MATTERS OF LIFE AND DEATH - THE NEW YORK REVIEW OF BOOKS

In August 1982, Hector and Rosalie Jean Zevallos, the owners of a clinic that carried out abortions in Granite City, Illinois, were abducted. They were threatened with death unless they closed down their clinic, and were held for eight days before being released. Connie Paige describes this early episode in the wave of antiabortion violence in her book. She also tells of the partial burning down of a Planned Parenthood clinic, in St. Paul, Minnesota. One director of the clinic needed constant police protection, while others were threatened with the kidnaping or death of their children. A year after the fire, a bomb was thrown through the window of the clinic. And after a similar firebombing of a clinic in Omaha, a letter sent to a local newspaper is said to have ended: "You'd bomb a concentration camp—why not an abortion clinic?" By comparison, the harassment of Geraldine Ferraro over her views on abortion in last year's election campaign seems almost civilized.

It is not surprising that abortion arouses such passion. The debate raises issues about feminism, about the relations between religion, morality, and law, and about the social control of medical technology. Underlying all this are questions about what it is to be a parent and about the right to life. With these matters at stake, how could abortion not cause deep and conflicting emotions? Yet it is hard not to be struck by the contrast between the complexity of the issues and the simplicity of the emotional responses.

Emotionalism and simplification lead to implausible claims on both sides. Some take it to be an obvious fact that an abortion is just something done to a woman's body, comparable to the removal of an appendix. Others take it to be an obvious fact that a newly fertilized egg is as much a person as any teen-ager or adult. Opponents on either side are accused of supporting either the oppression of women or murder. It is sad that the debate is like this, since its outcome will affect even larger issues than the ones now seen to be at stake.

The distinctively modern voice in the abortion argument is the feminist one. For too many centuries the discussion, conducted by male theologians and philosophers, centered entirely on the fetus. The issue has been transformed by those prepared to say, as Beverly Wildung Harrison does in her book, that "the controversy over abortion is but one dimension of that far broader world historical struggle to enable us to 'become the subjects of our lives."' She argues persuasively that procreation is so central to women that having a choice over it is a condition of their having proper control over their lives. Her case for the right to choose is partly utilitarian, based on the unhappiness of those forced to bear unwanted children. She also deplores the injustice of denying women the ability to make decisions that will deeply affect their lives.

One benefit of the change in consciousness brought about by the current wave of feminism is that it is now unthinkable to ignore the issue of women's choice. And most of us now see that if men could get pregnant the right to choose would have had a central place in the debate long ago. All the same, there is something inadequate about the feminist case as it is often made. It is often presented as a matter of women controlling their own bodies, as if what happens during the period of being pregnant were the main issue. Yet the awfulness of an unwanted pregnancy is not primarily a matter of nine months' invasion of the body. A far greater disaster is a lifetime of unwanted parenthood. To some of us, avoiding this disaster is a sufficient justification for abortion. There is the solution of giving the baby at birth to be brought up by one of the many couples who desperately want children and who are unable to have them. This possibility is not something just to dismiss, yet I doubt whether the satisfaction of this real need justifies forcing women to bear children they do not want and then go through the trauma of giving them away. Respect for the autonomy of women is hardly compatible with making surrogate motherhood compulsory.

But to justify abortion by appealing either to the disaster of unwanted parenthood or to respect for women's autonomy presupposes that killing a fetus has a special status that marks it off from killing, say, a five-year-old child. No feminist would defend child murder as being justified by the greater control it would give women over their lives. To say this is not to suggest a reductio ad absurdum, implying that consistent feminists would have to accept child murder. It is to argue that personal autonomy does not have obvious priority over the right to life. For all its power, the feminist case is incomplete without an answer to the claim that the unborn child is a person with that right.

When we consider the status of the fetus, the antiabortion position has obvious strengths. Fetal development is more like a smooth curve than a series of sudden jumps to more and more advanced states; so there is some force to the argument that a line cannot be drawn specifying just when a "person" comes into being. If we do not draw the line at conception, there seems no sharp and stable boundary until birth. One way of drawing a line has been to say that a fetus is not a person until it is "viable"—when it can live outside the womb. But "viability" is not a stable boundary, since it changes with medical technology. To draw the line at viability is to give up the idea that characteristics of the fetus itself determine whether or not it is a person. Two fetuses at the same stage of development may be in hospitals differing in the level of their technology, so that one will survive outside the womb and one will not. In such a case it seems paradoxical to say that one is not a person and may be aborted, while the other is a person with a right to life.

