What is the ethical issue on abortion?

Abortion is one of the controversial issues discussed in medical ethics. Abortion is

advocated by the persons who have themselves been born. Abortion is a human
right issue because human beings have a right to life. When does a person begin to
exist is a moral issue.
What is the moral status of a fetus?
The central ethical question in the abortion debate is over the moral status of the
embryo and fetus. Opinions range from the belief that the fetus is a human being with
full moral status and rights from conception to the belief that a fetus has no rights,
even if it is human in a biological sense.

Abortion

English Language Learners Definition ofabortion

: a medical procedure used to end a pregnancy and cause the death of the
fetus

The abortion debate asks whether it can be morally right to terminate a pregnancy before normal childbirth.
Some people think that abortion is always wrong. Some think that abortion is right when the mother's life is at risk.
Others think that there is a range of circumstances in which abortion is morally acceptable.
Legal position
 Introduction to the abortion debate

 Reasons for abortion

 Privacy

 Roe versus Wade

 Fathers' rights

 Historical attitudes to abortion

 Constitutional argument
Medical topics
 Methods of abortion

 Female infanticide

 Selective abortion

 Medical evidence in the UK (BBC News)

 Two women's experiences (BBC News)

Philosophical and ethical concerns
 Introduction

 Moral personhood

 Difficult cases

 Consistency

 Right to life?

 Future like ours

 Abortion in self-defence

 Responsibility of the mother

 Disability in the foetus

 Moral certainty
The rights of the mother
Rights of the unborn child
The rights of the father
Religious views on abortion

 Abortion was legalized in 1973, but the topic remains controversial.

 The central ethical question in the abortion debate is over the moral status of the embryo and
fetus.
 Opinions range from the belief that the fetus is a human being with full moral status and rights
from conception to the belief that a fetus has no rights, even if it is human in a biological sense.
Most Americans’ beliefs fall somewhere in the middle.
 Moral philosophers from various perspectives provide nuanced examinations of the abortion
question that go beyond the standard political breakdowns.
 In 1973 in Roe v. Wade, the United States Supreme Court based its finding of a woman’s
constitutional right to have an abortion up until viability on two factors: the legal status of the
fetus and the woman’s right to privacy.
 In 2007, the Supreme Court upheld a law signed by President Bush in 2003 that opposes a form
of abortion called intact dilation and extraction, or “partial-birth abortion.” The law includes no
health exception.
 In 2016, the Supreme Court ruled that states cannot place restrictions on the delivery of abortion
services that create an undue burden for women seeking an abortion.
 FRAMING THE ISSUE

Despite the 1973 ruling by the Supreme Court in Roe v. Wade that women have a
constitutional right to make the decision to terminate a pregnancy, abortion remains one
of the most divisive and emotionally charged issues in American politics. At one end of
the debate over this practice are those who regard abortion as murder—a despicable
and heinous crime. At the other end are those who regard any attempt to restrict
abortion as a violation of women’s rights to privacy and bodily self-determination. Most
Americans are somewhere in the middle.

The central philosophical question in the abortion debate concerns the moral status of
the embryo and fetus. If the fetus is a person, with the same right to life as any human
being who has been born, it would seem that very few, if any, abortions could be
justified, because it is not morally permissible to kill children because they are unwanted
or illegitimate or disabled. However, the morality of abortion is not necessarily settled so
straightforwardly. Even if one accepts the argument that the fetus is a person, it does
not automatically follow that it has a right to the use of the pregnant woman’s body.
Thus, the morality of abortion depends not only on the moral status of the fetus, but also
on whether the pregnant woman has an obligation to continue to gestate the fetus.

ETHICAL CONSIDERATIONS

Public opinion on abortion falls into three camps—conservative, liberal, and moderate
(or gradualist)—each of which draws on both science and ethical thinking.

