gp essay on abortion

• - Google Chrome

Intended for healthcare professionals

• Access provided by Google Indexer
• My email alerts
• BMA member login
• Username * Password * Forgot your log in details? Need to activate BMA Member Log In Log in via OpenAthens Log in via your institution

Search form

• Advanced search
• Search responses
• Search blogs
• News & Views
• Reflection is...

Reflection is protection in abortion care—an essay by Sandy Goldbeck-Wood

• Related content
• Peer review
• Sandy Goldbeck-Wood , editor in chief, BMJ Sexual and Reproductive Health
• goldbeckwood{at}doctors.org.uk

Allowing the space for conscientious reflection is essential if harm is to be minimised—for professionals as well as for women, writes Sandy Goldbeck-Wood

Where I conduct abortions, all procedures are preceded by an exploratory conversation with women to establish that they are necessary. As well as ensuring compliance with the UK Abortion Act, we aim to allow space for ambivalence, invite reflection, and rule out coercion; a process that from the outset acknowledges the woman as the final arbiter of the likely balance of risks and benefits but that does not simply rubber stamp a request without a genuine effort to understand her situation.

I see this as protecting women from potential future harm caused by unexplored ambivalence—harm which occasionally reappears in psychosexual counselling as unresolvable guilt, impairing health and relationships. My hope is that without necessarily changing the decision, deeper reflection may result in greater resolution and integration, a better chance that a woman, whatever her decision, will be able to “move on.”

But the discussion also protects me, the surgeon. Despite my belief in properly delivered abortion as an ethical and evidence based part of women’s healthcare, there are moments when it is distasteful to carry out. I understand why, in addition to colleagues who have religious objections to abortion, some doctors experience a deep emotional unease or aesthetic aversion to the process. But meaning can protect against harm, 1 and when performing an otherwise violent act, it really matters for your own sense of integrity that you genuinely believe that it is, on balance, necessary.

Haunted by a difficult case

I am still haunted by an abortion I performed recently and want to explore why it was so difficult. I have little doubt that the woman richly fulfilled the legal requirements for abortion. She was homeless, a substance misuser, a recent arrival from abroad, and lacking social benefits. Distraught about the need to terminate her pregnancy, she was clear, for reasons easy to follow, that she was not in a position to bring a baby into the world.

In her second trimester of pregnancy, having struggled to make her decision, she chose surgical rather than medical abortion in order not to have to live consciously through something potentially traumatic. I felt for her, shared her dismay that things should have to be this way. Still, empathy for painful dilemmas is commonplace in the pregnancy advisory clinic and does not normally interfere with doing the procedure.

In this case, though, the procedure was also a physical struggle. I wrestled even with the “easy bit” of this routine procedure, accessing her cervix with the suction curette. I watched heterogeneous pregnancy tissue whoosh into the vacuum container, well differentiated and multicoloured, unlike the whitish placental tissue of early abortions. Anyone with any imagination will see this for what it is: pieces of fetal organs and blood vessels. I admit I often feel distaste at this.

Violence of the procedure

This time, the tissue clung tightly to the uterine wall and I had to make many passes with the suction curette to remove it. A large piece removed with sponge forceps would not pass down the tubing even with the tip removed. I found myself—saw myself—battling, literally, to push the pregnancy of a woman who was reluctant to terminate down a suction curette with my gloved hands.

The violence of this situation struck me keenly. Perhaps I felt a bit like the perpetrator of systemic violence—the brutal arm of the state removing a pregnancy from a woman who, given other circumstances, would have liked to keep it. Perhaps I felt violated too. An involuntary wave of physical revulsion passed through me, and, on my surgeon’s stool between the woman’s surgically draped legs, I felt tears quietly run down my face.

The moment passed quickly. I inserted an intrauterine contraceptive, descrubbed, signed out on the computer, composed myself, and documented the procedure in brief, technical terms, bypassing, as healthcare practitioners conventionally do, the subjective or interpersonal aspects of the encounter.

But what do we make of a gynaecologist unexpectedly weeping over a difficult termination in a woman who felt forced to terminate? Or put another way, of an emotional response that asserts itself unusually within a professional routine? I am aware that my story could most conveniently be suppressed. In being told, it could be retrofitted into various pre-rehearsed arguments about abortion and politics. If you wanted to use it to confirm prior beliefs, you could make this a story about the evils of abortion, or the wrongs of the current immigration and benefit system, or an indictment of one doctor’s oversensitivity, or, as I have chosen to see it, about the importance of reflection.

I know little, actually, about the circumstances of my patient’s residency in the UK or benefit entitlements, only that she was under a degree of existential duress that was difficult to distinguish from coercion; and that I found the physical fight with the resistant pregnancy tissue hard to stomach. I do not in the end feel harmed or shamed by the procedure, or the shedding of a few tears over it, but I am clear about my need for preoperative, and in this case postoperative, reflection.

What I see in my story is the responsible, vulnerable human practitioner at the heart of all healthcare. No matter what our technical competence and experience, we stand and fall on the quality and integrity of the processes we work within, and on one another. Whatever the law says, I have no ultimate moral defence that what I was doing on that occasion was “right.” Rather, I depend on the grace of colleagues and systems which work in reflective, humane, conscientious ways and on my capacity for conscientious reflection.

Respect for the integrity of all parties

Abortion is a sensitive area for all concerned. It is not surprising that many practitioners choose to avoid it for emotional and aesthetic reasons, even if they do not hold religious beliefs that oppose it, and we should not blame them, as long as they do not act in ways which disadvantage patients. 2 But those who choose, for humane and ethical reasons, to perform abortion, need a context in which to work that respects the integrity of all parties.

A woman needs space to explore any ambivalence in relation to the potential life, which no one feels more keenly than she does, without fear of losing her autonomy. This is true whether she is able to bring it to fruition or not.

To avoid brutalisation, abortion should not be offered on a conveyor belt but through a reflective process. We will not achieve this by criminalising abortion, overpowering women’s autonomy over their bodies, or pretending that healthcare practitioners, politicians, or religious leaders can know what is best for individuals. Rather, we need structures and processes which support shared conscientious reflection . So that when the tissue is distressingly hard to remove, the practitioners involved know due process has been served. And when it is gone, and the woman wakes up, she knows it too.

UK abortion is regulated by criminal law

Unlike in many European countries, abortion in the UK is regulated by criminal law. For an exemption to apply, certification is required from two doctors that there is as a minimum a greater risk of harm to the mental health of the mother if the pregnancy is continued than if it is terminated.

The BMA, the Royal College of Obstetricians and Gynaecologists, the British Association of Abortion Care Providers, the British Pregnancy Advisory Service, Marie Stopes UK, and the Royal College of Midwives are campaigning for decriminalisation of abortion in the UK. The Faculty of Sexual and Reproductive Healthcare is due to vote on the issue on 23 November.

Sandy Goldbeck-Wood is a trainer for the Institute of Psychosexual Medicine, which, in common with several other disciplines, sees practitioner self reflection as an essential source of information about the clinical encounter. As editor in chief of BMJ Sexual and Reproductive Health (formerly the Journal of Family Planning and Reproductive Health Care ), she has argued that both practitioner and patient subjective accounts have a place in the health debate. This article was adapted from a piece of writing used to reflect on practice while clinical lead for an NHS abortion service.

Competing interests: I have read and understood BMJ policy on declaration of interests and declare that I am a member of an Anglican church.

Patient consent not required (patient anonymised, dead, or hypothetical).

Provenance and peer review: Not commissioned; not externally peer reviewed.

• ↵ Antonovsky A. Health, stress and coping. Jossey-Bass Publishers, 1979 .
• ↵ Kasliwal A, Hatfield J. Conscientious objection in sexual health—a guideline that respects diverse views but emphasises patients’ rights. BMJ Sex Reprod Health ( forthcoming ). doi:10.1136/bmjsrh-2017-101853 .

• Open access
• Published: 12 March 2020

Is it morally permissible for general practitioners to disclose their opinion on a woman’s decision on abortion?

• Lynnlette Aung 1 &
• Selena Knight   ORCID: orcid.org/0000-0003-0372-0284 2  

BMC Medical Ethics volume  21 , Article number:  19 ( 2020 ) Cite this article

4764 Accesses

1 Citations

1 Altmetric

Metrics details

This paper considers ethical dilemmas arising where a patient asks their General Practitioner for advice and their personal opinion regarding whether or not to have an abortion. Patients often seek their General Practitioner’s advice regarding treatments and procedures, which may occasionally lead to the General Practitioner facing a difficult dilemma of whether to share their personal opinion with their patient. As General Practitioners are more accessible as the first point of contact for patients and often have a closer relationship with them, they may be particularly exposed to such situations. Additionally, the significance of abortion as a sensitive topic and the fact the General Practitioner may have their own personal viewpoint on its morality may make it particularly difficult for them to know how to respond to such a request.

This paper explores the difficulties arising in such a situation and considers whether it could ever be ethically justifiable for General Practitioners to express their opinions on such a matter. We consider the duties of a doctor, and highlight the need for clearer guidance for healthcare professionals on managing tensions in their professional boundaries between their personal moral views and their professional responsibilities. A range of ethical viewpoints are considered to explore how a doctor might ap, in particular the principle of autonomy, virtue ethics, and consequentialism.

Conclusions

This article recognises that a General Practitioner in a situation such as this faces many ethical challenges. We propose that offering their opinion to the patient where specifically requested may be morally justifiable. A virtue ethics approach in particular requires that the General Practitioner applies practical wisdom to make this decision, and where they do disclose their opinion ensure this is done so in such a manner that it does not harm the patient and promotes flourishing. We encourage GPs and other healthcare professionals to consider their own moral perspectives on sensitive issues such as abortion, and reflect on how their moral viewpoints have the potential to influence their practice. In doing so, we hope clinicians can be better should they be faced with a situation such as this.

Peer Review reports

The Abortion Act 1967 is the legal statute governing abortion in England, Scotland and Wales, outlining criterion which must be satisfied to legally terminate a pregnancy [ 1 ]. Two clinicians must confirm that the relevant criterion have been met [ 1 ]. Whilst this would not commonly be a General Practitioner (GP), it is not unusual for them to be the patient’s first point of contact when considering this option, and so the GP may have a role in signposting or referring them to abortion services.

Regardless of the circumstances of the patient or consultation, part of a GP’s role is to provide patients with appropriate information to empower them to make informed decisions. Where a patient consults their GP wishing to discuss abortion, the GP would be expected to provide broad information regarding the clinical risks and benefits of the procedure, but may also feel it appropriate to provide other information that may be relevant for the patient such as the potential emotional implications and long-term medical and psychological sequalae. GPs would not be required to provide detailed clinical or technical information, which is more commonly provided by a dedicated counselling service or the abortion provider themselves. Given that the requirements in terms of appropriate information provision are not in dispute, this article focuses on the ethical challenges arising in terms of whether the GP should share their personal opinion about whether the patient should have an abortion, where such opinion has been specifically sought by the patient.

Although abortion itself is a of course a highly morally sensitive subject, this article focuses on the ethical challenges arising out of the patient’s specific request for the GP’s advice and the relationship between the patient and GP, rather than the morality of abortion in itself. Irrespective of whether the patient or GP feels abortion is morally right or wrong, the issues discussed here are not whether it is right or wrong, but rather, irrespective of their opinion, whether that opinion should be shared with the patient. This article only considers circumstances where a GP has specifically been asked by the patient for their opinion, not situations of spontaneous disclosure decided by the GP, which generally be considered unprofessional and not ethically appropriate.

In order to illustrate the ethical challenges arising from such a situation, the following hypothetical case of Mrs. X shall be considered:

Mrs X is 34 year old woman who is 9 weeks pregnant and consults her GP, whom she knows well and has a longstanding therapeutic doctor-patient relationship. She is unsure whether she wishes to continue her pregnancy. She has a history of severe anxiety, and explains that she worries she would be unable to commit to looking after a child, and that whilst she is currently stable her anxiety could relapse. She is happily married and would like children in the future, but fears now is not the right time for a pregnancy. She is visibly distressed about what to do. She appreciates the emotional implications of having an abortion, and wonders if she would regret it. She asks the GP for their personal opinion, specifically what her GP feels she ought to do and what they would do in her position.

Vignettes such as this have been used to illustrate ethical dilemmas which can arise in the context of the doctor-patient relationship. Of comparison, Toon discusses the case of a doctor who is asked to advise couple of have recently had a baby with severe anoxic brain damage [ 2 ].. In the case the doctor strongly advises the couple to consider adoption. Toon suggests that the doctor here is taking the place of a wise friend, a concept we shall similarly apply to the case of Mrs. X. Whilst Toon’s case might raise controversy around the actual decision which is made by the advising doctor (that due to the baby’s disability they ought to be adopted), the case of Mrs. X does not consider the content of the decision or GP’s opinion, but rather whether this should even be shared in the first place.

With reference to the case of Mrs. X, this article considers a number of perspectives to explore these ethical issues. Firstly, the professional duties of a doctor are considered with specific reference to the UK’s professional guidance issued by the General Medical Council (GMC) [ 3 ]. The principle of autonomy is then considered, in particular how the GP’s decision of whether or not to disclose their opinion may subsequently influence the patient and either promote or limit her autonomy. We then discuss the nature of the difficulties arising from deciding where to draw and how to define professional boundaries relating to the GP’s professional duties and their personal moral opinion. Following this, a virtue ethics approach is considered, with particular reference to the concept of the GP acting as a “wise friend” in this situation. We consider how this concept can be both inherently challenging but also beneficial in helping the GP decide what to do. We also consider the need for the GP to apply practical wisdom if they inadvertently take on this role, and discuss what different forms of wisdom this might encompass. Other aspects of virtue ethics such as virtuous character traits and the concept of flourishing are discussed. Finally, a consequentialist approach is considered, where the complexities in predicting the consequences of decisions surrounding abortion and disclosure of opinion are highlighted.

This paper focuses on GPs for a number of reasons. GPs are particularly well placed to provide continuity of care, and the longer-term relationships can give them a better understanding of their patient’s circumstances compared to those in secondary care [ 4 ]. Patients may also be more inclined to seek advice from their GP about personal or sensitive matters, particularly where they have an especially close or trustworthy professional relationship, and are easily accessible as a first point of contact. That said, due to the ability of patients to self-refer directly to abortion services, GPs may not have these conversations often, and so whilst patients might expect their GPs to have the knowledge and skills to have such conversations, a lack of experience and confidence may mean this is in fact not the case. Additionally, the highly morally sensitive nature of abortion means that the GP may have their own views on its morality, although they may not have considered how these could affect their patient consultations until unexpectedly faced with a situation such as that described here. It is therefore particularly important that GPs consider such a situation in advance so they have an approach which they feel comfortable with and is right for both themselves and their patient.

Whilst this article focuses on GPs, the issues discussed here are relevant to other doctors and healthcare professionals, who will invariably also face challenging decisions arising from the interface between their professional role and their personal moral viewpoints. Additionally, whilst this article focuses on the example of abortion, the application of the ethical principles and issues discussed have relevance to situations involving other sensitive procedures or decisions.

The duties of a doctor

In the UK, the professional duties of a doctor are outlined in the GMC’s ‘Good Medical Practice’, to which all UK doctors must abide [ 3 ]. The GMC states that to provide an appropriate standard of care doctors should consider “psychological, spiritual, social and cultural factors” (p.7) [ 3 ]. Doctors are expected to care for patients holistically, which includes attempting to understand their personal situation and values.

The GMC offers guidance to doctors in terms of disclosing personal beliefs, clearly advising: “you must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress” (p.18) [ 3 ]. This recognises the potential risk of causing offense, distress, or unduly influencing the patient which may result from disclosing their personal view about a patient’s situation. This is particularly pertinent in a case such as that of Mrs. X, given the sensitive and life-changing nature of the decision in hand.

Separate guidance is offered in the GMC’s guidance ‘Personal beliefs and medical practice 2013’, which states that doctors are allowed to express their own personal beliefs “only if a patient asks [the doctor] directly about them, or indicates they would welcome such a discussion” (p.5) [ 5 ]. This suggests it may be permissible for the GP to disclose their opinion to the patient in this scenario, given that they have specifically sought it. Disclosing their opinion might be further supported by the GMC’s requirement for doctors to act with “honesty and integrity” (p.21), and to “respond honestly to [patients’] questions” (p.13) [ 3 ].

Whilst this professional guidance endeavours to provide clarity, there is the potential for these professional duties to conflict. If the GP discloses their opinion at the patient’s request, whilst they are being honest, there is a risk it might exacerbate her distress if it differs from the option she was perhaps considering, and particularly given it might be difficult to predict how she might respond to whatever the GP’s opinion is. Conversely, if they decline to share their opinion to minimise any potential distress, the patient may perceive them as failing to fulfil their duty to act with honesty and integrity. Whilst these duties and professional guidelines are intended to provide guidance on such circumstances, they do not necessarily help the GP in making a decision in a case such as this.

Respect for autonomy, described as “deliberated self-rule” (p. 184) is a founding principle of healthcare ethics [ 6 ]. It is often considered a cornerstone of a therapeutic doctor-patient relationship which should be promoted wherever possible. Significantly interfering with or influencing a patient’s decision risks that such a decision is not truly autonomous and undermines the patient’s free will [ 7 ]. Mrs. X’s autonomy must be carefully considered, as there is a chance that the GP’s opinion may influence her decision.

Nevertheless, it has been proposed that respecting a person’s autonomy does not necessarily mean non-interference altogether [ 4 ]. Part of a doctor’s role is to enable patients to exercise their autonomy, with one part of this being the provision of necessary and relevant information to allow them to make an informed decision. In Mrs. X’s case, this might include the GP sharing their opinion on the matter, given that they have specifically been asked. Furthermore, it is Mrs. X’s own choice to ask her GP for their opinion and so arguably in doing so they are acting according to the her wishes and thus respecting their autonomy.

The principle of respect for autonomy conveys that one should be free from coercion in decision-making [ 7 ]. Considering the case of Mrs. X, the GP disclosing their opinion would not necessarily equate to coercion – this term portrays a patient being forced into a decision against their will, whereas here the GP has been invited to share their opinion by the patient. There are measures which the GP might take to ensure that in sharing their personal opinion they do not risk impeding a patient’s autonomy nor coerce the patient, for example reiterating to the patient that the final decision is theirs to make, or even suggesting to the patient before providing their opinion that it may influence their final decision.

Whilst sharing their personal opinion could be considered to have the potential to impede Mrs. X’s ability to make an autonomous decision, if disclosed in an appropriate and sensitive manner it could be ethically justified for the GP to do so. It may even promote her autonomy as provision of information can supporting her in more autonomous and better informed decision-making. Clearly the manner by which the GP does so is crucially important to ensure Mrs. X continues to be able to exert her autonomy, without undue pressure, by making the final decision herself.

Professional boundaries – where do we draw the line?

The GMC highlights that appropriate professional boundaries “are essential to maintaining a relationship of trust between a doctor and a patient” (p.5) and to ensure professionalism is upheld in practice [ 5 ]. Dilemmas arise when deciding where to draw the lines of professional boundaries in medicine, particularly in general practice. This reflects the fact that GPs may take on multiple roles in order to provide a holistic approach to patient care, and that they may have longer-term relationships with their patients [ 4 ]. Patients may consider their GP to be their doctor, but also to potentially fulfil other roles including confidant, professional, advice-giver, advocate, and in some circumstances, even friend. The type of relationship that forms between the GP and the patient will influence the way in which professional boundaries are established and experienced by both parties. A number of different models of physician-patient relationship have been described – paternalistic (the physician determines what intervention is best for the patient); informative (the physician provides the patient with information and the patient selects the option they prefer); interpretive (the physician elicits the patient’s values and wishes and helps them determine which option best achieves these); and finally deliberative (the physician helps the patient choose the best values which can be realised in the clinical situation) [ 8 ]. The challenge faced by the GP in Mrs. X’s situation is how they can attempt to continue the already established therapeutic and supportive relationship they have with Mrs. X, whilst still maintaining their professional integrity and appropriate professional boundaries.

In the case of Mrs. X, the GP is being asked for their personal opinion but in a professional capacity, indicating potentially blurring of the boundaries which normally exist between a patient and their doctor. Such a request might indicate that she views her GP more akin to a “wise friend” than a medical professional, a status which has been described by Toon [ 4 ]. This might be more likely to occur where a GP plays a significant role in helping a patient with more personal or sensitive issues such as mental illness or supporting with psychosocial difficulties, or where there is a pre-existing long-term therapeutic relationship. Such a relationship may represent either the interpretive or the deliberative model – the patient is not purely asking for scientific advice or direction from the GP, but rather is personally asking for advice and thus inherently the personal values of both the GP and the patient may be shared. It has been suggested that whilst boundaries are important to preserve objectivity, “on occasions, it feels the right thing to do to break down those boundaries just enough to help the patient over a hurdle.” [ 9 ] Neighbour argues that doctors have an authority that they can use in the patient’s best interest, called the “apostolic function” [ 9 ]. If one views medical authority as something to be used for the patient’s good, then it may be appropriate for a GP to assist a patient’s decision-making by offering advice, assuming such advice is in the patient’s best interest [ 9 ].

However, taking on the role of “wise friend” has the potential to be problematic . In most circumstances it is not considered appropriate for a doctor to befriend their patient in the true sense of the word, and particularly here where Mrs. X is vulnerable and seeking their doctors advice on a highly morally sensitive issue. There is also a lack of reciprocity in the relationship which might normally be expected from a true friendship - whilst Mrs. X has sought her GP’s opinion and advice, the GP would not reciprocate this and seek Mrs. X’s advice were they to be faced with a difficult decision themselves. Furthermore, the concept of friendship in this relationship is problematic because of the significant power imbalance which inherently exists between doctors and their patients. Doctors possess a certain power by virtue of their professional role, which whilst can be beneficial in some situations, also has the potential to place the patient at risk of harm. This would be of particular concern in Mrs. X’s case where she is particularly vulnerable due to her situation and the sensitive nature of the issue in question. If the power imbalance is significant, there is risk that the patient may feel unable to refuse the advice or feel unduly influenced by it, impeding on her autonomy. It is imperative that the GP is aware of the power differential existing between themselves and Mrs. X and how this might impact on the consultation. It may be necessary for them to adapt their consultation style and carefully consider what information they provide to the patient (and how they provide it) to manage this power imbalance and avoid any potential adverse outcomes which might arise.

Due to the sensitivity of abortion, it is highly possible the GP will have their own personal moral viewpoint about this topic and potentially specifically what Mrs. X should do. Depending on a number of factors (e.g. the strength of the GP’s views on the morality of abortion; the patient’s own views regarding abortion; the exact circumstances of the patient and the reason for their request for an abortion; any prior experiences of the GP), a consultation such as this might evoke certain and potentially difficult emotions for the GP. This is not necessarily problematic - it has been proposed that doctors function better and patients experience a better service where doctors have few boundaries between their personal and professional self, which could involve sharing their emotions and moral viewpoints [ 10 ]. Acknowledging and sharing emotions has the potential to strengthen the doctor-patient relationship - the act of a doctor disclosing their emotions has been proposed as enabling patients to view them as a “fellow human”, with positive implications for the relationship [ 11 ]. Emotions and conscience have been considered important and valid features of British general practice [ 12 ] which have the potential to be used constructively to contribute to an empathetic approach to patient care.

However, safeguards are necessary to ensure that the GP manages these emotions and any potential disclosure of their opinion is done so appropriately to ensure no harm is caused. Doctors should be aware of their emotions and consider how these might influence the consultation, both consciously (for example when they are deciding what they should advise the patient and how their emotions might influence this), but also subconsciously (for example ensuring their tone does not appear judgmental, or even considering aspects of the consultation such as their body language). Self-awareness is an important component of professionalism and particular relevant in a case such as this. As Papanikitas describes, whilst GPs do not necessarily operate in a neutral state, they must remain aware of their values and consider the extent to which such values and beliefs should be allowed to influence their practice [ 13 ].

Practical wisdom, virtues and flourishing

Virtue ethics is implicit in much of the literature in medical professionalism, whereby doctors are encouraged to demonstrate traditional virtues and positive character traits in order to care for their patients in accordance with moral principles. Virtue ethics has been suggested to promote a more holistic ethical approach, as it often involves consideration of wider aspects of the patient’s life beyond just their medical needs [ 14 ]. This holistic approach to patient care is particularly advocated in general practice, and thus virtue ethics has particular relevance to the case of Mrs. X.

A central component of virtue ethics is that one should use practical wisdom to choose the morally right course of action. Toon describes practical wisdom as “an ability to perceive situations from a virtuous perspective and to analyse the virtuous course of action” [ 2 ].. There are a number of forms of “wisdom” which might need to be drawn upon if the GP is to use practical wisdom to choose the right course of action in the case of Mrs. X.

Firstly, the GP might be expected to have sufficient knowledge (‘wisdom’) of the patient and their circumstances, values, desires, and personal narrative to be able to decide whether it is appropriate in the first place to share their opinion with the patient. For example, if the GP had a certain opinion that they knew directly opposed the views of the patient (for example because of the patient’s religious views) they might be more wary of sharing it in order to avoid causing undue distress or conflict. Similarly, if the GP knew the patient was particularly vulnerable and influenceable they might be less inclined to share their opinion to ensure they do not unduly influence the patient. However, it is of course difficult for a GP to have sufficient in depth knowledge of a patient’s personal circumstances to be able to really understand and advise them. Even where doctors and patients have a close relationship, they would be unlikely to share their true deep inner thoughts with their doctor, thus limiting the knowledge the GP would be able to have in this area.

Another form of ‘wisdom’ the GP might be expected to have would be about abortion itself. Mrs. X might understandably expect that their GP would have prior experience in relation to abortion through their professional background - for example that they may have previously advised women in similar circumstances, or have seen the consequences of women choosing different options when faced with a similar decision. Mrs. X may perceive that such experience would place her GP in a position to provide accurate and beneficial advice and recommend the right course of action. However, as already discussed, many women refer themselves directly to abortion services bypassing their GP, and much of the counselling surrounding abortion is provided by dedicated abortion services. The GP may therefore have limited experience in advising women in Mrs. X’s situation, and so may lack the knowledge and experience to be considered wise in this sense. Additionally, given that every woman’s circumstances are different, even where a GP may have experience with patients who undergone abortions (with either positive or negative outcomes), it would not be possible for them to these experiences to be able to provide advice regarding Mrs. X’s specific circumstances.

