Tag Archives: abortion

Unknown's avatar A. E. 12:51 am on June 23, 2019
Tags: abortion, disability rights, eugenics, forced abortion, Human Rights, medical ethics, rights of the disabled   

Adventures in State-sponsored Eugenics

If you have not yet heard of the recent court-decision made in the United Kingdom, wherein the judge has determined that a mentally disabled woman should be forced to terminate her pregnancy against her will, I would highly recommend that you do so — I prefer this version for the commentary provided, but the one doing the most rounds at present is here. Alarmingly, though not unexpectedly, some sections of the online peanut gallery appear to have latched on to the fact that the woman’s mother is Catholic as a means of justifying why this decision was the right one to make; ignoring entirely that it’s not the mother who’s getting an abortion — it’s her daughter, whom, despite her lacking the ability to make legal decisions of her own accord, does have an opinion on the fate of her pregnancy; an opinion that is no less worthy of consideration on account of her disability. As it happens, the judge presiding over this case has decided, in a similar vein, that the opinion of the woman’s doctors are more “legitimate” than that of the women herself, in addition to that of her mother and her social worker.

Now, you might argue, as the prosecution has, that the doctors are more knowledgeable in this regard than are either of the aforementioned parties; by which you would be suggesting that mind-reading and the foreseeing of multiple, hypothetical future outcomes are things one might learn in medical school. Given that this is not the case, we are left with an assumption that a forced abortion is in any way a better thing to do to a person than allowing her to birth the child would be. Ultimately, this is a matter of opinion, rather than fact — the only reason that the opinion of the doctors, presumably none of whom will be getting an abortion as a result of this, is being given precedence over that of the person who actually is getting an abortion, is because the latter is severely disabled and presently residing in the care of the state. Thus, there are a number of very important, actually quite relevant to you things to be learned from this that need to be discussed in light of this decision; this is remains the case irrespective of whether or not you are personally disabled, or even if you genuinely believe that this woman should be forced to have an abortion. It is not even necessary to delve into a discussion regarding the ethics of abortion in and of itself: All of the points that need to be made have much more to do with the mother-to-be, someone who is definitely alive and who’s basic legal status as a “person” should no longer be up for debate.

Now, it is my impression that the version of this case as it is being presented by the media is using intentionally-vague terms, such as “learning disabled” and “mood disorder”, in order to preserve the woman’s identity by avoiding specifics — I can understand that. This, of course, makes it harder for me to attempt to understand the possible implications behind her being forced to abort her pregnancy; nevertheless, I can make some generalizations. Even for those of us who are not severely disabled, it is important that we try to get an understanding of the threshold: Call me a pessimist, but I have good reason to suspect that this threshold will be progressively lowered as time goes on. Now that the U.K. has set this precedent — that the “her body, her choice” rhetoric doesn’t apply to all women — we can expect other, even non-U.K. jurisdictions to test the same waters somewhere down the line. After all, this is the same process that led us to legalizing medical euthanasia: Today, the Netherlands; tomorrow, the world.

According to Wikipedia, the term “learning disabled” is used in Britain as a stand-in for “intellectually disabled”. Assuming that this is true, and considering that the disabled woman in question is in institutional care, I would imagine her to be at least moderately, if not severely cognitively impaired; somewhere in the IQ range of 40 and under, let’s say. As well, she is claimed to have the mental age of a six-to-nine year-old child, in addition to a “moderately severe” mood disorder. Again, because we are not given any hints as to exactly what behavioral issues the woman has, I cannot possibly hazard a guess as to what her doctors’ specific concerns are regarding her ability to continue the pregnancy. What I can do is attempt to argue why their concerns — so long as they are based in her mental faculties, rather than her literal, physical ability to carry the pregnancy — ought not to matter in the first place.