The difficulty of drawing any line during pregnancy that is sharp and reflects a cogent moral view may suggest to some that the moral frontier should be at birth. Conception and birth, unlike the fetal states between them, seem to be clear and important boundaries. But if facts about what the fetus or baby is like should determine whether it is a person, birth is not an easy line to defend. Is the newborn baby so very different from how it was yesterday in the womb? We make great efforts to keep premature babies alive. Why should a baby at the same stage of development have no claim on us just because it is still in the womb?

The bold course for the supporter of abortion, who sees that even birth may not be a clear and defensible line, is to deny that newborn babies are persons with a right to life. And a traditional philosophical view lends some support to this denial. It has often been argued that being a person is bound up with a minimal level of self-consciousness, an awareness of a frontier between yourself and the rest of the world and awareness of yourself as having continuous existence over time. It is far from clear that newborn babies have any of this self-consciousness. Perhaps they have to discover where they end and the rest of the world begins. And it would be a very confident developmental psychologist who claimed to know that babies have the concept of their own existence over time.

But if the supporter of abortion takes the bold course of denying, on these grounds, that babies have a right to life, the prolife party may feel that they can rest their case. For making the right to life depend on a degree of self-consciousness that babies do not have seems like accepting a reductio ad absurdum. The boundary of the right to life becomes intolerably vague. When does self-consciousness begin? At three months? At three years? How can we tell? And the position also seems repulsive. The prolifers have always said that even early abortion is morally like killing babies. The reply that they are indeed the same, and that both are acceptable, is not an attractive one.

We are right to be appalled by the conclusions that appear to lie in wait if we deny the right to life on such grounds. This is not to say that infanticide can never be justified. In cases of babies born with terrible abnormalities, there are reasons that perhaps justify overriding our normal respect for the life of a baby. But the extreme cases that may justify infanticide need not count against the view that killing a healthy baby is unthinkable.

While we are right to recoil from any position that removes moral protection from the lives of babies, this does not show that it is wrong to link being a person with being self-conscious. Perhaps there is not enough agreement about the use of the word "person" for it to be clear that any of the rival views on this issue of definition are simply mistaken. An alternate diagnosis of the general wrongness of infanticide is compatible with the view that one becomes a person at a later stage than birth. We have to take into account how babies are accepted into the human community. It does not need saying that, for many of us, the birth of a child is one of the deepest experiences in life. And our developing relationship with a baby starts from the moment it is born. The emotions of childbirth and of the early days and weeks of parenthood are utterly incompatible with regarding babies as disposable living material. Most of us are incapable of adopting such an attitude. And even if we could adopt it, the world would be a worse place if we did so. In other words, even if babies do not have whatever properties are required for being persons with a right to life, there are reasons having to do with our own moral feelings, and our relations with our children, which are more than adequate to justify extending moral protection to them. The same reasons may not apply to the unborn fetus.

The impasse in the abortion debate partly results from all parties treating it as an issue with only one dimension. The prochoice party often wrongly supposes that the woman's claim to control her own life is enough to justify abortion, no matter what rights a fetus may have. And the prolife party often assumes that the only objection to killing someone is that he or she is a person with a right to life. Once this assumption is conceded, it is indeed hard to resist the antiabortion case. On this assumption, if it is wrong to kill babies, they must qualify as persons. And since it is difficult to draw sharp boundaries between conception and infancy, the prolife case can seem overwhelming. But the assumption should be denied. The effects of certain kinds of acts, not on those they are done to, but on those who do them, can be of overriding importance. Take the case of research on embryos. The practice of in vitro fertilization, which has helped many infertile couples, is most effective if more embryos are produced than will finally be allowed to develop into babies. Research on these "spare" embryos may help us to understand why some people are not fertile and why some forms of congenital defects occur. Research may lead eventually to ways of avoiding these problems, and perhaps also to the development of better contraceptive techniques. But there are obvious worries about how far such research is permissible. Since the embryos are never going to develop, claims about damaging their potential do not arise. And before the nervous system starts to develop, they may not have any morally relevant properties that would distinguish them, so far as rights are concerned, from, say, an oyster. One plausible view is that the embryos may be used for research, but only before the nervous system starts to develop. This recognizes the claim any conscious being has on us that we not cause it pain, and draws the line well short of where that could happen.

But there is a disturbing possible extension of the research program. There is some evidence that Parkinson's disease could most effectively be treated by transplanting material from the embryonic nervous system. To provide these transplants, the "spare" embryos would have to be allowed to develop well beyond the proposed limit. We might well be dealing with embryos with some degree of consciousness, including the capacity to feel pain. In reply to this, a supporter of the program might cite the great potential benefits to sufferers from Parkinson's disease, and suggest the use of anesthetics to avoid fetal pain.

