Tuesday, May 20, 2008

Dipping a toe into the abortion question

This whole abortion debate has become very odd. Apparently it seems that if you support reducing the time limit on abortion from 24 to say 22 or 20, you are, invariably, just a secret anti-abortionist, in bed with anti-abortionists, or worse still are not being honest with scientific knowledge or what the 'medical profession' says. Oh yes, you're probably a God Botherer too.

Now you may be wondering why I chose to use quotations around 'medical profession' and there is a simple reason to be honest. The phrase, just like the language that is used when talking about climate change, is being thrown out in this argument with the subtle subtext that there is that mythical type of knowledge called 'scientific consensus'. If you listen or read the things being said about abortion you will always see the phrase trotted out as if its presence alone can make an argument right.

The problem is, having read too many articles in the last few days on this subject, what I can see is not the overwhelming view of the 'medical profession' being in agreement. There have been things said and things written which do not all sing from the same hymn sheet. As such whilst one should read and assess what is being said, it would be unwise to stand up and say the medical profession says X, when evidently they don't.

Of course equally I'm not saying either side is right per se. Just that to pretend there is consensus is to misrepresent the reality of the diversity of view amongst doctors and their peers. The question we should be asking therefore is why the differences? Can it all really be explained away by the easy and lazy ad hominen arguments of 'pro-life loony', 'religious nutjob', or 'secret anti-abortion agenda'? I don't think so, because there are some of us in the middle who actually have views that are based on the ethical questions of 'how do we define viable?' and 'what rules should apply to our actions when we have defined what viable means?'.

Laying my cards on the table I should say that I have always been rather proud of the settlement that Britain achieved on abortion. Rather than muddying the waters like Roe vs Wade does in the US, the matter was resolved by agreeing that abortion should be illegal if the child can survive outside of the womb (as well as some other exceptional circumstances of course). The argument today for me as it stands is about that question, not about whether some of the people supporting a reduction in the time limit secretly want to end it altogether.

We have heard over the past few days, from the likes of Dawn Primarolo and assorted commentators, that the 'survival rate' for a child at 23, 22 or 21 weeks has not changed since 1990 when the time limit was reduced from 28 weeks. In today's Times David Aaronvitch argues that if 'viability' has not changed then people supporting a reduction just "don't like abortion". I'm not sure anyone could be more wrong if they tried frankly, because there is a slightly more sophisticated way of looking at this.

The way to look at this is best illustrated, ironically enough, by an anti-death penalty argument. Given that the most ardent of pro-choicers (who incidentally wind me up just as much as loopy pro-lifers) tend to be ardent anti-death penalty advocates as well, so it seemed rather fitting. You see, when it comes to capital punishment, the miscarriage of justice, the mistake, the hanging of just one innocent man is a powerful argument against its presence. The argument is made that the risk of that happening, and we know it has, is to great for the state to commit homicide.

Now take that principle and think about viability in conjunction the 'survival rate' of premature babies. Surely, unless the rate is zero, then that is evidence that a foetus can be viable. Don't get me wrong, that doesn't mean that all are viable, after all, not all babies are even viable when they're born normally, although the majority are of course. The thing is, if we take the principle that one mistake in the matter of capital punishment is a risk to far, then should we not be applying that same principle to how we define the very notion of 'viability'?

If just one premature foetus survives at 21 weeks, then is it not correct to say that a foetus can be viable at 21 weeks and as such the state cannot take the risk of making a mistake like it does with its fully developed adult population when it comes to criminal justice? You don't have to be anti-abortion or a pious religious nutjob to support reducing the limit at all. After all, if it is better to let a guilty man go free than to execute an innocent man, shouldn't we take the same view on the matter of whether a foetus is viable?

45 comments:

haddock said...

just "don't like abortion" is I think a reasonable position to take, I just don't like lots of things and like others. Often I cannot say just why, it's called choice, intuition, instinct; call it whatever.
I note that many MPs have talked about their views, in an ideal world they would poll the views of their constituents and vote according to the voters views..... not their own politically expedient view.
Your argument regarding hanging is a good one, I've not heard that before.

Anonymous said...

But the death penalty is the state acting to end a life. Abortion legislation is the state regulating someone else's decision (whether or not it is ending a life depends on one's perspective on philosophical issues well beyond those of viability - it cannot simply be disentangled in that way). It is entirely plausible to differentiate between the restraints placed upon state actions and those placed upon individual choice.

The argument is of course somewhat muddied by the role of the NHS as the main provider of abortion in the UK - just as debates about self-responsibility and government intervention on obesity, long-term health risks from alcohol and the like are similarly muddled by the same institution.

silas said...