CONSERVATIVE

Conservatives regard the fetus as a human being, with the same rights as any human
being who has been born, from the beginning of pregnancy onward. Some conservative
groups—such as the Catholic Church—consider the fetus to be a human being with full
moral rights even earlier than the beginning of pregnancy, which occurs when the
embryo implants in the uterus. The Church regards the embryo as a full human being
from conception (the conjoining of sperm and egg). This is because at conception the
embryo receives its own unique genetic code, distinct from that of its mother or father.
Therefore, Catholic doctrine regards conception, not implantation, as the beginning of
the life of a human being.

Although conservatives concede that the fetus changes dramatically during gestation,
they do not accept these changes as relevant to moral standing. Conservatives argue
that there is no stage of development at which we can say, now we have a human
being, whereas a day or a week or a month earlier we did not. Any attempt to place the
onset of humanity at a particular moment—whether it is when brain waves appear, or
when the fetus begins to look human, or when quickening, sentience, or viability occur
—is bound to be arbitrary because all of these stages will occur if the fetus is allowed to
grow and develop.
A secular antiabortion argument given by Don Marquis in 1989 differs from the
traditional conservative view in that it is not based on the fetus being human, thus
avoiding the charge of “speciesism.” Rather, Marquis argues that abortion is wrong for
the same reason that killing anyone is wrong—namely, that killing deprives its victim of
a valuable future, what he calls “a future like ours.” It is possible that some animals have
a future like ours. If so, then killing them is also wrong. This raises two questions about
what it is to have a future like ours. First, what precisely is involved in this notion? Does
it essentially belong to rational, future-oriented, plan-making beings? If so, then killing
most nonhuman animals would not be wrong, but neither would killing those who are
severely developmentally disabled. Second, at what point does the life of a being with a
future like ours start? Marquis assumes that we are essentially human animals, so our
lives start with the beginning of our organisms. But Jeff McMahan denies this, arguing
that we are essentially embodied minds, and not human organisms. In McMahan’s view,
our lives do not start until our organism becomes conscious, probably sometime in the
second trimester. Early abortion, in his view, does not kill someone with a future like
ours, but rather prevents that individual from coming into existence – in much the way
contraception does.

LIBERAL

Liberals, like Mary Anne Warren in her classic defense of abortion, do not deny that the
fetus is biologically human, but Warren denies that biological humanity is either
necessary or sufficient for personhood and a right to life. Indeed, Warren thinks that the
conservative is guilty of a logical mistake: confusing biological humans and persons.
She argues that species membership is an arbitrary basis for moral standing, and
maintains that it is the killing of persons, not humans, that is wrong. Persons are beings
with certain psychological traits, including sentience, consciousness, the capacity for
rational thought, and the ability to use language. There may be some nonhuman
persons (e.g., some animals), and there may be biological humans that are not persons,
including early gestation fetuses, who have no person-making characteristics. By the
end of the second trimester, fetuses are probably sentient, but even late gestation
fetuses are less personlike than most mammals. Therefore, if killing animals is
permissible, so is abortion, throughout pregnancy.

In 1971, Judith Thomson gave a completely different pro-choice argument, claiming that
even if the personhood of the fetus were granted, this would not settle the morality of
abortion because the fetus’s right to life does not necessarily give it a right to use the
pregnant woman’s body. No one, Thomson says, has the right to use your body unless
you give him permission–not even if he needs it for life itself. At least in the case of
rape, the pregnant woman has not given the fetus the right to use her body. (Thus,
Thomson’s argument, somewhat ironically for an article entitled “A Defense of Abortion,”
provides those who are generally anti-choice with a rationale for making an exception in
the case of rape, as do many pro-lifers–though not the Catholic Church.) Thomson
maintains that whether a woman has a moral obligation to allow a fetus to remain in her
body is a separate question from whether the fetus is a person with a right to life, and
depends instead on the amount of sacrifice or burden it imposes on her.
In 2003, Margaret Little argued that while abortion is not murder, neither is it necessarily
moral. A pregnant woman and her fetus are not strangers; she is biologically its mother.
However, she may have conflicts of duties. For example, a woman’s relationship to her
children who have been born goes beyond mere biological connection and imposes
stronger obligations. For this reason, their interests may trump those of the fetus. At the
same time, even if the fetus is not a person, it is a “burgeoning human life,” and as such
is worthy of respect. Many women believe that bringing a child into the world when they
are not able to nurture it would be disrespectful of human life. The main reason women
choose abortion, according to Little, is that they think it would be wrong to have a child
when they are not capable of being good mothers.

