden about the impact of the decision two years ago.

“In the end, this ruling is not a ‘win’ for abortion — it just maintains the status quo, which is a dire public health crisis in which 14 states have criminalized abortion,” Nancy Northup, president and CEO of the Center for Reproductive Rights, said in a statement.

The mifepristone case began five months after the Supreme Court overturned Roe. Abortion opponents initially won a sweeping ruling nearly a year ago from U.S. District Judge Matthew Kacsmaryk , a Trump nominee in Texas, which would have revoked the drug’s approval entirely. The 5th U.S. Circuit Court of Appeals left intact the FDA’s initial approval of mifepristone. But it would reverse changes regulators made in 2016 and 2021 that eased some conditions for administering the drug.

The Supreme Court put the appeals court’s modified ruling on hold, then agreed to hear the case, though Justices Samuel Alito, the author of the decision overturning Roe, and Clarence Thomas would have allowed some restrictions to take effect while the case proceeded. But they, too, joined the court’s opinion Thursday.

The push to restrict abortion pills likely won’t stop with the Supreme Court’s ruling, said the lawyer who represented anti-abortion doctors and their organizations in the case.

The decision that the doctors don’t have the legal right to sue leaves open the way for lawsuits from others, including three other states that Kacsmaryk had previously allowed to join the case, said Erin Hawley, an attorney for the group Alliance Defending Freedom.

Hawley said she expects Idaho, Kansas and Missouri to continue the lawsuit originally filed in Texas.

Kansas Attorney General Kris Kobach, a Republican, asserted in a statement that the states have “standing that the doctors did not,” confirming that he will press ahead with the case in Kacsmaryk’s court.

Associated Press writers Lindsay Whitehurst, Linley Sanders and Kimberlee Kruesi contributed to this report. Kruesi reported from Nashville, Tennessee.

Follow the AP’s coverage of the U.S. Supreme Court at https://apnews.com/hub/us-supreme-court .

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Access to abortion pills to continue with unanimous U.S. Supreme Court ruling

Updated: Jun. 13, 2024, 8:00 a.m. |
Published: Jun. 13, 2024, 7:52 a.m.

The Supreme Court is seen on Capitol Hill in Washington, April 25, 2024. (AP Photo/J. Scott Applewhite, File) AP

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The U.S. Supreme Court on Thursday unanimously preserved access to a medication that was used in nearly two-thirds of all abortions in the U.S. last year, in the court’s first abortion decision since conservative justices overturned Roe v. Wade two years ago.

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Article Contents

I. introduction, ii. how many induced abortions and miscarriages are there, iii. causes of miscarriage, iv. other reasons for prioritizing anti-abortion advocacy, v. the central argument, vi. is the deprivation account true, vii. is there an alternative account of the wrongness of killing, viii. differing norms for killing and letting die, ix. implications.

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The Scourges: Why Abortion Is Even More Morally Serious than Miscarriage

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Calum Miller, The Scourges: Why Abortion Is Even More Morally Serious than Miscarriage, The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine , Volume 48, Issue 3, June 2023, Pages 225–242, https://doi.org/10.1093/jmp/jhad014

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1) Methods of abortion are often degrading. In England and Wales, for example, around 10,000 abortions every year involve dismembering the live fetus, a fetus at around 14 weeks’ gestation or more ( Department of Health and Social Care, 2020 ). In some other countries, surgical abortions (of which those at later gestations involve dismemberment) are more common still ( Guttmacher Institute, 2019 ; Popinchalk and Sedgh, 2019 ). Public opinion in the U.S. shifted significantly toward the pro-life position in the mid-1990s ( Gallup, 2020 ) around the time partial-birth abortion began to be publicized, eventually leading to a federal prohibition. Partial birth abortion was normally performed on healthy babies in healthy mothers ( New York Times, 1997 ) and involved delivering a living child all except for the head, at which point “blunt scissors” are forced into the baby’s skull so that the “skull contents” (i.e., the brain) can be suctioned out ( Haskell, 1992 ). One nurse testified:

Dr. Haskell went in with forceps and grabbed the baby’s legs and pulled them down into the birth canal. Then he delivered the baby’s body and the arms—everything but the head. The doctor kept the head right inside the uterus … The baby’s little fingers were clasping and unclasping, and his little feet were kicking. Then the doctor stuck the scissors in the back of his head, and the baby’s arms jerked out, like a startle reaction, like a flinch, like a baby does when he thinks he is going to fall. The doctor opened up the scissors, stuck a high-powered suction tube into the opening, and sucked the baby’s brains out. Now the baby went completely limp … He cut the umbilical cord and delivered the placenta. He threw the baby in a pan, along with the placenta and the instruments he had just used. ( Supreme Court of the United States, Gonzales v. Carhart , 550 U.S. 124 (2007) , 8)

In my experience, those hearing this description have described it as straightforward murder, if not a crime against humanity, regardless of their general position on abortion. In any case, it is not difficult to see why someone would regard this, other things being equal, as worse than a miscarriage, even than a stillbirth of the same gestation. It is worth noting that recent research suggests fetal pain from 12 weeks is distinctly possible—and certainly at later stages ( Derbyshire and Bockmann, 2020 ).

