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Is abortion a medical issue or is it a moral issue or a legal issue?

"Is abortion a medical issue or is it a moral issue or a legal issue?" A pregnancy where the life of the mother is in jeopardy and where abortion can save the life of the mother seems to be clearly a medical issue, though recent Catholic religious behavior on this one point challenges this conclusion.
http://www.huffingtonpost.com/2010/12/21/ariz-hospital-loses-catho_n_799863.html

A pregnancy where the life of the mother is NOT in jeopardy, could an abortion be considered a medical issue? Treatment of mental distress is and has been an object of medical therapy. If an abortion carried out to relieve the woman's mental distress of a forced rape is primarily a medical issue (or is it?--look at the Oklahoma abortion law http://abcnews.go.com/Health/okla-abortion-law-exceptions-rape/story?id=10507849 that states that rape is no exception ) then what about an abortion carried out to terminate the mental distress of some other form of unwanted pregnancy? Or what about abortion of fetus found on screening to have a fatal, incurable genetic disorder?

One may finally conclude that the abortion issue cannot be separated into medical, moral or legal. Is this why abortion has continue to smolder throughout our society for so many, many years? And yet this unsettled issue is causing so much distress to many and even unwarranted death to some (both clinical and homicidal) that one would wonder when, if ever, the issue will be resolved and what will be the outcome resolution. ..Maurice.
asked Jan 30, 2011 at 11:50AM in Other
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  • 2
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    answered Jan 31, 2011 at 10:39AM
    Abortion is "in the eye of the beholder". I don't believe the dilemmas around it will ever be resolved, especially with the rise and popularity of anti-abortion political factions and personalities in the United States. Worldwide, the Catholic Church is highly influential. It is most known for an anti-abortion stance, but there are many other religions against abortion as well, such a evangelical protestantism and Mormonism. I lived/worked in the most Mormon (LDS) region of Idaho, north of the Utah border for a year. I recall that no abortions were allowed or even allowed to be discussed by any hospital in that region. If someone needed an abortion, they would have to go to another state, unless perhaps it was allowed in Boise, which I don't know. Boise and Coeur D'alene, Idaho, are less LDS influenced, especially Coeur D'Alene in the Panhandle. Again, whether that is right or wrong is "in the eye of the beholder".

    Traveling for an abortion is a global phenomenon:

    "In the US, about 8% of abortions are performed on women who travel from another state.[110] However, that is driven at least partly by differing limits on abortion according to gestational age or the scarcity of doctors trained and willing to do later abortions.[citation needed] Thousands of women every year travel from Northern Ireland, the Republic of Ireland, Poland, and other countries where elective abortion is illegal, to Britain or other countries with less restrictive laws, in order to obtain abortions.[111][112]"
    http://en.wikipedia.org/wiki/Abortion

    This is where abortion becomes a medical, and especially medical ethics issue:

    "Abortion has a low risk of maternal mortality except for abortions performed unsafely, which result in 70,000 deaths and 5 million disabilities per year.[2] Abortions are unsafe when performed by persons without the proper skills or outside of a medically safe environment. An estimated 42 million abortions are performed annually with 20 million of those abortions done unsafely."
    http://en.wikipedia.org/wiki/Abortion

    So half of abortions worldwide are unsafe.

    Another issue of medicine and criminal law is attacks on physicians performing abortions, as well as other crimes associated with the anti-abortion movement, such as:
    Murders; attempted murder, assault, and kidnapping; arson, bombing, and property crime; anthrax threats
    http://en.wikipedia.org/wiki/Anti-abortion_violence

    I rest my case. Yes, it is a medical issue, but so much more.
    Many folks are reluctant or afraid to openly discuss abortion, so let's see who answers your question, Maurice. As for me, I would prefer not to have an abortion, and would be sad about the loss of a child if I had one in my life. I know there are many infertile couples who are waiting for newborns to adopt, so that is an option as well. But a life and death situation would certainly result in my decision to go forward with an abortion. Fortunately I never had to face the dilemma. I certainly do not force my views on others; it is deeply personal.
  • 2
    Votes
    answered Jan 31, 2011 at 11:10AM
    It is all three. First it is a medical procedure requiring a trained medical person to asses the total medical condition, decide whether a medical abortion is medically appropriate and to then perform the procedure in an approved medical way.

    It is a moral issue because at some, as yet undefined, moment in time the zygote becomes a human being and an abortion by definition terminates the life of a human being. Under what conditions is the deliberate ending of a human life morally justified, if at all? That is the ultimate moral test in abortion. What is right? What is wrong? Questions of morality.

