“Recognizing Conscience in Abortion Provision” is the title of a recent article in The NEW ENGLAND JOURNAL of MEDICINE, by Lisa Harris, M.D., Ph.D. ,  of the University of Michigan Hospitals, Department of Ob-Gyn, and Planned Parenthood of Mid- and South Michigan.1 The author shows that both sides of the abortion debate appeal to a  moral standard to justify the personal and legal positions to which they adhere. If we know what these standards are, we can decide if we want to oppose or support legal legislation that is based on such reasoning. The Republican Party’s 2012 position is, “Faithful to the ‘self-evident’ truths enshrined in the Declaration of Independence we assert the sanctity of human life and assert that the unborn child has a fundamental individual right to life…”

IPPA encourages people to refer not only to moral standards or moral beliefs by referring to which they support their positions, but also to go on and to identify the contents of those beliefs. We have been disappointed that in the past many pundits and public figures have justified their positions by appealing to moral mandates and “ethics” without giving them any content. During the 2008 U.S. Presidential campaigns, Hillary Clinton said that “There is a moral imperative to ensure quality affordable health care is available to all Americans.  President Obama’s first economic advisor, Lawrence Summers, said the same thing. The columnist Thomas Friedman said, “We need to re-establish the core balance between our markets, ethics, and regulations.” And the economist and columnist Paul Krugman said that helping the needy through health benefits “is the morally right thing to do; it’s also a far more effective form of economic stimulus than cutting the capital gains tax.” But none of these figures went  on to say what the relevant moral principles are.

To refer at least to the basic parts of one’s beliefs is to strengthen a position; it does the same for an opponent when she does it. It allows the reader or listener to look at a person’s guiding principles, for consistency, relevant co-existing values cited or just implicit, and coherence of the guidelines with human experience.  Do the guidelines appeal to fundamentals daily shared by many humans, or do they require beliefs exclusive to one group of people? Are the guidelines workable in the sense that they do not put unreasonable demands on a person’s basic motives (two of which are, to preserve her own life and to avoid long term suffering)?

In Dr. Harris’s articles, those health workers opposed to abortion were supported legally by the Church Amendment of 1973, enacted after Roe v. Wade. It states that a health worker may appeal to “his [sic] religious beliefs or moral convictions” in refusing to perform or assist in abortion procedures” and could not be punished for the stance. The Bush administration extended the protection even to workers indirectly connected with the procedure. The Obama administration revoked the extension of the rule. But the article does not say what the content of those moral convictions are. I will return to this.

I was particularly pleased to find that in the case of providers, Dr. Harris does not avoid identifying the specifics of their moral reasons for doing the procedure.  Even before Roe, doctors treated safe abortion as lifesaving, aware that unskilled procedures often led to the death of the pregnant woman. Even working legally, abortion providers still face harassment and threats. But they consider themselves motivated in part by “reasons of conscience”. She describes some of their principles  as follows (my italics): “They see women’s reproductive autonomy as the linchpin of full personhood and self-determination, or they believe that women themselves best understand the life contexts in which childbearing decisions are made, or they value health of a woman more than the potential life of a fetus, among other reasons.”

IPPA treats the nurturance of health and psychological well-being as a fundamental moral principle to which each person can appeal. This is demanded by our bodies, which expresses health in joy and suffering.  Thus we regard   some of the providers’ reasons as empirically confirmable bases for a justifiable choice. The pregnant woman exercises choice because she is the one who experiences the suffering and joy of child birth along with the knowledge of the risks to her own health, and so her judgments trump those of outsiders. As for the value judgment of the greater worth of the mother’s life over that of the fetus, or the other way around, there is no general agreement on the facts cited as to when human life begins.

In the absence of any reference within the article to the arguments against abortion, we are left on our own to find what beliefs or reasons of might be offered. This absence of content for the opponents’ position is a weakness in an otherwise fine essay. Although many religious groups oppose abortion, I will give one example. The Roman Catholic Church bases its doctrine on natural law and the word of God as interpreted by the Vatican. The life which they seek to protect is that of the fetus. Human life, they say, begins when the woman’s egg is fertilized by a male sperm. In the words of Pope John Paul II, “Frequently man lives as if God did not exist, and even puts himself in God’s place…He claims for himself the Creator’s right to interfere  in the mystery of human life. Rejecting divine law and moral principles, he openly attacks the family.” (August, 2002, Poland) The Code of Canon Law (1983) states, “A person who actually procures an abortion incurs automatic excommunication.” (Canon 1398) Note that this “punishment” implicitly elevates the killing of a fetus into an evil above all other forms of murder, including genocide.

Now that parts of the anti-abortion position are before us, I can respond to them. The biggest weakness is that none of them have anything to do with the actual human experience of the pregnant woman who makes the choice, which consideration is basic to the abortion provider’s stance. Second, they rely on non-empirical entities called natural law and divine law, in the content of which only members of their own church may believe. So on this point, the persuasiveness is weak. Third, there is no reference to other values in which the Vatican also believes. One is compassion, applied to the pregnant woman, who does not want the pregnancy. Medicine regularly “interferes” with the mystery of human life when a patient seeks treatment for an ailment.  Another value, affirmed by the Vatican, is the strength of the family, which may be financially weakened by an unwanted child. Fourth, providers of abortion would probably say that human life begins when the fetus has some cognitive awareness in brain function, not at insemination. But here, the choice of a starting point for human life is optional, and there is no clear true one.

Finally, there are inconsistencies in the Vatican’s use of the sanction of excommunication, leaving it open to such critics as Sam Harris, who says,

Even among non-Catholics, its doctrines are widely associated with the concepts of “morality” and “human values.” However, the Vatican is an organization that excommunicates women for attempting to become priests but does not excommunicate male priests for raping children. It excommunicates doctors who perform abortions to save a mother’s life—even if the mother is a nine year old girl raped by her stepfather and pregnant with twins—but did not excommunicate a single member of the Third Reich for committing genocide. Are we really obliged to consider such a diabolical inversion of priorities to be evidence of an alternative “moral” framework?2

To be persuasive, moral frameworks must be specific, and consistent with the range and realities of human experience.

  1. Lisa Harris, M.D. “Recognizing Conscience in Abortion Provision,” The New England Journal of Medicine vol. 367.11, Sept. 13, 2012, 981-985.
  2. Sam Harris, The Moral Landscape (New York: Free Press, 2010) 35.

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