Some of us will feel very disturbed by this reply. We shudder at this idea in rather the same way we do at the thought of using anesthetized babies for research. Moreover, a problem arises for those of us who accept the objection made by the animal rights movement to "speciesism"—discrimination against a conscious being merely on grounds of its belonging to a different species. Apart from what they have the potential to become, fetuses and babies do not seem to have any of the intrinsic properties of persons with a right to life that would give them stronger moral claims than the monkeys used for research. And "spare" embryos will not develop any potential they have. Yet it is hard to believe that our revulsion against research on this late stage, or against research on anesthetized babies, is merely a prejudice to be eliminated.

The most powerful objection to using anesthetized fetuses for research is what this would do to us, as researchers or as members of a society where such research went on. We remember the experiments Nazi doctors were prepared to do on human beings, and wonder about the strength of the barriers that prevent us from performing atrocities. These barriers must be at least as much emotional as intellectual. We respond to people, whether babies, children, or adults, in ways that make it unthinkable, for most of us, to treat them in the fashion of Nazi doctors. Fetuses, as they develop, start to seem more like babies. Can we be sure that fetal research could be kept in a separate emotional compartment? Or do we risk an erosion of the responses that prevent some of the worst horrors that human beings have shown themselves capable of? Perhaps the risk that these barriers will be weakened is a small one, but even a small risk of a great disaster should not readily be dismissed.

If this line of thought is accepted, the moral claims of late fetuses and of babies are not exhausted by any rights depending on their qualifying as persons. Perhaps they are not persons, and have less of the required self-consciousness than some nonhuman animals. But we have reasons, to do with ourselves rather than them, for not treating them as merely disposable.

The prolife case, then, seems simplistic when we examine the way our moral responses are linked to values more complex than is suggested by single-minded fixation on the "right to life" of "persons." That case becomes more vulnerable when we question the dubious assumption that becoming a person must be a sharp, all-or-none affair. It is the absence of sharp boundaries defining a person that gives plausibility to the claim that to abandon conception as the moral frontier is to start on a slippery slope toward abolishing the distinction between the fetus and the newborn child. But why should becoming a person not be a gradual affair, like becoming middle-aged? Of course any abortion law will need sharp boundaries. But this by itself proves nothing. Speed limits have to be precise rather than blurred, but this does not prove that danger starts at precisely 55 mph. The view that being a person is something that starts abruptly is typically assumed rather than argued. Yet the alternative only has to be stated for the need for argument to be apparent.

A different version of the prolife case claims not that the fetus is a person, but that the fetus is a human being. (President Reagan, in his State of the Union message this year, expressed the thought that science is proving this true.) But it is hard to see what this claim comes to. Obviously the fetus is a being, and it is human rather than belonging to any other species. There is also no doubt that it is living. The problem is that these points could all be made about the living human sperm cell, yet few would think that "human beings" of that kind had rights. The argument exploits the fact that the "human beings" we are most aware of are also persons. There is a sense in which the newly fertilized egg is a human being, but it isn't the kind of human being you can share a joke with or have as a friend.

Another prolife argument, with great intuitive appeal, asks: "If you were glad you were not aborted yourself, how can you justify aborting someone else?" But again things are more complicated than the simple intuitive response suggests. The premise of the argument is quite correct. I am glad I was not aborted, since I should not be here if I had been. But for the same reason, I am glad my parents did not use a contraceptive, or practice chastity. Unless we accept that we ought to produce as many children as possible, the argument seems to prove too much.

The problem of distinguishing between infanticide and abortion still remains, and it can only be dealt with by examining the moral justifications for taking life. There seem three central objections to an act of killing someone. It is a violation of that person's autonomy, perhaps the most extreme violation possible. It is objectionable because of the loss of the years of life that person would otherwise have enjoyed. And it is objectionable because of the effects on other persons than the one killed. The first objection, about autonomy, is in the Kantian tradition, while the other two objections are broadly utilitarian. How does each apply to infanticide and abortion?

The Kantian appeal to autonomy is linked to the question of being a person. I do not violate someone's autonomy unless I override a decision they have made or a desire they have. (And satisfying this condition may be insufficient, at least to constitute a morally objectionable violation of your autonomy. Your decision or desire may be to harm someone else. But this qualification can be ignored here.) If being a person requires some minimal level of self-consciousness, it seems that only persons will have the desire to go on living that would make killing them a violation of their autonomy.