In order to apply practical wisdom, virtue ethics also the moral agent to act according to virtuous characteristics and behaviours. It is therefore necessary to consider which virtues the GP might apply in this situation in order to choose the morally right course of action. Whilst there is no set list of virtues, there might be certain ones which are of particular relevance here. On one hand, the virtuous characteristics of integrity and honesty might be used to justify the GP disclosing their opinion, particularly given that Mrs. X has specifically requested it, and so if the GP has a particular opinion some may consider it dishonest and disingenuous to not share it. However, frank disclosure of the doctor’s opinion might oppose other virtues such as compassion (for example if the disclosure is likely to cause the patient distress), or discernment. Aristotle proposes virtues as traits lying in the middle between two vices [ 15 ], and frank disclosure with no thought to the consequences, whilst being honest would oppose other virtues and not be considered to in the middle of such vices. Applying virtues therefore cannot necessarily direct the GP to whether they should or should not disclose their opinion, but it does encourage them to reflect on the manner by which they might make and communicate their decision, whether this be disclosure or non-disclosure.

Finally, where considering a virtue ethics approach to a situation such as this it is necessary to consider the concept of flourishing, which forms an important aspect of this moral theory. It has been suggested that “the main purpose of medicine is to help patients construct a flourishing narrative” (p.45) and therefore the most virtuous course of action would be that by which the agent uses appropriately chosen virtues to maximise Mrs. X’s flourishing [ 14 ]. Given that she has asked the GP for their opinion to help her reach a decision, one might argue that the GP is obliged share this to help her reach an informed decision which is most likely to lead to her achieving eudaimonia and a flourishing narrative. However, difficulties may arise in determining the ideal flourishing narrative for the patient, as the GP’s idea of what is best for the patient or what may constitute a flourishing narrative may differ from the patient’s. Additionally, should the GP, even unintentionally, expresses their opinion insensitively they may cause the patient undue distress.

By using virtues to guide actions, we can attempt to resolve some of the ethical dilemmas encountered in medicine. In this case, a virtue ethics approach requires the GP to consider which virtues might guide them to make the right decision, and how such decisions should be shared with the patient. Perhaps more helpfully it also encourages the doctor to employ practical wisdom, considering the patient, their circumstances, the procedure in question, and also their own prior knowledge and experience. Disclosing their opinion, if this is the course of action taken by the GP, must be undertaken using the GP’s practical wisdom to do so with care and awareness for the patient’s circumstances to minimise any potential distress and avoid demonstrating vices. Through employing knowledge, experience and practical wisdom, provided the GP shares their opinion in a sensitive manner, they may be able to offer important and helpful advice which the patient may wish to consider in their decision-making.

Consequentialism

Consequentialism claims that the “moral rightness of acts… depends only on the consequences of that act.” [ 16 ] Therefore a consequentialist would deem the ethical course of action as being the one which promotes the best consequences for Mrs. X.

Sharing their opinion with Mrs. X, having been asked, could be a justified course of action for the GP from a consequentialist perspective, as doing so may build trust and in the long-term be beneficial for the doctor-patient relationship [ 17 ]. This might be particularly important for a patient such as Mrs. X, who’s anxiety may mean that she requires an ongoing supportive relationship with healthcare professionals.

However, there are also potential negative consequences of the GP sharing their opinion with Mrs. X. Establishing which course of action results in the best overall consequences is difficult, and would be particularly so here. It is extremely challenging, arguably impossible, for the GP to determine whether continuing the pregnancy or having an abortion would result in the best consequences for her. Abortions are often considered only in the short-term sequelae, resulting in an inherent difficulty in taking a consequentialist approach to such cases. If the GP offers their opinion, whatever it may be, and the patient disagrees or is distressed by their view, or takes their advice and later regrets their decision, it could have devastating consequences personally, professionally, and potentially even medico-legally.

It is extremely difficult for a consequentialist approach to be used to recommend a course of action in this case. Given the significant uncertainty surrounding whether an abortion or continuing the pregnancy would result in the best overall consequences, it is extremely difficult to predict the consequences of the GP offering their personal opinion. Whilst on one hand a consequentialist approach may support disclosure in order to foster a positive doctor-patient relationship, doing so could also hinder or adversely impact the patient’s longer-term independence in decision-making. Additionally, there is potential for the patient to blame the GP for their final decision, having been advised, if adverse events occur post decision-making.

This article has explored a number of perspectives to consider if it can be appropriate for GPs to offer their personal advice to a patient about whether they should have an abortion.

From a professional perspective, the GMC guidelines do not necessarily provide clarity in this situation, describing potentially conflicting duties, stating that personal beliefs can be disclosed when specifically requested but not if it causes the patient distress, the chance of which may be hard to determine in cases such as this. The GMC also requires doctors to act with honesty and integrity, which can be problematic when taken alongside their guidelines stating not to express personal beliefs. As a result, the GMC guidelines may not always fully equip doctors in knowing how to approach situations such as that in the case of Mrs. X, leaving GPs to their own ethical judgements.

Neutrality is underlined in the GMC guidelines, and seems to serve this purpose. However, they also emphasise doctors working towards their patient’s best interests which is difficult if GPs are focusing on being neutral and protecting themselves medicolegally. This is perhaps a reason for the GMC to update their guidance on this matter to provide more clarity to enable doctors to make appropriate decisions in such circumstances. There may also be a need for training for medical students, doctors and other healthcare professionals on how to approach such situations where they might be asked disclose their personal opinions in emotive situations.

The case here presents the GP with many ethical challenges – whether they should disclose their opinion, if so how it should be done, as well as of course the inherent moral difficulty which arises from questions on the topic of abortion. The GP has been placed in a difficult situation, as the request for their personal advice would generally be considered to fall outside the remit of a doctor’s traditional role, blurring the professional boundaries which form part of a traditional doctor-patient relationship. The GP may have their own personal opinions regarding the morality of abortion, and it may be difficult for them to know the extent to which these opinions should be shared with the patient, if at all. If doctors have particularly strong opinions, it may be difficult for them to remain neutral [ 18 ]. It is therefore essential that GPs and other healthcare professionals are aware of their pre-existing moral viewpoints and emotions to ensure they do not adversely impact the patient or consultation. They may also need to be aware of the potential medicolegal ramifications of providing advice, for example should the GP advise a specific course of action and the patient feel they are harmed, should they follow their advice.

In offering their personal opinion to the patient, there could be some potential positive value. Given the patient has specifically requested her GP to disclose their opinion on her pregnancy, this may be indicative of an established and trustworthy relationship where such advice is valued and welcomed by the patient. It may also promote her autonomy in helping her reach an informed decision provided disclosure is managed sensitively and appropriately (for example the doctor ensuring they provide balanced information, offer their opinion in a non-judgmental way and emphasise that the final decision is of course the patient’s). It is essential that a GP apply practical wisdom to this situation – whilst they not be able to acquire a full understanding of all of these, they should endeavour to try to understand to the best of their abilities the patient’s circumstances, have some knowledge of abortion and its consequences, and of course have awareness of their own prior experiences, emotions and moral viewpoints to try to address the patient’s request in a constructive way to avoid harm. Ultimately, the nature of the decision in question as being extremely morally sensitive means that not only is the GP in this circumstance facing an ethical dilemma, but the patient also is. Simply acknowledging the presence of this moral dilemma may be an important start to any subsequent conversations between the patient and the doctor about what they should do. Situations such as this give rise to difficult decisions for both the patient and doctor, and whilst there may not be one size fits all solution, recognition of the challenges of a decision such as this and the potential impact on the doctor-patient relationship are essential.

Availability of data and materials

Not applicable.

Abbreviations

General practitioner

General medical council

Abortion Act Abortion Act 1967. Available at: https://www.legislation.gov.uk/ukpga/1967/87/section/1 Accessed: 19 Apr 2019.

Toon P. Setting boundaries. In: Bowman D, Spicer J, editors. Primary care ethics. Oxford: Radcliffe; 2007. p. 86–99.

Google Scholar  

GMC General Medical Council. The duties of a doctor registered with the General Medical Council. UK: General Medical Council; 2018. Available at: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/duties-of-a-doctor Accessed: 19 Apr 2019. (was 2).

Bowman D, Spicer J, editors. Primary care ethics. 1st ed. Oxon: Radcliffe Publishing Ltd; 2007.

General Medical Council. Personal beliefs and medical practice. UK: General Medical Council; 2013. Available at: https://www.gmc-uk.org/-/media/documents/personal-beliefs-and-medical-practice_pdf-58833376.pdf Accessed: 13 Apr 2019.

Gillon R. Medical ethics: four principles plus attention to scope. Br Med J 1994;309: 184–188. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2540719/ Accessed: 19 Apr.2019.

Harish D, Kumar A, Singh A. Patient autonomy and Informed Consent: The Core of Modern Day Ethical Medical. J Indian Acad Forensic Med. 2015;37(4):410–4 Available at: http://medind.nic.in/jal/t15/i4/jalt15i4p410.pdf Accessed: 19 Apr 2019.

Article   Google Scholar  

Emanuel EJ, Emanuel LL. Four Models of the Physician-Patient Relationship. JAMA. 1992;267:16 Research Library pg. 2221.

Neighbour R. The inner consultation. 2nd ed. Oxon: Radcliffe Publishing Ltd; 2005.

Papanikitas A. The inescapability of conscience in primary healthcare. In: Papanikitas A, Spicer J, editors. Handbook of primary care ethics. 1st ed. London: CRC Press/ Taylor & Francis Ltd; 2018. p. 341–53.

Robinson F. Should doctors share their personal experiences of healthcare with patients? Br Med J. 2018;363:k4312.

Papanikitas A. From the classroom to the clinic: Ethics education and general practice. UK: PhD Thesis, King’s College London; 2013. Available at: https://kclpure.kcl.ac.uk/portal/files/35588265/2014_Papanikitas_Andrew_96005985_ethesis.pdf Accessed: 19 Apr 2019.

Papanikitas A. Self awareness and professionalism. InnovAiT. 2017;10(8):452–7. https://doi.org/10.1177/1755738017710962 .

Toon P. A Flourishing Practice. London: Royal College of General Practitioners; 2014. Available at: https://oapen.org/search?identifier=625890 Accessed 13 Apr 2019.

Book   Google Scholar  

Gardiner P. A virtue ethics approach to moral dilemmas in medicine. J Med Ethics. 2003;29:297–302.

Sinnott-Armstrong W. Consequentialism . The Stanford Encyclopedia of Philosophy Available at: https://plato.stanford.edu/entries/consequentialism/ (2015, Accessed: 19 Apr 2019.

Morse DS et al. “Enough about me, lets get back to you”: Physician self-disclosure during primary care encounters. Ann Intern Med 2008;149(11):835–883. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20440869 . Accessed: 19 Apr 2019.

Papanikitas A, Lewis G, McKenzie-Edwards E. Should GPs avoid making ethical judgements? Br J Gen Pract. 2016;66(649):441–2. https://doi.org/10.3399/bjgp16X686497 .

Download references

Acknowledgements

The authors have not received any funding for this work.

Author information

Authors and affiliations.

St George’s University, University of London, London, UK

Lynnlette Aung

King’s College London, London, UK

Selena Knight

You can also search for this author in PubMed   Google Scholar

Contributions

LA conceived the idea for the work and wrote an initial draft. SK subsequently helped develop the ideas within the manuscript. Further editing was undertaken by both authors. The authors read and approved the final manuscript.

Corresponding author

Correspondence to Selena Knight .

Ethics declarations

Ethics approval and consent to participate.

Not applicable (the included case is hypothetical).

Consent for publication

Competing interests.

The authors declare that they have no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Aung, L., Knight, S. Is it morally permissible for general practitioners to disclose their opinion on a woman’s decision on abortion?. BMC Med Ethics 21 , 19 (2020). https://doi.org/10.1186/s12910-020-0464-9

Download citation

Received : 23 September 2019

Accepted : 04 March 2020

Published : 12 March 2020

DOI : https://doi.org/10.1186/s12910-020-0464-9

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Clinical ethics
• women’s health
• Professionalism

BMC Medical Ethics

ISSN: 1472-6939

• General enquiries: [email protected]

Numbers, Facts and Trends Shaping Your World

Read our research on:

Full Topic List

Regions & Countries

• Publications
• Our Methods
• Short Reads
• Tools & Resources

Read Our Research On:

Pro-Choice Does Not Mean Pro-Abortion: An Argument for Abortion Rights Featuring the Rev. Carlton Veazey

Since the Supreme Court’s historic 1973 decision in Roe v. Wade , the issue of a woman’s right to an abortion has fostered one of the most contentious moral and political debates in America. Opponents of abortion rights argue that life begins at conception – making abortion tantamount to homicide. Abortion rights advocates, in contrast, maintain that women have a right to decide what happens to their bodies – sometimes without any restrictions.

To explore the case for abortion rights, the Pew Forum turns to the Rev. Carlton W. Veazey, who for more than a decade has been president of the Religious Coalition for Reproductive Choice. Based in Washington, D.C., the coalition advocates for reproductive choice and religious freedom on behalf of about 40 religious groups and organizations. Prior to joining the coalition, Veazey spent 33 years as a pastor at Zion Baptist Church in Washington, D.C.

A counterargument explaining the case against abortion rights is made by the Rev. J. Daniel Mindling, professor of moral theology at Mount St. Mary’s Seminary.

Featuring: The Rev. Carlton W. Veazey, President, Religious Coalition for Reproductive Choice

Interviewer: David Masci, Senior Research Fellow, Pew Forum on Religion & Public Life

Question & Answer

Can you explain how your Christian faith informs your views in support of abortion rights?

I grew up in a Christian home. My father was a Baptist minister for many years in Memphis, Tenn. One of the things that he instilled in me – I used to hear it so much – was free will, free will, free will. It was ingrained in me that you have the ability to make choices. You have the ability to decide what you want to do. You are responsible for your decisions, but God has given you that responsibility, that option to make decisions.

I had firsthand experience of seeing black women and poor women being disproportionately impacted by the fact that they had no choices about an unintended pregnancy, even if it would damage their health or cause great hardship in their family. And I remember some of them being maimed in back-alley abortions; some of them died. There was no legal choice before Roe v. Wade .

But in this day and time, we have a clearer understanding that men and women are moral agents and equipped to make decisions about even the most difficult and complex matters. We must ensure a woman can determine when and whether to have children according to her own conscience and religious beliefs and without governmental interference or coercion. We must also ensure that women have the resources to have a healthy, safe pregnancy, if that is their decision, and that women and families have the resources to raise a child with security.

The right to choose has changed and expanded over the years since Roe v. Wade . We now speak of reproductive justice – and that includes comprehensive sex education, family planning and contraception, adequate medical care, a safe environment, the ability to continue a pregnancy and the resources that make that choice possible. That is my moral framework.

You talk about free will, and as a Christian you believe in free will. But you also said that God gave us free will and gave us the opportunity to make right and wrong choices. Why do you believe that abortion can, at least in some instances, be the right choice?

Dan Maguire, a former Jesuit priest and professor of moral theology and ethics at Marquette University, says that to have a child can be a sacred choice, but to not have a child can also be a sacred choice.

And these choices revolve around circumstances and issues – like whether a person is old enough to care for a child or whether a woman already has more children than she can care for. Also, remember that medical circumstances are the reason many women have an abortion – for example, if they are having chemotherapy for cancer or have a life-threatening chronic illness – and most later-term abortions occur because of fetal abnormalities that will result in stillbirth or the death of the child. These are difficult decisions; they’re moral decisions, sometimes requiring a woman to decide if she will risk her life for a pregnancy.

Abortion is a very serious decision and each decision depends on circumstances. That’s why I tell people: I am not pro-abortion, I am pro-choice. And that’s an important distinction.

You’ve talked about the right of a woman to make a choice. Does the fetus have any rights?

First, let me say that the religious, pro-choice position is based on respect for human life, including potential life and existing life.

But I do not believe that life as we know it starts at conception. I am troubled by the implications of a fetus having legal rights because that could pit the fetus against the woman carrying the fetus; for example, if the woman needed a medical procedure, the law could require the fetus to be considered separately and equally.

From a religious perspective, it’s more important to consider the moral issues involved in making a decision about abortion. Also, it’s important to remember that religious traditions have very different ideas about the status of the fetus. Roman Catholic doctrine regards a fertilized egg as a human being. Judaism holds that life begins with the first breath.

What about at the very end of a woman’s pregnancy? Does a fetus acquire rights after the point of viability, when it can survive outside the womb? Or let me ask it another way: Assuming a woman is healthy and her fetus is healthy, should the woman be able to terminate her pregnancy until the end of her pregnancy?

There’s an assumption that a woman would end a viable pregnancy carelessly or without a reason. The facts don’t bear this out. Most abortions are performed in the first 12 weeks of pregnancy. Late abortions are virtually always performed for the most serious medical and health reasons, including saving the woman’s life.

But what if such a case came before you? If you were that woman’s pastor, what would you say?

I would talk to her in a helpful, positive, respectful way and help her discuss what was troubling her. I would suggest alternatives such as adoption.

Let me shift gears a little bit. Many Americans have said they favor a compromise, or reaching a middle-ground policy, on abortion. Do you sympathize with this desire and do you think that both sides should compromise to end this rancorous debate?

I have been to more middle-ground and common-ground meetings than I can remember and I’ve never been to one where we walked out with any decision.

That being said, I think that we all should agree that abortion should be rare. How do we do that? We do that by providing comprehensive sex education in schools and in religious congregations and by ensuring that there is accurate information about contraception and that contraception is available. Unfortunately, the U.S. Congress has not been willing to pass a bill to fund comprehensive sex education, but they are willing to put a lot of money into failed and harmful abstinence-only programs that often rely on scare tactics and inaccurate information.

Former Surgeon General David Satcher has shown that abstinence-only programs do not work and that we should provide young people with the information to protect themselves. Education that stresses abstinence and provides accurate information about contraception will reduce the abortion rate. That is the ground that I stand on. I would say that here is a way we can work together to reduce the need for abortions.

Abortion has become central to what many people call the “culture wars.” Some consider it to be the most contentious moral issue in America today. Why do many Catholics, evangelical Christians and other people of faith disagree with you?

I was raised to respect differing views so the rigid views against abortion are hard for me to understand. I will often tell someone on the other side, “I respect you. I may disagree with your theological perspective, but I respect your views. But I think it’s totally arrogant for you to tell me that I need to believe what you believe.” It’s not that I think we should not try to win each other over. But we have to respect people’s different religious beliefs.

But what about people who believe that life begins at conception and that terminating a pregnancy is murder? For them, it may not just be about respecting or tolerating each other’s viewpoints; they believe this is an issue of life or death. What do you say to people who make that kind of argument?

I would say that they have a right to their beliefs, as do I. I would try to explain that my views are grounded in my religion, as are theirs. I believe that we must ensure that women are treated with dignity and respect and that women are able to follow the dictates of their conscience – and that includes their reproductive decisions. Ultimately, it is the government’s responsibility to ensure that women have the ability to make decisions of conscience and have access to reproductive health services.

Some in the anti-abortion camp contend that the existence of legalized abortion is a sign of the self-centeredness and selfishness of our age. Is there any validity to this view?

Although abortion is a very difficult decision, it can be the most responsible decision a person can make when faced with an unintended pregnancy or a pregnancy that will have serious health consequences.

Depending on the circumstances, it might be selfish to bring a child into the world. You know, a lot of people say, “You must bring this child into the world.” They are 100 percent supportive while the child is in the womb. As soon as the child is born, they abort the child in other ways. They abort a child through lack of health care, lack of education, lack of housing, and through poverty, which can drive a child into drugs or the criminal justice system.

So is it selfish to bring children into the world and not care for them? I think the other side can be very selfish by neglecting the children we have already. For all practical purposes, children whom we are neglecting are being aborted.

This transcript has been edited for clarity, spelling and grammar.

Sign up for our weekly newsletter

Fresh data delivery Saturday mornings

Sign up for The Briefing

Weekly updates on the world of news & information

• Religion & Abortion
• Religion & Social Values

Cultural Issues and the 2024 Election

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.

1615 L St. NW, Suite 800 Washington, DC 20036 USA (+1) 202-419-4300 | Main (+1) 202-857-8562 | Fax (+1) 202-419-4372 |  Media Inquiries

Research Topics

• Email Newsletters

ABOUT PEW RESEARCH CENTER  Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of  The Pew Charitable Trusts .

© 2024 Pew Research Center

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Rom J Morphol Embryol
• v.61(1); Jan-Mar 2020

A research on abortion: ethics, legislation and socio-medical outcomes. Case study: Romania

Andreea mihaela niţă.

1 Faculty of Social Sciences, University of Craiova, Romania

Cristina Ilie Goga

This article presents a research study on abortion from a theoretical and empirical point of view. The theoretical part is based on the method of social documents analysis, and presents a complex perspective on abortion, highlighting items of medical, ethical, moral, religious, social, economic and legal elements. The empirical part presents the results of a sociological survey, based on the opinion survey method through the application of the enquiry technique, conducted in Romania, on a sample of 1260 women. The purpose of the survey is to identify Romanians perception on the decision to voluntary interrupt pregnancy, and to determine the core reasons in carrying out an abortion.

The analysis of abortion by means of medical and social documents

Abortion means a pregnancy interruption “before the fetus is viable” [ 1 ] or “before the fetus is able to live independently in the extrauterine environment, usually before the 20 th week of pregnancy” [ 2 ]. “Clinical miscarriage is both a common and distressing complication of early pregnancy with many etiological factors like genetic factors, immune factors, infection factors but also psychological factors” [ 3 ]. Induced abortion is a practice found in all countries, but the decision to interrupt the pregnancy involves a multitude of aspects of medical, ethical, moral, religious, social, economic, and legal order.

In a more simplistic manner, Winston Nagan has classified opinions which have as central element “abortion”, in two major categories: the opinion that the priority element is represented by fetus and his entitlement to life and the second opinion, which focuses around women’s rights [ 4 ].

From the medical point of view, since ancient times there have been four moments, generally accepted, which determine the embryo’s life: ( i ) conception; ( ii ) period of formation; ( iii ) detection moment of fetal movement; ( iv ) time of birth [ 5 ]. Contemporary medicine found the following moments in the evolution of intrauterine fetal: “ 1 . At 18 days of pregnancy, the fetal heartbeat can be perceived and it starts running the circulatory system; 2 . At 5 weeks, they become more clear: the nose, cheeks and fingers of the fetus; 3 . At 6 weeks, they start to function: the nervous system, stomach, kidneys and liver of the fetus, and its skeleton is clearly distinguished; 4 . At 7 weeks (50 days), brain waves are felt. The fetus has all the internal and external organs definitively outlined. 5 . At 10 weeks (70 days), the unborn child has all the features clearly defined as a child after birth (9 months); 6 . At 12 weeks (92 days, 3 months), the fetus has all organs definitely shaped, managing to move, lacking only the breath” [ 6 ]. Even if most of the laws that allow abortion consider the period up to 12 weeks acceptable for such an intervention, according to the above-mentioned steps, there can be defined different moments, which can represent the beginning of life. Nowadays, “abortion is one of the most common gynecological experiences and perhaps the majority of women will undergo an abortion in their lifetimes” [ 7 ]. “Safe abortions carry few health risks, but « every year, close to 20 million women risk their lives and health by undergoing unsafe abortions » and 25% will face a complication with permanent consequences” [ 8 , 9 ].

From the ethical point of view, most of the times, the interruption of pregnancy is on the border between woman’s right over her own body and the child’s (fetus) entitlement to life. Judith Jarvis Thomson supported the supremacy of woman’s right over her own body as a premise of freedom, arguing that we cannot force a person to bear in her womb and give birth to an unwanted child, if for different circumstances, she does not want to do this [ 10 ]. To support his position, the author uses an imaginary experiment, that of a violinist to which we are connected for nine months, in order to save his life. However, Thomson debates the problem of the differentiation between the fetus and the human being, by carrying out a debate on the timing which makes this difference (period of conception, 10 weeks of pregnancy, etc.) and highlighting that for people who support abortion, the fetus is not an alive human being [ 10 ].

Carol Gilligan noted that women undergo a true “moral dilemma”, a “moral conflict” with regards to voluntary interruption of pregnancy, such a decision often takes into account the human relationships, the possibility of not hurting the others, the responsibility towards others [ 11 ]. Gilligan applied qualitative interviews to a number of 29 women from different social classes, which were put in a position to decide whether or not to commit abortion. The interview focused on the woman’s choice, on alternative options, on individuals and existing conflicts. The conclusion was that the central moral issue was the conflict between the self (the pregnant woman) and others who may be hurt as a result of the potential pregnancy [ 12 ].

From the religious point of view, abortion is unacceptable for all religions and a small number of abortions can be seen in deeply religious societies and families. Christianity considers the beginning of human life from conception, and abortion is considered to be a form of homicide [ 13 ]. For Christians, “at the same time, abortion is giving up their faith”, riot and murder, which means that by an abortion we attack Jesus Christ himself and God [ 14 ]. Islam does not approve abortion, relying on the sacral life belief as specified in Chapter 6, Verse 151 of the Koran: “Do not kill a soul which Allah has made sacred (inviolable)” [ 15 ]. Buddhism considers abortion as a negative act, but nevertheless supports for medical reasons [ 16 ]. Judaism disapproves abortion, Tanah considering it to be a mortal sin. Hinduism considers abortion as a crime and also the greatest sin [ 17 ].

From the socio-economic point of view, the decision to carry out an abortion is many times determined by the relations within the social, family or financial frame. Moreover, studies have been conducted, which have linked the legalization of abortions and the decrease of the crime rate: “legalized abortion may lead to reduced crime either through reductions in cohort sizes or through lower per capita offending rates for affected cohorts” [ 18 ].

Legal regulation on abortion establishes conditions of the abortion in every state. In Europe and America, only in the XVIIth century abortion was incriminated and was considered an insignificant misdemeanor or a felony, depending on when was happening. Due to the large number of illegal abortions and deaths, two centuries later, many states have changed legislation within the meaning of legalizing voluntary interruption of pregnancy [ 6 ]. In contemporary society, international organizations like the United Nations or the European Union consider sexual and reproductive rights as fundamental rights [ 19 , 20 ], and promotes the acceptance of abortion as part of those rights. However, not all states have developed permissive legislation in the field of voluntary interruption of pregnancy.