MODERATE

The moderate, or gradualist, agrees with the liberal that a one-celled zygote is not a
human person, but agrees with the conservative that the late-gestation fetus is virtually
identical to a born infant. Thus, the moderate thinks that early abortions are morally
better than late ones and that the reasons for having them should be stronger as the
pregnancy progresses. A reason that might justify an early abortion, such as not
wanting to become a mother, would not justify an abortion in the seventh month to the
moderate.

fetal-development-timeline

THE LEGAL PERSPECTIVE

In 1973 in Roe v. Wade, the United States Supreme Court based its finding of a
woman’s constitutional right to have an abortion up until viability on two factors: the
legal status of the fetus and the woman’s right to privacy. Concluding that outside of
abortion law, the unborn had never been treated as full legal persons, the Court then
looked to see if there were any state interests compelling enough to override a woman’s
right to make this personal decision for herself. It decided that there were none at all in
the first trimester of pregnancy. In the second trimester, states may impose restrictions
intended to protect maternal health. The state’s interest in protecting potential life
becomes “compelling,” and trumps the woman’s right to privacy only until the fetus
becomes viable, somewhere between 24 and 28 weeks. After viability, states may
prohibit abortion altogether if they choose, unless continuing the pregnancy would
threaten the woman’s life or health.

Planned Parenthood of Southeastern Pennsylvania v. Casey (1992) pitted the justices

who wanted to reverse Roe against those who wished to preserve it. Neither side won,
and the result was a compromise written by Justices O’Connor, Kennedy, and Souter. It
upheld Roe’s central finding, that women have a constitutionally protected right to
choose abortion, prior to viability, while rejecting the trimester framework. Casey held
that the state’s profound interest in protecting potential life existed at all stages of
pregnancy, not just after viability. States may enact procedures and rules reflecting its
preference for childbirth over abortion, so long as these rules and procedures do not
constitute an “undue burden” on the woman’s choice.

The Court interpreted the undue burden standard as permitting a counseling

requirement directing doctors to provide information about the abortion procedure, the
relative risks of abortion and childbirth, embryonic and fetal development, and available
resources should the woman choose to carry to term, provided the information given to
the woman is truthful and not misleading. The Court also upheld a waiting period of 24
hours, as its intent is to make the abortion decision more informed and deliberate.
However, the Court struck down a husband notification provision, for two reasons. First,
such a requirement may put women at risk. Second, requiring husband notification
reflects and perpetuates a now unconstitutional understanding of the marital
relationship. The husband’s interest in the life of the child does not permit the state to
empower him with a “troubling degree of authority” over his wife.

When it became clear to those in the anti-abortion camp that Roe was unlikely to be
overturned, a new strategy of restricting abortions was developed. This strategy
includes outlawing particular methods of abortion, imposing time limits based on claims
of fetal sentience, and imposing restrictions on clinics and doctors who perform
abortions in the name of protecting maternal health.

Outlawing abortion methods

In 2003, President Bush signed into law a bill that banned a particular abortion
technique, known to doctors as “intact dilation and evacuation” and to the general public
as “partial-birth abortion.” The bill described intact D&E as a “gruesome, inhumane”
procedure that is “never medically necessary to preserve a woman’s health,” in which a
fetus is partially delivered alive and a physician performs “an overt act that the person
knows will kill the partially delivered living fetus.”

The law, which included no health exception, was found unconstitutional in 2005 but
was upheld by the Supreme Court in the case of Gonzales v. Carhart in 2007. The
majority reaffirmed its rulings in Roe and Casey that, before viability, a state may not
prohibit any woman from making the ultimate decision to terminate her pregnancy. At
the same time, states may enact restrictions on abortion for the purpose of expressing
its concern for potential life, as long as they do not impose a substantial obstacle to her
seeking an abortion. The majority held that the Partial-Birth Abortion Act did not impose
an undue burden on women seeking abortions in the second trimester, since there were
other methods available to physicians, in particular, the standard dilation and extraction,
in which the fetus is dismembered prior to being removed from the woman’s body.