The problem with trying to settle the abortion question by an appeal to autonomy, or by related claims about person-hood, is that it is highly doubtful that infants have the self-consciousness required, either for being persons, or for killing them to be a violation of autonomy. The Kantian argument leaves infanticide no more objectionable than the morning-after pill.

On the other hand, the first utilitarian argument, about the years of life that are lost, is like the "you-are-glad-you-were-not-aborted" argument. It proves too much. It makes the morning-after pill, and contraception, as bad as infanticide. All eliminate a lifetime that would otherwise have been enjoyed. This is the weakness of all arguments that appeal not to what the fetus is now, but to the potential it has to become a developed person. On these views, abortion is wrong because it prevents the existence of a particular person, the one the aborted fetus would have become. But you are a particular person, and contraception, as well as abortion, could have prevented your existence.

The escape from this might be to interpret potentiality differently. Perhaps the destruction of the potential is not just a matter of the loss of a future developed person, but also the loss of something that started on the way there: the program for producing a person already exists, since all the genes are present. But this leaves open many questions. If the properties the fetus now has do not confer a right to life, and the argument about one fewer future person does not either, why should combining these two considerations suddenly give the desired result? Of course a compound can have properties not possessed by its individual ingredients. But here it would be more convincing to be told something about the moral chemistry involved. And it is hardly to be supposed that the explanation could have the plain obviousness the right-to-lifers claim for their view of abortion.

Since, in their different ways, the Kantian and the first utilitarian objections to killing equate contraception and infanticide, they are of little help in drawing the required moral boundary between infanticide and abortion. In a way that will strike some as disconcerting, the other utilitarian objection, citing the effects of an act of killing on other people, turns out to be centrally relevant. The effects on our attitudes to babies and children become decisive. If the worries I have raised about the dehumanizing effects of late fetal research have any substance, there are parallel worries about late abortion. And, once the child has left the womb, the effect on us of an act of killing obviously becomes much greater.

There is room for reasonable disagreement among those who accept this line of thought. The case against abortion grows more powerful as the pregnancy nears termination, and the case against infanticide is much stronger still. But there is a countervailing case for abortions, even late ones. A powerful argument can be made in favor of bringing to birth only wanted children, and for extending the control of women over their lives. People may legitimately give different weight to the considerations for and against late abortion. And, even with the far more powerful presumption against infanticide, some of us hold that in the case of certain disastrous handicaps at birth the avoidance of a great deal of misery can tip the decision against preserving life. But central to the whole issue is the conflict between such claims and the defense of our emotional responses to babies.

Underlying the prolife view is sometimes an inarticulate feeling for this point. Supporters of that view often have an intuitive sense that the standard arguments in favor of the right to choose abortion justify too much, perhaps including an erosion of our responses to babies. The prolife position is not motivated only by an awareness of this threat, but is often an expression of the threatened responses themselves. The simplifying and questionable prolife assumptions can be exposed, but these underlying emotional responses should not be dismissed. On the contrary, sensitivity to them is necessary for an adequate defense of the prochoice view.

The stridency that characterizes the abortion argument may partly result from its underlying complexity. It is a major public issue and, for many, a major private decision. Yet a central part of the problem, the status of the fetus, has a troubling ambiguity. The fetus just before birth is very like a baby; the newly fertilized egg is not. As psychologists know, we sometimes find ambiguity hard to tolerate in things that matter. Here, faced with the ambiguous figure, we vehemently assert that it is a duck and denounce the blindness of those who claim to see a rabbit.

But the passion is also linked to the way abortion is the scene of a conflict between larger views of the world. Connie Paige, whose account of the exploitation of the abortion issue by far-right politicians is in the useful tradition of muckraking journalism, suggests that conservatives can see in abortion "a quick and easy symbol for sexual permissiveness and feminism." She describes one of the leaders of the movement, who believes that the issue of abortion will, for conservatives, become what opposition to the war in Vietnam had been for liberals: "a hook to acquaint them with a whole new world view." Organizations such as the one called "Stop the Babykillers" made a notable contribution in 1980 to the replacement of liberal senators like McGovern by more conservative politicians. And no doubt the issue of abortion can also work the other way, drawing people who support it into seeing other issues from the perspective of the women's movement.

On each side, the views held cannot simply be the result of pressure-group leaders manipulating the emotional responses of their followers. Distinctive views on abortion come naturally to different kinds of people with different general systems of belief. Kristin Luker, in her sensitive and illuminating study of activists in the rival pressure groups, gives a portrait of the different worlds they inhabit.