Currently, at national level were established four categories of legislation on pregnancy interruption area:

( i )  Prohibitive legislations , ones that do not allow abortion, most often outlining exceptions in abortion in cases where the pregnant woman’s life is endangered. In some countries, there is a prohibition of abortion in all circumstances, however, resorting to an abortion in the case of an imminent threat to the mother’s life. Same regulation is also found in some countries where abortion is allowed in cases like rape, incest, fetal problems, etc. In this category are 66 states, with 25.5% of world population [ 21 ].

( ii )  Restrictive legislation that allow abortion in cases of health preservation . Loosely, the term “health” should be interpreted according to the World Health Organization (WHO) definition as: “health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” [ 22 ]. This type of legislation is adopted in 59 states populated by 13.8% of the world population [ 21 ].

( iii )  Legislation allowing abortion on a socio-economic motivation . This category includes items such as the woman’s age or ability to care for a child, fetal problems, cases of rape or incest, etc. In this category are 13 countries, where we have 21.3% of the world population [ 21 ].

( iv )  Legislation which do not impose restrictions on abortion . In the case of this legislation, abortion is permitted for any reason up to 12 weeks of pregnancy, with some exceptions (Romania – 14 weeks, Slovenia – 10 weeks, Sweden – 18 weeks), the interruption of pregnancy after this period has some restrictions. This type of legislation is adopted in 61 countries with 39.5% of the world population [21].

The Centre for Reproductive Rights has carried out from 1998 a map of the world’s states, based on the legislation typology of each country (Figure ​ (Figure1 1 ).

The analysis of states according to the legislation regarding abortion. Source: Centre for Reproductive Rights. The World’s Abortion Laws, 2018 [ 23 ]

An unplanned pregnancy, socio-economic context or various medical problems [ 24 ], lead many times to the decision of interrupting pregnancy, regardless the legislative restrictions. In the study “Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008” issued in 2011 by the WHO , it was determined that within the states with restrictive legislation on abortion, we may also encounter a large number of illegal abortions. The illegal abortions may also be resulting in an increased risk of woman’s health and life considering that most of the times inappropriate techniques are being used, the hygienic conditions are precarious and the medical treatments are incorrectly administered [ 25 ]. Although abortions done according to medical guidelines carry very low risk of complications, 1–3 unsafe abortions contribute substantially to maternal morbidity and death worldwide [ 26 ].

WHO has estimated for the year 2008, the fact that worldwide women between the ages of 15 and 44 years carried out 21.6 million “unsafe” abortions, which involved a high degree of risk and were distributed as follows: 0.4 million in the developed regions and a number of 21.2 million in the states in course of development [ 25 ].

Case study: Romania

Legal perspective on abortion

In Romania, abortion was brought under regulation by the first Criminal Code of the United Principalities, from 1864.

The Criminal Code from 1864, provided the abortion infringement in Article 246, on which was regulated as follows: “Any person, who, using means such as food, drinks, pills or any other means, which will consciously help a pregnant woman to commit abortion, will be punished to a minimum reclusion (three years).

The woman who by herself shall use the means of abortion, or would accept to use means of abortion which were shown or given to her for this purpose, will be punished with imprisonment from six months to two years, if the result would be an abortion. In a situation where abortion was carried out on an illegitimate baby by his mother, the punishment will be imprisonment from six months to one year.

Doctors, surgeons, health officers, pharmacists (apothecary) and midwives who will indicate, will give or will facilitate these means, shall be punished with reclusion of at least four years, if the abortion took place. If abortion will cause the death of the mother, the punishment will be much austere of four years” (Art. 246) [ 27 ].

The Criminal Code from 1864, reissued in 1912, amended in part the Article 246 for the purposes of eliminating the abortion of an illegitimate baby case. Furthermore, it was no longer specified the minimum of four years of reclusion, in case of abortion carried out with the help of the medical staff, leaving the punishment to the discretion of the Court (Art. 246) [ 28 ].

The Criminal Code from 1936 regulated abortion in the Articles 482–485. Abortion was defined as an interruption of the normal course of pregnancy, being punished as follows:

“ 1 . When the crime is committed without the consent of the pregnant woman, the punishment was reformatory imprisonment from 2 to 5 years. If it caused the pregnant woman any health injury or a serious infirmity, the punishment was reformatory imprisonment from 3 to 6 years, and if it has caused her death, reformatory imprisonment from 7 to 10 years;

2 . When the crime was committed by the unmarried pregnant woman by herself, or when she agreed that someone else should provoke the abortion, the punishment is reformatory imprisonment from 3 to 6 months, and if the woman is married, the punishment is reformatory imprisonment from 6 months to one year. Same penalty applies also to the person who commits the crime with the woman’s consent. If abortion was committed for the purpose of obtaining a benefit, the punishment increases with another 2 years of reformatory imprisonment.

If it caused the pregnant woman any health injuries or a severe disablement, the punishment will be reformatory imprisonment from one to 3 years, and if it has caused her death, the punishment is reformatory imprisonment from 3 to 5 years” (Art. 482) [ 29 ].

The criminal legislation from 1936 specifies that it is not considered as an abortion the interruption from the normal course of pregnancy, if it was carried out by a doctor “when woman’s life was in imminent danger or when the pregnancy aggravates a woman’s disease, putting her life in danger, which could not be removed by other means and it is obvious that the intervention wasn’t performed with another purpose than that of saving the woman’s life” and “when one of the parents has reached a permanent alienation and it is certain that the child will bear serious mental flaws” (Art. 484, Par. 1 and Par. 2) [ 29 ].

In the event of an imminent danger, the doctor was obliged to notify prosecutor’s office in writing, within 48 hours after the intervention, on the performance of the abortion. “In the other cases, the doctor was able to intervene only with the authorization of the prosecutor’s office, given on the basis of a medical certificate from hospital or a notice given as a result of a consultation between the doctor who will intervene and at least a professor doctor in the disease which caused the intervention. General’s Office Prosecutor, in all cases provided by this Article, shall be obliged to maintain the confidentiality of all communications or authorizations, up to the intercession of any possible complaints” (Art. 484) [ 29 ].

The legislation of 1936 provided a reformatory injunction from one to three years for the abortions committed by doctors, sanitary agents, pharmacists, apothecary or midwives (Art. 485) [ 29 ].

Abortion on demand has been legalized for the first time in Romania in the year 1957 by the Decree No. 463, under the condition that it had to be carried out in a hospital and to be carried out in the first quarter of the pregnancy [ 30 ]. In the year 1966, demographic policy of Romania has dramatically changed by introducing the Decree No. 770 from September 29 th , which prohibited abortion. Thus, the voluntary interruption of pregnancy became a crime, with certain exceptions, namely: endangering the mother’s life, physical or mental serious disability; serious or heritable illness, mother’s age over 45 years, if the pregnancy was a result of rape or incest or if the woman gave birth to at least four children who were still in her care (Art. 2) [ 31 ].

In the Criminal Code from 1968, the abortion crime was governed by Articles 185–188.

The Article 185, “the illegal induced abortion”, stipulated that “the interruption of pregnancy by any means, outside the conditions permitted by law, with the consent of the pregnant woman will be punished with imprisonment from one to 3 years”. The act referred to above, without the prior consent from the pregnant woman, was punished with prison from two to five years. If the abortion carried out with the consent of the pregnant woman caused any serious body injury, the punishment was imprisonment from two to five years, and when it caused the death of the woman, the prison sentence was from five to 10 years. When abortion was carried out without the prior consent of the woman, if it caused her a serious physical injury, the punishment was imprisonment from three to six years, and if it caused the woman’s death, the punishment was imprisonment from seven to 12 years (Art. 185) [ 32 ].

“When abortion was carried out in order to obtain a material benefit, the maximum punishment was increased by two years, and if the abortion was made by a doctor, in addition to the prison punishment could also be applied the prohibition to no longer practice the profession of doctor”.

Article 186, “abortion caused by the woman”, stipulated that “the interruption of the pregnancy course, committed by the pregnant woman, was punished with imprisonment from 6 months to 2 years”, quoting the fact that by the same punishment was also sanctioned “the pregnant woman’s act to consent in interrupting the pregnancy course made out by another person” (Art. 186) [ 26 ].

The Regulations of the Criminal Code in 1968, also provided the crime of “ownership of tools or materials that can cause abortion”, the conditions of this holding being met when these types of instruments were held outside the hospital’s specialized institutions, the infringement shall be punished with imprisonment from three months to one year (Art. 187) [ 32 ].

Furthermore, the doctors who performed an abortion in the event of extreme urgency, without prior legal authorization and if they did not announce the competent authority within the legal deadline, they were punished by imprisonment from one month to three months (Art. 188) [ 32 ].

In the year 1985, it has been issued the Decree No. 411 of December 26 th , by which the conditions imposed by the Decree No. 770 of 1966 have been hardened, meaning that it has increased the number of children, that a woman could have in order to request an abortion, from four to five children [ 33 ].

The Articles 185–188 of the Criminal Code and the Decree No. 770/1966 on the interruption of the pregnancy course have been abrogated by Decree-Law No. 1 from December 26 th , 1989, which was published in the Official Gazette No. 4 of December 27 th , 1989 (Par. 8 and Par. 12) [ 34 ].

The Criminal Code from 1968, reissued in 1997, maintained Article 185 about “the illegal induced abortion”, but drastically modified. Thus, in this case of the Criminal Code, we identify abortion as “the interruption of pregnancy course, by any means, committed in any of the following circumstances: ( a ) outside medical institutions or authorized medical practices for this purpose; ( b ) by a person who does not have the capacity of specialized doctor; ( c ) if age pregnancy has exceeded 14 weeks”, the punishment laid down was the imprisonment from 6 months to 3 years” (Art. 185, Par. 1) [ 35 ]. For the abortion committed without the prior consent of the pregnant woman, the punishment consisted in strict prison conditions from two to seven years and with the prohibition of certain rights (Art. 185, Par. 2) [ 35 ].

For the situation of causing serious physical injury to the pregnant woman, the punishment was strict prison from three to 10 years and the removal of certain rights, and if it had as a result the death of the pregnant woman, the punishment was strict prison from five to 15 years and the prohibition of certain rights (Art. 185, Par. 3) [ 35 ].

The attempt was punished for the crimes specified in the various cases of abortion.

Consideration should also be given in the Criminal Code reissued in 1997 for not punishing the interruption of the pregnancy course carried out by the doctor, if this interruption “was necessary to save the life, health or the physical integrity of the pregnant woman from a grave and imminent danger and that it could not be removed otherwise; in the case of a over fourteen weeks pregnancy, when the interruption of the pregnancy course should take place from therapeutic reasons” and even in a situation of a woman’s lack of consent, when it has not been given the opportunity to express her will, and abortion “was imposed by therapeutic reasons” (Art. 185, Par. 4) [ 35 ].

Criminal Code from 2004 covers abortion in Article 190, defined in the same way as in the prior Criminal Code, with the difference that it affects the limits of the punishment. So, in the event of pregnancy interruption, in accordance with the conditions specified in Paragraph 1, “the penalty provided was prison time from 6 months to one year or days-fine” (Art. 190, Par. 1) [ 36 ].

Nowadays, in Romania, abortion is governed by the criminal law of 2009, which entered into force in 2014, by the section called “aggression against an unborn child”. It should be specified that current criminal law does not punish the woman responsible for carrying out abortion, but only the person who is involved in carrying out the abortion. There is no punishment for the pregnant woman who injures her fetus during pregnancy.

In Article 201, we can find the details on the pregnancy interruption infringement. Thus, the pregnancy interruption can be performed in one of the following circumstances: “outside of medical institutions or medical practices authorized for this purpose; by a person who does not have the capacity of specialist doctor in Obstetrics and Gynecology and the right of free medical practice in this specialty; if gestational age has exceeded 14 weeks”, the punishment is the imprisonment for six months to three years, or fine and the prohibition to exercise certain rights (Art. 201, Par. 1) [ 37 ].

Article 201, Paragraph 2 specifies that “the interruption of the pregnancy committed under any circumstances, without the prior consent of the pregnant woman, can be punished with imprisonment from 2 to 7 years and with the prohibition to exercise some rights” (Art. 201, Par. 1) [ 37 ].

If by facts referred to above (Art. 201, Par. 1 and Par. 2) [ 37 ] “it has caused the pregnant woman’s physical injury, the punishment is the imprisonment from 3 to 10 years and the prohibition to exercise some rights, and if it has had as a result the pregnant woman’s death, the punishment is the imprisonment from 6 to 12 years and the prohibition to exercise some rights” (Art. 201, Par. 3) [ 37 ]. When the facts have been committed by a doctor, “in addition to the imprisonment punishment, it will also be applied the prohibition to exercise the profession of doctor (Art. 201, Par. 4) [ 37 ].

Criminal legislation specifies that “the interruption of pregnancy does not constitute an infringement with the purpose of a treatment carried out by a specialist doctor in Obstetrics and Gynecology, until the pregnancy age of twenty-four weeks is reached, or the subsequent pregnancy interruption, for the purpose of treatment, is in the interests of the mother or the fetus” (Art. 201, Par. 6) [ 37 ]. However, it can all be found in the phrases “therapeutic purposes” and “the interest of the mother and of the unborn child”, which predisposes the text of law to an interpretation, finally the doctors are the only ones in the position to decide what should be done in such cases, assuming direct responsibility [ 38 ].

Article 202 of the Criminal Code defines the crime of harming an unborn child, pointing out the punishments for the various types of injuries that can occur during pregnancy or in the childbirth period and which can be caused by the mother or by the persons who assist the birth, with the specification that the mother who harms her fetus during pregnancy is not punished and does not constitute an infringement if the injury has been committed during pregnancy or during childbirth period if the facts have been “committed by a doctor or by an authorized person to assist the birth or to follow the pregnancy, if they have been committed in the course of the medical act, complying with the specific provisions of his profession and have been made in the interest of the pregnant woman or fetus, as a result of the exercise of an inherent risk in the medical act” (Art. 202, Par. 6) [ 37 ].

The fact situation in Romania

During the period 1948–1955, called “the small baby boom” [ 39 ], Romania registered an average fertility rate of 3.23 children for a woman. Between 1955 and 1962, the fertility rate has been less than three children for a woman, and in 1962, fertility has reached an average of two children for a woman. This phenomenon occurred because of the Decree No. 463/1957 on liberalization of abortion. After the liberalization from 1957, the abortion rate has increased from 220 abortions per 100 born-alive children in the year 1960, to 400 abortions per 100 born-alive children, in the year 1965 [ 40 ].

The application of provisions of Decrees No. 770 of 1966 and No. 411 of 1985 has led to an increase of the birth rate in the first three years (an average of 3.7 children in 1967, and 3.6 children in 1968), followed by a regression until 1989, when it was recorded an average of 2.2 children, but also a maternal death rate caused by illegal abortions, raising up to 85 deaths of 100 000 births in the year of 1965, and 170 deaths in 1983. It was estimated that more than 80% of maternal deaths between 1980–1989 was caused by legal constraints [ 30 ].

After the Romanian Revolution in December 1989 and after the communism fall, with the abrogation of Articles 185–188 of the Criminal Code and of the Decree No. 770/1966, by the Decree of Law No. 1 of December 26 th , 1989, abortion has become legal in Romania and so, in the following years, it has reached the highest rate of abortion in Europe. Subsequently, the number of abortion has dropped gradually, with increasing use of birth control [ 41 ].

Statistical data issued by the Ministry of Health and by the National Institute of Statistics (INS) in Romania show corresponding figures to a legally carried out abortion. The abortion number is much higher, if it would take into account the number of illegal abortion, especially those carried out before 1989, and those carried out in private clinics, after the year 1990. Summing the declared abortions in the period 1958–2014, it is to be noted the number of them, 22 037 747 exceeds the current Romanian population. A detailed statistical research of abortion rate, in terms of years we have exposed in Table ​ Table1 1 .

The number of abortions declared in Romania in the period 1958–2016

Source: Pro Vita Association (Bucharest, Romania), National Institute of Statistics (INS – Romania), EUROSTAT [ 42 , 43 , 44 ]

Data issued by the United Nations International Children’s Emergency Fund (UNICEF) in June 2016, for the period 1989–2014, in matters of reproductive behavior, indicates a fertility rate for Romania with a continuous decrease, in proportion to the decrease of the number of births, but also a lower number of abortion rate reported to 100 deliveries (Table ​ (Table2 2 ).

Reproductive behavior in Romania in 1989–2014

Source: United Nations International Children’s Emergency Fund (UNICEF), Transformative Monitoring for Enhanced Equity (TransMonEE) Data. Country profiles: Romania, 1989–2015 [ 45 ].

By analyzing data issued for the period 1990–2015 by the International Organization of Health , UNICEF , United Nations Fund for Population Activity (UNFPA), The World Bank and the United Nations Population Division, it is noticed that maternal mortality rate has currently dropped as compared with 1990 (Table ​ (Table3 3 ).

Maternal mortality estimation in Romania in 1990–2015

Source: World Health Organization (WHO), Global Health Observatory Data. Maternal mortality country profiles: Romania, 2015 [ 46 ].

Opinion survey: women’s opinion on abortion

Argument for choosing the research theme

Although the problematic on abortion in Romania has been extensively investigated and debated, it has not been carried out in an ample sociological study, covering Romanian women’s perception on abortion. We have assumed making a study at national level, in order to identify the opinion on abortion, on the motivation to carry out an abortion, and to identify the correlation between religious convictions and the attitude toward abortion.

Examining the literature field of study

In the conceptual register of the research, we have highlighted items, such as the specialized literature, legislation, statistical documents.

Formulation of hypotheses and objectives

The first hypothesis was that Romanian women accept abortion, having an open attitude towards this act. Thus, the first objective of the research was to identify Romanian women’s attitude towards abortion.

The second hypothesis, from which we started, was that high religious beliefs generate a lower tolerance towards abortion. Thus, the second objective of our research has been to identify the correlation between the religious beliefs and the attitude towards abortion.

The third hypothesis of the survey was that, the main motivation in carrying out an abortion is the fact that a woman does not want a baby, and the main motivation for keeping the pregnancy is that the person wants a baby. In this context, the third objective of the research was to identify main motivation in carrying out an abortion and in maintaining a pregnancy.

Another hypothesis was that modern Romanian legislation on the abortion is considered fair. Based on this hypothesis, we have assumed the fourth objective, which is to identify the degree of satisfaction towards the current regulatory provisions governing the abortion.

Research methodology

The research method is that of a sociological survey by the application of the questionnaire technique. We used the sampling by age and residence looking at representative numbers of population from more developed as well as underdeveloped areas.

Determination of the sample to be studied

Because abortion is a typical women’s experience, we have chosen to make the quantitative research only among women. We have constructed the sample by selecting a number of 1260 women between the ages of 15 and 44 years (the most frequently encountered age among women who give birth to a child). We also used the quota sampling techniques, taking into account the following variables: age group and the residence (urban/rural), so that the persons included in the sample could retain characteristic of the general population.

By the sample of 1260 women, we have made a percentage of investigation of 0.03% of the total population.

The Questionnaires number applied was distributed as follows (Table ​ (Table4 4 ).

The sampling rates based on the age, and the region of residence

Source: Sample built, based on the population data issued by the National Institute of Statistics (INS – Romania) based on population census conducted in 2011 [ 47 ].

Data collection

Data collection was carried out by questionnaires administered by 32 field operators between May 1 st –May 31 st , 2018.

The analysis of the research results

In the next section, we will present the main results of the quantitative research carried out at national level.

Almost three-quarters of women included in the sample agree with carrying out an abortion in certain circumstances (70%) and only 24% have chosen to support the answer “ No, never ”. In modern contemporary society, abortion is the first solution of women for which a pregnancy is not desired. Even if advanced medical techniques are a lot safer, an abortion still carries a health risk. However, 6% of respondents agree with carrying out abortion regardless of circumstances (Table ​ (Table5 5 ).

Opinion on the possibility of carrying out an abortion

Although abortions carried out after 14 weeks are illegal, except for medical reasons, more than half of the surveyed women stated they would agree with abortion in certain circumstances. At the opposite pole, 31% have mentioned they would never agree on abortions after 14 weeks. Five percent were totally accepting the idea of abortion made to a pregnancy that has exceeded 14 weeks (Table ​ (Table6 6 ).

Opinion on the possibility of carrying out an abortion after the period of 14 weeks of pregnancy

For 53% of respondents, abortion is considered a crime as well as the right of a women. On the other hand, 28% of the women considered abortion as a crime and 16% associate abortion with a woman’s right (Table ​ (Table7 7 ).

Opinion on abortion: at the border between crime and a woman’s right

Opinions on what women abort at the time of the voluntary pregnancy interruption are split in two: 59% consider that it depends on the time of the abortion, and more specifically on the pregnancy development stage, 24% consider that regardless of the period in which it is carried out, women abort a child, and 14% have opted a fetus (Table ​ (Table8 8 ).

Abortion of a child vs. abortion of a fetus

Among respondents who consider that women abort a child or a fetus related to the time of abortion, 37.5% have considered that the difference between a baby and a fetus appears after 14 weeks of pregnancy (the period legally accepted for abortion). Thirty-three percent of them have mentioned that the distinction should be performed at the first few heartbeats; 18.1% think it is about when the child has all the features definitively outlined and can move by himself; 2.8% consider that the difference appears when the first encephalopathy traces are being felt and the child has formed all internal and external organs. A percentage of 1.7% of respondents consider that this difference occurs at the beginning of the central nervous system, and 1.4% when the unborn child has all the features that we can clearly see to a newborn child (Table ​ (Table9 9 ).

The opinion on the moment that makes the difference between a fetus and a child

We noticed that highly religious people make a clear association between abortion and crime. They also consider that at the time of pregnancy interruption it is aborted a child and not a fetus. However, unexpectedly, we noticed that 27% of the women, who declare themselves to be very religious, have also stated that they see abortion as a crime but also as a woman’s right. Thirty-one percent of the women, who also claimed profound religious beliefs, consider that abortion may be associated with the abortion of a child but also of a fetus, this depending on the time of abortion (Tables ​ (Tables10 10 and ​ and11 11 ).

The correlation between the level of religious beliefs and the perspective on abortion seen as a crime or a right

The correlation between the level of religious beliefs and the perspective on abortion procedure conducted on a fetus or a child

More than half of the respondents have opted for the main reason for abortion the appearance of medical problems to the child. Baby’s health represents the main concern of future mothers, and of each parent, and the birth of a child with serious health issues, is a factor which frightens any future parent, being many times, at least theoretically, one good reason for opting for abortion. At the opposite side, 12% of respondents would not choose abortion under any circumstances. Other reasons for which women would opt for an abortion are: if the woman would have a medical problem (22%) or would not want the child (10%) (Table ​ (Table12 12 ).

Potential reasons for carrying out an abortion

Most of the women want to give birth to a child, 56% of the respondents, representing also the reason that would determine them to keep the child. Morality (26%), faith (10%) or legal restrictions (4%), are the three other reasons for which women would not interrupt a pregnancy. Only 2% of the respondents have mentioned other reasons such as health or age.

A percentage of 23% of the surveyed people said that they have done an abortion so far, and 77% did not opted for a surgical intervention either because there was no need, or because they have kept the pregnancy (Table ​ (Table13 13 ).

Rate of abortion among women in the sample

Most respondents, 87% specified that they have carried out an abortion during the first 14 weeks – legally accepted limit for abortion: 43.6% have made abortion in the first four weeks, 39.1% between weeks 4–8, and 4.3% between weeks 8–14. It should be noted that 8.7% could not appreciate the pregnancy period in which they carried out abortion, by opting to answer with the option “ I don’t know ”, and a percentage of 4.3% refused to answer to this question.

Performing an abortion is based on many reasons, but the fact that the women have not wanted a child is the main reason mentioned by 47.8% of people surveyed, who have done minimum an abortion so far. Among the reasons for the interruption of pregnancy, it is also included: women with medical problems (13.3%), not the right time to be a mother (10.7%), age motivation (8.7%), due to medical problems of the child (4.3%), the lack of money (4.3%), family pressure (4.3%), partner/spouse did not wanted. A percentage of 3.3% of women had different reasons for abortion, as follows: age difference too large between children, career, marital status, etc. Asked later whether they regretted the abortion, a rate of 69.6% of women who said they had at least one abortion regret it (34.8% opted for “ Yes ”, and 34.8% said “ Yes, partially ”). 26.1% of surveyed women do not regret the choice to interrupted the pregnancy, and 4.3% chose to not answer this question. We noted that, for women who have already experienced abortion, the causes were more diverse than the grounds on which the previous question was asked: “What are the reasons that determined you to have an abortion?” (Table ​ (Table14 14 ).

The reasons that led the women in the sample to have an abortion

The majority of the respondents (37.5%) considered that “nervous depression” is the main consequence of abortion, followed by “insomnia and nightmares” (24.6%), “disorders in alimentation” and “affective disorders” (each for 7.7% of respondents), “deterioration of interpersonal relationships” and “the feeling of guilt”(for 6.3% of the respondents), “sexual disorders” and “panic attacks” (for 6.3% of the respondents) (Table ​ (Table15 15 ).

Opinion on the consequences of abortion

Over half of the respondents believe that abortion should be legal in certain circumstances, as currently provided by law, 39% say it should be always legal, and only 6% opted for the illegal option (Table ​ (Table16 16 ).

Opinion on the legal regulation of abortion

Although the current legislation does not punish pregnant women who interrupt pregnancy or intentionally injured their fetus, survey results indicate that 61% of women surveyed believe that the national law should punish the woman and only 28% agree with the current legislation (Table ​ (Table17 17 ).