Without wishing to sound like a eugenicist, doesn't the quality of life of the baby come into it?

While I'm sure that there are cases where some foetuses have survived at 21 weeks, what physical state are they in? What quality of life are they going to have?

I'm in favour of a living will agreement; and if I am diagnosed with a terminal illness, or something like Alzheimer's, I hope that my partner will kill me in a manner she sees fit as and when it becomes obvious my quality of life has deteriorated to such an extent that I am no longer enjoying it.

If I was able, I would have liked this option from my initial conception. If I had been - as my mother, a midwife, used to say - "born too early" and not fully formed (and you will have seen from the range of research that a large percentage of babies who went less than 24 weeks have both physical and mental problems which can require life long care) then I would have preferred to be terminated.

If a foetus can survive outside the womb without round the clock intensive care, then it's viable. At the present time, I have not seen any evidence that shows any foetus born under 23 weeks can survive without spending time in the ICU - often for periods as long as they would have been in the womb for full term pregnancy.

Again, I don't wish to sound like a eugenicist, but I am aware that it does sound suspiciously like it.

Blue Eyes said...

Dizzy this is exactly my take on the issue. I can see why some people are totally against abortion, but I can't understand why anyone would want to risk aborting a foetus that *could* be viable under the right conditions.

Tony Kennick said...

"the matter was resolved by agreeing that abortion should be legal if the child can survive outside of the womb"

I'm not sure this retains your intended meaning.

silas said...

Oh, and with regard to the more fanatical pro-lifers in the US, do you not find it shocking that there are some who would kill doctors and nurses in abortion clinics, yet still claim to be pro-life?

The Conservative Right have claimed that they are only pro-life WRT "innocent" lives. Foetuses are seen as innocent, people who have committed crimes (or "crimes" against their religious view that abortion is evil) are not innocent, so deserve their death.

There is even a Roman Catholic viewpoint which vehemently disagrees with the views put forward by Pope John Paul II and Mother Teresa that capital punishment is wrong and should be avoided wherever possible. Yep, God's representative on Earth is wrong, not them.

http://www.roman-catholic.com/Roman/Articles/CapitalPunishment.htm

Anonymous said...

'the matter was resolved by agreeing that abortion should be legal if the child can survive outside of the womb'

Good article, Dizzy. Just wanted to clarify the above sentence - did you mean 'illegal' or 'cannot survive'? It sounds like you're saying the argument was settled by allowing abortion for babies that can survive, rather than those that cannot.

If your original wording is correct, fine. I must disagree with you. But I just wanted to make sure I understood your argument correctly, not trying to be picky with your writing.

This is a difficult and complex issue and anyone who takes time to put forth their views should be applauded.

Ray Griffin, Coventry

Ann said...

This has to be one of the most sensible articles on abortion I have ever read. Unlike the tosh written by Ashley and Aaronovitch.
I too agree that the idea of viability is crucial, but there are still certain occasions when a late abortion would be the lesser of two evils.
After a child was raped for example.
However, what the pro-choice loonies fail to recognise is the psychological damage that some women suffer by having an abortion. As a female ex-university lecturer I often used to have to deal with the fall-out.
This is increased by lateness.
In general I am pro-choice - before 20 weeks - because it is the lesser of two evils - a miserable life for both the woman and child.
But we ought to recognise that abortion is a lousy form of contraception, and through education and counselling we ought to be doing our best to ensure that the number of abortions decreases, to prevent the guilt and psychological problems I used to see in my students who had had abortions.

Anonymous said...

Dizzy, is there a typo here?

"Rather than muddying the waters like Roe vs Wade does in the US, the matter was resolved by agreeing that abortion should be legal if the child can survive outside of the womb (as well as some other exceptional circumstances of course)."

Should "can" be "cannot"?

Oh, and on your criminal law analogy, the English principle was always "better 10 guilty men go free than 1 innocent is wrongly punished". Only 10. That suggests that we'd allow abortion provided the survival rate is below 10%, rather than needing it to get down to zero.

dizzy said...

fixed the confusing word. typo on train

Anonymous said...

Late abortion has always seemed "out of sight out of mind" to me.

Why it is legal to kill a fully formed child in the womb but not out of the womb has never been fully explained.

whatever said...

I was unfortunate enough to read David Aaronovitch's article with my early morning tea... which I prefer to drink rather than snort down my nose. Typical liberal "any opinion is fine as long as it's mine".

He completely ignores that the majority opinion in this country, particularly among women, is for a reduction of the abortion limit. LOL - what does the opinion of the citizenry matter!

