Bioethics. Группа авторов

path as to be able immediately (or almost immediately) to exercise their capacities for characteristically human mental functions – possess that kind of value and that right.⁴

      Since human beings are valuable in the way that qualifies them as having a right to life in virtue of what they are, it follows that they have that right, whatever it entails, from the point at which they come into being – and that point (as shown in our first section) is at conception.

      In sum, human beings are valuable (as subjects of rights) in virtue of what they are. But what they are are human physical organisms. Human physical organisms come to be at conception. Therefore, what is intrinsically valuable (as a subject of rights) comes to be at conception.

The Argument that Abortion is Justified as Non‐intentional Killing

      Some “pro‐choice” philosophers have attempted to justify abortion by denying that all abortions are intentional killing. They have granted (at least for the sake of argument) that an unborn human being has a right to life but have then argued that this right does not entail that the child in utero is morally entitled to the use of the mother’s body for life support. In effect, their argument is that, at least in many cases, abortion is not a case of intentionally killing the child, but a choice not to provide the child with assistance, that is, a choice to expel (or “evict”) the child from the womb, despite the likelihood or certainty that expulsion (or “eviction”) will result in his or her death (Little, 1999; McDonagh, 1996; Thomson, 1971).

Various analogies have been proposed by people making this argument. The mother’s gestating a child has been compared to allowing someone the use of one’s kidneys or even to donating an organ. We are not required (morally or as a matter of law) to allow someone to use our kidneys, or to donate organs to others, even when they would die without this assistance (and we could survive in good health despite rendering it). Analogously, the argument continues, a woman is not morally required to allow the fetus the use of her body. We shall call this “the bodily rights argument.”

      It may be objected that a woman has a special responsibility to the child she is carrying, whereas in the cases of withholding assistance to which abortion is compared there is no such special responsibility. Proponents of the bodily rights argument have replied, however, that the mother has not voluntarily assumed responsibility for the child, or a personal relationship with the child, and we have strong responsibilities to others only if we have voluntarily assumed such responsibilities (Thomson, 1971) or have consented to a personal relationship which generates such responsibilities (Little, 1999). True, the mother may have voluntarily performed an act which she knew may result in a child’s conception, but that is distinct from consenting to gestate the child if a child is conceived. And so (according to this position) it is not until the woman consents to pregnancy, or perhaps not until the parents consent to care for the child by taking the baby home from the hospital or birthing center, that the full duties of parenthood accrue to the mother (and perhaps the father).

      In reply to this argument we wish to make several points. We grant that in some few cases abortion is not intentional killing, but a choice to expel the child, the child’s death being an unintended, albeit foreseen and (rightly or wrongly) accepted, side effect. However, these constitute a small minority of abortions. In the vast majority of cases, the death of the child in utero is precisely the object of the abortion. In most cases the end sought is to avoid being a parent; but abortion brings that about only by bringing it about that the child dies. Indeed, the attempted abortion would be considered by the woman requesting it and the abortionist performing it to have been unsuccessful if the child survives. In most cases abortion is intentional killing. Thus, even if the bodily rights argument succeeded, it would justify only a small percentage of abortions.

      Still, in some few cases abortion is chosen as a means precisely toward ending the condition of pregnancy, and the woman requesting the termination of her pregnancy would not object if somehow the child survived. A pregnant woman may have less or more serious reasons for seeking the termination of this condition, but if that is her objective, then the child’s death resulting from his or her expulsion will be a side effect, rather than the means chosen. For example, an actress may wish not to be pregnant because the pregnancy will change her figure during a time in which she is filming scenes in which having a slender appearance is important; or a woman may dread the discomforts, pains, and difficulties involved in pregnancy. (Of course, in many abortions there may be mixed motives: the parties making the choice may intend both ending the condition of pregnancy and the death of the child.)

      Nevertheless, while it is true that in some cases abortion is not intentional killing, it remains misleading to describe it simply as choosing not to provide bodily life support. Rather, it is actively expelling the human embryo or fetus from the womb. There is a significant moral difference between not doing something that would assist someone, and doing something that causes someone harm, even if that harm is an unintended (but foreseen) side effect. It is more difficult morally to justify the latter than it is the former. Abortion is the act of extracting the unborn human being from the womb – an extraction that usually rips him or her to pieces or does him or her violence in some other way.

It is true that in some cases causing death as a side effect is morally permissible. For example, in some cases it is morally right to use force to stop a potentially lethal attack on one’s family or country, even if one foresees that the force used will also result in the assailant’s death. Similarly, there are instances in which it is permissible to perform an act that one knows or believes will, as a side effect, cause the death of a child in utero. For example, if a pregnant woman is discovered to have a cancerous uterus, and this is a proximate danger to the mother’s life, it can be morally right to remove the cancerous uterus with the baby in it, even if the child will die as a result. A similar situation can occur in ectopic pregnancies. But in such cases, not only is the child’s death a side effect, but the mother’s life is in proximate danger. It is worth noting also that in these cases what is done (the means) is the correction of a pathology (such as a cancerous uterus, or a ruptured uterine tube). Thus, in such cases, not only the child’s death, but also the ending of the pregnancy, are side effects. So, such acts are what traditional casuistry referred to as indirect or non‐intentional, abortions.

      But it is also clear that not every case of causing death as a side effect is morally right. For example, if a man’s daughter has a serious respiratory disease and the father is told that his continued smoking in her presence will cause her death, it would obviously be immoral for him to continue the smoking. Similarly, if a man works for a steel company in a city with significant levels of air pollution, and his child has a serious respiratory problem making the air pollution a danger to her life, certainly he should move to another city. He should move, we would say, even if that meant he had to resign a prestigious position or make a significant career change.

      In both examples, (a) the parent has a special responsibility to his child, but (b) the act that would cause the child’s death would avoid a harm to the parent but cause a significantly worse harm to his child. And so, although the harm done would be a side effect, in both cases the act that caused the death would be an unjust act, and morally wrongful as such. The special responsibility of parents to their children requires that they at least refrain from performing acts that cause terrible harms to their children in order to avoid significantly lesser harms to themselves.

      But (a) and (b) also obtain in intentional abortions (that is, those in which the removal of the child is directly sought, rather than the correction of a life‐threatening pathology) even though they are not, strictly speaking, intentional killing. First, the mother has a special responsibility to her child, in virtue of being her biological mother (as does the father in virtue of his paternal relationship). The parental relationship itself – not just the voluntary acceptance of that relationship – gives rise to a special responsibility to a child.

      Proponents of the bodily rights argument deny this point. Many claim that one has full parental responsibilities only if one has voluntarily assumed them.