Opinion on the possibility of punishing the woman who interrupts the course of pregnancy or injures the fetus

For the majority of the respondents (40.6%), the penalty provided by the current legislation, the imprisonment between six months and three years or a fine and deprivation of certain rights for the illegal abortion is considered fair, for a percentage of 39.6% the punishment is too small for 9.5% of the respondents is too high. Imprisonment between two and seven years and deprivation of certain rights for an abortion performed without the consent of the pregnant woman is considered too small for 65% of interviewees. Fourteen percent of them think it is fair and only 19% of respondents consider that Romanian legislation is too severe with people who commit such an act considering the punishment as too much. The imprisonment from three to 10 years and deprivation of certain rights for the facts described above, if an injury was caused to the woman, is considered to be too small for more than half of those included in the survey, 64% and almost 22% for nearly a quarter of them. Only 9% of the respondents mentioned that this legislative measure is too severe for such actions (Table ​ (Table18 18 ).

Opinion on the regulation of abortion of the Romanian Criminal Code (Art. 201)

Conclusions

After analyzing the results of the sociological research regarding abortion undertaken at national level, we see that 76% of the Romanian women accept abortion, indicating that the majority accepts only certain circumstances (a certain period after conception, for medical reasons, etc.). A percentage of 64% of the respondents indicated that they accept the idea of abortion after 14 weeks of pregnancy (for solid reasons or regardless the reason). This study shows that over 50% of Romanian women see abortion as a right of women but also a woman’s crime and believe that in the moment of interruption of a pregnancy, a fetus is aborted. Mostly, the association of abortion with crime and with the idea that a child is aborted is frequently found within very religious people. The main motivation for Romanian women in taking the decision not to perform an abortion is that they would want the child, and the main reason to perform an abortion is the child’s medical problems. However, it is noted that, in real situations, in which women have already done at least one abortion, most women resort to abortion because they did not want the child towards the hypothetical situation in which women felt that the main reason of abortion is a medical problem. Regarding the satisfaction with the current national legislation of the abortion, the situation is rather surprising. A significant percentage (61%) of respondents felt as necessary to punish the woman who performs an illegal abortion, although the legislation does not provide a punishment. On the other hand, satisfaction level to the penalties provided by law for various violations of the legal conditions for conducting abortion is low, on average only 25.5% of respondents are being satisfied with these, the majority (average 56.2%) considering the penalties as unsatisfactory. Understood as a social phenomenon, intensified by human vulnerabilities, of which the most obvious is accepting the comfort [ 48 ], abortion today is no longer, in Romanian society, from a legal or religious perspective, a problem. Perceptions on the legislative sanction, moral and religious will perpetual vary depending on beliefs, environment, education, etc. The only and the biggest social problem of Romania is truly represented by the steadily falling birth rate.

Conflict of interests

The authors declare that they have no conflict of interests.

There Are More Than Two Sides to the Abortion Debate

Readers share their perspectives.

Sign up for Conor’s newsletter here.

Earlier this week I curated some nuanced commentary on abortion and solicited your thoughts on the same subject. What follows includes perspectives from several different sides of the debate. I hope each one informs your thinking, even if only about how some other people think.

We begin with a personal reflection.

Cheryl was 16 when New York State passed a statute legalizing abortion and 19 when Roe v. Wade was decided in 1973. At the time she was opposed to the change, because “it just felt wrong.” Less than a year later, her mother got pregnant and announced she was getting an abortion.

She recalled:

My parents were still married to each other, and we were financially stable. Nonetheless, my mother’s announcement immediately made me a supporter of the legal right to abortion. My mother never loved me. My father was physically abusive and both parents were emotionally and psychologically abusive on a virtually daily basis. My home life was hellish. When my mother told me about the intended abortion, my first thought was, “Thank God that they won’t be given another life to destroy.” I don’t deny that there are reasons to oppose abortion. As a feminist and a lawyer, I can now articulate several reasons for my support of legal abortion: a woman’s right to privacy and autonomy and to the equal protection of the laws are near the top of the list. (I agree with Ruth Bader Ginsburg that equal protection is a better legal rationale for the right to abortion than privacy.) But my emotional reaction from 1971 still resonates with me. Most people who comment on the issue, on both sides, do not understand what it is to go through childhood unloved. It is horrific beyond my powers of description. To me, there is nothing more immoral than forcing that kind of life on any child. Anti-abortion activists often like to ask supporters of abortion rights: “Well, what if your mother had decided to abort you?” All I can say is that I have spent a great portion of my life wishing that my mother had done exactly that.

Steven had related thoughts:

I have respect for the idea that there should be some restrictions on abortion. But the most fundamental, and I believe flawed, unstated assumptions of the anti-choice are that A) they are acting on behalf of the fetus, and more importantly B) they know what the fetus would want. I would rather not have been born than to have been born to a mother who did not want me. All children should be wanted children—for the sake of all concerned. You can say that different fetuses would “want” different things—though it’s hard to say a clump of cells “wants” anything. How would we know? The argument lands, as it does generally, with the question of who should be making that decision. Who best speaks in the fetus’s interests? Who is better positioned morally or practically than the expectant mother?

Geoff self-describes as “pro-life” and guilty of some hypocrisy. He writes:

I’m pro-life because I have a hard time with the dehumanization that comes with the extremes of abortion on demand … Should it be okay to get an abortion when you find your child has Down syndrome? What of another abnormality? Or just that you didn’t want a girl? Any argument that these are legitimate reasons is disturbing. But so many of the pro-life just don’t seem to care about life unless it’s a fetus they can force a woman to carry. The hypocrisy is real. While you can argue that someone on death row made a choice that got them to that point, whereas a fetus had no say, I find it still hard to swallow that you can claim one life must be protected and the other must be taken. Life should be life. At least in the Catholic Church this is more consistent. I myself am guilty of a degree of hypocrisy. My wife and I used IVF to have our twins. There were other embryos created and not inserted. They were eventually destroyed. So did I support killing a life? Maybe? I didn’t want to donate them for someone else to give birth to—it felt wrong to think my twins may have brothers or sisters in the world they would never know about. Yet does that mean I was more willing to kill my embryos than to have them adopted? Sure seems like it. So I made a morality deal with myself and moved the goal post—the embryos were not yet in a womb and were so early in development that they couldn’t be considered fully human life. They were still potential life.

Colleen, a mother of three, describes why she ended her fourth pregnancy:

I was young when I first engaged this debate. Raised Catholic, anti-choice, and so committed to my position that I broke my parents’ hearts by giving birth during my junior year of college. At that time, my sense of my own rights in the matter was almost irrelevant. I was enslaved by my body. One husband and two babies later I heard a remarkable Jesuit theologian (I wish I could remember his name) speak on the matter and he, a Catholic priest, framed it most directly. We prioritize one life over another all the time. Most obviously, we justify the taking of life in war with all kinds of arguments that often turn out to be untrue. We also do so as we decide who merits access to health care or income support or other life-sustaining things. So the question of abortion then boils down to: Who gets to decide? Who gets to decide that the life of a human in gestation is actually more valuable than the life of the woman who serves as host—or vice versa? Who gets to decide when the load a woman is being asked to carry is more than she can bear? The state? Looking back over history, he argued that he certainly had more faith in the person most involved to make the best decision than in any formalized structure—church or state—created by men. Every form of birth control available failed me at one point or another, so when yet a 4th pregnancy threatened to interrupt the education I had finally been able to resume, I said “Enough.” And as I cried and struggled to come to that position, the question that haunted me was “Doesn’t MY life count?” And I decided it did.

Florence articulates what it would take to make her anti-abortion:

What people seem to miss is that depriving a woman of bodily autonomy is slavery. A person who does not control his/her own body is—what? A slave. At its simplest, this is the issue. I will be anti-abortion when men and women are equal in all facets of life—wages, chores, child-rearing responsibilities, registering for the draft, to name a few obvious ones. When there is birth control that is effective, where women do not bear most of the responsibility. We need to raise boys who are respectful to girls, who do not think that they are entitled to coerce a girl into having sex that she doesn’t really want or is unprepared for. We need for sex education to be provided in schools so young couples know what they are getting into when they have sex. Especially the repercussions of pregnancy. We need to raise girls who are confident and secure, who don’t believe they need a male to “complete” them. Who have enough agency to say “no” and to know why. We have to make abortion unnecessary … We have so far to go. If abortion is ruled illegal, or otherwise curtailed, we will never know if the solutions to women’s second-class status will work. We will be set back to the 50s or worse. I don’t want to go back. Women have fought from the beginning of time to own their bodies and their lives. To deprive us of all of the amazing strides forward will affect all future generations.

Similarly, Ben agrees that in our current environment, abortion is often the only way women can retain equal citizenship and participation in society, but also agrees with pro-lifers who critique the status quo, writing that he doesn’t want a world where a daughter’s equality depends on her right “to perform an act of violence on their potential descendents.” Here’s how he resolves his conflictedness:

Conservatives arguing for a more family-centered society, in which abortion is unnecessary to protect the equal rights of women, are like liberals who argue for defunding the police and relying on addiction, counselling, and other services, in that they argue for removing what offends them without clear, credible plans to replace the functions it serves. I sincerely hope we can move towards a world in which armed police are less necessary. But before we can remove the guardrails of the police, we need to make the rest of the changes so that the world works without them. Once liberal cities that have shown interest in defunding the police can prove that they can fund alternatives, and that those alternatives work, then I will throw my support behind defunding the police. Similarly, once conservative politicians demonstrate a credible commitment to an alternative vision of society in which women are supported, families are not taken for granted, and careers and short-term productivity are not the golden calves they are today, I will be willing to support further restrictions on abortion. But until I trust that they are interested in solving the underlying problem (not merely eliminating an aspect they find offensive), I will defend abortion, as terrible as it is, within reasonable legal limits.

Two readers objected to foregrounding gender equality. One emailed anonymously, writing in part:

A fetus either is or isn’t a person. The reason I’m pro-life is that I’ve never heard a coherent defense of the proposition that a fetus is not a person, and I’m not sure one can be made. I’ve read plenty of progressive commentary, and when it bothers to make an argument for abortion “rights” at all, it talks about “the importance of women’s healthcare” or something as if that were the issue.

Christopher expanded on that last argument:

Of the many competing ethical concerns, the one that trumps them all is the status of the fetus. It is the only organism that gets destroyed by the procedure. Whether that is permissible trumps all other concerns. Otherwise important ethical claims related to a woman’s bodily autonomy, less relevant social disparities caused by the differences in men’s and women’s reproductive functions, and even less relevant differences in partisan commitments to welfare that would make abortion less appealing––all of that is secondary. The relentless strategy by the pro-choice to sidestep this question and pretend that a woman’s right to bodily autonomy is the primary ethical concern is, to me, somewhere between shibboleth and mass delusion. We should spend more time, even if it’s unproductive, arguing about the status of the fetus, because that is the question, and we should spend less time indulging this assault-on-women’s-rights narrative pushed by the Left.

Jean is critical of the pro-life movement:

Long-acting reversible contraceptives, robust, science-based sex education for teens, and a stronger social safety net would all go a remarkable way toward decreasing the number of abortions sought. Yet all the emphasis seems to be on simply making abortion illegal. For many, overturning Roe v. Wade is not about reducing abortions so much as signalling that abortion is wrong. If so-called pro-lifers were as concerned about abortion as they seem to be, they would spend more time, effort, and money supporting efforts to reduce the need for abortion—not simply trying to make it illegal without addressing why women seek it out. Imagine, in other words, a world where women hardly needed to rely on abortion for their well-being and ability to thrive. Imagine a world where almost any woman who got pregnant had planned to do so, or was capable of caring for that child. What is the anti-abortion movement doing to promote that world?

Destiny has one relevant answer. She writes:

I run a pro-life feminist group and we often say that our goal is not to make abortion illegal, but rather unnecessary and unthinkable by supporting women and humanizing the unborn child so well.

Robert suggests a different focus:

Any well-reasoned discussion of abortion policy must include contraception because abortion is about unwanted children brought on by poorly reasoned choices about sex. Such choices will always be more emotional than rational. Leaving out contraception makes it an unrealistic, airy discussion of moral philosophy. In particular, we need to consider government-funded programs of long-acting reversible contraception which enable reasoned choices outside the emotional circumstances of having sexual intercourse.

Last but not least, if anyone can unite the pro-life and pro-choice movements, it’s Errol, whose thoughts would rankle majorities in both factions as well as a majority of Americans. He writes:

The decision to keep the child should not be left up solely to the woman. Yes, it is her body that the child grows in, however once that child is birthed it is now two people’s responsibility. That’s entirely unfair to the father when he desired the abortion but the mother couldn’t find it in her heart to do it. If a woman wants to abort and the man wants to keep it, she should abort. However I feel the same way if a man wants to abort. The next 18+ years of your life are on the line. I view that as a trade-off that warrants the male’s input. Abortion is a conversation that needs to be had by two people, because those two will be directly tied to the result for a majority of their life. No one else should be involved with that decision, but it should not be solely hers, either.

Thanks to all who contributed answers to this week’s question, whether or not they were among the ones published. What subjects would you like to see fellow readers address in future installments? Email [email protected].

By submitting an email, you’ve agreed to let us use it—in part or in full—in this newsletter and on our website. Published feedback includes a writer’s full name, city, and state, unless otherwise requested in your initial note.

Four pro-life philosophers make the case against abortion

To put it mildly, the American Philosophical Association is not a bastion of pro-life sentiment. Hence, I was surprised to discover that the A.P.A. had organized a pro-life symposium, “New Pro-Life Bioethics,” at our annual conference this month in Philadelphia. Hosted by Jorge Garcia (Boston College), the panel featured the philosophers Celia Wolf-Devine (Stonehill College), Anthony McCarthy (Bios Centre in London) and Francis Beckwith (Baylor University), all of whom presented the case against abortion in terms of current political and academic values.

Recognizing the omnipresent call for a “welcoming” society, Ms. Wolf-Devine explored contemporary society’s emphasis on the virtue of inclusion and the vice of exclusion. The call for inclusion emphasizes the need to pay special attention to the more vulnerable members of society, who can easily be treated as non-persons in society’s commerce. She argued that our national practice of abortion, comparatively one of the most extreme in terms of legal permissiveness, contradicts the good of inclusion by condemning an entire category of human beings to death, often on the slightest of grounds. There is something contradictory in a society that claims to be welcoming and protective of the vulnerable but that shows a callous indifference to the fate of human beings before the moment of birth.

There is something contradictory in a society that claims to be protective of the vulnerable but shows a callous indifference to the fate of human beings before the moment of birth.

Mr. McCarthy’s paper tackled the question of abortion from the perspective of equality. A common egalitarian argument in favor of abortion and the funding thereof goes something like this: If a woman has an unwanted pregnancy and is denied access to abortion, she might be required to sacrifice educational and work opportunities. Since men do not become pregnant, they face no such obstacles to pursuing their professional goals. Restrictions to abortion access thus places women in a position of inequality with men.

Mr. McCarthy counter-argued that, in fact, the practice of abortion creates a certain inequality between men and women since it does not respect the experiences, such as pregnancy, which are unique to women. Some proponents of abortion deride pregnancy as a malign condition. A disgruntled audience member referred to pregnant women as “incubators.” Mr. McCarthy argued that authentic gender equality involves respect for what makes women different, including support for the well-being of both women and children through pregnancy, childbirth and beyond. He pointed out that in his native England, pregnant women acting as surrogates are given a certain amount of time after birth to decide whether to keep the child they bore and not fulfill the conditions of the surrogacy contract. This is done out of acknowledgment of the gender-specific biological and emotional changes undergone by a woman who has nurtured a child in the womb.

The most compelling argument against abortion remains what it has been for decades: Directly killing innocent human beings is gravely unjust.

Mr. Beckwith explored the question of abortion in light of the longstanding philosophical dispute concerning the “criteria of personhood.” The question of which human beings count as persons is closely yoked to the political question of which human beings will receive civil protection and which can be killed without legal penalty. The personhood criteria range from the most inclusive (genetic identity as a member of the species Homo sapiens ) to the more restrictive (evidence of consciousness) to the most exclusionary (evidence of rationality and self-motivating behavior).

Mr. Beckwith has long used the argument from personal identity (the continuity between my mature, conscious self and my embryonic, fetal and childhood self and my future older, possibly demented self) to make the case against abortion, infanticide and euthanasia. To draw the line between personhood and non-personhood after conception or before natural death is to make an arbitrary distinction—and a lethal one at that. Mr. Beckwith noted, however, that none of the usual candidates for a criterion of personhood is completely satisfying. Even the common pro-life argument from species membership could, unamended, smack of a certain materialism.

The most compelling argument against abortion remains what it has been for decades: Directly killing innocent human beings is gravely unjust. Abortion is the direct killing of innocent human beings. But political debate rarely proceeds by such crystalline syllogisms. The aim of the A.P.A.’s pro-life symposium was to amplify the argument by showing how our practice of abortion brutally violates the values of inclusion, equality and personhood that contemporary society claims to cherish. In the very month we grimly commemorate Roe v. Wade, such new philosophical directions are welcome winter light.

John J. Conley, S.J., is a Jesuit of the Maryland Province and a regular columnist for America . He is the current Francis J. Knott Chair of Philosophy and Theology at Loyola University, Maryland.

Most popular

Your source for jobs, books, retreats, and much more.