Ms. Luker interviewed at length a sample of 212 California participants in the abortion debate. "Activists" on the prolife side were defined as those spending ten or more hours a week on the issue, and prochoice "activists" were those spending five or more hours a week. (The prolife campaigners were devoting more time to the issue. Applying the same cutoff point to the two groups at the start of the study would have yielded no activists on the prochoice side.) A weakness of the study is that it is not quite clear what the ratio of men to women was in the sample, but it appears that more than 80 percent were women. Kristin Luker found that, while male activists on both sides were very similar in education, occupation, income, and family position, this was far from true of the women involved. The prolife women activists, by comparison with the prochoice ones, tend to have had less education, are more likely to have married, and tend to have had more children. The prochoice women activists have a lot more money, and are much more likely to be in paid employment. Of the prochoice women, 94 percent had jobs, as against 37 percent of the prolife women activists. There were predictably large differences in religious affiliation as well. Eighty percent of the prolife women activists were Catholic and only 5 percent had no religion, while 63 percent of the prochoice women activists had no religion.

The prolife women activists tend to believe that traditional sex roles reflect deep natural differences between men and women, that sex is primarily for procreation, and that parenthood is a natural function rather than a social choice. They are dubious about sex education, hostile to premarital sex, and hostile to the availability of contraception and abortion to teen-agers without parental consent. The prochoice women activists tend to think that men and women are very similar by nature, and lay less emphasis on the importance of the family in women's lives. They do not think that sex should be tied to procreation, and believe in sexual freedom. They accept teen-age sex but not teen-age parenthood. And they think that the availability of abortion improves the quality of parenthood, by making it a matter of choice.

If the members of the two groups read Kristin Luker's book, they may find to their surprise that they are able to sympathize with some aspects of each other's viewpoint. The most militant prolife advocate might find it hard to denounce as morally irresponsible the members of the prochoice group, in view of their earnest concern that children should have a better upbringing than reluctant teen-age mothers are likely to give them. And, as one who supports the availability of contraception and abortion to teen-agers, if necessary without parental consent, I am impressed by the decency of the reasons the prolife women gave for taking the opposite view. They worry about cutting off parental support and resources when children need them most. They fear that teen-agers may make hasty decisions alone, through underestimating how understanding and helpful parents will be.

Although Kristin Luker's book should help people to see that their opponents are not moral monsters, it will not encourage a tendency to compromise. For, as she emphasizes, the differences about abortion, teen-age sex, and so on are bound up with deeper and more general moral differences. Most notable is the difference between a morality of absolute commands and prohibitions, set in a scheme of religious belief, and the more secular approach of the prochoice activists, who are motivated by the bad consequences of denying abortion both for women and for the quality of parenthood. And this underlying issue is not one where some plausible compromise is in sight. We are deeply divided between religious and secular world views, and also between absolutist and consequentialist moralities.

 

In the absence of a satisfactory defense of the fetal right to life, however, those of us who support the right to abortion can feel our case is a powerful one. The policy of forcing women to bear and rear unwanted children involves a degree of misery and servitude that is an obvious moral evil. It could only be justified by showing that it averts a greater evil. There is room for disagreement whether the effects on us of late abortions could count as a greater evil. But the prolife arguments do not come near to establishing that abortion in general is such an evil.

The disastrous consequences of restrictive attitudes toward abortion become greater as reproductive technology advances. With the development of tests for fetal abnormality, it is possible to reduce the risks of having a severely handicapped child. The agonizing dilemma of having to decide for or against treatment, which now faces the parents of a spina bifida baby, can be eliminated by detecting the abnormality between the sixteenth and eighteenth week of pregnancy. But if abortion is banned, this test and others become pointless, and appalling disorders will continue to blight people's lives.

The effects of the prolife campaign in the United States, moreover, are being felt in other countries. With one eye on the election-year influence of the prolife movement, the Reagan administration last year cut off funds to those non-government organizations working in the third world that are prepared to support abortion as a means of population control.

The World Bank estimates that the world's population will almost double to nearly ten billion in the next seventy years. The evidence is that third world families, like those anywhere else, seize the choice that contraceptives offer. Their availability owes a lot to organizations like the International Planned Parenthood Federation. The IPPF does not advocate abortion as a form of birth control, but, like the prochoice movement in the United States, thinks abortion should be available where contraception has failed. For this crime, the quarter of its funds that comes from the United States has been cut off. Apart from the probable effect of increasing abortions by reducing the availability of contraceptives, the combined effects of a greater population explosion, and of reduced procreative choice, on people in the poorest countries of the world should need no emphasis. The influence of the prolife movement will be felt further away than Granite City, Illinois, and St. Paul, Minnesota.