I don't have any particular axe to grind, I had an abortion myself 40 years ago. I haven't had any traumatic reaction, altho I did once wonder whether the long subsequent years without conceiving were just punishment. In the event, some 13 married years later I conceived the daughter who is the light of my life, but I have never found the courage to tell her I aborted her prior sibling. She would be horrified, she couldn't do it herself, and that is a modern young woman who professes no religion.

You don't have to be a God-botherer to value life.

On the other hand, I have wrestled in my mind to reach any conclusion on this. Could I be responsible for telling a woman she must carry to term a baby she doesn't want? I don't think so.

Would I support any move to return to the morality of a bygone era? Absolutely. I had my abortion because I made ONE departure from the mores of the day, and the stigma would have been too much to live with. Right or wrong, that kept most of us on the straight & narrow.

Now, anything goes... sleep around, conceive for a council house, dump your rabbits on the State. And if you don't fancy that, just kill them in the womb. And all encouraged by NuLabour and their cheerleader for irresponsibility, Harriet Harman.

Sorry if I sound angry. I AM angry.

Anonymous said...

I have no problem with the reduction in time in theory. Its just that considering it took me 3 weeks to get a doctor's appointment last time I am not hopeful if I become pregnant that I could be seen in time to meet the new deadline. That and the systemic organ failure that tends to haunt the premature children later in life.

Alex said...

Spot on, dizzy. The sensible point for the limit is not at the point where viability is marginal, but where it is certain that any aborted foetus would not be viable.

I would add that on the one hand the 'medical profession' extols the potential life saving benefits of hybrid embryos, but doesn't seem to be too keen on the idea that more technology might be used to improve the viability of premature foetuses.

Thomas B said...

INterestingly, I believe your analogy between the death penalty and the benefit of the doubt is taken up by John Paul II in his encyclical Evangelium Vitae - namely that although we cannot be sure when ensoulment takes place, we have to give the benefit of the doubt to the unborn child/foetus.

Anonymous said...

Whether or not it is possible for a foetus to survive outside the womb at 21 weeks is surely irrelevant?

Picture a scenario when a woman discovers she is pregnant. Say it is unwanted. Now imagine this discovery is made 18 weeks into the pregnancy. Should we tell her that she has realistically about one week to make possibly the biggest decision of her life, or should we give her enough time to get over the shock, consider her options, speak to friends and relatives, and make a decision she won't regret?

That's the issue here - arguing over 20 or 24 weeks is simply absurd, but not surprising when you consider how many MPs have science degrees.

dizzy said...

How does a woman go 4.5 months without a period and not know she is pregnant?

Dave said...

There ain't no right way to do a wrong thing.
Pro-lifers who reason that it's OK to murder doctors who carry out abortions should remeber that.
Also everyone who thinks that a 20 week old foetus is only a bunch of cells watch a video of an abortion.

It's wrong. But if we call the unborn child "it" or a foetus then it makes it OK.
I didn't think I had an opinion on this but as I get older I realise that I can't be neutral.
It's wrong.
But sometimes we have to do things that we know are wrong, and hope that we can live with the consequences.
As in most areas of life and politics, the people who make the decisions don't have to live with the consequences.

Pete Chown said...

Suppose it became possible to "grow" a baby from eggs and sperm, entirely in the laboratory. At this point, embryos would be viable at any stage of their development, so would you then be completely opposed to abortion?

When setting the abortion time limit, I think you need to ask a different and harder question: when does a baby acquire its distinct humanity? To use a religious metaphor, we might imagine God placing a soul in the embryo at a certain stage in its development.

It seems to me that a very early stage embryo has the potential to become a human being, but it is not there yet. It has no nervous system therefore presumably no thoughts, so abortion is reasonable. On the other hand, when a baby is born, it is obviously capable of pleasure, pain and other emotions. This tells me that there must be a time limit for abortions, but without giving much of a clue what it should be.

I think 24 weeks is a reasonable guess at the right answer to my question, but there isn't really much evidence. We have to decide on a time limit, because as I've said, the extremes seem unreasonable. Unfortunately, this means we have no choice but to base policy on educated guesswork.

Drew Belobaba said...

I think the whole pro-abortion argument about the "survival rate" or children born before 24 weeks is profoundly misleading. Listening to Radio 4 this morning I heard an interview from a lady whose son was born at 21 weeks or so. The medical staff at the hospital refused to put him on life support because he would probably die. After several hours they began to give him basic care to make sure he died comfortably but not the care necessary to extend his life. Only after 36 hours did they give him the care necessary to ensure his survival. How many children are allowed to die because medical professionals decide that they aren't worth the bother and refuse them the care that would allow them to live.

conand said...