The latest from america

• Search Menu
• Sign in through your institution
• Browse content in Arts and Humanities
• Browse content in Archaeology
• Anglo-Saxon and Medieval Archaeology
• Archaeological Methodology and Techniques
• Archaeology by Region
• Archaeology of Religion
• Archaeology of Trade and Exchange
• Biblical Archaeology
• Contemporary and Public Archaeology
• Environmental Archaeology
• Historical Archaeology
• History and Theory of Archaeology
• Industrial Archaeology
• Landscape Archaeology
• Mortuary Archaeology
• Prehistoric Archaeology
• Underwater Archaeology
• Zooarchaeology
• Browse content in Architecture
• Architectural Structure and Design
• History of Architecture
• Residential and Domestic Buildings
• Theory of Architecture
• Browse content in Art
• Art Subjects and Themes
• History of Art
• Industrial and Commercial Art
• Theory of Art
• Biographical Studies
• Byzantine Studies
• Browse content in Classical Studies
• Classical History
• Classical Philosophy
• Classical Mythology
• Classical Literature
• Classical Reception
• Classical Art and Architecture
• Classical Oratory and Rhetoric
• Greek and Roman Epigraphy
• Greek and Roman Law
• Greek and Roman Papyrology
• Greek and Roman Archaeology
• Late Antiquity
• Religion in the Ancient World
• Digital Humanities
• Browse content in History
• Colonialism and Imperialism
• Diplomatic History
• Environmental History
• Genealogy, Heraldry, Names, and Honours
• Genocide and Ethnic Cleansing
• Historical Geography
• History by Period
• History of Emotions
• History of Agriculture
• History of Education
• History of Gender and Sexuality
• Industrial History
• Intellectual History
• International History
• Labour History
• Legal and Constitutional History
• Local and Family History
• Maritime History
• Military History
• National Liberation and Post-Colonialism
• Oral History
• Political History
• Public History
• Regional and National History
• Revolutions and Rebellions
• Slavery and Abolition of Slavery
• Social and Cultural History
• Theory, Methods, and Historiography
• Urban History
• World History
• Browse content in Language Teaching and Learning
• Language Learning (Specific Skills)
• Language Teaching Theory and Methods
• Browse content in Linguistics
• Applied Linguistics
• Cognitive Linguistics
• Computational Linguistics
• Forensic Linguistics
• Grammar, Syntax and Morphology
• Historical and Diachronic Linguistics
• History of English
• Language Acquisition
• Language Evolution
• Language Reference
• Language Variation
• Language Families
• Lexicography
• Linguistic Anthropology
• Linguistic Theories
• Linguistic Typology
• Phonetics and Phonology
• Psycholinguistics
• Sociolinguistics
• Translation and Interpretation
• Writing Systems
• Browse content in Literature
• Bibliography
• Children's Literature Studies
• Literary Studies (Asian)
• Literary Studies (European)
• Literary Studies (Eco-criticism)
• Literary Studies (Romanticism)
• Literary Studies (American)
• Literary Studies (Modernism)
• Literary Studies - World
• Literary Studies (1500 to 1800)
• Literary Studies (19th Century)
• Literary Studies (20th Century onwards)
• Literary Studies (African American Literature)
• Literary Studies (British and Irish)
• Literary Studies (Early and Medieval)
• Literary Studies (Fiction, Novelists, and Prose Writers)
• Literary Studies (Gender Studies)
• Literary Studies (Graphic Novels)
• Literary Studies (History of the Book)
• Literary Studies (Plays and Playwrights)
• Literary Studies (Poetry and Poets)
• Literary Studies (Postcolonial Literature)
• Literary Studies (Queer Studies)
• Literary Studies (Science Fiction)
• Literary Studies (Travel Literature)
• Literary Studies (War Literature)
• Literary Studies (Women's Writing)
• Literary Theory and Cultural Studies
• Mythology and Folklore
• Shakespeare Studies and Criticism
• Browse content in Media Studies
• Browse content in Music
• Applied Music
• Dance and Music
• Ethics in Music
• Ethnomusicology
• Gender and Sexuality in Music
• Medicine and Music
• Music Cultures
• Music and Religion
• Music and Media
• Music and Culture
• Music Education and Pedagogy
• Music Theory and Analysis
• Musical Scores, Lyrics, and Libretti
• Musical Structures, Styles, and Techniques
• Musicology and Music History
• Performance Practice and Studies
• Race and Ethnicity in Music
• Sound Studies
• Browse content in Performing Arts
• Browse content in Philosophy
• Aesthetics and Philosophy of Art
• Epistemology
• Feminist Philosophy
• History of Western Philosophy
• Metaphysics
• Moral Philosophy
• Non-Western Philosophy
• Philosophy of Science
• Philosophy of Language
• Philosophy of Mind
• Philosophy of Perception
• Philosophy of Action
• Philosophy of Law
• Philosophy of Religion
• Philosophy of Mathematics and Logic
• Practical Ethics
• Social and Political Philosophy
• Browse content in Religion
• Biblical Studies
• Christianity
• East Asian Religions
• History of Religion
• Judaism and Jewish Studies
• Qumran Studies
• Religion and Education
• Religion and Health
• Religion and Politics
• Religion and Science
• Religion and Law
• Religion and Art, Literature, and Music
• Religious Studies
• Browse content in Society and Culture
• Cookery, Food, and Drink
• Cultural Studies
• Customs and Traditions
• Ethical Issues and Debates
• Hobbies, Games, Arts and Crafts
• Natural world, Country Life, and Pets
• Popular Beliefs and Controversial Knowledge
• Sports and Outdoor Recreation
• Technology and Society
• Travel and Holiday
• Visual Culture
• Browse content in Law
• Arbitration
• Browse content in Company and Commercial Law
• Commercial Law
• Company Law
• Browse content in Comparative Law
• Systems of Law
• Competition Law
• Browse content in Constitutional and Administrative Law
• Government Powers
• Judicial Review
• Local Government Law
• Military and Defence Law
• Parliamentary and Legislative Practice
• Construction Law
• Contract Law
• Browse content in Criminal Law
• Criminal Procedure
• Criminal Evidence Law
• Sentencing and Punishment
• Employment and Labour Law
• Environment and Energy Law
• Browse content in Financial Law
• Banking Law
• Insolvency Law
• History of Law
• Human Rights and Immigration
• Intellectual Property Law
• Browse content in International Law
• Private International Law and Conflict of Laws
• Public International Law
• IT and Communications Law
• Jurisprudence and Philosophy of Law
• Law and Politics
• Law and Society
• Browse content in Legal System and Practice
• Courts and Procedure
• Legal Skills and Practice
• Primary Sources of Law
• Regulation of Legal Profession
• Medical and Healthcare Law
• Browse content in Policing
• Criminal Investigation and Detection
• Police and Security Services
• Police Procedure and Law
• Police Regional Planning
• Browse content in Property Law
• Personal Property Law
• Study and Revision
• Terrorism and National Security Law
• Browse content in Trusts Law
• Wills and Probate or Succession
• Browse content in Medicine and Health
• Browse content in Allied Health Professions
• Arts Therapies
• Clinical Science
• Dietetics and Nutrition
• Occupational Therapy
• Operating Department Practice
• Physiotherapy
• Radiography
• Speech and Language Therapy
• Browse content in Anaesthetics
• General Anaesthesia
• Neuroanaesthesia
• Browse content in Clinical Medicine
• Acute Medicine
• Cardiovascular Medicine
• Clinical Genetics
• Clinical Pharmacology and Therapeutics
• Dermatology
• Endocrinology and Diabetes
• Gastroenterology
• Genito-urinary Medicine
• Geriatric Medicine
• Infectious Diseases
• Medical Toxicology
• Medical Oncology
• Pain Medicine
• Palliative Medicine
• Rehabilitation Medicine
• Respiratory Medicine and Pulmonology
• Rheumatology
• Sleep Medicine
• Sports and Exercise Medicine
• Clinical Neuroscience
• Community Medical Services
• Critical Care
• Emergency Medicine
• Forensic Medicine
• Haematology
• History of Medicine
• Browse content in Medical Dentistry
• Oral and Maxillofacial Surgery
• Paediatric Dentistry
• Restorative Dentistry and Orthodontics
• Surgical Dentistry
• Browse content in Medical Skills
• Clinical Skills
• Communication Skills
• Nursing Skills
• Surgical Skills
• Medical Ethics
• Medical Statistics and Methodology
• Browse content in Neurology
• Clinical Neurophysiology
• Neuropathology
• Nursing Studies
• Browse content in Obstetrics and Gynaecology
• Gynaecology
• Occupational Medicine
• Ophthalmology
• Otolaryngology (ENT)
• Browse content in Paediatrics
• Neonatology
• Browse content in Pathology
• Chemical Pathology
• Clinical Cytogenetics and Molecular Genetics
• Histopathology
• Medical Microbiology and Virology
• Patient Education and Information
• Browse content in Pharmacology
• Psychopharmacology
• Browse content in Popular Health
• Caring for Others
• Complementary and Alternative Medicine
• Self-help and Personal Development
• Browse content in Preclinical Medicine
• Cell Biology
• Molecular Biology and Genetics
• Reproduction, Growth and Development
• Primary Care
• Professional Development in Medicine
• Browse content in Psychiatry
• Addiction Medicine
• Child and Adolescent Psychiatry
• Forensic Psychiatry
• Learning Disabilities
• Old Age Psychiatry
• Psychotherapy
• Browse content in Public Health and Epidemiology
• Epidemiology
• Public Health
• Browse content in Radiology
• Clinical Radiology
• Interventional Radiology
• Nuclear Medicine
• Radiation Oncology
• Reproductive Medicine
• Browse content in Surgery
• Cardiothoracic Surgery
• Gastro-intestinal and Colorectal Surgery
• General Surgery
• Neurosurgery
• Paediatric Surgery
• Peri-operative Care
• Plastic and Reconstructive Surgery
• Surgical Oncology
• Transplant Surgery
• Trauma and Orthopaedic Surgery
• Vascular Surgery
• Browse content in Science and Mathematics
• Browse content in Biological Sciences
• Aquatic Biology
• Biochemistry
• Bioinformatics and Computational Biology
• Developmental Biology
• Ecology and Conservation
• Evolutionary Biology
• Genetics and Genomics
• Microbiology
• Molecular and Cell Biology
• Natural History
• Plant Sciences and Forestry
• Research Methods in Life Sciences
• Structural Biology
• Systems Biology
• Zoology and Animal Sciences
• Browse content in Chemistry
• Analytical Chemistry
• Computational Chemistry
• Crystallography
• Environmental Chemistry
• Industrial Chemistry
• Inorganic Chemistry
• Materials Chemistry
• Medicinal Chemistry
• Mineralogy and Gems
• Organic Chemistry
• Physical Chemistry
• Polymer Chemistry
• Study and Communication Skills in Chemistry
• Theoretical Chemistry
• Browse content in Computer Science
• Artificial Intelligence
• Computer Architecture and Logic Design
• Game Studies
• Human-Computer Interaction
• Mathematical Theory of Computation
• Programming Languages
• Software Engineering
• Systems Analysis and Design
• Virtual Reality
• Browse content in Computing
• Business Applications
• Computer Security
• Computer Games
• Computer Networking and Communications
• Digital Lifestyle
• Graphical and Digital Media Applications
• Operating Systems
• Browse content in Earth Sciences and Geography
• Atmospheric Sciences
• Environmental Geography
• Geology and the Lithosphere
• Maps and Map-making
• Meteorology and Climatology
• Oceanography and Hydrology
• Palaeontology
• Physical Geography and Topography
• Regional Geography
• Soil Science
• Urban Geography
• Browse content in Engineering and Technology
• Agriculture and Farming
• Biological Engineering
• Civil Engineering, Surveying, and Building
• Electronics and Communications Engineering
• Energy Technology
• Engineering (General)
• Environmental Science, Engineering, and Technology
• History of Engineering and Technology
• Mechanical Engineering and Materials
• Technology of Industrial Chemistry
• Transport Technology and Trades
• Browse content in Environmental Science
• Applied Ecology (Environmental Science)
• Conservation of the Environment (Environmental Science)
• Environmental Sustainability
• Environmentalist Thought and Ideology (Environmental Science)
• Management of Land and Natural Resources (Environmental Science)
• Natural Disasters (Environmental Science)
• Nuclear Issues (Environmental Science)
• Pollution and Threats to the Environment (Environmental Science)
• Social Impact of Environmental Issues (Environmental Science)
• History of Science and Technology
• Browse content in Materials Science
• Ceramics and Glasses
• Composite Materials
• Metals, Alloying, and Corrosion
• Nanotechnology
• Browse content in Mathematics
• Applied Mathematics
• Biomathematics and Statistics
• History of Mathematics
• Mathematical Education
• Mathematical Finance
• Mathematical Analysis
• Numerical and Computational Mathematics
• Probability and Statistics
• Pure Mathematics
• Browse content in Neuroscience
• Cognition and Behavioural Neuroscience
• Development of the Nervous System
• Disorders of the Nervous System
• History of Neuroscience
• Invertebrate Neurobiology
• Molecular and Cellular Systems
• Neuroendocrinology and Autonomic Nervous System
• Neuroscientific Techniques
• Sensory and Motor Systems
• Browse content in Physics
• Astronomy and Astrophysics
• Atomic, Molecular, and Optical Physics
• Biological and Medical Physics
• Classical Mechanics
• Computational Physics
• Condensed Matter Physics
• Electromagnetism, Optics, and Acoustics
• History of Physics
• Mathematical and Statistical Physics
• Measurement Science
• Nuclear Physics
• Particles and Fields
• Plasma Physics
• Quantum Physics
• Relativity and Gravitation
• Semiconductor and Mesoscopic Physics
• Browse content in Psychology
• Affective Sciences
• Clinical Psychology
• Cognitive Psychology
• Cognitive Neuroscience
• Criminal and Forensic Psychology
• Developmental Psychology
• Educational Psychology
• Evolutionary Psychology
• Health Psychology
• History and Systems in Psychology
• Music Psychology
• Neuropsychology
• Organizational Psychology
• Psychological Assessment and Testing
• Psychology of Human-Technology Interaction
• Psychology Professional Development and Training
• Research Methods in Psychology
• Social Psychology
• Browse content in Social Sciences
• Browse content in Anthropology
• Anthropology of Religion
• Human Evolution
• Medical Anthropology
• Physical Anthropology
• Regional Anthropology
• Social and Cultural Anthropology
• Theory and Practice of Anthropology
• Browse content in Business and Management
• Business Strategy
• Business Ethics
• Business History
• Business and Government
• Business and Technology
• Business and the Environment
• Comparative Management
• Corporate Governance
• Corporate Social Responsibility
• Entrepreneurship
• Health Management
• Human Resource Management
• Industrial and Employment Relations
• Industry Studies
• Information and Communication Technologies
• International Business
• Knowledge Management
• Management and Management Techniques
• Operations Management
• Organizational Theory and Behaviour
• Pensions and Pension Management
• Public and Nonprofit Management
• Strategic Management
• Supply Chain Management
• Browse content in Criminology and Criminal Justice
• Criminal Justice
• Criminology
• Forms of Crime
• International and Comparative Criminology
• Youth Violence and Juvenile Justice
• Development Studies
• Browse content in Economics
• Agricultural, Environmental, and Natural Resource Economics
• Asian Economics
• Behavioural Finance
• Behavioural Economics and Neuroeconomics
• Econometrics and Mathematical Economics
• Economic Systems
• Economic History
• Economic Methodology
• Economic Development and Growth
• Financial Markets
• Financial Institutions and Services
• General Economics and Teaching
• Health, Education, and Welfare
• History of Economic Thought
• International Economics
• Labour and Demographic Economics
• Law and Economics
• Macroeconomics and Monetary Economics
• Microeconomics
• Public Economics
• Urban, Rural, and Regional Economics
• Welfare Economics
• Browse content in Education
• Adult Education and Continuous Learning
• Care and Counselling of Students
• Early Childhood and Elementary Education
• Educational Equipment and Technology
• Educational Strategies and Policy
• Higher and Further Education
• Organization and Management of Education
• Philosophy and Theory of Education
• Schools Studies
• Secondary Education
• Teaching of a Specific Subject
• Teaching of Specific Groups and Special Educational Needs
• Teaching Skills and Techniques
• Browse content in Environment
• Applied Ecology (Social Science)
• Climate Change
• Conservation of the Environment (Social Science)
• Environmentalist Thought and Ideology (Social Science)
• Natural Disasters (Environment)
• Social Impact of Environmental Issues (Social Science)
• Browse content in Human Geography
• Cultural Geography
• Economic Geography
• Political Geography
• Browse content in Interdisciplinary Studies
• Communication Studies
• Museums, Libraries, and Information Sciences
• Browse content in Politics
• African Politics
• Asian Politics
• Chinese Politics
• Comparative Politics
• Conflict Politics
• Elections and Electoral Studies
• Environmental Politics
• Ethnic Politics
• European Union
• Foreign Policy
• Gender and Politics
• Human Rights and Politics
• Indian Politics
• International Relations
• International Organization (Politics)
• International Political Economy
• Irish Politics
• Latin American Politics
• Middle Eastern Politics
• Political Methodology
• Political Communication
• Political Philosophy
• Political Sociology
• Political Behaviour
• Political Economy
• Political Institutions
• Political Theory
• Politics and Law
• Politics of Development
• Public Administration
• Public Policy
• Quantitative Political Methodology
• Regional Political Studies
• Russian Politics
• Security Studies
• State and Local Government
• UK Politics
• US Politics
• Browse content in Regional and Area Studies
• African Studies
• Asian Studies
• East Asian Studies
• Japanese Studies
• Latin American Studies
• Middle Eastern Studies
• Native American Studies
• Scottish Studies
• Browse content in Research and Information
• Research Methods
• Browse content in Social Work
• Addictions and Substance Misuse
• Adoption and Fostering
• Care of the Elderly
• Child and Adolescent Social Work
• Couple and Family Social Work
• Direct Practice and Clinical Social Work
• Emergency Services
• Human Behaviour and the Social Environment
• International and Global Issues in Social Work
• Mental and Behavioural Health
• Social Justice and Human Rights
• Social Policy and Advocacy
• Social Work and Crime and Justice
• Social Work Macro Practice
• Social Work Practice Settings
• Social Work Research and Evidence-based Practice
• Welfare and Benefit Systems
• Browse content in Sociology
• Childhood Studies
• Community Development
• Comparative and Historical Sociology
• Economic Sociology
• Gender and Sexuality
• Gerontology and Ageing
• Health, Illness, and Medicine
• Marriage and the Family
• Migration Studies
• Occupations, Professions, and Work
• Organizations
• Population and Demography
• Race and Ethnicity
• Social Theory
• Social Movements and Social Change
• Social Research and Statistics
• Social Stratification, Inequality, and Mobility
• Sociology of Religion
• Sociology of Education
• Sport and Leisure
• Urban and Rural Studies
• Browse content in Warfare and Defence
• Defence Strategy, Planning, and Research
• Land Forces and Warfare
• Military Administration
• Military Life and Institutions
• Naval Forces and Warfare
• Other Warfare and Defence Issues
• Peace Studies and Conflict Resolution
• Weapons and Equipment

• < Previous chapter
• Next chapter >

John Harris is Sir David Alliance Professor of Bioethics at the Institute of Medicine, Law, and Bioethics, University of Manchester. In 2001 he was the first philosopher to have been elected a Fellow of the Academy of Medical Sciences. He has been a member of the Human Genetics Commission since its foundation in 1999. The author or editor of fourteen books and over 150 papers, his recent books include Bioethics (Oxford University Press, 2001), A Companion to Genetics: Philosophy and the Genetic Revolution, co‐edited with Justine Burley (Blackwell, 2002), and On Cloning (Routledge, 2004).

Søren Holm is Professorial Fellow in Bioethics at Cardiff Law School and Director of the Cardiff Centre for Ethics, Law, and Society. He is also adjunct Professor of Medical Ethics in the Section for Medical Ethics, University of Oslo. He has written on many subjects in bioethics and the philosophy of medicine, and his most recent publications have been on biobanking and on stem‐cell research.

• Published: 02 September 2009
• Cite Icon Cite
• Permissions Icon Permissions

Abortion is one of those classic problems that has been discussed in all of the major ‘fertile periods’ of practical philosophy, from the flourishing of Greek thought, through the medieval period, in the Renaissance and from the start of modern applied ethics in the 1960s. This article begins with a brief historical overview of the discussion of the ethics of abortion, and then proceeds to a range of questions that have been prominent in the philosophical discussion about abortion since the 1960s. The two main areas of controversy have been how to understand the moral status of the fetus, and whether a right to abortion can be based in the mother's right to autonomy.

1. Introduction

Abortion is one of those classic problems that has been discussed in all of the major ‘fertile periods’ of practical philosophy, from the flourishing of Greek thought, through the medieval period, in the Renaissance and from the start of modern applied ethics in the 1960s. According to The Oxford English Dictionary abortion is: ‘The act of giving untimely birth to offspring, premature delivery, miscarriage; the procuring of premature delivery so as to destroy offspring. (In [medicine] abortion is limited to a delivery so premature that the offspring cannot live, i.e. in the case of the human fetus before the sixth month)’ (Oxford English Dictionary, OED Online 2001). This definition encompasses both spontaneous abortion and abortion caused by some form of (usually medical) intervention. It is the latter type of abortion that has interested philosophers and policy-makers, and when in the following we use the term ‘abortion’ it is always in the sense of'abortion caused by human intervention'.

The chapter begins with a brief historical overview of the discussion of the ethics of abortion, and then proceeds to a range of questions that have been prominent in the philosophical discussion about abortion since the 1960s. The two main areas of controversy have been (1) how to understand the moral status of the fetus, and (2) whether a right to abortion can be based in the mother's right to autonomy (or

Thanks to Jeff McMahan for helpful suggestions and comments on an early version of this chapter.

some other right the mother holds)? Other debates have concentrated on whether there is a moral difference between early and late abortions, whether abortion after prenatal diagnosis is morally different from other forms of abortion, and whether there should be a legal right to abortion even if our ethical analysis shows that abortion is ethically problematic.

The modern literature on the ethics of abortion is extensive, and it is impossible in this chapter to do justice to all the arguments that have been presented. Taking as a basis our view of what issues are most important, we therefore look at the first two areas of controversy identified above in some detail, and give a shorter overview of the other questions mentioned.

How we resolve the moral issues concerning abortion, and the arguments that are found to be the most convincing in this context, have implications for a wide range of other issues in reproductive ethics. The analysis of the moral status of the fetus does, for instance, have implications for the ethics of many of the techniques involved in in vitro fertilization, research on embryos, and pre-implantation genetic diagnosis. We have, however, decided to concentrate on the issue of abortion, since this raises more than sufficient issues of its own.

This chapter has been co-authored by two people with very different views about the ethics of abortion, and about the final merits of many of the arguments presented here (see e.g. Harris 1985 ; Holm 1996 ). We hope that this has resulted in a chapter that will help our readers to make up their own minds. That is, after all, the main purpose of practical ethics.

2. A Brief Historical Introduction

Abortion has been discussed as an ethical and legal question as far back as we have a written record. Even during the earliest parts of this history we can find the whole range of views concerning the ethical analysis of abortion from the most restrictive to the most permissive.

Plato, for instance, mentions abortion performed by midwives in Theaetetus (i49d) and advocates abortion (and infanticide) for those who have passed the age of lawful procreation in the Republic (bk. V, 461c):

But when, I take it, the men and the women have passed the age of lawful procreation, we shall leave them free to form such relations with whomsoever they please…firstadmonishing them preferably not even to bring to light anything whatever thus conceived, but if they are unable to prevent a birth to dispose of it on the understanding that we cannot rear such an offspring. (Plato 1994 : 700)

In a given time period the philosophical discussion is often coloured by the most fashionable philosophical and religious views during that period, and by the most recent beliefs about the intricacies of reproductive biology.

Until the invention of the microscope and the discovery of the human egg, most philosophers, for instance, based their ethical analysis of abortion on the mistaken factual belief that the woman provided only unformed matter to the fetus, whereas the generative principles giving form to the fetus were exclusively present in the sperm.

When Aquinas therefore believed that the fetus received a soul only some time after conception, it was partially because he believed that a soul could be received only by a suitably formed individual, and that the generative (male) forces in the sperm needed time to form the unformed (female) matter.

In the Western world the philosophical debate about abortion has until recently been carried out within a Christian framework, where it could be taken as a given that killing an innocent human being was ethically wrong, and where the two main questions therefore became (1) when does the fetus become a human being, and (2) under what conditions can a fetus be killed when it has become a human being.

One of the arguments that has been prominent in the historical debate about the second of these questions is the argument from double effect, an argument that has also been prominent in debates about active euthanasia. This argument has been used to show that there may be cases where it is morally permissible to kill a fetus as a side effect of some other medical intervention—for instance, the removal of a cancerous womb in a pregnant woman.

According to the argument from double effect it is permissible to perform an act which has two effects one good and one bad if:

the act is intended to produce the good effect;

the bad effect is an unintended side effect of the act;

there is no way of producing the good effect without producing the bad effect;

the badness of the side effect does not outweigh the goodness of the intended effect.

There is an extensive literature on the argument from double effect and it is rejected by most modern consequentialists. What is rehearsed in most of the literature is the more general underlying question whether only the consequences of an act matter in the moral evaluation of that act, or whether other factors (in this case the intention of the act) are also morally relevant. The critics of the ‘double-effect’ argument point mainly to two problems with the argument. Their first claim is that it is superfluous, since, if the goodness of the intended effect outweighs the badness of the side effect, you ought to perform the action, even if you do not intend to do so. Their second claim is that, if it is not superfluous, it is pernicious, since it allows the agent to do bad things (all things considered) as long as his intentions are pure.

At the beginning of the modern era of practical ethics discussions about abortion were very prominent. Many of the most prominentfiguresin the early phase of medical ethics wrote extensively on abortion (see e.g. Joseph Fletcher 1966 ; Paul Ramsey 1970 ,1978; Daniel Callahan 1972 ; James Gustafson 1975 ; Richard McCormick 1981 ); and it was also an issue of intense public debates in the late 1960s and early 1970s. At the public policy level many Western countries changed their legal regulation of abortion around this time, either by legislation passed by national parliaments, or by judicial decision (like the famous Roe v. Wade decision of the US Supreme Court in 1973).

3. The Status of The Fetus

One of the main strategies for showing the moral respectability of abortion or at least its moral neutrality is to show that the killing of the fetus that is part of the abortion procedure is not morally wrong. The main class of arguments trying to show this are the so-called ‘personhood arguments.’ These build on ideas in John Locke, and were first used in the abortion debate by Joseph Fletcher ( 1966 , 1972 ), and later developed by Mary Anne Warren ( 1973 ), Jonathan Glover ( 1977 ), Peter Singer ( 1979 ), John Harris ( 1980 , 1985 ), Michael Lockwood ( 1985 ), and H. Tristram Engelhardt ( 1986 ). A useful book-length analysis of the whole question of moral status and personhood can be found in Mary Anne Warren's Moral Status: Obligations to Persons and Other Living Things (1997).

In the following sections we will first lay out the personhood arguments and then look at arguments trying to show that killing a fetus is actually wrong, and that the personhood analysis is misguided.

4. What is ‘Personhood’?

In the middle of the seventeenth century in his Essay Concerning Human Understanding the philosopher John Locke attempted to give an account of the sorts of features that make an individual a person:

We must consider what person stands for; which I think is a thinking intelligent being, that has reason and reflection, and can consider itself the same thinking thing, in different times and places; which it does only by that consciousness which is inseparable from thinking and seems to me essential to it; it being impossible for anyone to perceive without perceiving that he does perceive. (Locke 1690 /1964:188)

This account of personhood identifies a range of capacities as the preconditions for personhood. These capacities are interesting in that they are species, gender, race, and organic-life-form neutral. Thus persons might, in principle, be members of any species, or indeed machines, if they have the right sorts of capacities. The connection between personhood and moral value arises in two principle ways. One of these ways involves the fact that the capacity for self-consciousness coupled with a minimum intelligence, identified by Locke, is not only necessary for moral agency but is also the minimum condition for almost any deliberative behaviour. More significantly, however, is the fact that it is these capacities that allow individuals to value their own existence and that of others. It allows individuals to take an interest in their own futures, and to take a view about how important it is for them to experience whatever future existence may be available (Harris 1980 , 1985 , 1992 ).

In this view, the wrong done to an individual when his existence is ended pre- maturely is the wrong of depriving that individual of something that he values. On the other hand, to kill or to fail to sustain the life of a non-person, in that it cannot deprive that individual of anything that he, she, or it could conceivably value, does that individual no harm. It takes from such individuals nothing that they would prefer not to have taken from them. This does not, of course, exhaust the wrongs that might be done in ending or failing to sustain the life of another sentient creature. Some of these wrongs will have to do with causing pain or suffering or apprehension to a creature, others will have to do with wrongs that may be done to those persons that take a benevolent interest in the individual concerned (Marquis 1989 ; Harris 1992 ).

This account gives one answer to the ethics of abortion and this is why theories of personhood have come to figure significantly in the abortion debate. To this extent, it does what a theory of personhood should try to do. It explains many of the judgements that we intuitively make about these issues, resolves some of the dilemmas that we have about the ethics of decision making, and gives us ways to approach new and possibly unforeseen dilemmas. In uniting and explaining some of our basic intuitions in biomedical ethics, it of course also violates some of these intuitions. In telling us how to handle existing hard cases, it creates some new hard cases.

4.1 Criteria for Personhood

This account offers criteria for personhood in that any self-conscious, minimally intelligent being will be a person. The problem is that we not only want reliable criteria for personhood, but we want detectable evidence of personhood. Here matters are not so simple, and we need to know whether and why we should assume that the sorts of creatures that we know to be normally capable of developing selfconsciousness—namely, human creatures—are persons at some time prior to the manifestation of the ‘symptoms’ of personhood.

Those who give prominence to theories of personhood, do so because they think that accounts of personhood help with questions about the ethics of killing and letting die. Many people who have been interested in the distinctions between different sorts of creatures that personhood highlights have followed John Locke in emphasizing a particular sort of mental life as characterizing personhood. Personhood provides a species-neutral way of grouping creatures that have lives that it would be wrong to end by killing or by letting die. These may include animals, machines, extraterrestrials, gods, angels, and devils. All, if they were capable of valuing existence, would, whatever else they were, be persons.

Personhood applied to human individuals implies that the life cycle of a given individual passes through a number of stages of different moral significance. The human individual comes into being before it acquires personhood. This individual will gradually move from being a potential or a pre-person into an actual person when she develops whatever characteristics are thought to be distinctive of person- hood. And if, eventually, she permanently loses these characteristics prior to death, she will have ceased to be a person.

Personhood then is an idea used to characterize individuals who have the highest moral importance or value. The term ‘respect for persons’ encapsulates this ‘ultimate’ moral importance and attempts to give it content—to explain just what those who accept the moral importance of persons are committed to in concrete terms. Respect for persons understood as a moral principle sets out the ways in which it is appropriate to behave towards those who matter morally in this ‘ultimate’ sense. Non-persons may, of course, be harmed in other ways; by being caused pain, for example. Respect for persons then not only describes the outcome—treating others in morally appropriate ways—but also points to the origin of this obligation in the ultimate or supreme moral value of particular sorts of individuals. We have examined one account of personhood derived from John Locke, which attempts to connect personhood with value and which gives one account of the wrongfulness of ending the lives of persons and hence one account of the rights and wrongs of abortion. On this account of personhood, abortion is permitted so long as neither the embryo nor the fetus is an individual possessing self-consciousness and an intelligence sufficient to value its own existence.

This account of personhood has a number of disadvantages. The first is that, depending on how the criteria for personhood are interpreted, it can lead to the conclusion that infanticide is permissible, since it is difficult to show relevant differences between the capacities of the late fetus and the newborn. For those who are clear that infanticide is morally impermissible, this will tend to rule out adoption of personhood as a criterion of moral worth. Whether accounts of personhood also permit ending the lives of severely mentally retarded adults will depend on whether the degree of retardation is such as to totally rule out self-consciousness and rudimentary intelligence. There will be few such cases. However, those in a permanent vegetative state (PVS) will have lost their personhood.

Are there other accounts of when a creature is a person?

5. Persons Exist When Human Life Begins

Many people have thought that the problem of when life becomes morally important, in the ultimate sense that personhood demands, is answered by knowing when life begins. When can human life be said to begin and is it plausible to believe that the life of a person begins simultaneously with human life? Human sperm and eggs are both alive prior to conception, and the egg undergoes a process of maturation without which conception would be impossible. Both sperm and egg are alive and are human, although this does not, of course, mean that either of them individually constitutes ‘human life’. The event most popularly taken to mark the starting point of human life is conception. But conception can result in a hydatidiform mole, a cancerous multiplication of cells that will never become a person, and, even when human life does begin at conception, it is not necessarily the life of an individual; twins may form at any point up to approximately fourteen days following conception.

Cloning also has raised problems for our understanding of when life begins. If one has a pre-implantation embryo in the early stages of development when all cells are toti-potent—that is, where any of the cells could become any part of the resulting individual, or indeed the whole individual—and one splits this early cell mass (anything up to the sixty-four-cell stage) into, say, four clumps of cells, each of the four clumps would constitute a new, viable embryo that could be implanted with every hope of successful development into adulthood. Each clump is the clone or identical ‘twin’ of each of the others and comes into being not through conception but because of the division of the early cell mass. These four clumps of cells can be recombined into one embryo. Thus, without the destruction of a single human cell, one human can be split into four and can be recombined again into one. Did ‘life’ in such a case begin as an individual, become four individuals, and then turn into a singleton again? All this occurred without the creation of extra matter and without the destruction of a single cell. Those who think that ensoulment, the point at which the divinely sent immortal soul is supposed to enter and animate the body, takes place at conception have an interesting problem to account for the splitting of one soul into four, and for the destruction of three souls when the four embryos are recombined into one, and to account for the destruction of three individuals without a single human cell being removed or killed.

5.1 Speciesism and Natural Kinds

It is possible simply to stipulate that membership of the human species confers moral importance and hence personhood (Warnock 1983 ). This stipulation of a preference for one kind of creature over another (particularly when this preference is asserted by self-interested individuals on behalf of their own kind) requires justification. Claims in which the moral priority and superiority of'our own kind’ have been asserted on behalf of Greeks at the expense of barbarians, whites over blacks, Nazis over Jews, and men over women have been common and seem of doubtful logic and more doubtful morality. Assertion of the superiority of our own kind, whether defined by species membership, race, gender, nationality, or religion, seems not only unjustified but unjustifiable. What then would support assertion of moral priority for membership of a natural kind?

5.2 Potentiality

How then to distinguish, in some morally significant respect, human embryos from the embryos and indeed the adult members of any other species? One feature of human embryos that members of other species do not share is their potential, not simply to be born and to be human, but to become the sort of complex, intelligent, self-conscious, multifaceted creatures typical of the human species.

There seem to be two problems with potentiality interpreted as the idea that human embryos or fetuses are morally important beings in virtue of their potential. The first is logical: acorns are not oak trees, nor eggs omelettes. It does not follow from the fact that something has potential to become something different that we must treat it always as if it had achieved that potential. We are all potentially dead but it does not follow that we must be treated now as if we are already dead.

