Abortion: Science, Politics, and a bit of Economics

About a week ago (i.e. before the 2017 General Election), I bought a book of compiled blogs by the guys who wrote ‘Freakonomics’ and ‘Superfreakonomics’. I read through several of their blogs, occasionally nodding at some of the ideas.

But there were a couple of blogs where I thought, “No, they’ve not understood this; that idea won’t work.” One of them was about abortion. Their idea was that abortion clinics would be sponsored for every pro-life protester who turned up outside; so the more protesters who appeared, the more money the clinic would get. They predicted that this idea would be taken up widely because it would discourage pro-life protesters from turning up.

My immediate thought was that this was a misunderstanding of why pro-life protesters do what they do. Their primary goal is not an economic one, to put abortion clinics out of business; their primary goal is to save lives. They’re not actually there to target the clinic; they’re there to target the women going into the clinic, hoping to engage them in (gentle!) conversation and to change their minds. Outside the clinic just happens to be the easiest place to meet those women.

So I started thinking about this blog. And then the 2017 General Election happened, and the Northern Irish Democratic Unionist Party unexpectedly became part of the Government, and the issue of abortion shot up the UK political agenda because the DUP are officially anti-abortion. So I decided to write this blog now.

First, some notes on terminology, because this subject is so hotly disputed that even the words used are under debate. The two sides usually call themselves “pro-life” and “pro-choice”. Neither term is entirely accurate; pro-choice folks usually only favour choice for the mother, not for the father or the grandparents or anyone claiming to represent the interests of the baby. And if pro-life folks support capital punishment, their label doesn’t fit especially well either. Nevertheless, I shall use those terms in this blog.

There’s also the question of what to call the thing that is inside the mother’s womb. Is it a “bundle of cells”; a “foetus”; or an “unborn baby”? I suppose you could describe any living thing as a “bundle of cells”, but such a description is too unspecific to be useful. I’ll use a mixture of the other two terms in this blog.

There are even disputes over basic facts. Below are are two pictures of what a foetus looks like at nine weeks’ gestation; the first comes from a US abortion clinic, the second from a pro-life blog. In this case, photographs of miscarried babies show that the pro-lifers are right, but this illustrates the depth of disagreement on the subject.

Abortion: The Science

To discuss the science and politics of abortion, it’s essential to recognise that there are two crucial questions which must be treated separately. These questions are:

1/ At what point does a foetus become entitled to human rights?

2/ How should the human rights of an unborn baby be balanced against the human rights of its mother (and possibly others too?)

Conveniently, the first of these questions is primarily a scientific one (although there are legal issues too) while the second is primarily a political one.

So: at what point does an unborn baby obtain human rights? The obvious answer is, “When it becomes a human being”. But when is that?

I can think of four possible points when a foetus might be considered to have become a human being:

1/ At the moment when the sperm fertilises the egg.

2/ At the moment when the unborn baby’s heart starts beating (about 6 weeks’ gestation).

3/ At the moment when the foetus can (eventually) survive unaided outside the womb (currently 20-24 weeks’ gestation).

4/ At the moment of birth.

Let’s discuss each of these.

1. When the sperm fertilises the egg. This is the moment at which a new individual is formed, according to embryology textbooks. So if humanity is defined according to individual identity, then this would be the answer. On the other side of the coin, at this point the foetus is literally a bundle of cells, bearing no resemblance at all to a human being.
2. When the unborn baby’s heart starts beating. This fits with the legal definition of death, which was (until recently) the moment when the heart stops beating. (Nowadays it’s defined as the moment of ‘brain death’, which allows for hearts to be kept going by artificial means – and, more controversially, for people whose hearts function but who show no other signs of life to have life support withdrawn). If we decide that humans are entitled to human rights from the moment they are alive, then that’s a good argument for this definition.
3. When the foetus can eventually survive unaided outside the womb (though may initially need medical intervention). This is the basis for current abortion law in the UK (for most pregnancies).
• Unfortunately, defining ‘humanity’ as starting at this point has two big problems. The first one is that, as medical technology improves, babies can survive being born earlier and earlier; in the 50 years since the Abortion Act was passed, the ‘viable limit’ has dropped from 28 weeks to about 20 weeks. How can a baby not be human if medical technology to sustain it is unavailable, but the same foetus be human if the technology is available?
• The second problem is also linked to medical technology. If an adult or child is terminally ill and needs medical help to stay alive, they will never again survive unaided, but they do not lose all their human rights. Human rights are based on the fact that they are alive now, not on whether they will be alive in the future. Applying a different standard to foetuses of less than 20 weeks' gestation is hypocritical.
4.  At birth. From one viewpoint, this is the easiest point at which to declare that a baby becomes entitled to human rights. But from another, it makes very little sense. If two foetuses are conceived at the same time but one is born prematurely while the other goes full-term, why should the premature baby have human rights while the other does not?