    It is a legal issue because the law defines the taking of human life as homicide. The law further defines the conditions under which a homicide is "permissible" or legal or "impermissible" which is illegal. For an act (abortion) to be defined as illegal the law must state with specificity what is being prohibited. The legal definition of a homicide is quite clear and unambiguous. However, the law is less clear about what is "human life". When does a zygote become "human life" which must be protected under law as would any other human life. Under what conditions is the taking of a human life by abortion "permissible"? Should the elements which define permissible be different when the age, condition, status of the human being are different? These are legal issues which define what a society deems to be legal and illegal, permissible or impermissible.

    Do the three issues overlap at any point? Of course. Law is always a reflection of a society's moral values. Any procedure requiring medical skills is a medical issue. The medical part is the easier to come to terms with: Do No Harm. But the moral side of the medical question is: do no harm - but to Whom?

    In our American society the moral foundation for our laws is to protect the rights of the individual above all else whenever possible. To protect the minority from the tyranny of the majority. In other societies the moral foundation is to protect "the people".

    Will the controversy ever be resolved? Not so long as religious (as opposed to moral) values are an essential part of the equation. What is the "right" answer to the abortion question? Ask five women, five men, all selected at random. You will hear the answer you like best.
  • 2
    Votes
    answered Jan 31, 2011 at 01:46PM
    It is interesting, but I seem to view abortion more from the woman's perspective, as well as that of the abortion performing physician. I am glad Steve brought the zygote as human being into primary focus as well. Laws on homicide do seem to depend on perception of "humanhood", so are much framed by societal values.
    Two questions:
    1. How is an elderly person with advanced Alzheimer's Disease, or someone who is brain dead but kept alive with machines, both of whom may have no more or less of "humanhood" than a zygote without memory and identity? Why are the adults kept alive, including by extraordinary means, but humans at conception often are not? What gives each kind of life value?
    2.. What is the difference between religious and moral values, or are they the same? Can one be moral and accept abortion? Every one of us was a zygote at one time. Think about it.
  • 1
    Votes
    answered Jan 31, 2011 at 02:16PM
    Kim, I think the correct term used to describe the issue is "personhood" rather than "humanhood". A fetus created by humans without animal genetic manipulation is human and there is no argument about that. But whether the fetus can be at the very early time of development can be understood and called a "person" is the matter for debate. The same debate might apply to the previous "person" who is now in a permanent state of unawareness and unresponsiveness to the world or the previous "person" who is now deceased. The Alzheimer Disease patient who is not in a permanent vegetative state is certainly a person and should be always accepted as such.

    With regard to zygotes or fetuses, I think the issue is not whether a zygote or a fetus can at some time enter "personhood" as we have all accomplished but "which and when". ..Maurice.
  • 2
    Votes
    answered Jan 31, 2011 at 02:54PM
    Kim,
    Excellent points. Especially morality vs religion. I am unable to draw a clear intellectual line between the two. To me, religion feels more like a system of personal beliefs most or many of which are not capable of being logically dissected and analyzed. They depend upon faith. Religious values are passed onto successive generations of believers. My religion tells me abortion is "wrong". Morality on the other hand is typically subject to rigorous intellectual analysis by philosophers.

    To me, as a man with no children, there is a huge difference between the perspective of the woman and the physician. For the woman, an abortion decision would seem to go directly to her sense of what it means to be a woman. To a physician, I would think it is less personal and more clinical. At least I would hope so. I don't want a Christian Science leaning surgeon bringing her religious beliefs to me on the operating table.

    Personhood, humanhood? To me, the common denominator is self-awareness. Not the potential of self-awareness nor the history of self-awareness. The ability to know now that I am me. Absent that, neither the person nor the human exist. What exists is an organism which might as well be a plant.
  • 2
    Votes
    answered Jan 31, 2011 at 03:12PM
    Good one, Steve. By the way, is someone in a "permanent vegetative state" the same as a zygote, and do they have a right to life, or should their life be terminated?
    Is there a difference as to whether a "human" is in a womb, or outside in the world (or institution?)
  • 2
    Votes
    answered Jan 31, 2011 at 04:07PM
    As I understand "personhood" it does represent the concept of self-awareness. And so the question as to whether the zygote or fetus is a person is whether the zygote or fetus KNOWS
    that they are an individual who will come into the world to live a life. The zygote has the genetic potential to live a life out of the womb but doesn't have the organ function yet to think. A fetus in a late stage could conceivably be aware of themselves. And so the debate about abortion goes on. ..Maurice.
  • 1
    Votes
    answered Jan 31, 2011 at 09:41PM
    Maurice, Kim . . . .and so it goes, and goes. Thankfully, I've never been in a position in which I've had to decide these matters,

    Yet.