The second difficulty with the potentiality argument involves the scope of the potential for personhood. If the human zygote has the potential to become an adult human being and is supposedly morally important in virtue of that potential, then what of the potential to become a zygote? Something has the potential to become a zygote, and whatever has the potential to become the zygote has whatever potential the zygote has. It follows that the unfertilized egg and the sperm also have the potential to become fully functioning adult humans. In addition, it is theoretically possible to stimulate eggs, including human eggs, to divide and develop without fertilization (parthenogenesis). As yet it has not been possible to continue the development process artificially beyond early stages of embryogenesis, but if it ever does become possible, then the single unfertilized egg, without need of sperm or cloning, would itself have the potential of the zygote.

Cloning by nuclear transfer, which involves deleting the nucleus of an unfertilized egg, inserting the nucleus taken from any adult cell, and electrically stimulating the resulting newly created egg to develop, can, in theory, produce a new human. This was the method used to produce the first cloned animal, Dolly the sheep, in 1997. This means that any cell from a normal human body has the potential to become a new ‘twin’ of that individual. All that is needed is an appropriate environment and appropriate stimulation. The techniques of parthenogenesis and cloning by nuclear substitution mean that conception is no longer the necessary precursor of human beings.

Thus, if the argument from potential is understood to afford protection and moral status to whatever has the potential to grow into a normal adult human being, then potentially every human cell deserves protection.

However, defenders of the argument from potential will claim that this view of potentiality misrepresents their position. John Finnis, for example, has argued that: ‘An organic capacity for developing eye-sight is not“the bare fact that something will become”sighted; it is an existing reality, a thoroughly unitary ensemble of dynamically inter-related primordia of, bases and structures for, development’. He concludes that ‘there is no sense whatever in which the unfertilized ovum and that sperm constitute one organism, a dynamic unity, identity, whole’ (1995: 50).

However, it is surely the case that A has the potential for Z if, when a certain number of things do and do not happen to A (or to A plus N), then A (or A plus N) will become Z. Even a ‘unitary ensemble of dynamically inter-related primordia of, bases and structures, for development’ must have a certain number of things happen to it and a certain number of things that do not happen to it if its potential is to be actualized. If A is a zygote, it must implant, be nourished, and have a genetic constitution compatible with survival to term and beyond. Moreover, insistence on a ‘unitary ensemble', on ‘one organism’, seems also to apply to cloning by nuclear substitution, surely an embarrassing fact. In any adult cell there is a complete single human genome, which, if treated appropriately, might be cloned. Thus this method of cloning allows for the ‘existing reality’ of a complete genome that exhibits the ‘dynamic unity, identity, whole [ness]’ that the Finnis analysis requires and we can therefore now ascribe potentiality in the Finnis sense to the nucleus of every cell in every body.

The moral importance of drawing attention to the potentiality of something suggests that it is actualizing a particular potential that matters. Our moral concern with what it is that has the potential to become an adult human being would be inexplicable if persons or adult humans did not matter. We are interested in the potentiality argument because we are interested in the potential to become a particular, and particularly valuable, sort of thing. If the zygote is important because it has the potential for personhood, and that is what makes it a matter of importance to protect and actualize its potential, then whatever has the potential to become a zygote must also be morally significant for the same reason. Those who value potentiality for personhood surely do so not because the potential is contained within 'one organism', but because it is the potential to become something the actualization of which has moral importance.

6. The Rejection of Abortion

Traditionally rejection of abortion has been based on the idea that killing innocent human beings is ethically wrong, and that the fetus obviously falls within the class of innocent human beings. As we have argued above, personhood arguments attempt to show, this traditional argument to be false by showing that the wrongness of killing is based in the possession of features that the fetus does not have.

We will now look at the positive arguments that support the traditional view that there is something seriously wrong involved in killing the fetus.

7. Religiously Based Arguments

There is a plethora of religiously based arguments that have been deployed in the abortion debate on both sides of the argument. Here we will outline only one of them, the position held by the Catholic Church at present. The reason for choosing this argument is that it has been prominent in the debates about abortion and that it is very often misunderstood and misquoted.

According to Catholic moral theology, certain basic moral truths are available to all human beings through rational deliberation, and to some through divine revelation within the Church. Among these is the idea that killing innocent human beings is wrong. Within the Church the combination of these two sources of moral truth enables moral theologians to see that the killing of innocent human beings is a special case of the killing of any innocent beings in possession of a rational soul (including any non-human beings with this characteristic).

Within the Catholic tradition the question about the wrongness of abortion therefore centres on the question of at what time the embryo or fetus becomes ensouled. The Catholic position is often described to be one of'immediate ensoulment'—that is, that the soul is present from the time of fertilization, but this is actu- ally not the case.

Another common misconception is that the views of the Pope on this matter have to be followed by all Catholics because the Pope's view is infallible in moral matters. According to Catholic theology, the Pope is infallible only when he declares new dogmas ex cathedra. Normal pronouncements of the Pope, even on matters of faith and morals, are not infallible, although they are, of course, seen as important. No Pope has ever spoken ex cathedra on the matter of the moral status of the fetus, and it is unlikely that it will ever happen, since the status of the fetus is not some- thing that is likely to give rise to an important dogmatic dispute.

While immediate ensoulment has been defended by some Catholic theologians, the position held by the Church is actually more complicated. Within a rich theo- logical tradition like the Catholic one, a problem very quickly occurs with regard to what one should do in cases of uncertainty, either factual uncertainty or moral uncertainty where bonafide moral authorities disagree on what the right analysis or course of action is. In the case of the ensoulment of the fetus, we have both factual and moral uncertainty. Some authorities defend immediate ensoulment, whereas others defend delayed ensoulment, with different views among the latter on when ensoulment actually occurs. In this situation the Church has adopted the position that, because killing is such a grave moral wrong, one should act cautiously and presume that there may be ensouhnent from conception. Abortion and the destruction of embryos should therefore be treated as the killing of an ensouled being.

8. A Life Like Ours

Personhood arguments claim that the wrongness of killing should be dissociated from species membership and membership of any other natural class, and should instead be located in the thwarting of an interest that the individual who is killed possesses. It is, however, possible to develop arguments with a similar structure that leads to the conclusion that killing the fetus is morally wrong.

One such argument has been proposed by Marquis ( 1989 ). He suggests that what is wrong with killing adult human beings is that we deprive them of their future, and that this can be further explicated as depriving them of ‘a life like ours’. The harm done to someone who is killed is not just that we go against their desire to keep on living (which may conceivably have many different levels of strength and importance, thereby making the magnitude of the wrongness of killing different in each case), but that we deprive them of their whole future, a future that is so multi- faceted that it only makes sense to describe it in broad terms like ‘a life like ours’. We do, for instance, deprive them not only of the future fulfilment of their present desires, but also of the future formation of new desires and preferences.

This analysis of the wrongness of killing has the great advantage that it can explain why it would be wrong to kill someone who temporarily has no preferences for going on living. It also avoids being speciesist, because it would make it wrong to kill any being or machine having a future sufficiently like the one we have.

On this analysis, the fetus that is killed is deprived of a life like ours in exactly the same way as any other human being who is killed. There may be other wrong- making factors involved in killing adults (for instance, relating to their preferences not to be killed), but the basic wrong-making factor is involved in killing both fetuses and adults. Killing a fetus is, therefore, seriously wrong and the same is eo ipse true for abortion. What is wrong in killing the fetus is not that we kill a being with potentiality for attaining the feature that would make it wrong to kill it, but that we kill a being that already has this feature (that is, a future like ours). The future of the fetus is no more logically uncertain or contingent than the future of any other biological individual.

This analysis faces two difficulties. One involves the apparent arbitrariness of the stipulation of a future ‘like mine’. We can imagine the future of persons from other planets—brainy fish, for example—being very unlike ‘mine’ but morally important in ways we could recognize. One way out is to attach importance to the content of the future that then becomes the person-making feature or to make personhood turn not on the character of the future but on the present capacity to want to experience it. A second difficulty may be to stop this argument collapsing into a form of the potentiality argument in that a given unfertilized egg and a sperm (or even the nucleus of one of my own cells) may also be said to have ‘a future like mine', a future that would include fertilization or cell nuclear substitution (cloning) as one of its events (see the discussion of this above).

9. Becoming a Person

A certain puzzle seems to be inherent in the idea that I at some point in my bio- logical life become a person, and then at some later point before my death may again become a non-person. The puzzle is the following. There seems to be no doubt that I am presently both a biological being and a person, and it would be difficult to argue that only one of these is essential to who I am. In a computer it may be possible to separate hardware and software, but in human beings and all other biological beings the two aspects of me seem to be inextricably and necessarily linked. However, if any personhood view is correct, then we can trace my biological identity as an individual further back in time than we can trace my personal identity. But if ‘person’ is part of what I essentially am, this is a peculiar result, because it would mean that the two sortals—both describing what I essentially am: that is, ‘Peter Jones (biological individual)’ and ‘Peter Jones (person)'— would have a different analysis. The first would be a substance sortal, whereas the second would be a phase sortal (like ‘child’ or ‘adult’). This problem can be resolved in three ways: (1) by denying that I am essentially a biological being, (2) by denying that I am essentially a person, or (3) by admitting that both sortals must be of the same type. Of these options only the third is attractive, and, since there is no doubt that ‘Peter Jones (biological individual)’ is a substance sortal, this entails that ‘Peter Jones (person)’ must also be a substance sortal—that is, that, if I am now essentially a person, then I must have been a person for as long as I have been a biological individual.

Against this it can be argued that I cannot have a biological identity and a personal identity. If I am essentially a person, I cannot also be essentially a living organism; if I am essentially a living organism, I cannot also be a person, unless ‘person’ is a phase sortal.

There are a number of other arguments aimed at showing that the idea that we become persons at some point in our biological life creates inconsistencies. Many of these are discussed by Lee ( 1996 ).

10. Parental Rights

Entitlement to abortion is often thought to be a derivative of rights possessed by adults, usually the mother. There are a number of candidate rights here, which would include ‘a woman's right to choose’, the right to control one's own body and what happens in and to it, the right to control reproduction (Dworkin 1993 ; Robertson 1994 ), the right to self-defence, and the right to autonomous control of one's life.

A first thing to notice is that all of these rights are limited by the requirement that they be generalizable, that they are compatible with a similar right or rights for all others. If the embryo or fetus is one of those others, then all of these other rights have to compete with similar rights claimed by or on behalf of the fetus. Thus the question of parental rights can arise only in a form that would readily permit abortion once the prior question of the moral status of the fetus has been settled. If the fetus has the same moral status as the mother, then their rights are in competition, and where they are incompatible one with another, some fair method of choosing between them must be found. Just as, for example, a woman's right to control her own body might involve ejecting the fetus, so the like right possessed by the fetus might involve retaining possession of the mother's body until birth.

A possible exception here might be the right to self-defence, famously invoked by Judith Jarvis Thomson ( 1971 ). Thomson suggested that the mother was entitled to view her fetus as a wrongful trespasser, which, in virtue either of her right of self- ownership or her right of self-defence, could legitimately and consistently with justice be ejected from her body. She asks us to imagine that you wake up in the morning and find yourself back to back in bed with an unconscious famous violinist. He has been found to have a fatal kidney ailment, and the Society of Music Lovers has canvassed all the available medical records and found that you alone have the right blood type. Now to save his life you have to remain plugged in. If you unplug him he will die. Thomson suggests that you may unplug him.

However, the plausibility of Thomson's suggestions depends upon acceptance of a highly individualistic interpretation of such rights. For most people, even a right to self-defence requires proportionality offeree. The fetus is, after all, an innocent threat, and there is only a relatively small chance that it constitutes a life-endangering threat. It is far from clear that a right to defend oneself from temporary trespassers extends to killing them.

This raises a further interesting question about the scope of the right to an abortion if such a right exists. Is it a right to kill the fetus or simply a right to eject it from one's body? In the case of most pregnancies this amounts to the same thing, for until around 23–24 weeks the fetus will not be viable outside the womb. But this non-viability is contingent on technology and we may see further reductions in the age of viability. Where fetuses might survive alive outside the body, does the right to abortion extend to a right to pursue the fetus into the world and ensure that it does not survive? Most of the rights-based arguments we have considered, like the right to control one's own body, would seem to embrace only a right to eject the fetus and not a right to kill it (see below).

One newly fledged right might yield a different conclusion. That is the right that is sometimes claimed to control the destiny of one's genes. Such a right if it can be sustained might embrace abortion, but such a right is highly problematic and is unlikely to have the requisite force. For example, it is sometimes invoked in defence of reproductive autonomy (Dworkin 1993 ; Robertson 1994 ), but if it includes the right to have children it must also constrain the right of those children to reproduce, for my daughter, in exercising the right to pass on her genes, will also pass on mine. A right that is extinguished by my daughter's right to reproduce is unlikely to justify my choice to extinguish my daughter's life.

10.1 Father's Rights

Although fathers have often claimed the right to control the reproductive destiny of their sexual partners, it seems unlikely that any such claim either to insist on or to prevent an abortion has any ultimate force. The claim by a father to prevent an abortion could be sustained only by demonstrating that an abortion was unaccept- ably immoral. Such a claim, if it could be sustained, would not be peculiar to fathers but could be made by any third party. If, on the other hand, it is a claim by a father to procure an abortion against the will of the mother, this would involve an assault on the mother's bodily integrity at least equivalent to rape and is unlikely to be sustainable in law or ethics. This is not, of course, to say that fathers do not have an interest in the fetus to which they have contributed twenty-three sets of chromosomes. The question is what is the ultimate force of this interest? We will leave aside the question of the possibility of non-paternity—that is, the possibility that the man who thinks he is the genetic father of a fetus en ventre sa mere is not in fact its genetic father—and look at the clearest case of a father's claims. Suppose a preg- nancy has arisen from a clear agreement between a man and a woman to have a child together and that subsequently the women decides to renege on the agreement and to have an abortion. Certainly the father has an interest and even a quasi- contractual claim against the mother. However, to enforce the claim in the sense of compelling the mother to forgo her termination and give birth is surely out of the question. There are a number of reasons for this. Giving birth is almost always more risky to the mother's health than termination of pregnancy. It is doubtful whether any moral claim by a man that involved subjecting a woman to involuntary risks to her health could succeed. Moreover, for the claim to succeed against the mother's will we would have to accept the denial of very basic rights to physical integrity for the mother. This is not to say that fathers may not be entitled to some form of compensation when such agreements are broken, but this is a long way from suggesting that they have enforceable moral rights.

11. Special Ethical Problems in Late Abortion?

In the debate about abortion it is often claimed that late abortions are more ethic- ally problematic than early abortions, and in this section we want to consider the arguments supporting such a view.

The arguments fall into three major categories focusing on:

increased risk to the pregnant woman;

developing features of the fetus;

developing relation between the fetus and others.

The first category of arguments is uncontroversial, but with limited scope. It simply states that, because the medical risks to the pregnant woman of an abortion increases with the length of gestation, early abortions are preferable to late abortions from both a technical and an ethical point of view. If the woman accepts the increased risk, it is unlikely that this line of argument could override that consent and make late abortion ethically prohibited.

Arguments based on features that the fetus develops during the pregnancy are usually based on either (1) sentience, or (2) viability. We will look at these in turn.

11.1 Sentience

It is generally accepted that the human fetus becomes sentient some time during pregnancy and that one of the abilities that develop is the ability to feel pain. There is disagreement about exactly when sentience and the ability to feel pain develops, but this does not affect the basic structure of the arguments based on sentience, but only exactly when they become valid.

The simplest argument based on sentience is the argument that inflicting pain on any kind of being is a morally bad thing to do, and that methods of abortion that create fetal pain are therefore morally problematic. This would rule out pain- producing methods of abortion after the development of fetal sentience, at least if it is the case that alternative methods are available that do not entail increased risk to the mother. If the only painless methods of abortion do entail increased risks for the mother, we would then have to balance these against the fetal pain produced by the standard methods of abortion.

A more complex sentience-based argument relies on the idea that personal identity is based on psychological continuity between successive stages of the same person. If this is accepted, it can then be argued that, although I am not personally identical to the early embryo, I am personally identical to the late-stage fetus, because its mental experiences have contributed to forming my present psychology, and that there is no discernible break between those early experiences (even though I may not be able to remember them) and my present mental life. If I am person- ally identical with the late-stage fetus, it must then follow that I was already a person at that time, and that I already possessed the rights that persons possess.

A third sentience-based argument draws an analogy between brain death and brain life and argues that the beginning of human personal life begins with the beginning of significant brain function. If I have died when my brain has died, it seems to make sense to say that I have started to live when my brain has started to live as a brain. This argument has been put forward by Kluge ( 1978 ) and by Lockwood ( 1985 ). The problem with the argument is that ‘brain death’, although almost universally accepted as a criterion of death, seems less acceptable as a criterion of loss of moral status, since many believe moral status to be lost without brain death. Moreover, brain death and for that matter brain birth seem important because the brain is required to support some capacities that are deemed morally relevant. If we identify these capacities, we might have reason to suppose that they develop at some point after the development of the brain and may be lost some time before the brain dies, just as legs are required by humans for running but humans have legs before they can run, and may cease to be able to run while still retaining these limbs.

11.2 Viability

A human fetus becomes viable outside the womb of the pregnant woman a considerable time before birth, as evidenced by our success in keeping pre-term babies alive in neonatal intensive care units from about 23–24 weeks into gestation. It has been argued that abortion becomes morally impermissible after viability.

The basic structure of the viability argument is the following, although each proponent of this argument has his own favoured variations.

The argument for abortion is an argument leading to the conclusion that a woman has a right to have her pregnancy terminated.

After viability the pregnancy can be terminated without killing the fetus either directly or indirectly by expelling it from the uterus in a non-viable state.

The woman has no independent rights to have the fetus killed.

Therefore: after viability there is no right to have the pregnancy terminated in a way that results in the killing of the fetus.

This argument has force only if premisses 1 and 3 are accepted, and these are resisted by some proponents of abortion who base their arguments for abortion on the personhood analysis discussed above.

One difficulty with the viability argument is that the fetal age where viability is attained depends on the technological development in neonatal intensive care. This means that the ethical status of a given abortion may change according to context. It might be ethically acceptable in a context where there is no access to neonatal care, and ethically unacceptable if there is such access.

11.3 Late Abortion and Social Bonding

The third category of arguments concerning late abortions relies on the idea that our moral obligations towards other individuals depend not only on their attributes but also on our relationship to them. This type of argument is related to an analysis of personhood and personal continuity that claims that personhood is, at least partially, constructed through the narratives we tell about persons (including their own self-narrative). Many of the things that I as a person believe about myself and that shape my life I only know through what I have been told by others, and from the reactions I experience in others to my actions and my telling of my own narrative. Personhood, personal identity, and moral status are, therefore, based not on some property or capacity of my body or my mental life, but on the personal narrative that I co-construct with others.

The core premiss of the argument linking this narrative understanding of person- hood to the ethics of abortion is that during pregnancy the fetus gradually becomes part of our social networks and obtains the beginnings of a specific personal narrative, and that this creates obligations on our part (and later may create obligations on the part of the present fetus towards the gestational mother).

12. Abortion Justified in Terms of Features of the Fetus

There is a persistent strand of thinking about abortion that locates the justification in terms of features of the fetus—particularly fetal abnormality or the presence of adverse genetic conditions. Much legislation on abortion specifically provides for abortion where there is evidence of fetal abnormality (e.g. United Kingdom Human Fertilization and Embryology Act 1990). While it is true that such considerations often constitute the reasons people have for opting for a termination of pregnancy, it is difficult to see how they could operate as justifications for abortion unless they are such as to change the moral status of the fetus.

12.1 Pre-natal Genetic Diagnosis

The question ‘what reproductive choices would be legitimate and which, if any, reproductive choices would be wrongful?’ is perhaps more helpful than the question ‘what degree of fetal abnormality would justify abortion'. To see why this is so we should consider pre-implantation genetic diagnosis (PIGD). Suppose a woman has six pre-implantation embryos in vitro awaiting implantation. PIGD has revealed that three have various genetic disorders and three seem healthy. Which should she implant? Does she have any moral reasons to avoid implanting those with genetic disorders? Notice two features of this case. Few would judge women to be under any moral or any legal obligation to implant any embryos. The decision to implant some or none is entirely within her unfettered discretion. She does not have to offer legal, moral, or any other justifications to anyone if she decides to implant none of the embryos. Under English Law, for example, she may implant only up to three without a special medical reason for implanting more. Which three should she implant? Can she say: ‘It is a matter of moral indifference whether or not my resulting child has a genetic disorder and therefore /have no reason to select the healthy embryos.’ This seems implausible. Since none of the embryos has a right or an entitlement to be chosen rather than the others, since none is a person, nor yet a moral agent, and none has begun the sort of biographical life that would give it interests, her choice is relatively free. She has a reason to do what she can to ensure that the individual she chooses is as good an individual as she can make it. She has a reason therefore to choose the embryo that is not already harmed in any particular way and that will have the best possible chance of a long and healthy life and the best possible chance of contributing positively to the world it will inhabit.

If, on the other hand, she chooses to implant an individual destined to suffer an illness, she will have created that illness and any harm that it will do. This woman has the same reason to select against an embryo with a genetic disease as her sister who is told that, if she conceives immediately, she will have a child with a genetic defect, but that if she postpones pregnancy and takes a course of treatment she will have a healthy child (Parfit 1984 : 366 ff.).

12.2 Unfair Discrimination against the Disabled

It is sometimes claimed that to choose not to have a child because of some adverse feature that will affect it is not only unfair discrimination against that particular feature but may also be self-defeating in terms of other values that we hold. Here the famous ‘aborting Beethoven’ fallacy (Harris 1992 : 179) is often invoked. We are asked whether it would be reasonable to abort a child because it was congenitally deaf and if we agree we are triumphantly told that we have just aborted Beethoven. However, it is as senseless to think that aborting any particular deaf child would involve the non-existence of Beethoven as it would be to celebrate the fact that, by practising contraception, we have just prevented the birth of a Hitler.

If abortions occur, we know that as a result both healthy fetuses and some with genetic diseases will never become persons. That does not mean that we deprive society of people like Einstein or Gandhi, nor does it mean that we pre-empt the existence of a Hitler or a Bin Laden, nor does it mean that we discriminate against such people nor against people like them.

12.3 Choosing who shall Exist

Choosing between existing people for whatever reason always involves the possibility of unfair discrimination because there will, inevitably, be people who are dis- advantaged by the choice. Choosing which sorts of people to bring into existence or choosing which embryos or fetuses to allow to become persons can never have this effect because there is no one who suffers adversely from the choice.

Readers should consider the question of whether their own parents were under any obligation to attempt to conceive in any particular month. If they had conceived in any month other than the one in which the reader was conceived, he or she would never have existed.

Suppose your parents had been told that by postponing pregnancy and changing their diet they would probably have a much healthier and longer-lived child. Had they done so you would never have existed but would you have had any ground for complaint? Would that have constituted discrimination against people with your genetic condition. It is surely a fallacy to think that choosing between preimplantation embryos or choosing to terminate pregnancies of embryos because other embryos would have a better chance in life constitutes unfair discrimination.

13. Enhancements

Consider again not the issue of disabilities or impairments but rather the issue of enhancements. Suppose some embryos had a genetic condition that conferred complete immunity to many major diseases—HIV/AIDS, cancer, and heart disease, for example, coupled with increased longevity. Any parent would surely have moral reasons to prefer to implant such embryos given the opportunity of choice. But such a decision would not imply that normal embryos had lives that were not worth living or were of poor or problematic quality. If I would prefer to confer these advantages on any future children that I may have, I am not implying that people like me, constituted as they are, have lives that are not worth living or that are of poor quality.

Most disabilities fall far short of the high standard of awfulness required to judge a life to be not worth living. This is why we must distinguish between having moral reasons for avoiding producing new disabled individuals and the question of enforcement, regulation, or prevention of the birth of such individuals.

13.1 The Moral Reasons We Have to Avoid Harm

There is continuum between harms and benefits such that the reasons we have to avoid harming others or creating others who will be unnecessarily harmed are continuous with the reasons we have for conferring benefits on others if we can. In short, to decide to withhold a benefit is in a sense to harm the individual we decline to benefit. We have reasons for declining to create or confer even trivial harms, and we have reasons to confer and not withhold even small benefits. But to say that it would, other things being equal, be better not to create an individual who will suffer an unnecessary harm is not to say that it would be better for that individual had he or she never been born, nor is it to say that the world would have been a better place had he or she never been born, nor is it to say that individuals with disabilities are somehow less valuable or lesser persons than others.

13.2 Gender Selection

Infanticide has been practised as a method of gender selection for millennia. Abortion has been added to the methods of gender selection, since it has been possible to determine gender in utero since the 1960s. For some the ethics of gender selection are a function of the methods chosen, for others gender selection is always wrong. The ethics of gender selection are beyond our purview here (Harris 1998 ). What can be said is that, while abortion seems a costly and inefficient method of achieving this end, it will be ethical if abortion is permissible for a number of the reasons considered above, if, for example, the moral status of the embryo or fetus is such as to permit it, or if abortion is legitimate because it is a dimension of the rights or autonomy of the mother.

14. Abortion, Social Consequences, and Legalization

A very frequent argument in the abortion debate claims that, although all (or most) abortions are ethically wrong, all things considered they should nevertheless not be legally prohibited.

The relation between the ethical wrongness of an act and its legal prohibition is not straightforward. It is a problem that has vexed political philosophers for many years, and an in-depth analysis is outside the scope of this chapter. It is, however, important to note that ethical wrongness is not in and of itself a sufficient reason for legal prohibition in all circumstances. It can, for instance, be ethically wrong in many situations to tell people the truth about themselves, but this does not seem to be sufficient to try to draft legislation prohibiting this specific class of truth-telling actions.

In general the arguments for not legally prohibiting an ethically bad type of action fall into three categories: (1) it is impossible to draft legal rules that accurately delineate the problematic acts from acts that are not problematic, (2) it is impossible to police the resultant legislation, either because it is very difficult or because the intrusions in private life necessary for policing the legal rules far outweigh the good to be gained, or (3) the prohibition will have such serious side effects that allowing the problematic act is on balance preferable.

The arguments trying to disassociate the ethical wrongness of abortion (assumed for the sake of argument to be firmly established) and its legal prohibition gener- ally point to the bad effects of not allowing abortions as the justification for not prohibiting it.