The conclusion I draw is that a foetus should be entitled to human rights either from the moment of fertilisation or from when its heart starts beating. Options 3 and 4 just don’t make sense from a scientific viewpoint.

There’s a bit more science in the next section, but it’s mostly about politics.

Abortion: The balance of human rights

The second big question relating to abortion is how to balance the rights of the unborn baby with the rights of the mother and others. I’ll focus on the mother’s rights, as many do. I’ll assume that the foetus does indeed have human rights.

The effects of pregnancy and giving birth on a woman are undeniably life-changing. It is likely to cause her discomfort and eventually severe pain. It may permanently change her body with anything from a Caesarean scar to a reshaping of her pelvis. It may affect her career and will certainly affect her finances and free time. It may affect her relationship with the father or with other members of her family, positively or negatively. It may change her circle of friends. It will bring a new person into her life who is utterly dependent on her, is very cute, and has no manners whatsoever. So forcing a woman to go through with a pregnancy is a very big imposition on her human rights.

If the pregnancy is truly unwanted, the woman may become emotionally desperate and threaten suicide. This is touted as a major justification for abortion by some pro-choice folk, on the grounds that it’s worth losing the baby’s life to avoid losing both the baby’s and the mother’s. Unfortunately for this view, a scientific study (actually, a combination of eight studies) concluded that giving a woman an abortion “does not reduce her mental health risks of unwanted or unintended pregnancy” [1]. But even without this argument, is it right to place such a big imposition on the human rights of women?

The answer lies in one’s view of human rights. If you take the view that the right to life supersedes all other human rights, then yes, it’s right to ban abortion after the point when the foetus becomes human. From this viewpoint, even in cases of pregnancy due to rape, abortion should not be permitted – for if it is, then rape becomes the only crime where the penalty for the crime includes capital punishment for a person who wasn’t even present!

If you take the view that human rights should be modified according to a person’s value to society, a different view emerges. Hardly anyone officially holds this view because it can lead to all kinds of inequality and discrimination. But in practice, if you ask people to decide whether a woman who plays a highly valued role in society which would be severely curtailed by pregnancy (say, an athlete who represents the national team) should be permitted to abort a foetus which currently plays no role in society, some folk are more likely to answer ‘Yes’ than they would in other cases. This ‘social value’ attitude also manifests itself in our current laws about aborting disabled babies; it’s legal in the UK to abort such foetuses right up to birth, and it's hard to think of a reason for such discrimination apart from the view that the disabled are of lesser value to society. So while the ‘social value’ view isn‘t officially acknowledged, it’s prevalent.

You may hold other views. My own view is the first one: the right to life outweighs everything else. But this raises a new question: how should society deal with women who are required to go through with unwanted pregnancies? I’ll come back to that at the end of the next section of this blog.

Abortion and current politics

I’ve demonstrated above that the UK’s current laws on abortion are a bit of a mess. I believe the reason is that they are actually biased towards women’s rights rather than foetus’s rights, for the stark reason that women vote and unborn babies don’t.

There is a historical analogy that is very appropriate here: it’s the analogy of slavery. It was once legal to own slaves in this country. Slaves were human beings, but were often viewed as sub-human and had very few human rights; it was legal for a slave-owner to kill a slave in many circumstances (though not all). Slave-owners and those who benefitted from slavery could vote; slaves could not. Courageous individuals sought to rescue the few slaves they could, and were roundly condemned for doing so.

Slavery was ended by long-term lobbying challenging the view that slaves were sub-human. Once it was accepted that slaves were fully human, conscience and public opinion turned against the whole idea of slavery. I look forward to the day when we look back on the days when we didn’t grant human rights to unborn babies with the same horror as we now look back on our ancestors’ attitude to slaves. I also wonder whether those pro-life folk who protest outside abortion clinics would do well to take tips from the anti-slavery campaign and to show images of healthy unborn babies with the message “I am human”, rather than displaying gruesome images of aborted foetuses as they often do now.

We can also take tips from the anti-slavery campaign on what we can do for women who are required to go through an unwanted pregnancy. When slavery was banned in Britain, slave owners were compensated for the loss of their slaves. There was a transition period for slaves to find new opportunities or even study for a new career. Similarly, I wouldn’t want to see pregnant women – particularly pregnant single women or girls -- treated as pariahs but  instead given financial and other support during pregnancy; and if they choose to give their babies up for adoption rather than to raise them, to have a transition period and maybe even stay in touch with the adopting family. In short, treat all concerned with as much practical love as possible.

Coming back to economics (finally!), it will cost money -- but isn't life worth more than money?

References

[1] Abortion Has No Benefits, But Does Have Risks, New Research Shows. Australian and New Zealand Journal of Psychiatry, April 2013. http://afterabortion.org/2013/abrotion-has-no-benefits-but-does-have-risks-new-research-shows/