A ban on this procedure was vetoed by President Clinton, opposed by the majority of House and Senate Democrats, and even declared unconstitutional by four Supreme Court judges. 15 Although partial birth abortions constituted only a small proportion of abortions, it was responsible for an estimated 3,000–5,000 abortions a year, 500–750 of which were after 7 months’ gestation ( Johnston, 2007 ). By contrast, Presidential candidate Elizabeth Warren (2019) described children dying by gun violence in the US as a “national health emergency,” responsible for around the same number of deaths ( Cunningham et al., 2018 ). Partial birth abortions alone counted only for a very small proportion of surgical abortions in the US. This is relevant because a major political party in the most powerful country in the world supporting this kind of degradation—while claiming that the same number of deaths from another cause is a “national health emergency”—adds a further level of systemic institutional degradation against human beings in the womb.

2) Abortion, on the pro-life view, involves a violent attack within the family—hence, many early Christian writers referred to it as “parricide.” As well as parricide being particularly destructive within a family, widespread parricide plausibly results in a more general destruction of the family by the normalization of the dispensability of children and the erosion of the appreciation for motherhood. Since, according to the Universal Declaration of Human Rights Article 16, the family is the “natural and fundamental group unit of society and is entitled to protection by society and the State,” 16 the widespread breakdown of the family is plausibly a unique and serious evil to be prevented at any cost, in contrast to miscarriage which—while causing families much grief—does not involve the same kind of relational fracturing. Relatedly, abortion contributes to a widespread culture of the dispensability of children, which plausibly contributes in the same way to more general societal harms. Along similar lines, pro-lifers often think that abortion contributes to a sexual culture that is likewise destructive to human flourishing (and disproportionately so for women and the poor) by severing the link between sex and procreation ( Alvaré, 2011 ).

3) Abortion involves the systematic and state-sponsored violence against a particular class of people, which most of us would regard as worse than the natural death of the same number of people. One reason we are appalled at the Holocaust, the Rwandan genocide, the Armenian genocide, and so on, is because of the systematic and state-sponsored violence specifically impacting (and even targeted toward) a vulnerable demographic group on a large scale. There are multiple elements here, all of which no doubt contribute to the horror of these genocides, and all of which seem on initial inspection to justify greater attention than the equivalent number of deaths by natural causes. Even on much smaller scales, many of us think that it is reasonable to take radical action over violence against vulnerable groups, exceeding our response to natural deaths among those groups. Perhaps the most salient example is from the Black Lives Matter movement. The Guardian reports that in 2016, 39 unarmed black men were killed by US police. Compared to other causes of death, this is a relatively small number. Yet, we rightly realize that it is much more salient than 39 deaths from natural causes, justifying a much more significant public response. As Colgrove puts it, “BLM has a particular target. It is not solely fixated on saving as many lives as possible. It is aimed at revealing (and undoing) systematic injustice that is directed toward certain people” ( Colgrove, 2021 ).

4) Abortion involves the systematic dehumanization of a class of people. One of the most basic rights of human beings is to be recognized as a person, 17 and it seems clear that the dehumanization of certain classes of people (whether Jews, black slaves, Tutsis, disabled people, or others) is a serious aggravating factor to many crimes, especially genocides. This raises a particularly salient point: as well as dehumanization being an aggravating element of mass killing, working to oppose dehumanization constitutes the bulk of pro-life work in many countries. It may even be that humanizing the fetus is the best way to garner public support for putting resources into preventing miscarriage, and that discussion of abortion is one of the best ways to demonstrate the humanity of the fetus (the Partial Birth Abortion Ban Act and its effect on public opinion suggest this may be the case). 18

5) In the case of abortion, tens to hundreds of millions of dollars are spent advocating for abortion all over the world as a basic human right and as a part of essential health care. There is not a similar movement promoting miscarriage. This means that the dehumanization involved in abortion is not only ideological: it is institutionalized in our economic system, with hundreds of millions of dollars invested into its propagation. 19

6) In the case of abortion, the killing and dehumanization receive the imprimatur of the state and the law (and institutions like the UN and the WHO, insofar as they are able to make pronouncements not reflecting international consensus). The expressive function of the law is powerful—we can see this by asking whether we would allow, for example, the state to declare that African Americans are not fully human, if for some reason it meant that they received better treatment. 20 People are divided on this question—which is enough, I think, to show that the expressive function of the law plausibly might outweigh a certain number of lost lives. It is one degradation to have a large number of the population dehumanize you: it is another level of degradation to have this enshrined in law, and in the major political institutions. Thus, the ideological and economic weight behind abortion is compounded by political weight; it is plausibly more degrading—and certainly more of a problem—for the dehumanization of a class of human beings to have the imprimatur of the ruling institutions. 21