The alleged bad effects if abortion is not permitted are (1) a large number of back-street abortions with consequent threat to the life or welfare of the mother and (2) a negative effect on the status of women and their opportunities to participate fully in society.

14.1 Back-Street Abortions

Historically there seems to be no doubt that abortions do take place in large numbers in societies where abortion is prohibited, and that this causes great suffering to women because these abortions are carried out in unsuitable conditions by unqualified persons. Some women are killed by botched abortions and many more are permanently damaged in various ways.

It is, on the other hand, evident that, when abortion is legalized (especially if it is legalized as ‘abortion on demand’), the number of abortions increases substantially. This creates a problem for the first type of argument based on the bad effects of prohibiting abortion. If a large increase in the number of abortions is acceptable to avoid the suffering to women caused by the prohibition of abortions, then abortion cannot be very wrong. But the argument is usually put forward by people who argue that abortion is seriously wrong, and they thereby seem to involve themselves in inconsistency.

14.2 The Status of Women in Society

A different argument for the dissociation between the ethical and the legal status of abortion is based on the more general effects of preventing women from controlling their reproduction. If the participation of women as equals in all aspects of society is an important good, then any law or social custom that makes such participation more difficult is prima facie problematic. The question then becomes one of balancing the bad of abortion against the good of equal participation. In this balancing it seems to be the case that, if abortion is a serious moral wrong, then the absence of a legal right to abortion would have to have a marked influence on women's opportunities to participate in society. It would furthermore have to have this effect, even if other means of reproductive control like contraception are freely available.

14.3 The Role of the Medical Profession

Any legal regulation of abortion must explicitly or implicitly deal with the role of the medical profession, since it is usually members of this profession who perform legal abortions. Should there be a conscience clause allowing persons with ethical objections to performing abortions to opt out, and how wide should the scope of this conscience clause be?

This is, again, a difficult question, involving both ethics and political philosophy, which we are unable to analyse in full within the scope of this chapter.

One point is nevertheless worth noting. Most (or perhaps all?) conscience clauses allow doctors and other health-care professionals to opt out of any direct involvement in abortions, but do at the same time require them to refer the patient to a colleague who is willing to perform the abortion. This requirement is clearly inconsistent. If the reason for allowing persons to opt out is that it is wrong to force someone to perform acts they believe to be seriously ethically wrong, it might seem inconsistent to force them to be causal agents in a chain of events leading to the performance of the act in question. However, this inconsistency can be resolved by only requiring doctors with moral objections to abortions to tell the patients of their entitlement to go elsewhere for advice, but not requiring them to give any specific advice concerning where to go.

A more radical solution to the problem of conscience clauses is to remove the whole area of abortion provision from the medical field. Early abortions are not technically difficult to perform, and the requirements for performing them safely and effectively have more to do with manual skill and training than with medical knowledge. We can, therefore, easily imagine ‘abortion by philosopher’ as an option—that is, a system where philosophers convinced by the personhood analysis or by Judith Jarvis Thomson's arguments outlined above are given the necessary training in abortion techniques and allowed to perform abortions according to their philosophical convictions.

15. The State of the Debate

Although the ethics of abortion remains one of the problems that most divides societies, the arguments for and against are well rehearsed and understood and there seems little room for new and convincing arguments on either side. Although opponents of abortion often see killing embryos as a form of murder and pro ponents view anti-abortionists as committed not only to enslaving women but as opponents of basic public-health measures that save many lives, both pro- and anti-abortionists are usually otherwise good citizens and highly moral beings. In such circumstances, where basically decent, moral people disagree and where there are no compelling or clearly decisive arguments on either side, the requirements of tolerance should surely prevail. This means that neither side should seek to impose its position on the other. No one who has conscientious objections to abortion should be forced either to have an abortion or to assist or support the abortion process. Equally no one who sees abortion as unproblematic should be denied access to abortion nor should he seek to impose his views on others.

Callahan, D. ( 1972 ). Abortion: Law, Choice and Morality. New York: Macmillan.

Google Scholar

Google Preview

Dworkin, R. ( 1993 ). Life's Dominion. London: HarperCollins.

Engelhardt, H. T. ( 1986 ). The Foundations of Bioethics. New York: Oxford University Press.

Finnis, J. ( 1995 a). ‘A Philosophical Case against Euthanasia’, in J. Keown (ed.), Euthanasia Examined: Ethical Clinical and Legal Perspectives. Cambridge: Cambridge University Press, 23–36.

——— ( 1995 b ). ‘The Fragile Case for Euthanasia: A Reply to John Harris’, in J. Keown (ed.), Euthanasia Examined: Ethical Clinical and Legal Perspectives. Cambridge: Cambridge University Press, 46–56.

Fletcher, J. ( 1966 ). Situation Ethics. London: SCM Press Ltd.

——— ( 1972 ). ‘ Indicators of Humanhood: A Tentative Profile of Man ’. Hastings Center Report , 215:1–4.

Glover, J. ( 1977 ). Causing Death and Saving Lives. Harmondsworth: Penguin.

Gustafson, J. M. ( 1975 ). The Contributions of Theology to Medical Ethics. Wisconsin: Marquette University Press.

Harris, J. ( 1980 ). Violence and Responsibility. London: Routledge & Kegan Paul.

——— ( 1985 ). The Value of Life. London: Routledge & Kegan Paul.

——— ( 1992 ) Wonderwoman and Superman. Oxford: Oxford University Press.

——— ( 1998 ). ‘Rights and Reproductive Choice’, in J. Harris and S. Holm (eds.), The Future of Human Reproduction. Oxford: Oxford University Press.

Holm, S. ( 1996 ). ‘The Moral Status of the Pre-Personal Human Being—the Argument from Potential Reconsidered’, in D. Evans (ed.), Conceiving the Embryo. Dordrecht: Kluwer, 193–220.

Kluge, E.-H. W. ( 1978 ). ‘Infanticide as the Murder of Persons', in M. Kohl (ed.), Infanticide and the Value of Life. Buffalo, NY: Prometheus.

Lee, P. ( 1996 ). Abortion and Unborn Human Life. Washington: Catholic University of America Press.

Locke, J. ( 1690 /1964). Essay Concerning Human Understanding , ed. A. S. Pringle-Pattison. Oxford: Clarendon Press.

Lockwood, M. ( 1985 ). ‘When does Life Begin’, in M. Lockwood (ed.), Moral Dilemmas in Modern Medicine. New York: Oxford University Press, 9–31.

——— ( 1988 ). ‘ Warnock versus Powell (and Harradine); When does Potentiality Count? ’ Bioethics , 2:187–213.

McCormick, R. A. ( 1981 ). How Brave a New World? London: SCM Press.

Marquis, D. ( 1989 ). ‘ Why Abortion is Immoral ’. Journal of Philosophy , 86:183–202.

Parfit, D. ( 1984 ). Reasons and Persons. Oxford: Oxford University Press.

Plato ( 1994 ). Plato: The Collected Dialogues Including the Letters , ed. E. Hamilton and H. Cairns. 15th Printing. Princeton: Princeton University Press.

Ramsey, P. ( 1970 ). Fabricated Man. New Haven: Yale University Press.

——— ( 1978 ). Ethics at the Edges of Life. New Haven: Yale University Press.

Robertson, J. A. ( 1994 ). Children of Choice. Princeton: Princeton University Press.

Singer, P. ( 1979 ). Practical Ethics. Cambridge: Cambridge University Press.

Thomson, J. J. ( 1971 ). ‘ A Defence of Abortion ’. Philosophy and Public Affairs , 1/1 (Fall), 47–66.

Tooley, M. ( 1985 ). Abortion and Infanticide. Oxford: Oxford University Press.

——— ( 1998 ). ‘Personhood’, in H. Kuhse and P. Singer (eds.), A Companion to Bioethics. Oxford: Blackwell, 117–27.

Warnock , Mary ( 1983 ). ‘ In Vitro Fertilization: The Ethical Issues ’. Philosophical Quarterly , 33: 241.

Warren, M. A. ( 1973 ). ‘ On the Moral and Legal Status of Abortion ’. Monist , 57/1: 43–61.

——— ( 1997 ). Moral Status: Obligations to Persons and Other Living Things. Oxford: Oxford University Press.

Roe v. Wade , 410 US 113 (1973).

• About Oxford Academic
• Publish journals with us
• University press partners
• What we publish
• New features  
• Open access
• Institutional account management
• Rights and permissions
• Get help with access
• Accessibility
• Advertising
• Media enquiries
• Oxford University Press
• Oxford Languages
• University of Oxford

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide

• Copyright © 2024 Oxford University Press
• Cookie settings
• Cookie policy
• Privacy policy
• Legal notice

This Feature Is Available To Subscribers Only

Sign In or Create an Account

This PDF is available to Subscribers Only

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

Reflections on Abortion, Values, and the Family

Cite this chapter.

• Jean Bethke Elshtain 3  

Part of the book series: The Hastings Center Series in Ethics ((HCSE))

231 Accesses

1 Citations

We live in a society marked by moral conflict. This conflict has deep historical roots and is reflected in our institutions, practices, laws, norms, and values. The abortion debate taps strongly held, powerfully experienced moral and political imperatives. These imperatives, in turn, are linked internally to a cluster of complex concerns and images evoking what sort of people we are anyway and what we aspire to be. The abortion debate won’t “go away, ” nor should it. For we are, after all, talking about matters of life and death, freedom and obligation, rights and duties: None of us can dispute that, and none of us can be nonplussed when we face the dilemmas that the abortion question poses.

My position has emerged complicatedly, first through familial and religious influence. As a child, I was taught the importance and integrity of life and the need to protect it. I remember my sisters and me doing our best to rescue fallen birds and nurse them back to health. We laboriously mixed an earthworm paste to feed to the birds through eye droppers. We mourned the deaths of baby chicks, ducks, and calves. Life was valuable, we were taught, not for instrumental reasons but in itself. The part of “me” that remains importantly the child that I was reasons thus: If a baby chick deserves respectful “tending to, ” does not a vulnerable, wholly dependent human life? Is that not what we are talking about if we talk ordinary language and refuse to retreat behind a screen of distancing, “medicalized” abstractions (“products of conception, ” “fetal matter, ” and so on)?

There are ways in which this direct and beautifully simple moral response has been both challenged and affirmed in my adult life. It has been challenged by my recognition of the desperate circumstances and situations in which many women find and have found themselves, for it is women who bear the most direct and inescapable brunt of human procreation. I do not call to mind here the desperate teenager alone but, say, the menopausal woman in her 50s who has every reason to believe that she is past reproductive age but finds, to her astonishment, that she is not. If one is a merciful and compassionate being, then one’s mercy and compassion must go out to these women and must not limit itself to the unborn. So I cannot accept an absolute prohibition on abortion. But I do not—and cannot—see that “right” as absolute. Here, I can draw on political and theoretical imperatives that are confirmatory of a respect-for-life position.

I am also influenced in my present position by a particular sort of social theory and philosophy—interpretive, reflective, and critical—together with my political concern that the white, middle-class or upper-middle-class majority has, all too often, presumed to legislate in behalf of, or undercover of, others, claiming that these others the poor or the minorities) require reforms that they might not be in a position to “see” for themselves. I believe that people must speak for themselves, in their own language, to their most urgent concerns. This belief introduces immediate ambiguity into the abortion debate—and deepens the ambiguity of my own position. For I am in fact part of a large majority that opposes both abortion on demand and an absolute restriction on abortion. This position suggests to me that my au-tobiographical history—though confirmed by a later commitment to a certain mode of social theorizing—is not mine alone but is shared by many Americans who are irrepressibly pragmatic yet stubbornly ethical and moral in their concerns. We should acknowledge, not quash, these moral sensibilities. The abortion debate is vital, for it means that we are still concerned about the sort of people we are and the kind of lives we are living.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Unable to display preview.  Download preview PDF.

Philip Abbott, The Family on Trial ( University Park: Pennsylvania State University Press, 1981 ), p. 138.

Google Scholar  

Michael Tooley, “Abortion and Infanticide,” in Marshall Cohen, Thomas Nagel, and Thomas Scanlon, eds., The Rights and Wrongs of Abortion ( Princeton, N.J.: Princeton University Press, 1974 ), pp. 54 – 55.

Elizabeth Rapaport and Paul Sagal, “One Step Forward, Two Steps Backward: Abortion and Ethical Theory,” in Marty Vetterling-Braggin, Frederick A. Elliston and Jane English, eds., Feminism and Philosophy ( Totowa, N.J.: Littlefield Adams, 1977 ), p. 410.

Quoted in Daniel Callahan, Abortion: Law, Choice and Morality ( New York: Macmillan, 1970 ), p. 462.

Cited in Lawrence Lader, Abortion (Indianapolis: Bobbs-Merrill, 1966), p. 156. (Italics added.)

Carol McMillen, Women, Reason and Nature ( Princeton, N.J.: Princeton University Press, 1982 ), p. 127.

Alasdair Maclntyre, After Virtue ( South Bend, Ind.: Notre Dame University Press, 1981 ), p. 205.

Peter Brown, The Cult of the Saints: Its Rise and Function in Latin ( Chicago: University of Chicago Press, 1981 ), p. 30.

Harry Boyte, The Backyard Revolution ( Philadelphia: Temple University Press, 1980 ).

Stanley Hauerwas, “The Moral Value of the Family,” in A Community of Character (South Bend, Ind.: University of Notre Dame Press, 1981 ), p. 165.

Download references

Author information

Authors and affiliations.

Department of Political Science, University of Massachusetts, Amherst, Massachusetts, 01003, USA

Jean Bethke Elshtain

You can also search for this author in PubMed   Google Scholar

Editor information

Editors and affiliations.

Mercy College, Dobbs Ferry, New York, USA

Sidney Callahan ( Associate Professor of Psychology ) ( Associate Professor of Psychology )

The Hastings Center Institute of Society, Ethics and the Life Sciences, Hastings-on-Hudson, New York, USA

Daniel Callahan ( Director of The Hastings Center ) ( Director of The Hastings Center )

Rights and permissions

Reprints and permissions

Copyright information

© 1984 The Hastings Center

About this chapter

Elshtain, J.B. (1984). Reflections on Abortion, Values, and the Family. In: Callahan, S., Callahan, D. (eds) Abortion. The Hastings Center Series in Ethics. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2753-0_3

Download citation

DOI : https://doi.org/10.1007/978-1-4613-2753-0_3

Publisher Name : Springer, Boston, MA

Print ISBN : 978-1-4612-9703-1

Online ISBN : 978-1-4613-2753-0

eBook Packages : Springer Book Archive

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

Home — Essay Samples — Philosophy — Ethics — Ethical Issues on Abortion

Ethical Issues on Abortion

• Categories: Abortion Ethics

About this sample

Words: 841 |

Published: Jun 6, 2024

Words: 841 | Pages: 2 | 5 min read

Cite this Essay

Let us write you an essay from scratch

• 450+ experts on 30 subjects ready to help
• Custom essay delivered in as few as 3 hours

Get high-quality help

Dr Jacklynne

Verified writer

• Expert in: Social Issues Philosophy

+ 120 experts online

By clicking “Check Writers’ Offers”, you agree to our terms of service and privacy policy . We’ll occasionally send you promo and account related email

No need to pay just yet!

Related Essays

2 pages / 1020 words

6 pages / 2770 words

5 pages / 2147 words

1 pages / 552 words

Remember! This is just a sample.

You can get your custom paper by one of our expert writers.

121 writers online

Still can’t find what you need?

Browse our vast selection of original essay samples, each expertly formatted and styled

Related Essays on Ethics

Utilitarianism is a prominent ethical theory that has influenced moral philosophy for centuries. In this essay, we will explore the definition and history of utilitarianism, examining its association with renowned philosophers [...]

Being a responsible person means taking the necessary steps to ensure that one is doing the right thing in the right way. It involves being accountable for one's actions and making wise considerations when faced with difficult [...]

In Harper Lee's novel "To Kill a Mockingbird," one of the most memorable characters is Atticus Finch, a lawyer who defends Tom Robinson, a black man falsely accused of raping a white woman. Atticus's decision to take on this [...]

Ethics and values are foundational principles that guide human behavior and shape the moral fabric of society. They define what is right and wrong, influence decision-making, and determine the standards by which individuals and [...]

Revenge is a complex and controversial topic that has been debated for centuries. Some argue that revenge is a natural human instinct, while others believe it is never justified. In this essay, we will explore the various [...]

Overview of the author's moral and ethical stance based on Levinas' theory Connection to biblical passage "Thou shalt not kill" Discussion of how scripture and Catholic teachings inform the author's conscience [...]

Related Topics

By clicking “Send”, you agree to our Terms of service and Privacy statement . We will occasionally send you account related emails.

Where do you want us to send this sample?

By clicking “Continue”, you agree to our terms of service and privacy policy.

Be careful. This essay is not unique

This essay was donated by a student and is likely to have been used and submitted before

Download this Sample

Free samples may contain mistakes and not unique parts

Sorry, we could not paraphrase this essay. Our professional writers can rewrite it and get you a unique paper.

Please check your inbox.

We can write you a custom essay that will follow your exact instructions and meet the deadlines. Let's fix your grades together!

Get Your Personalized Essay in 3 Hours or Less!

We use cookies to personalyze your web-site experience. By continuing we’ll assume you board with our cookie policy .

• Instructions Followed To The Letter
• Deadlines Met At Every Stage
• Unique And Plagiarism Free

• Share full article

Advertisement

Supported by

Guest Essay

Melinda French Gates: The Enemies of Progress Play Offense. I Want to Help Even the Match.

By Melinda French Gates

Ms. French Gates is a philanthropist and the founder of the charitable organization Pivotal.

Many years ago, I received this piece of advice: “Set your own agenda, or someone else will set it for you.” I’ve carried those words with me ever since.

That’s why, next week, I will leave the Bill & Melinda Gates Foundation , of which I was a co-founder almost 25 years ago, to open a new chapter in my philanthropy. To begin, I am announcing $1 billion in new spending over the next two years for people and organizations working on behalf of women and families around the world, including on reproductive rights in the United States.

In nearly 20 years as an advocate for women and girls, I have learned that there will always be people who say it’s not the right time to talk about gender equality. Not if you want to be relevant. Not if you want to be effective with world leaders (most of them men). The second the global agenda gets crowded, women and girls fall off.

It’s frustrating and shortsighted. Decades of research on economics , well-being and governance make it clear that investing in women and girls benefits everyone. We know that economies with women’s full participation have more room to grow. That women’s political participation is associated with decreased corruption. That peace agreements are more durable when women are involved in writing them. That reducing the time women spend in poor health could add as much as $1 trillion to the global economy by 2040.

And yet, around the world, women are seeing a tremendous upsurge in political violence and other threats to their safety, in conflict zones where rape is used as a tool of war, in Afghanistan where the Taliban takeover has erased 20 years of progress for women and girls, in many low-income countries where the number of acutely malnourished pregnant and breastfeeding women is soaring.

In the United States, maternal mortality rates continue to be unconscionable , with Black and Native American mothers at highest risk. Women in 14 states have lost the right to terminate a pregnancy under almost any circumstances. We remain the only advanced economy without any form of national paid family leave. And the number of teenage girls experiencing suicidal thoughts and persistent feelings of sadness and hopelessness is at a decade high.

Despite the pressing need, only about 2 percent of charitable giving in the United States goes to organizations focused on women and girls, and only about half a percentage point goes to organizations focused on women of color specifically.

When we allow this cause to go so chronically underfunded, we all pay the cost. As shocking as it is to contemplate, my 1-year-old granddaughter may grow up with fewer rights than I had.

Over the past few weeks, as part of the $1 billion in new funding I’m committing to these efforts, I have begun directing new grants through my organization, Pivotal, to groups working in the United States to protect the rights of women and advance their power and influence. These include the National Women’s Law Center, the National Domestic Workers Alliance and the Center for Reproductive Rights.

While I have long focused on improving contraceptive access overseas, in the post-Dobbs era, I now feel compelled to support reproductive rights here at home. For too long, a lack of money has forced organizations fighting for women's rights into a defensive posture while the enemies of progress play offense. I want to help even the match.

I’m also experimenting with novel tactics to bring a wider range of perspectives into philanthropy. Recently, I offered 12 people whose work I admire their own $20 million grant-making fund to distribute as he or she sees fit. That group — which includes the former prime minister of New Zealand, Jacinda Ardern, the athlete and maternal-health advocate Allyson Felix, and an Afghan champion of girls’ education, Shabana Basij-Rasikh — represents a wide range of expertise and experience. I’m eager to see the landscape of funding opportunities through their eyes, and the results their approaches unlock.

In the fall, I will introduce a $250 million initiative focused on improving the mental and physical health of women and girls globally. By issuing an open call to grass-roots organizations beyond the reach of major funders, I hope to lift up groups with personal connections to the issues they work on. People on the front lines should get the attention and investment they deserve, including from me.

As a young woman, I could never have imagined that one day I would be part of an effort like this. Because I have been given this extraordinary opportunity, I am determined to do everything I can to seize it and to set an agenda that helps other women and girls set theirs, too.

Melinda French Gates is a philanthropist and the founder of Pivotal, a charitable, investment and advocacy organization.

Source photographs by Bryan Bedder, filipfoto, and Westend61, via Getty Images.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

Follow the New York Times Opinion section on Facebook , Instagram , TikTok , WhatsApp , X and Threads .

• Newsletters
• Account Activating this button will toggle the display of additional content Account Sign out

Texas’ New Plan for Responding to the Horror of Its Abortion Ban: Blame Doctors

Last week, in a widely watched case, the Texas Supreme Court rejected the claims of Amanda Zurawski and her fellow plaintiffs that they had suffered injuries after being denied emergency access to abortion due to lack of clarity in the state’s abortion ban. Zurawski v. State of Texas has offered an important model for lawyers seeking to chip away at sweeping state bans and even eventually undermine Dobbs v. Jackson Women’s Health Organization , the 2022 decision that overturned Roe v. Wade . Now the state Supreme Court’s decision offers a preview of conservatives’ response to the medical tragedies that have been all too common after Dobbs : to blame physicians and hint that the life of the fetus ultimately counts as much as or more than that of the pregnant patient.

From the beginning, Zurawski had significance for patients outside Texas. Republicans have been increasingly hostile to abortion exceptions since 2022, demanding that sexual assault victims report to law enforcement when such exemptions do exist, dropping rape and incest exemptions altogether in many other states, and going so far as to require physicians to prove their innocence rather than necessitating that prosecutors prove their guilt . Nevertheless, exceptions are critical to the post- Dobbs regime: They are popular with voters and offer the hope—in reality the illusion—that abortion bans do not operate as harshly as we may expect.

The Zurawski litigation illuminated how exceptions fail patients in the real world. Physicians, afraid of harsh sentences up to life in prison, turn away even those they feel confident will qualify under exceptions. The exemptions, by their own terms, do not apply to any number of serious medical complications or fetal conditions incompatible with life. The Zurawski plaintiffs argued that Texas’ law should cover these circumstances and that if the opposite was true, it was unconstitutional.

Although this did not succeed in Texas, Zurawski created a blueprint for litigation in other states. It also kicked off a political nightmare for Republicans. Earlier this year, when Kate Cox, a Texas woman who learned that her fetus had trisomy 18, a condition that usually proves fatal within the first year, the state’s Supreme Court denied her petition for an abortion. In the aftermath, Republicans were flummoxed about how to respond.

The Texas Supreme Court offered Republicans one way to address the emergencies Dobbs has produced. The court began by limiting physicians’ discretion about when to intervene. The plaintiffs in Zurawski argued that physicians require protection when they believe in good faith that they need to protect the life or health of their patients. The court disagreed, suggesting that the standard was whether a reasonable physician would believe a particular procedure to be lifesaving.

On the surface, this doesn’t sound so bad. Who doesn’t want doctors to have to act reasonably? But determining how sick a patient must be is never straightforward—and is all the more complicated when the wrong answer will be determined after the fact by a prosecutor and the physicians with whom they consult, and when guessing wrong will result in a penalty of up to life in prison.

The court’s message was that physicians were the problem. They had misunderstood what the court portrayed as a perfectly clear law. Doctors were the ones who had refused to act reasonably and denied help to the patients that the court thought were deserving, like Amanda Zurawski herself. Texas had stressed the same argument throughout litigation in the case.

Republicans may well borrow the same strategy. If Americans don’t like the new reality that Dobbs has brought on, the party will argue, the GOP is not to blame. It is all the doctors’ fault. This allows conservatives to have it both ways: They frighten—or, in the case of Kate Cox’s doctor, block—physicians who might be willing to offer “reasonable” care, then blame the physicians for failing to care for their patients.

The court’s interpretation of the state constitution was just as revealing. The plaintiffs had argued that Texas’ ban discriminated on the basis of sex because only some persons are capable of pregnancy. The court rejected this argument, drawing both on Dobbs and on claims that have emerged in cases about transgender youth. Regulating abortion, the court reasoned, was no different from regulating gender-affirming care—it was a rule governing a specific medical procedure, not discrimination on the basis of sex.

What about the right to life? The Dobbs case held that U.S. citizens have 14 th Amendment rights only when that liberty was deeply rooted in history and tradition. Is there a federal or state right to access abortion to avoid death or serious bodily harm? As Reva Siegel and I have written elsewhere , there seems to be historical evidence to support this argument. And the political case for such a right is strong too. If courts say that there is no constitutional limit on state abortion bans—even if patients bleed to death—that will raise yet more grave questions about what Dobbs permits.

The Texas Supreme Court did not rule out the idea that the state constitution recognizes a right to life for the patient—or deny that high courts in other conservative states had identified a right to lifesaving abortions. But if there was such a right, the court noted, it would account for “the lives of pregnant women experiencing life-threatening complications while also valuing and protecting unborn life.” In other words, the court suggested, fetuses too have rights to life, and that means that the state has every right to deny treatment to pregnant patients in an effort to prioritize the well-being of unborn ones. Texas may not yet have written fetal personhood—the idea that fetuses are rights-holding people—into its constitutional law in clear terms, but the idea of fetal rights has already affected the lives of pregnant patients in the state.

Voters don’t seem to like the idea that fetal rights trump patients’ rights. The Texas Supreme Court has suggested that judges, not voters, may be the ones who decide the question.