We know that the woman is at least capable of voicing her own opposition to the abortion, even though the courts have apparently decided that her opinion regarding what happens to her own body doesn’t matter. Now, let’s address this concept of mental age: To have a certain mental age is not synonymous with actually behaving as if one literally were that age; in this instance, her having a mental age of six-to-nine does not mean that she can effectively be regarded as a literal child. All that it means is that she has a level of cognitive functioning similar to that of a non-disabled child of around that age range. Furthermore, it says nothing specific about her emotional intelligence — that is, her ability to process her feelings and regulate her reactions in relation to various situations. Assuming that she doesn’t suffer from a blunted emotional response (given that the prosecution’s argument would make even less sense if that were the case), let’s say that she has an emotional intelligence comparable to that of a six-to-nine year-old child. Following from this, try to think of a sad or otherwise emotional event that might have happened to you when you were around that age. As much as you may have been affected more strongly owing to a lack of life experience, that did not make your feelings at the time any less “real.” The immense grief and sense of loss that you may have felt over the death of your beloved goldfish was still real grief and loss; it’s just that it doesn’t hurt as much when it happens to you twenty years down the road. “The first cut is the deepest,” as they say.

It’s important to understand this, as much of the prosecution’s argument (and that in the judge’s ruling) seems to be based upon the premise that the woman would be more traumatized by her child being taken away than she would be if the pregnancy were terminated. Right now, they argue, the child is “not a real baby” — so it is alleged that we can abort it and she’ll just have to get over it. The judge, for whatever reason, doesn’t appear to have considered the idea that the woman’s pregnancy is real to her — she’s been carrying her child for 22 weeks now; she clearly knows that she is pregnant and what that means; and she seems to understand the abortion procedure at least well enough to know that its result will be the loss of her baby. Even six year-old children can wrap their heads around the idea of a baby “being inside a woman’s belly” — just ask any parent with more than one kid. Their non-understanding of the technical details of pregnancy does not inhibit them from getting “the gist of it,” so to speak.

Despite all this, the judge seems to think that she knows better than both the woman and her mother what the former is capable of comprehending. It is always appalling to me to see someone rights being stripped from them, especially when that someone is severely disabled or in an otherwise vulnerable position, by reasoning of what someone else thinks is “in their best interests.” This is the kind of insidious paternalism that oftentimes turns deadly, just as it has here. The prosecution has had the gall to suggest that this woman would be more affected by her baby being taken from her by social services (though remaining alive) than she would be by being forced to undergo an invasive, deeply emotional medical procedure, against her will, that results in her baby’s death — this assumption is no better backed-up by her being severely cognitively disabled than it would be were she any less so. As a matter of fact, I for one would imagine that the trauma of undergoing a forced abortion would be greatly compounded by her disabilities, rather than somehow “alleviated.” This is particularly the case in consideration of her “moderately severe” mood disorder; this being the next item on the agenda.

As it is used here, a “mood disorder” could refer to virtually any of them: She might be prone to depression, or mania, or both; this is not elaborated on either. However, it may be a safe bet that the exact disorder being referred to contains at least some depressive component, given the wording and reasoning deployed by both the prosecution and the judge. Speaking from experience (and readily backed by clinical research), the last thing that anyone suffering from a depressive disorder wants to hear is bad news — since this woman has already voiced that she doesn’t want to have an abortion, there’s no other way to describe the court’s ruling than as “bad news”, and extremely bad news, at that. Regardless of her realistic ability to care for it, she wanted this baby; now, she’s going to lose it. She doesn’t need to have a normal IQ level to be profoundly, emotionally affected by this decision; alongside surely many others, I can personally attest to my not being cognitively impaired ever getting in the way of becoming extremely upset on receipt of bad news, even when such news might not warrant quite the same response in someone without a mood disorder — that’s kind of what these things will do to a person. If she was already going to have a difficult time dealing with the stress of child-rearing, she’s really going to have a hard time dealing with the revelation that her child is going to be killed at the behest of the state — again, her having a mood disorder is a better argument against forcing her to endure an abortion than it is for it. How could you possibly hope to convince her, even if superficially, that going against her wishes really was “in her best interests”, considering that her ability to process this type of information is greatly impaired in both cognitive and emotional terms?