OK Aaronvitch I put my hands up, I don't like abortion. Or at least the abortion of viable/sensate human beings.

Late abortions performed by the NHS are state sponsored murder. I thought we were all against that kind of thing nowadays.

From another point of view our liberty and quality of life are built on the deaths of others, mainly German&Russian soldiers and civilians.

It appears that many people feel queasy at the thought of Prince Harry machine gunning 'Terry Taliban' but are comfortable paying for sensate babies to be killed.

In the parliamentary debates of yesterday we heard the view from many MPs that hybrid embryos and saviour siblings must be allowed to save life/improve quality of life. (A view I share)
Today many of those same MPs will vote to keep the rules governing state murder of babies (because their existence is inconvenient) the same.
This is puzzling. I guess I'm mainly talking about 'LibDem' MPs, as most Labour MPs don't usually vote on abortion issues. As those Labour MPs seemingly have no independent view on this crucial issue their votes and 'views' can largely be ignored.
As for the 'Liberal' MPs, it doesn't strike me as very Liberal to encourage the view that innocent people should be killed by the state.

haddock said...

there is a lot of emotional claptrap about agonising decisions, moral dilemas etc etc when we all know that abortion can be, and often is a simple lifestyle choice as I commented on Mrs Dales Diary:
"murder as means of contraception for skanks and slappers is never right.... some women should have 4 or 5 murders on their conscience; what a world we live in."

Anonymous said...

This is the most sensible article I have read on this issue. Abortion is never pleasant and usually the lesser of two evils. The cut off date will always be a compromise and basing it on the limit of viability is probably the least worst of the alternatives. I am speaking as an atheist medic.

Incidentally I once saw a 16 year old girl who came to casualty in labour who claimed not to know she was pregnant - it does happen probably something to do with denial and stupidity. She was rather large so it wasn't obvious

StockyMan said...

Dizzy, women can easily go 4/5 months without a period if they are on certain contraceptives. If those contraceptives fail and they then get pregnant they might not realise. (Although when it would start to show physically I'm not sure). Also don't some women continue to have light periods when pregnant?

Is the argument about whether babies can survive outside of the womb really an argument about when life begins? Genuine question, because I'm not really sure why being able to survive without being attached to their mother is a reason to not abort a foetus...

dizzy said...

I personalyl find this whole 4/5 months thing hard to beleive as anything more than an excpetional occurance rather than a perfectly ordinary one.

As for whether this is an argument about when life begins, I would not go down that route as you would first of all have to start off by defining what we consider life to be. There is an argument that sentience, consciousness, also called self-awareness is the point at which life begins for a human. only problem with that is that you could argue that a new born baby is not self-aware yet and justify infanticide. That's why I think it;s dangerous to see the debate in those terms.

Anonymous said...

the whole viability argument is anyway entirely academic. anyone who has had a baby born at term - 40 or 41 weeks, or later even - will be able to tell you the chances of that child surviving without help is pretty much nil. they can't move, they can't eat, they are at risk from suffocation if a cover falls over their mouth, their heads aren't fully formed so if they fall over - an inevitability unless you hold them up - they're likely to suffer brain damage....etc...etc...
the argument therefore becomes about money: is it the nhs that has to intervene to save the child and look after it, or is it a parent, adoptive parent, social worker, etc.

dreamingspire said...

Haddock (way up at the start), please understand the the representative status of MPs: they are there to make the decisions on our behalf. At least (and at last) this time they are getting the chance to do that.

kozmicstu said...

Dizzy, my worry about basing the upper cutoff on the viability of the child is that I see it as inevitable that medical science will eventually advance to the point that a feotus might be viable from 18 weeks, 12 weeks, 8 weeks, or even an entire gestation (much as IVF has eliminated the requirement for the man to be involved in the birth process, one day it would seem plausible that the woman will similarly be unnecessary...)

Given this circumstance, do we then say that all abortion is unjustified on the basis of viability? It seems to me that any date we might set will eventually be arbitrary, so a rational argument must be made for moving from one arbitrary date to another. Another sign of the arbitrary nature of the 20 weeks date is the other amendments calling for 22 weeks, 18 weeks and 12 weeks.

I'm just not sure there's a real need. I blogged my own thoughts here but have no reason to believe them more valid than anyone else's.

J said...

Dizzy, this is a false argument as the decision of the mother to abort is not generally based on viability; nor, as was pointed out above, is the state aborting but it is regulating the right of mothers not to bring unwanted children into an already overpopulated world.

Anonymous said...

Surely viability outside the womb is a straw man. Until the abortion, the child isn't outside the womb.

dizzy said...

It's not a false argument because the law make clear the conditions under which it is not permissable and this about those conditions.