In her dissent, Justice Ruth Bader Ginsburg described the ruling as “alarming,” and said
that it “tolerates, indeed applauds, federal intervention to ban nationwide a procedure
found necessary and proper in certain cases by the American College of Obstetricians
and Gynecologists.” For example, intact dilation and extraction may be safer for the
woman–and more likely to preserve her future fertility–than standard dilation and
extraction, because dismembering the fetus in utero might puncture her uterus.
Ginsburg argued that decisions about whether a particular procedure is medically
indicated should belong to the woman’s doctors, and not to the Congress of the United
States.

Imposing limits based on fetal sentience

In 2010, Nebraska banned all abortion after 20 weeks, on the ground that a fetus at that
stage can feel pain. Since then, 14 more states (Alabama, Arkansas, Arizona, Georgia,
Idaho, Indiana, Kansas, Louisiana, Missouri, North Dakota, Oklahoma, Texas, West
Virginia, and Wisconsin) have passed similar laws. In 2015, the Pain-Capable Unborn
Child Protection Act passed the House of Representatives; the motion to consider the
bill in the Senate was withdrawn. The bill prohibits a physician from performing an
abortion after 20 weeks, except where necessary to save the life of a pregnant woman
(excluding psychological or emotional conditions) or in cases of rape or incest against a
minor.

Although such laws have not been challenged in court, they are clearly unconstitutional,
since the Supreme Court has reaffirmed in Casey and Carhart a woman’s constitutional
right to choose abortion, prior to viability, and 20-week old fetuses are not viable. Some
premature infants are being saved as early as 22 weeks. However, it appears that,
absent development of an artificial placenta, 22 weeks represents the absolute lower
limit on viability.

Are 20-week old fetuses sentient? The American College of Obstetricians and
Gynecologists says it knows of no legitimate scientific information that supports the
claim that a 20-week old fetus can feel pain. However, some researchers think that
fetuses might become sentient as early as 17 weeks. In March 2016, Utah became the
first state to require doctors to give anesthesia to women having an abortion at 20
weeks or later. The law does not apply to women having abortions needed to save their
lives, or in cases of rape or incest. An obstetrician-gynecologist in Utah, who spends
half of a Saturday each month in an abortion clinic, protested in the New York Times,
“You’re asking me to invent a procedure that doesn’t have any research to back it up.
You want me to experiment on my patients.”

Protecting women’s health

As stated above, Casey allowed states to restrict abortions based on a concern for
women’s health as long as the restrictions did not impose an undue burden on the
choice. A key issue raised by Whole Woman’s Health v. Hellerstedt, decided in 2016,
was how judges should evaluate such health-justified restrictions. The case concerned
a 2013 Texas law that required any physician performing an abortion to have admitting
privileges at a hospital not more than 30 miles from the abortion facility, and required
any abortion facility to meet the minimum standards for ambulatory surgical centers.
The district court said that the law was unconstitutional because of its impact on access
to abortion in Texas. Many abortion facilities would be unable to meet these
requirements and would be forced to close, thereby severely limiting access to abortion.
Moreover, the law’s provisions were unnecessary to protect women’s health. Abortion is
an extremely safe procedure with very low rates of complications and virtually no
deaths.

Writing for the majority, Justice Breyer said that “the Court, when determining the
constitutionality of laws regulating abortion procedures, has placed considerable weight
upon evidence and argument presented in judicial procedures.” In other words, states
may not simply assert that the restrictions are necessary, but must have factual
evidence to show that they are. Moreover, the Court has an independent constitutional
duty to review factual findings where constitutional rights are at stake. Presumably, this
decision ends the strategy of seeking to limit abortion in the guise of protecting maternal
health.

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the linen and laundry service is providing a satisfactory service to its users. However the services can be
further improved by removing the present deficiencies both at structure and process level.