December 14, 2009

Follow-up: what about "therapeutic abortions"?

David Kjos made a really good comment on my previous post on abortion arguments on Twitter. Since Haloscan will be going bye-bye in a couple of weeks, I thought it appropriate to simply copy the comment here and reply rather than do so in the comments. (I have also decided to temporarily shut down the commenting feature until something more permanent than Haloscan can be implemented, which unfortunately automatically gives me the last word, so I hope David doesn't mind, at least for awhile.)

He writes:

This is off-topic, but ...

On the "therapeutic abortion":

I can agree if certain death for both mother and child is imminent. But I don't believe abortion to save the life of the mother should be a foregone conclusion, or considered self-defense.

First, it's not self defense because the child is not assaulting the mother.

Second, what mother or father would not -- or should not -- stand between an armed assailant and their child, or risk their lives in any number of ways, to save that child? We naturally expect that kind of self sacrifice. How is risking one's life in order to carry a child to term different?

Back on-topic, you are so right about the absurdity of the extreme case argument. What if a[n unemployed] green man from Mars with no medical insurance and no family or church to call upon suddenly needs a gizzard transplant? Am I allowed to rob a bank to finance the operation?

Thanks for the question.

I suppose that the textbook case of a life-threatening pregnancy is an ectopic pregnancy, in which a zygote implants somewhere other than the uterine lining, typically the Fallopian tube. Many ectopic pregnancies will abort spontaneously, but about half do not. Left untreated, a developing fetus will eventually grow to the point that it causes serious tissue damage or hemorrhaging that can lead to the death of the mother - and therefore also of the unborn child, who is almost always non-viable at this stage of gestation. Recent surgeries have successfully saved the life of both mother and child, but my arguments here are based on the past situation where no such surgery was available (and my assumption that such procedures are still somewhat rare and experimental).

A therapeutic abortion is not "self-defense" in the same sense as, say, shooting an armed robber or a rabid animal that is attacking you. Rather, it's more like defending yourself against a life-threatening cancer. While I don't regard pregnancy like a disease by any stretch, the situations are comparable in that nothing is attacking the mother with malicious intent, but an otherwise normal biological function has gone very wrong and now threatens her life.

So the situation that I was considering when I wrote my previous post was not merely one in which the mother is risking her health by carrying the child to term - rather, it is one in which (as David says) death is virtually imminent and drastic measures must be taken to prevent it. Not doing so isn't a mere risk, nor is it analogous to a parent risking his or her own life to shield a child from harm; it's tantamount to suicide.

Suppose a patient went into a surgeon's office and requested the amputation of her leg above the knee. No medical condition required the amputation; the patient simply had a sexual fetish associated with amputees. If the doctor carried out the surgery, it would be a mutilation and he would be guilty of medical malpractice. (In fact, the desire to become an amputee is considered a mental illness called Bodily Integrity Identity Disorder.) On the other hand, if the same woman had cancer, and the only way to stop the disease were to amputate her leg above the knee, the same procedure (while still disfiguring) is now life-saving surgery.

And this is how I see abortion in the case of an ectopic pregnancy, when no other life-saving measure is possible that would preserve the life of both mother and child. Obviously I don't deny that the unborn child is a human being deserving of life, or that therapeutic abortion is other than a necessary evil. It's just that in some cases, drastic measures are required to save one life instead of losing two. The intent is not to kill, but to save life, albeit with "collateral damage."

Again, let me stress one more time: such conditions are very rare. And just because some abortions may be medically justifiable in the face of a life-threatening pregnancy, that does not mean we can morally justify millions of abortions that have been carried out for no medically necessary reason.