At risk of appearing to deploy the “Everyone I don’t like is Hitler” form of “argument” that we’ve all grown so tired of in recent years, what has happened in this case really is comparable to what was done to the intellectually, emotionally, and physically disabled under the Third Reich’s euthanasia program: In essence, this woman’s status as severely disabled has been decided as rendering her own thoughts on what happens to her and her baby to be irrelevant. Of course, the Nazis took this line of thinking a step further by actually killing the severely disabled; in this case, it is “only” the baby that will be killed, on account if its mother being severely disabled — not to suggest that this is any better an outcome, of course. Sadly, this is far from the first time that a woman, disabled or otherwise, has been forced to undergo an unwanted abortion; some women have even been forcibly, permanently sterilized, whether the force applied be literal or practical in nature. Not only in Nazi Germany but as well, historically, in the United States, Canada, and many other Western nations, have women deemed “unfit” to reproduce been sterilized against their will by order of the government; that said, it obviously remains the case that non-liberal governments top the charts in this regard. Arguably, the only reason that this particular form of eugenics ever became unpopular in the West was because the Nazi’s soured the public’s opinion of it. Over seventy years later, it appears to be re-entering the discussion — if there’s any “re-emerging Nazi ideals” that we should be seriously concerned about countering, this one would make a good candidate.

This woman is not being sterilized, but she is having her rights blatantly violated by being forced to terminate her pregnancy. Remember: Disabled people of any form, regardless of how disabled they may be, are still people — they, too, are entitled to protection of these alleged “human rights” that we keep hearing about. No matter what the reason, whether or not her body and her baby’s right to life should be violated in this manner should never, under any circumstances, depend upon the strength of her mental faculties or lack thereof: The government should not be able to force you to undergo an invasive, ultimately non-essential procedure simply because they believe you to be too stupid to decide whether or not that’s an option you’d like to take. If it would be unethical to force her to donate a kidney, it is quite unethical to force her to abort her baby — the fact that she is cognitively disabled does not alter her status as a human being. Surely, we can identify a massive difference between whether or not one can advocate for themselves in legal matters and whether or not they may do so in their own, personal affairs. Lastly, it is not as if she’s brain dead — as outlined above, she is capable of possessing her own thoughts and feelings; whether those thoughts and feelings are “legitimate” is not up to the courts to decide, for precisely the same reason as why courts should not be deciding what does or doesn’t constitute “hate speech.”

We really, really do not want to continue down this path of determining of who gets to have more rights and who gets to have less. Joke about how there should be a “license to have children” all you want, but the bulk of those who seriously advocate such things almost always fail to consider just what kind of questions would be on the test, let alone the possibility that they themselves might fail it. It’s a lot less funny when you’re the one who’s had their rights taken away entirely on the basis of factors quite beyond your control.

Now that the U.K. has joined the ranks of China and North Korea as places on Earth where it is currently possible to legally force a woman to have an abortion, one of the more important questions we need to be asking ourselves is this: Where does one draw the line? At what point, and in what condition, does one person become “less human” than another, if such a thing could be determined? But of course, where you might personally do so is fundamentally irrelevant; you are likely not who would be making that decision. As such, we should all consider ourselves to be potentially subjected to this type of third-party decision-making on our behalf — time and time again, history has shown that it is better for one to be critical of any instance of their government blatantly violating the rights of its citizens, no matter what the reason given for doing so, than it is to blindly hope and pray that such a thing will never happen to them.

Unknown's avatar A. E. 2:43 pm on March 21, 2019
Tags: abortion, bioethics, pro-abortion, pro-choice   

Arguing Against Abortion, Part 1: Preventing Undue Pain & Suffering

In the abortion debate, there is a tendency for abortion advocates to ground their morals in terms of how an unwanted pregnancy could affect the well-being of the mother; the bulk of these arguments can be boiled down to the possibility that she may not be financially or emotionally prepared for a child. When this potential child comes into the discussion, it is often in terms of how much suffering it will supposedly go through if it is born to an unprepared mother, with the assumption being that terminating the pregnancy is therefore more ‘ethical’ for both parties in the long-term — it is this second assumption that I’d like to challenge.