    But the time will likely come. And if it does, I hope I will act out of neither religious beliefs nor a moral code but simply out of love. Does that mean both religion and morality will have failed me?
    Too many questions, too few answers
  • 2
    Votes
    answered Feb 01, 2011 at 08:37AM
    And goes.....
    Even the concept of "humanhood" versus "personhood" is not agreed upon, as already noted.
    There are just issues in human discourse that are impossible to resolve. Perhaps every view has legitimacy. Unfortunately, the diversity of views still allows the disabilities and deaths of zygotes, fetuses, women, and physicians.
  • 3
    Votes
    answered Feb 01, 2011 at 10:48AM
    Maurice,
    First, I agree that the issue of abortion is, indeed, one that involves all three areas depending upon who is answering the question. However, since religion is personal, non-testable, and not dependent upon any factual evidence but rather upon whatever dogma one is "taught" by their own religion, it should apply ONLY to those of that particular religion and not be foisted upon others. In short, no legal decision should EVER be based upon anyone's religious beliefs. That, however, still leaves the other two. It is here that I think Steve makes one of the most salient points, and one I have been arguing in favor of for years.

    Currently, the Supreme Court decisions apply the viability test to determine when an abortion should be legal. The problem with this approach is that it originated in the middle of the last century when medical science was decidedly less advanced. In point of fact, there is no basic science preventing us from developing a fetus entirely in vitro, thus circumventing that entire approach. The much better one is to determine when the fetus becomes self-aware. Before that point, it would seem to be an aggregation of cells that has the "potential" to become human. After that point, I believe it should be considered to BE human and be subject to the protections we provide for all people (remember, there are even circumstances when homicide involving an adult is legally justified).

    We must also recognize that for those who feel that because the fetus, at any stage, has the "potential" to become human and therefore must be protected, they now have an additional issue. With today's science, virtually any cell in the body has the "potential" to become another human being. Thus, any procedure which kills a cell (like surgery), may be considered homicide using that argument. Ultimately, once we make the determination as to when the fetus becomes self aware, the remainder of the argument will always resolve into individual beliefs and will, thus, never be reconcilable among all people.


    Finally, I would like to comment upon the issue of people with dementia syndromes and coma. A person with a dementia syndrome may not be aware of their surroundings, or even know who or where they are, but they are certainly self aware in the broadest sense of the concept. They can, for example, experience pain and pleasure even if they have no control over the stimuli. Therefore, while they must be considered "human," whether their lives should continue should be no one's decision but theirs in an advanced directive (within the limits of the law). A patient in a persistent coma presents a conundrum for which I have no immediate answer. There comes a point when continuing life support seems to serve no rational purpose, but when that point is, and who (besides the patient themselves) should be allowed to determine what action to take remains open to continued debate.
    • Eric,
      You and I are very much in agreement. Must be your legal training:)

      Dementia, Alzheimer, brain injury, coma etc. are the real challenges for society. A well crafted and distributed Final Directive is the key. But the issue of who does it and how it is done remains. Legal and medical but especially legal. Health care professionals tend to be very cooperative whenever possible. If one can appoint and in effect "authorize" an executor, guardian or custodian one should be able to appoint and authorize a "terminator".
      -Steve
      Steve Whitmore Esq. commented Feb 01, 2011 at 04:23PM
  • 1
    Votes
    answered Feb 01, 2011 at 11:38AM
    Here is an overview of US states with laws regarding fetal homicide, incorporating definitions of "humanhood" and "personhood" in many cases:.

    http://www.nrlc.org/unborn_victims/Statehomicidelaws092302.html

    Here is Canadian commentary supporting fetal homicide law:

    http://network.nationalpost.com/np/blogs/fullcomment/archive/2007/11/22/margaret-somerville-defending-fetal-homicide-laws.aspx

    Here is a Canadian abortion rights argument against a
    fetal homicide law:

    http://www.arcc-cdac.ca/fetal_homicide_law.html

    And a Member of Parliament's tabling of the "Unborn Victims of Crime" Act:

    http://arpacanada.ca/index.php/issuesresearch/41-pro-life/112-unborn-victims-of-crime-bill-introduced-action-item

    I think both woman and fetus need protection in the commission of a crime. I am wondering, however, if fetal homicide laws can also be applied to physicians who perform abortions, which is a criminalization of a medical procedure, an ethically questionable action, at best.
    There have been some high profile homicides of pregnant women in Western Canada the last few years. Killing a woman whether pregnant or not, should not be lumped in with a abortion.
  • 1
    Votes
    answered Feb 02, 2011 at 08:45AM
    Most of the 25 US states that have laws on fetal homicide, do not distinguish between "human" and "person". Having looked at the laws on the link, I am concerned that abortion as a medically necessary procedure, could be prosecuted under a fetal homicide law. For example, Idaho, a state I resided in, has the following terminology:
    "Idaho: Murder is defined as the killing of a "human embryo or fetus" under certain conditions. The law provides that manslaughter includes the unlawful killing of a human embryo or fetus without malice."
    Can "without malice" be interpreted as an abortion, rather than an assault or homicide?