But even in dictating what happens to pregnant patients across the state, other Republicans will join the court in pointing the finger at the doctors charged with implementing draconian bans. “The law entrusts physicians,” the court explained, “with the profound weight of the recommendation to end the life of a child.”

The U.S. Supreme Court is likely to make things worse for pregnant patients later this month, when it hands down a ruling on whether the federal Emergency Medical Treatment and Labor Act preempts an Idaho ban with very narrow emergency exceptions . None of this makes Zurawski a waste. It may not have changed the reality on the ground for patients in Texas, but it did tell an important story about the kind of America Dobbs has created—and it delivered voters a reminder that they still have the power to change it.

• Our Writers
• How to Order
• Assignment Writing Service
• Report Writing Service
• Buy Coursework
• Dissertation Writing Service
• Research Paper Writing Service
• All Essay Services
• Buy Research Paper
• Buy Term Paper
• Buy Dissertation
• Buy Case study
• Buy Presentation
• Buy Personal statement

Persuasive Essay Guide

Persuasive Essay About Abortion

Crafting a Convincing Persuasive Essay About Abortion

People also read

A Comprehensive Guide to Writing an Effective Persuasive Essay

200+ Persuasive Essay Topics to Help You Out

Learn How to Create a Persuasive Essay Outline

30+ Persuasive Essay Examples To Get You Started

Read Excellent Examples of Persuasive Essay About Gun Control

How to Write a Persuasive Essay About Covid19 | Examples & Tips

Learn to Write Persuasive Essay About Business With Examples and Tips

Check Out 12 Persuasive Essay About Online Education Examples

Persuasive Essay About Smoking - Making a Powerful Argument with Examples

Are you about to write a persuasive essay on abortion but wondering how to begin?

Writing an effective persuasive essay on the topic of abortion can be a difficult task for many students. 

It is important to understand both sides of the issue and form an argument based on facts and logical reasoning. This requires research and understanding, which takes time and effort.

In this blog, we will provide you with some easy steps to craft a persuasive essay about abortion that is compelling and convincing. Moreover, we have included some example essays and interesting facts to read and get inspired by. 

So let's start!

• 1. How To Write a Persuasive Essay About Abortion?
• 2. Persuasive Essay About Abortion Examples
• 3. Examples of Argumentative Essay About Abortion
• 4. Abortion Persuasive Essay Topics
• 5. Facts About Abortion You Need to Know

How To Write a Persuasive Essay About Abortion?

Abortion is a controversial topic, with people having differing points of view and opinions on the matter. There are those who oppose abortion, while some people endorse pro-choice arguments. 

It is also an emotionally charged subject, so you need to be extra careful when crafting your persuasive essay .

Before you start writing your persuasive essay, you need to understand the following steps.

Step 1: Choose Your Position

The first step to writing a persuasive essay on abortion is to decide your position. Do you support the practice or are you against it? You need to make sure that you have a clear opinion before you begin writing. 

Once you have decided, research and find evidence that supports your position. This will help strengthen your argument. 

Check out the video below to get more insights into this topic:

Step 2: Choose Your Audience

The next step is to decide who your audience will be. Will you write for pro-life or pro-choice individuals? Or both? 

Knowing who you are writing for will guide your writing and help you include the most relevant facts and information.

Paper Due? Why Suffer? That's our Job!

Step 3: Define Your Argument

Now that you have chosen your position and audience, it is time to craft your argument. 

Start by defining what you believe and why, making sure to use evidence to support your claims. You also need to consider the opposing arguments and come up with counter arguments. This helps make your essay more balanced and convincing.

Step 4: Format Your Essay

Once you have the argument ready, it is time to craft your persuasive essay. Follow a standard format for the essay, with an introduction, body paragraphs, and conclusion. 

Make sure that each paragraph is organized and flows smoothly. Use clear and concise language, getting straight to the point.

Step 5: Proofread and Edit

The last step in writing your persuasive essay is to make sure that you proofread and edit it carefully. Look for spelling, grammar, punctuation, or factual errors and correct them. This will help make your essay more professional and convincing.

These are the steps you need to follow when writing a persuasive essay on abortion. It is a good idea to read some examples before you start so you can know how they should be written.

Continue reading to find helpful examples.

Persuasive Essay About Abortion Examples

To help you get started, here are some example persuasive essays on abortion that may be useful for your own paper.

Short Persuasive Essay About Abortion

Persuasive Essay About No To Abortion

What Is Abortion? - Essay Example

Persuasive Speech on Abortion

Legal Abortion Persuasive Essay

Persuasive Essay About Abortion in the Philippines

Persuasive Essay about legalizing abortion

You can also read m ore persuasive essay examples to imp rove your persuasive skills.

Examples of Argumentative Essay About Abortion

An argumentative essay is a type of essay that presents both sides of an argument. These essays rely heavily on logic and evidence.

Here are some examples of argumentative essay with introduction, body and conclusion that you can use as a reference in writing your own argumentative essay. 

Abortion Persuasive Essay Introduction

Argumentative Essay About Abortion Conclusion

Argumentative Essay About Abortion Pdf

Argumentative Essay About Abortion in the Philippines

Argumentative Essay About Abortion - Introduction

Abortion Persuasive Essay Topics

If you are looking for some topics to write your persuasive essay on abortion, here are some examples:

• Should abortion be legal in the United States?
• Is it ethical to perform abortions, considering its pros and cons?
• What should be done to reduce the number of unwanted pregnancies that lead to abortions?
• Is there a connection between abortion and psychological trauma?
• What are the ethical implications of abortion on demand?
• How has the debate over abortion changed over time?
• Should there be legal restrictions on late-term abortions?
• Does gender play a role in how people view abortion rights?
• Is it possible to reduce poverty and unwanted pregnancies through better sex education?
• How is the anti-abortion point of view affected by religious beliefs and values? 

These are just some of the potential topics that you can use for your persuasive essay on abortion. Think carefully about the topic you want to write about and make sure it is something that interests you. 

Check out m ore persuasive essay topics that will help you explore other things that you can write about!

Tough Essay Due? Hire Tough Writers!

Facts About Abortion You Need to Know

Here are some facts about abortion that will help you formulate better arguments.

• According to the Guttmacher Institute , 1 in 4 pregnancies end in abortion.
• The majority of abortions are performed in the first trimester.
• Abortion is one of the safest medical procedures, with less than a 0.5% risk of major complications.
• In the United States, 14 states have laws that restrict or ban most forms of abortion after 20 weeks gestation.
• Seven out of 198 nations allow elective abortions after 20 weeks of pregnancy.
• In places where abortion is illegal, more women die during childbirth and due to complications resulting from pregnancy.
• A majority of pregnant women who opt for abortions do so for financial and social reasons.
• According to estimates, 56 million abortions occur annually.

In conclusion, these are some of the examples, steps, and topics that you can use to write a persuasive essay. Make sure to do your research thoroughly and back up your arguments with evidence. This will make your essay more professional and convincing. 

Need the services of a persuasive essay writing service ? We've got your back!

MyPerfectWords.com that provides help to students in the form of professionally written essays. Our persuasive essay writer can craft quality persuasive essays on any topic, including abortion. 

So, just ask our experts ' do my essay ' and get professional help.

Frequently Asked Questions

What should i talk about in an essay about abortion.

When writing an essay about abortion, it is important to cover all the aspects of the subject. This includes discussing both sides of the argument, providing facts and evidence to support your claims, and exploring potential solutions.

What is a good argument for abortion?

A good argument for abortion could be that it is a woman’s choice to choose whether or not to have an abortion. It is also important to consider the potential risks of carrying a pregnancy to term.

Write Essay Within 60 Seconds!

Caleb S. has been providing writing services for over five years and has a Masters degree from Oxford University. He is an expert in his craft and takes great pride in helping students achieve their academic goals. Caleb is a dedicated professional who always puts his clients first.

Paper Due? Why Suffer? That’s our Job!

Keep reading

• Use Messenger
• Send us an email

Essay on Abortion

An overview of abortion.

Abortion refers to the termination of a pregnancy by removing or expelling the fetus or embryo from the uterus before it is ready for birth. There are two major forms of abortion: spontaneous, which is often referred to as a miscarriage or the purposeful abortion, which is often induced abortion. The term abortion is commonly used to refer to the induced abortion, and this is the abortion, which has been filled with controversy. In the developed nations, induced abortions are the safest form of medical procedures in medicine if they are conducted under the local law. Thus, abortions are arguably the most common medical procedures in the United States annually. More than 40 percent of women confirm that they have terminated a pregnancy at least once in their reproductive life. Abortions are conducted by women from all forms of life; however, the typical woman who terminates her pregnancy may either be white, young, poor, unmarried, or over the age of 40 years (Berer, 2004). Therefore, citing the grounds on which abortions are conducted, there are numerous instances of unsafe abortions, which are conducted either by untrained persons or outside the medical profession.

In the United States and the world in general, abortion remains widespread. The United States Supreme Court ratified the legalization of abortion in an effort to make the procedure safer; this was done through the Roe v. Wade decision of 1973. However, abortions are the most risky procedures and are responsible for over 75 thousand maternal deaths and over 5 million disabilities annually. In the United States alone, between 20 and 30 million abortions are conducted annually, and out of this number, between 10 and 20 million abortions are performed in an unsafe manner (Berer, 2004). These illegal abortions are conducted in an unsafe manner; therefore, they contribute to 14 percent of all deaths or women; this arises mainly due to severe complications. This has led to increasing controversy citing the large numbers of abortions that are conducted annually. However, there is a hope since the improvement in the access and quality of medical services has reduced the incidence of abortion because of easier access of family planning education and the use of contraceptives (Jones, Darroch, Henshaw, 2002). However, the large numbers of abortions, more so, the illegal abortions continue to be alarming. Despite the introduction of more effective contraceptives, and their widespread availability, more than half of the pregnancies conceived in the United States are considered unplanned. Out of these pregnancies, half are aborted. Thus, abortion remains an issue in the society.

Is abortion a social issue?

Conflict theorists emphasize that coercion, change, domination, and conflict in society are inevitable. The conflict standpoint is based on the notion that the society is comprised of different groups who are in a constant struggle with one another for the access of scarce and valuable resources; these may either be money, prestige, power, or the authority to enforce one’s value on the society. The conflict theorists argue that a conflict exists in the society when a group of people who on believing that their interests are not being met, or that they are not receiving a fair share of the society’s resources, works to counter what they perceive as a disadvantage.

Prior to 1973, abortion was illegal in the United States, unless in situations where a woman’s health was at stake. If the doctor indicated, a woman had the option of choosing to terminate her pregnancy, and the doctor would carry out the abortion without any of them violating the law. However, in March 1970, Jane Roe, an unmarried woman from Dallas County, Texas, initiated a federal action against the county’s District Attorney. Roe sought a judgment that would declare the Texas criminal abortion legislation unconstitutional on their face, and seek an injunction, which would prevent the defendant from implementing the statutes.

Joe asserted that she was an unmarried, but pregnant lady; she wished to terminate her pregnancy by seeking the services of a professional and licensed practitioner under safe clinical environment. However, she noted that she was unable to contract the service since she was not able to get access to a legal abortion in Texas since her life was not under any form of threat from the pregnancy. Furthermore, Joe stated that she was not in a financial position to travel to another state to secure a safe abortion. She argued that the Texas statute was unconstitutional and vague, and was in contravention of her right of her right to privacy, which was guaranteed by the First, Fourth, Fifth, Ninth, and Fourteenth Amendments. Joe purported to sue on her behalf and on behalf of all other women who were in a similar situation to hers.

There are critical observations from Joe’s arguments; women who do not to have a baby should not be forced to have one. A pregnancy is a blessing if it is planned; however, a forced pregnancy is similar to any form of bodily invasion, and is abhorrence to the American values and traditions (Schwarz, 1990). Therefore, the United States constitution protects women from a forced pregnancy in a similar way that the constitution cannot force an American citizen to donate his or her bone marrow or to contribute a kidney to another. The Supreme Court looked into the facts and evidence of the case, and ruled that Roe was right, and her rights to privacy were violated; therefore, the Court decreed that all women had a right to a legal and safe abortion on demand. There was joy throughout America from the modern women; the ruling was seen as a massive step towards women’s rights. However, many years have passed since the Roe v. Wade, and abortion has remained one of the most contentious issues in the United States and the world. The ruling was of similar magnitude to the women’s suffrage, and almost as controversial. It has freed women from dependency, fear, threat of injury, and ill health; it has given women the power to shape their lives.

The social ramifications of the case and the social and moral ones have continued to affect the two sides of the abortion debate . The people who thought that the 7-2 majority ruling in favor of abortion were overly optimistic; abortion has become one of the most emotional, and controversial political debate. Prior to Roe v. wade ruling, women who had abortions risked suffering from pain, death, serious injury, prosecution, and sterility. Presently, abortion is safer, cheaper, and a more common phenomenon. The legalization of abortion has created other reasons for securing abortions; women are being coerced by their boyfriends and husbands who are unwilling to become fathers due to financial pressures, the panic of losing a job, quitting school, becoming homeless, or out of fear of being kicked out into the street (Schwarz, 1990). Abortion, which is based on this reasons often leads to Post Traumatic Stress Disorder; this occurs when a woman is not able to work through her emotional imbalances resulting from the trauma of an abortion. This can have severe results such as depression, eating disorders, and in severe cases, it can result in suicide. Women who secure an abortion out of their free will have no remorse and are happy that they made the choice; however, a number of women state that abortion affected them negatively.

Thus, it can be argued that abortion is a social issue . Based on the sociological imagination, people’s behaviors and attitudes should be perceived in the context of the social forces that shape the actions. Wright Mills developed the theory, and he emphasized that the changes in the society have a massive effect on our lives. Prior to 1970, legal abortions were unheard in the United States and people perceived abortion as a despicable act. However, once the law changed allowing doctors to conduct legal abortions, the people’s attitudes changed. To prove the fact that abortion is a social issue, we have to look at the components of a social issue. A social issue is an aspect of the society that concerns the people and would like it changed. It is comprised of two components: the objective condition, which is an aspect of the society that can be measured. The objective condition in the case of abortion entails the question whether abortions are legal, who obtains an abortion, and under what circumstances is an abortion secured (Henslin, 2008). The second component is the subjective condition; this is the concern that a significant number of people have about the objective condition. In the case of abortion, the subjective condition entails some people’s distress that a pregnant woman must carry the unwanted baby to full term (Henslin, 2008). It also includes the distress that a woman can terminate her pregnancy on demand. Thus, abortion is a social issue.

Controversy Surrounding Abortion

Abortion, human cloning, and evolution are all human issues that are very controversial. Christians’ believe in life after death. They also believe that life begins immediately at conception. Buddhists believe in reincarnation while atheists do not believe in God tend to be supporters of the right to choose. This means that perception and focus are the key issues when people from any faith choose to be supporters or opponents of any controversial issue like abortion. If an individual decides to focus on one part of the story, then definitely there will be a distorted representation of what they support. The result is that there will be people who are neutral or ignorant on abortion while others choose to support abortions as others oppose the act.

Groups’ strongly opposing or supporting abortions have completely varying opinions on the subject. It is vital to note that an individual may either be a strong supporter or oppose the act since any compromise means a choice of life over death and vice versa. This strange facet of abortion makes it a very controversial act and subject because both supporters and opponents meet nowhere. Personal faiths through religion make them view the subject differently. Some believe that a woman has the right to make an absolute choice, thus; the right to choose is more prevalent to those supporting abortion. However, for the opponents, they support the constitutional and human right to life. It is vital to note that both pro-choice and pro-life groups rely on the constitution like the Fourteenth Amendment, human rights, and scientific facts (Knapp, 2001).

In the 1973 case of Roe v. Wade, the U.S Supreme court ruled that the woman has the right to make a choice giving support to the pro-choice groups that support abortion. This meant that, the fetus has no rights and is at the indispensable mercy of the mother. The rights of the state and the fetus cannot overrule the choice that the mother has made. In another case in 1992, Roe in Planned Parenthood v. Casey, the US Supreme Court maintained that a woman has the power and the right to commit an abortion (Knapp, 2001).

Pro-choice supporters argue that those campaigning against abortion consume a lot of resources and effort. They feel that there are so many women who are living in total paucity and misery because they were coerced to deliver children who are unwanted. The resources spent by the anti-abortion campaigns can be used to support the social welfare of those women and relive them out of their misery. According to Knapp (2001), every day, almost 50,000 children die because of lack of food, medicine, shelter, and clothing. Today, the population stands at 7 billion meaning that there is an impending disaster because the resource is continually being depleted. Any unwanted baby may adversely affect the natural balance of resources to persons. It is estimated that, the development around the globe will have to slow down because there will be more mouths to feed than before.

Pro-choice supporters believe that every human being has the right to political, sexual, and reproductive freedom. Pro-life supporters should note that they are supporting and protecting their religious freedoms. It is important to note that the church and the state have to separate. This implies that any anti-abortion law should be critically re-examined since it may merge the church and state. This is not legal because people make a personal choice as to the faith of affiliation while the state is supposed to respect everyone irrespective of faith.

In the Roe v. Casey ruling of 1992, the woman has the absolute choice to dictate what she wants to do with her body. Pro-choice supporters argue that this makes a woman to be a lesser being than the fetus she is carrying. According to the American Civil Liberties Union (ACLU), “forcing a woman to carry an unwanted fetus is like forcing a person to be cloned in order to save another life with the extra organs.” This is completely wrong considering that one’s body will be used without her consent to aid the prosperity of another life. The rights of a woman exceed those of the fetus she is carrying because the woman is independent and is a social entity, unlike the fetus. For many centuries, many women have been rated as having unequal rights to men. Abortion is the only avenue that can make them regain a socio-economic status equal to that of men. Women can access better education, housing, and jobs only if they are in a position of controlling the sexual and reproductive rights.

Debate Surrounding Abortion

Legal Debate

Pro-choice advocates argue that abortion should be legalized to reduce the chances of unsafe abortions. A study carried out by the World Health Organization showed that most of the unsafe abortions occur in countries where abortion is illegal (Knapp, 2001). In countries like the Republic of Ireland, abortion is illegal, in the United States of America; abortion is legal while, in Canada, it can be performed upon demand, or consent.

Ethical Debate

An ethical analysis on abortion seeks to establish what is right or wrong about abortion. This ethical debate sheds light over the validity of the rights of the fetus versus those of the mother. In terms of personhood, a fetus is not aware of self, does not think, and is therefore, dependent on the mother. This means that the mother has an absolute right on choice over what to with the fetus. At certain epochs, pro-life supporters have supported selective abortion. This means that they support abortion if a fetus poses a danger to the mother, if the baby was conceived without the mother’s consent like in cases of rape, contraceptive failure, or incest. The other case is where the fetus may be having severe deformities due to diseases, mental of physical defects. Other cases happen when a mother involuntarily aborts because of starvation or malnutrition. This sparks a debate within the pro-life supporters who are assumed the “undecided lot.”

On the contrary, pro-life supporters assume that fetuses are human, and they are subjected to a lot of pain in the event of an abortion. It is wrong to assume that a fetus is not a human being since it does not talk, or is not a social entity. Pro-life supporters also argue that a fetus is a potential life and any threat to it is breaking a fundamental right to life that is entrenched in almost all constitutions across the world. Pro-choice supporters posit that abortion is an act of unjust discrimination to the unborn and that this acts deprives them to the access to a valuable future.

In conclusion, prior to 1973, abortion was illegal and was only applicable legally as an option only when the mother’s life was in danger. However, the Supreme Court’s ruling on Roe v. Wade case changed all this; women perceived the ruling as a liberating to them. However, the legalization of abortion came with its own controversies, and it has even been labeled a social problem in the United States and the world over. However, it is critical to note that abortion or no abortion, persons have to take a keen look at the problems facing the society today and make a responsible choice. Today, we are 7 billion people, resources are overstretched, the world economy is weakening, and nations are growing unstable. Any person who thinks of bringing an unwanted child into the world without careful consideration should be aware of the consequences of the hard life. Every nation has a national budget in order to account and cater for everyone. On the same note, every parent or teenager should have a responsible plan for life. If every act is unaccounted for, then the number of children losing their lives due to paucity is set to increase tremendously. It is good to care for what we can see instead of spending valuable resources campaigning for fetuses that are yet to claim an entity in the social arena.

Berer, M. (2004). National laws and unsafe abortion: the parameters of change. Reproductive Health Matters, 12 (24): 1–8.

Henslin, J. M. (2008). Social Problems: A Down-To-Earth Approach . (8 ed.). New York, NY: Longman Publishers.

Jones, R. K., Darroch, J. E., Henshaw, S. K. (2002). Contraceptive Use among U.S. Women Having Abortions in 2000-2001. Perspectives on Sexual and Reproductive Health, 34 (6): 294–303.

Knapp, L. (2001). Controversy: The Abortion Controversy . Michigan: Greenhaven Press.

Schwarz, S. D. (1990). The Moral Question of Abortion . Chicago: Loyola University Press.

Danger of Drug Addiction

Drug addiction is a serious problem in modern society that affects somehow every nation and every family. Every drug abuse results in a great number of serious illnesses and lethal outcomes. That is why, before you start experimenting with these poison substances think over the danger of drug addiction. This is a very old story…

Paper Chromatography Experiment Report

Introduction This is just one of the simple ways of identifying unknown compounds and separate mixtures. It is a separation technique that works based on the compound interactions as those compounds tend to move within a supporting medium. The compounds interact in two phases which are the mobile and stationary phase. The technique helps in…

Euthanasia: a Right to Die or a Right to Kill?

Wikipedia gives the following definition of euthanasia: “It is a practice of ending life in a manner which relieves pain and suffering”. And there is one more detailed definition from Committee on Medical Ethics: “Euthanasia is a deliberate intervention undertaken with the intention of ending life to relieve intractable suffering”. Bonuses and Discounts give up…

Our Services

• Academic ghostwriting
• Admission essay help
• Article writing
• Assignment writing
• College paper writing
• Coursework writing
• Dissertation writing
• Homework writing
• Online classes
• Personal statement writing
• Report writing
• Research paper writing
• Speech writing
• Term paper writing
• Writing tips
• Write my paper

Rep. Byron Donalds says Black families were stronger during Jim Crow era

The comments from the Florida Republican, who is Black, drew a sharp rebuke from House Minority Leader Hakeem Jeffries (D-N.Y.) and other Democrats.

Rep. Byron Donalds (R-Fla.), campaigning Tuesday for former president Donald Trump , argued Black families were stronger during the Jim Crow era, drawing vocal condemnation from Democrats including House Minority Leader Hakeem Jeffries (D-N.Y.).

Donalds, who has been mentioned as a possible running mate for Trump, made the comments at a Trump campaign event in Philadelphia with Rep. Wesley Hunt (R-Tex.) that was aimed at Black voters. Donalds and Hunt are both Black.

The Philadelphia Inquirer quoted Donalds as saying he was beginning to see the “reinvigoration of Black family” in America and suggesting that Black family values had been in decline since Black voters embraced the Democratic Party after the civil rights movement.

“You see, during Jim Crow, the Black family was together. During Jim Crow, more Black people were not just conservative — Black people have always been conservative-minded — but more Black people voted conservatively,” Donalds said. “And then HEW, Lyndon Johnson — you go down that road, and now we are where we are.”

2024 presidential election

Donalds appeared to refer to the former federal Department of Health, Education and Welfare. President Johnson’s Great Society programs in the 1960s endeavored to end poverty and racial injustice in America.

Jeffries, who also is Black, gave a House floor speech Wednesday that castigated Donalds over the comments.

“It has come to my attention that a so-called leader has made the factually inaccurate statement that Black folks were better off during Jim Crow,” Jeffries said. “That’s an outlandish, outrageous and out-of-pocket observation.”

President Biden’s reelection campaign also drew attention to Donalds’s comments in an X post , posting his quote and saying, “Trump VP contender Byron Donalds claims life was better for Black Americans during Jim Crow.”

“Donald Trump spent his adult life, and then his presidency undermining the progress Black communities fought so hard for,” Biden campaign spokesperson Sarafina Chitika said in a statement, adding that it therefore made sense that Trump’s version of Black outreach was “promising to take America back to Jim Crow.”

Donalds responded to Democratic criticism of his remarks in a video posted to X . He told viewers that Biden’s reelection campaign is “lying to you once again and they’re gaslighting” by claiming Donalds said Black people did better under Jim Crow laws.

“What I said was, is that you had more Black families under Jim Crow, and it was the Democrat policies — under HEW, under the welfare state — that did help to destroy the Black family,” Donalds said.

The controversy comes as Trump works to chip away at Biden’s large advantage with Black voters, long a key voting bloc in Democratic victories. Trump held a Bronx rally last month where he said African Americans have been “getting slaughtered” by Biden’s policies. Donalds helped introduce Trump at the rally.

Biden and Vice President Harris, who is Black, visited Philadelphia last week to launch a Black voter coalition and paint Trump as a threat to the Black community.

“Donald Trump is pandering and peddling lies and stereotypes for your votes so he can win for himself, not for you,” Biden said.

A Washington Post-Ipsos poll from April found 74 percent of Black registered voters said they will “definitely” or “probably” vote for Biden, while 14 percent said the same for Trump. Trump won 12 percent of Black voters in the 2020 presidential election, according to exit polls .

Trump has a long history of antagonistic comments toward the Black community that Biden’s campaign has highlighted as Trump makes more of an effort to peel off Black voters. Last week, a former producer on “The Apprentice” — the TV show that made Trump famous — wrote in an essay that Trump used a racist slur while discussing a finalist on the show’s first season, which aired in 2004. Trump’s campaign called the account “completely fabricated.”

During the Jim Crow era, Black Americans faced state and local laws that made racial discrimination legal.

Jeffries listed several reasons he said Black people were not better off during the period, saying they could be lynched, denied a high-quality education and denied the right to vote — all “without consequence.”

“How dare you make such an ignorant observation?” Jeffries said of Donalds. “You better check yourself before you wreck yourself.”

Donalds received support on X from Hunt , the other Black GOP congressman who headlined the Trump campaign event in Philadelphia. Hunt wrote that he was present and that “I can tell you for a fact what Byron and I were talking about is the Democrat party breaking up two parent black families with their failed policies.”