Anonymous said...

I wish Dawn Primalo would do something about her moustache. Sorry, hairy upper lip.

haddock said...

dreamingspire, you are a bloody idealist if you think they are there making decisions on our behalf, they make them in our name on their behalf.... as in the referendum promise/denial

Anoneumouse said...

A very cogent argument Dizzy. However, when it comes to lefty's like Red Dawn, one has to wonder about any life being viable outside the womb.

Anonymous said...

Must say my main concern is about the pain that the baby is subjected to as it is killed.

Anonymous said...

Surely the main reasons of shame and scorn for making late abortions available in the late 70's have now passed in today's society?

ThunderDragon said...

"Given that the most ardent of pro-choicers... tend to be ardent anti-death penalty advocates as well..."

Except in America, of course.

xerxes said...

My opposition to the death penalty has nothing to do with innocent lives being taken. It's the state taking of any life when there are viable alternatives.

Which means I'm not that happy about state-aided or state-sanctioned abortions either. Except I know that the alternative if the number of weeks are reduced, are the dangers of the back alley and individually engineered miscarriages.

It's a pragmatic morality here. Which is rarely grey, more black and blue.

stockyman said...

Kozmicstu raises an interesting point. What will happen when medical science allows us to create an artificial womb? It's a while a way yet to be sure, but it's bound to happen one day. The implications are mind-boggling. There'd be thousands children each year being gestated by the state and then either cared for by them or put up for adoption. That is presuming the abortion laws are scrapped as being akin to infanticide.

Unity said...

You're forgetting that you're not dealing with natural viability but with viability based on the use of medical technology.

Try this though experiment - a neonate is born at 28 weeks gestation and the parents immediately refuse consent for any invasive medical procedures. No intubation. no injections. no drips, just whatever care the mother can provide naturally.

The neonate will die in a matter od hours - certainly before a court order could be obtained to override the parent's refusal of consent.

So where, then, does viability rest?

It's not as simple as you think.

Anonymous said...

Three short comments.

1 Remember that the US controversy is partly fuelled by the fact that the legality was established not by a democratic decision of the legislators accountable to the people (as here) but by litigation, and the construction of the "Legal Fiction" that the framers of the Constitution must have intended this as a consequence of the principles they laid down.

2 It is a not a "principle of English law" that "better a guilty man go free" .. rather an argument that is used to justify the heavier burden of proof in a criminal trial. There is a difference.

3 There is nothing unreasonable in being anti- abortion/pro death penalty per se.
The child in the womb is being killed for who he/she is, or the inconvenience he/she may present.

No only has the child done nothing wrong but cannot form any guilty mind to justify the harshmess of the treatment being meted out in a fashion that Human and Animal Rights enthusiasts would call "cruel and inhuman" if applied to any other sentient creature.

The convicted felon has at least been judged on evidence and has had the opportunity to put his/her case and to appeal - sometimes at considerable length and certainly for longer than the life of the infant under imminent threat of dismemberment.

Martin Sewell

Anonymous said...

DreamingSpires,

You cannot now be approved as a Labour Candidate without being pro-abortion. That does somewhat dilute the conscience argument and leaves that side of the house worryingly at risk of being unrepresentative of their constituents, does it not?

Pro abortionists do shy away from the democratic will when it does not suit them.

Anonymous said...

j,

If we are so worried about bringing children into this overpopulated world why are we spending money and intellectual effort on the complexities of in vitro fertilisation?

The American Columist Ann Coulter has pointed out that all too often when feminists talk about the woman's right to chose- what is actually being defended is the woman's right to have sex with men she does not want to have children by. Somewhat less lofty when put in that fashion.

The Tin Drummer said...

I respect Unity's research and learning but I don't really follow the "natural viability" argument. Isn't a 28 week neonate (like my partner's strapping 15 year old son) in an analogous position to anyone who's had an accident (in this case untimely birth) and needs intervention to stay alive? Are we saying that people in intensive care are not viable people? Or that existence is only justified by health? I would understand (kind of) if Unity and others meant neonates who would always need intervention but if he means babies who need it for a while, like my partner's son, and who can then survive, it seems a rather brutal way of looking human life.

bma said...

It has nothing to do with the viability of the foetus. It has everything to do with a woman's right to control what happens to her own body. You wouldn't (I assume) force somebody against their will to keep another person alive (e.g. by donating an organ) so why force a woman against her will to keep a foetus alive? Yes, you might give all sorts of reasons why someone should donate an organ, but at the end of the day it's their choice.

Even if a foetus was viable at 4 weeks, I'd support abortion at 24 weeks and beyond.