    Oklahoma seems to go the furthest in including a blastocyst in the homicide law:
    "The law defines "unborn child" as "the unborn offspring of human beings from the moment of conception, through pregnancy, and until live birth including the human conceptus, zygote, morula, blastocyst, embryo and fetus."

    There seems to be a conflict between Roe vs. Wade and state laws in many cases.
    This conflict would certainly contribute in the US to the irresolvable dilemma of abortion.

    Support for abortion also seems to be declining:
    "A Gallup poll conducted in May 2009 indicates that a minority of Americans, 37%, believe that abortion should be legal in any or most circumstances, compared to 41% in May 2008.[53] Similarly, an April 2009 Pew Research Center poll showed a softening of support for legal abortion compared to the previous years of polling. People who said they support abortion in all or most cases dropped from 54% in 2008 to 46% in 2009.[54]"
  • 1
    Votes
    answered Feb 02, 2011 at 11:07AM
    I am late into this debate but have a set of questions and directions which are different.

    Abortion has been used a weapon against women in male dominated cultures and it covers all three aspects. Use of rape and forcing abortions on the same victims is a war weapon. Abortion for selective female infanticide is a criminal act and its use is growing in Asia and Africa. Use of ultrasound for sex determination has given rise to female infanticide. Advances in medical diagnosis has been misused and diverted to unintended use. Use of abortion to control population was advocated by several international agencies and associations and was used in India by Mrs Indira Gandhi to control population growth for short period.

    Thus in addition to the medical, legal and moral aspect, we have abortion religion, politics, abortion wars, international and national policy and public health issue. Due to lack of vocal and influential advocacy groups, abortion research has remained underfunded. Pharmaceutical industry bailed out of R&D several decades ago to develop safe alternatives, new medicines or new options for abortions. Abortion clinics are under siege or threats and the security aspect needs to be considered.
    • Excellent points. Also worthy of mention is the China "one child" policy. But where does medical ethics lead us in a world of overpopulation, scarce resources, and quality of life? Abortion is often a political tool, and has been over the centuries. If there are no abortions, then some way has to be found to deal with global challenges that can only worsen with time. Unfortunately, even debating this topic is fraught with emotion and irrationality much of the time.
      Kim M Robinson commented Feb 02, 2011 at 11:15AM
  • 1
    Votes
    answered Feb 03, 2011 at 10:35AM
    Development of contraceptive vaccine by the WHO and PP were derailed by the persistent opposition from the right wing, religious, conservative and pro-life movements. Development of safe and effective contraceptive and abortion pills were similarly halted under pressure. Pharmaceutical and biotechnology industry is running scared and its executives picketed or directly threatened by ultras of these pressure groups.

    I think abortion politics has played a greater role during the past 2 decades resulting in unintended negative results and consequences.
  • 0
    Votes
    answered Feb 03, 2011 at 01:01PM
    Krishan, I can't 'conceive" that there could be any laws anywhere prohibiting the devising, manufacturing nor prescribing contraceptive drugs which interfere with even just fertilization of an ovum by a sperm. There can be no possible argument that such a drug "kills" a "human" or a "person". Any such law, based on religious doctrine regarding the necessity not to interfere with the ovum-sperm interaction should be overturned based on the principle of justice. No law or threat must force the decision of one religion onto citizens who may be of another religion or belief. ..Maurice.
  • 1
    Votes
    answered Feb 04, 2011 at 09:27PM
    Maurice,

    It is pure pressure tactics like calls for boycott of a pharma company products, picket lines or demonstrations at company offices, disruption at annual meetings, full page ads in local newspaper, media which resulted in pharma bail out of contraception R&D. Similarly withholding funds from international organizations like WHO and similar pressure tactics resulted in severe budget cuts for the contraception vaccine for women and men. R&D is legally allowed but considered morally reprehensible by a section of society. Doing R&D poses security risk for the company and its staff, extra costs and government does not offer any protection. On a global scale a cheap, mass produced, safe and effective contraception vaccine can be effective in controlling unchecked population growth. Gender politics and perceived lack of market has slowed the development of a contraceptive vaccine for men.
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