In this first part, I want to talk about the process of abortion in terms of the suffering that is inflicted on the fetus itself, rather than continue the critique of the very old, very tired political bandwagon of “women’s reproductive rights” and what-have-you, as this lens is one that very few are willing to look through. Though I suppose it is far easier to empathize with an already-born woman than with the so-called “clump of cells” hidden away inside of her, the fact that you need an ultrasound to see the latter should not get in the way of having at least some sympathy for the poor thing — it didn’t ask for any of this, either.

In the interest of transparency, I am personally on the pro-life side of things, though this has not always been the case. In my perfect world, there would be no abortion. That said, I understand that this is extremely unlikely to happen, thus I am more in favour of limiting the availability of abortion to under 20 weeks; the point at which we know for certain that the fetus is capable of feeling pain, with some research suggesting that they may be more sensitive to pain during this developmental stage than they are after birth. It has always been my belief (and that of most medical professionals, might I add) that inflicting pain on a living thing is only morally justified when it is necessary to preserve its life (assuming of course that it will not subsequently live the rest of its life in such a state); in terms of taking its life, therefore, it is never justified. If we are going to be ending a life prematurely, for whatever reason, it should be done in such a way that causes a minimal amount of pain and suffering, which is precisely what all present methods of abortion in the 20+ week range does not do. In this respect, it doesn’t really matter what you think of the legal status of this biological entity, as we know that it can feel pain after 20 weeks of gestation and that ought to be the only thing that matters. I don’t really care about what we call it and neither should you.

Let’s start by going over some of these methods that are used to perform such abortions — that is, the “medical procedure” wherein a live fetus is “terminated,” thus I am not referring to miscarriages nor stillbirths, both of which are uniquely characterized by the fetus already being dead. For an abortion the fetus starts out alive, which is an important distinction to make. This distinction still applies to what are termed “non-viable pregnancies,” i.e. the fetus cannot survive post-birth and/or is unlikely to be born alive, and it applies specifically because it is still alive, its chances of survival outside the womb notwithstanding. Similarly, a person on life support is still alive despite their dependency on machinery to remain so, and one will further note that we refer to brain-dead patients as such, rather than just “dead” — there is an important distinction between the two, regardless of future prospects.

So, methods: typically, for late-term abortions, the fetus will need to be “destroyed” prior to its removal; this seems to be most commonly accomplished via a fatal injection of either potassium chloride or digoxin, which is injected into either the fetus’s body or the amniotic sac surrounding it. Potassium chloride (KCI) we know from its use in lethal injections, and we know from botched lethal injections that it causes a severe, painful burning sensation in the recipient before causing cardiac arrest — this is why lethal injections use a total of three drugs for the job, the other two being administered before the KCI to first induce unconsciousness and paralysis, respectively. But, since we do not grant the same courtesy to fetuses undergoing abortion that we do for criminals undergoing execution, a fetus will only receive the KCI injection. Digoxin, meanwhile, is said to cause “considerable pain at the injection site” when administered for non-abortive purposes in both adults and children, and as such, injection “is not generally recommended unless other routes cannot be used.” [1] No matter which of the two drugs are used, fetal death is not instantaneous; in fact, the process can take several hours. Now, if KCI is injected directly into the fetus’s heart it will stop beating immediately — but, remember, not having a heart beat is not necessarily the same as being dead, and so long as the nerves and brain tissue remain intact, the odds of the fetus experiencing excruciating levels of pain during this phase of its “termination” are fairly high.