7) If, as many prominent philosophers have thought, virtue is a constituent of well-being, then on the pro-life view abortion is also extremely harmful to those participating in abortion. More generally, if you think that our character is more important than our experiences, you would have a strong interest in preventing abortion that does not apply to miscarriage. There is also evidence linking abortion with increased suicide rates and increased mortality ( Fergusson et al., 2013 ; Karalis et al., 2017 ), suggesting more lives may be lost due to abortion (though of course, not enough to match those lost in miscarriage). While this does not necessarily make abortion more degrading for the primary victim, it is another reason to oppose more strongly than miscarriage. 22

8) One of the primary obstacles to generating substantial societal support for miscarriage and abortion prevention is the view that unborn human beings are not really human, or are not equally morally considerable. (Effective) anti-abortion advocacy helps to remove this obstacle for both causes, and perhaps more effectively than miscarriage prevention advocacy.

The main similarity between babies or fetuses killed by abortion and those whose lives are ended in miscarriage is that they are both deprived of the same subjective goods. 26

However, deprivation of subjective goods is not the primary determinant of the wrongness of killing.

If 1 and 2, then the main similarity between abortion and miscarriage has little to do with the wrongness of killing.

Hence, the main similarity between abortion and miscarriage has little to do with the wrongness of killing.

McMahan (2002) , in his magisterial volume on the ethics of killing, offers pointers toward both of these.

profoundly offends our sense of the moral equality of persons…The common view, in short, is that the wrongness of killing persons does not vary with such factors such as the degree of harm caused to the victim, the age, intelligence, temperament, or social circumstances of the victim, whether the victim is well liked or generally despised, and so on. ( 2002 , 234–5)

McMahan dubs this the Equal Wrongness Thesis.

If the killing of persons is always equally wrong, and if all persons are of equal worth, the wrongness of killing may be a function of the worth of the person (rather than of the value of the person’s subsequent life)…a person, a being of incalculable worth, demands the highest respect. To kill a person…is an egregious failure of respect for the person and his worth. It is to annihilate that which is irreplaceable, to show contempt for that which demands reverence…Killing is, in short, an offence against what might be called a requirement of respect for persons and their worth. ( 2002 , 242) 30

McMahan defends the respect account of the wrongness of killing at greater length, but let me add some additional motivations for this thesis:

Third, it takes seriously our special status as persons rather than just sentient beings, connecting this in a plausible way to our inviolable right to life.

Sixth, it explains our intuitions about particularly aggravated killings: for example, racially motivated or particularly degrading killings.

How much such persons might be able to contribute to the rest of society (e.g., if they have the cure for cancer).

How many expected years of life that person has remaining.

How many vulnerable people that person has depending on them (including if they are pregnant).

Whether that person belongs to a protected class of human beings disproportionately affected by systemic injustice.

How likely the person is to survive the intervention.

Prudential unity considerations (i.e., the time-relative interest account).

Whether that person would prefer to live or die.

Other competing goods—not just saving lives, but other cultural goods and other sources of human flourishing, and the prevention of harm and/or misery.

The proximity of the person.

Special relationships we might have with the person.

The circumstances and cause of death: including whether the person is being killed by another person or by natural disease, and the reason for their being killed (if homicide).

To use an example that may be more (though far from entirely) analogous to abortion, suppose a disease has been unleashed, and you can save only:

1) A group of ten young girls, deeply integrated into their local communities, whose death would be extremely painful and degrading, and would lead to much misery for both the victims and perennially for their families.

2) A disparate collection of eleven hermits with no social contact at all, who would be missed by no one, who are in comas, and who would die quickly and painlessly.

All that is needed for my argument to work, therefore, are the following claims:

1) The norms for killing and letting die are distinct.

2) Norms other than the equality and inviolability of persons (and numbers) are applicable in the case of letting die.

3) Some of these norms in the case of letting die can outweigh numerical considerations.

Alvaré , H. M. 2011 . Abortion, sexual markets and the law. In Persons, Moral Worth, and Embryos: A Critical Analysis of Pro-Choice Arguments , ed. S. Napier , 255 – 79 . Dordrecht, The Netherlands : Springer .

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This appears to have been first published by Annas (1989) , who cites Leonard Glantz as the inspiration.

Berg and Ord seem to suggest this; Simkulet, by contrast, insists that pro-lifers must be unaware or simply morally monstrous.

Condic (2011) offers a fuller discussion.

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The Scourges: Why Abortion Is Even More Morally Serious than Miscarriage

I. INTRODUCTION

II. HOW MANY INDUCED ABORTIONS AND MISCARRIAGES ARE THERE?

III. CAUSES OF MISCARRIAGE

IV. OTHER REASONS FOR PRIORITIZING ANTI-ABORTION ADVOCACY

V. THE CENTRAL ARGUMENT

VI. IS THE DEPRIVATION ACCOUNT TRUE?

VII. IS THERE AN ALTERNATIVE ACCOUNT OF THE WRONGNESS OF KILLING?

VIII. DIFFERING NORMS FOR KILLING AND LETTING DIE

IX. IMPLICATIONS

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Unanimous Supreme Court preserves access to widely used abortion medication

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