The adamant and uniform pro-choice viewpoints expressed in each of the target articles demonstrates how mainstream bioethics has become a homogeneous and insular advocacy movement that seeks to institutionalize progressive ideology as the reigning paradigm of healthcare public policy. That’s fine. In a democratic society people certainly have a right to organize and advocate for their opinions.
But bioethics holds itself out as something more. The field presumes to serve the entire society, liberal and conservative, pro-choice and pro-life, rich and poor, people of all races and ethnicities. Yet, none of the target articles authors even make a bow toward those with whom they disagree on abortion rights, or indeed, attempt to grapple substantively with the beliefs of those who oppose the existing abortion regime.
Space does not permit a full delineation but let me focus on two examples. In “Beyond Abortion: The Consequences of Overturning Roe,” Paltrow, Harris, and Marshall (2022) accuse pro-lifers of racism because African American women have a large percentage of abortions and would be disproportionately impacted by access restrictions. To say the least, it seems an odd form of racism when a movement wants more babies of color to be born, not fewer. Pro-life advocacy may be many things, but racist isn’t one of them.
The authors also describe fetuses as “potential life.” This assertion is both unscientific and a deflection. In the biological sense of the term, fetuses and embryos are fully “human life.” They are living organisms—i.e., human beings—as embryology textbooks make clear (Moore et al. 2013). Indeed, when the authors of the featured articles were zygotes, they were the same organisms that they are today. Even the Supreme Court ruled in the 1992 case Planned Parenthood v Casey that, “the State … may express profound respect for the life of the unborn” (my emphasis).
The scientific fact that unborn humans are living members of our species is the moral cornerstone of the pro-life movement. One can disagree with that formulation, but it is ethically consistent and morally cogent. Merely assuming the pro-choice perspective is a self-evident truth, as the feature articles authors do, does not make it so.
ROE’S POISONOUS FRUIT
Roe v Wade arrogantly presumed to settle the abortion question for the entire country. Instead, the ruling caused a severe backlash, leading to the profound divisions of our current national moment.
Little attention is paid in bioethics to pro-choice absolutism and increasing claims that the right to abortion should be unlimited. Some states have already enacted such statutes. Thus, a new Colorado law states:
A pregnant individual has a fundamental right to continue a pregnancy and give birth or to have an abortion and to make decisions about how to exercise that right. (Colorado 2022)
Note, that the right created includes no restrictions as to viability, meaning that a baby who could survive independently outside the womb can be destroyed in Colorado without legal consequence.
This is remarkable. We are often told that no right is absolute. Indeed, legal constraints are placed on enumerated Constitutional rights such as speech and the free exercise of religion. And yet, contemporary pro-choice advocacy would elevate abortion—of which there is no mention in the Constitution or its Amendments—into what could be called a “hyper-right.” To say the least, this is a highly contentious proposition.
Instrumentalizing the Unborn
In the abortion debate, nascent human beings are often denigrated by pro-choice activists as mere “clumps of cells.” Some go so far as to call fetuses “parasites, or “invaders” that are morally akin to “tumors” (Matt Walsh 2013). Such dehumanization not only justifies their destruction in abortion, but also opens the door to viewing the unborn as mere instrumentalities. Embryonic stem cell research (ESCR) already treats early embryos as akin morally to yeast. And now, researchers want to go even farther. Recently, the International Society for Stem Cell Research repealed the “14-Day Rule” eliminating all time constraints in which embryos could be maintained for experimental purposes (ISSCR Guidelines 2021).
This could lead eventually to live fetal experimentation. Indeed, the legal groundwork that would justify such grotesque experiments are already being laid. Vermont recently enacted a law, in the name of protecting an unlimited abortion license, that states in part, “A fertilized egg, embryo, or fetus shall not have independent rights under Vermont law” (Vermont 2019) (The Colorado law referenced above has a similar provision).
Notice that the stripping of all moral status from the unborn is independent of the existence of a pregnancy. This is another way of saying that no born person owes nascent human life any duty of respect, care, or concern. And let no reader say that scientists would never do that. They already have (Carter Snead 2020).
Forcing Doctors to Perform Abortions
In the aftermath of Roe, the government enacted statutes protecting doctors from being forced to participate. Now, that “medical conscience” comity is under sustained assault to increase access to abortion. Thus, Ronit Y. Stahl and Ezekiel Emanuel wrote in the New England Journal of Medicine that doctors must participate in requested procedures with which they morally disagree. That specifically includes abortion. Dissenting doctors, they write, “have two choices: select an area of medicine, such as radiology, that will not put them in situations that conflict with their personal morality or, if there is no such area, leave the profession” (Stahl and Emanuel 2017).
Whatever one thinks of abortion, destroying medical conscience would have deleterious consequences:
- It would fertilize the noxious weeds of national disunity.
- It would add to the creeping authoritarianism afflicting our society. If freedom of religion can be pushed aside by government fiat, so can other fundamental freedoms.
- It would lead to years of bitter litigation. Once again, the Supreme Court would be dragged into raw partisan politics.
- There could be a significant “brain drain” from the medical professions and talented young people may avoid the field altogether.
- It could also be bad for patient outcomes. Coercion hardly leads to optimal care.
Slouching toward Infanticide
Creating a constitutional right to abortion has fueled advocacy for the next logical step; permitting infanticide. Indeed, several notable bioethicists have repeatedly argued that infanticide is morally equivalent to abortion. Thus, Princeton’s Peter Singer has argued that since neither a fetus nor a neonate is a “person,” infanticide and abortion are morally indistinguishable (Singer 1994). Similarly, a controversial essay published in the Journal of Medical Ethics argued in favor of what the authors dubbed “after-birth abortion,” in order to “emphasize that the moral status of the individual killed is comparable with that of a fetus (on which “abortions” in the traditional sense are performed) rather than to that of a child (Giubilini and Minerva 2011).”
The concept of after-birth abortion was most recently defended again in The Journal of Medical Ethics:
The moral status of an infant is equivalent to that of a fetus in the sense that both lack those properties that justify the attribution of a right to life to an individual. Both a fetus and a newborn certainly are human beings [emphasis mine] and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’. (Veit 2020)
Infanticide has not been legalized in the United States. Yet. But terminally ill and severely disabled infants are lethally injected in the Netherlands under a bureaucratic bioethical guideline known as the Groningen Protocol (Verhagen and Sauer 2005). To say the least, it makes infanticide no longer unthinkable and its intellectual kinship to abortion is vividly clear.
Like the abolitionists, anti-child labor campaigners, the civil rights movement, women’s suffrage, temperance, anti-war activism, feminism, gay rights, labor union organizing, and so forth, in bringing the country to this portentous moment, pro-life campaigners acted in the grand tradition of social activism that has been a hallmark of the American experience. Now that they finally succeeded in achieving the demise of Roe through decades of committed political engagement, abortion will be restored to the dynamic democratic sphere where it belongs. The coming debates will certainly be contentious, but if democracy is allowed to work, public policy will be more likely to reflect the views of the majority freely enacted and our angry differences may abate. Whatever one thinks about the morality of abortion, that, at least, would be worth celebrating.