This is not the only way to go about things, of course. As it turns out, the “induction of fetal demise” is not a universal prerequisite for its removal in the second trimester. One could also go about it by the infamous dilation and evacuation (D&E) procedure, which involves the insertion of a suction tube into the uterus, through the amniotic sac and pressed up against the fetus’s chest and abdomen. Once turned on, the fetus will perish as a predictable result of having its internal organs vacuumed out of its body. The chance that this disembowelment occurs quickly enough that the fetus does not experience any pain is quite low, as its tiny organs are still too big to fit down the tube all at once, regardless of the amount of suction being applied. I’m not going to post them here, but if the reader is so inclined they may do a Google image search for autopsy photos of fetuses at 20 weeks; in doing so, they may note that the stomach, for example, is about the size of an adult, male thumb from the tip to the first knuckle. The tubes used for this procedure vary in size from between 6 to 16 mm in diameter — even at 16 mm, this is still smaller than my own adult, female thumb. Now factor in that we are not just removing the stomach in this matter but as well the heart, lungs, intestines; in essence, every organ but the brain, which of course is the part responsible for processing pain. With that in mind, I remain very unconvinced that this would be a “quick and painless” death for the fetus in question.

The last method available is what’s called a partial-birth or intact dilation and extraction (D&X) abortion, which does not call for the fetus to be terminated in utero. As far as I can tell, this procedure is used in cases where the fetus may have been “wanted” but has been found to be non-viable, and the parents wish to keep the fetus’s body relatively intact for viewing and burial purposes. While this may potentially be the least painful of all the methods discussed here, it is my view that it also carries the highest degree of cognitive dissonance in terms of what we determine to be a baby or infant (and thus “worthy” of protection) vs. what we determine to be “merely” a fetus (and thus potentially subject to disposal) — but I’ll get to that in a minute. The procedure is, in essence, as follows: after the cervix has been sufficiently dilated the fetus is partially extracted from the mother’s body, just enough for the abortionist to puncture the base of the skull, insert a suction tube into the brain and remove its contents, after which the body is extracted completely.

Now, this would probably provide for a quicker death in comparison to a D&E procedure, but how much quicker and, subsequently, how much less painful we do not know for certain; I am not at all sure whether it is objectively more or less painful to have a tube thrust into one’s skull than it is to have one’s chest and abdominal cavity sucked out through a similar tube. In any case, we ought to consider the standard that we have set not only for doctor-assisted suicides but for our pets, as well: in neither case would we consider it acceptable for a family member on their deathbed, be they human or otherwise, to be euthanized via puncturing a hole in their skull and vacuuming out their brain. At the very least, hypothetically speaking, there would certainly be a reasonable demand made to have the subject rendered unconscious beforehand. Again, this standard is applied in a variety of real-life circumstances ranging between having a dog put to sleep to the execution of criminals, the latter of whom have (more often than not) committed extraordinarily horrific crimes in order to earn such a punishment — but we do not apply this standard to a fetus. The arbitrary line-drawing of how much of its body has passed through the birth canal as the determining factor between ‘fetus’ and ‘infant,’ too, is suspect: essentially, if the subject has its head out enough then it has been “properly” born and is therefore entitled to care and protection as a legally-recognized “person,” but if every other body part but the head has completely exited the same passage, it remains completely legal to kill it. (This is somewhat of a separate discussion entirely, but it’s certainly something to think about.)

In sum, the first argument is as follows: after the 20th week of gestation, wherein the nervous system has developed enough to have the capacity of experiencing pain, abortion of any form should not be performed, regardless of the viability or non-viability of the fetus in question, on the basis that the current methods at our disposal cause what I have argued to be an inhumane amount of pain to be inflicted on a living creature in the process of ending its life. Irrespective of whether or not we consider the fetus to be a “person,” the current precedent and standard of care set for the “destruction” of non-humans indicates that, at the very least, the fetus should be sedated prior to termination; this standard is not presently met by any of the methods discussed above.

In the second part, I will be arguing against the utility of distinguishing between viable and non-viable pregnancies. When I’ve finished writing it, I will link to it here.