abortion ethical dilemma essay

The Ethical Dilemma of Abortion

Article sidebar.

Main Article Content

This paper discusses the extremely complex and important topic and dilemma of abortion.  Specifically, that the pro-life versus pro-choice dilemma is an imperative one that continues to cause ethical tensions in the United States.  For this reason, this issue and dilemma warrants close scrutiny.  It affects many major areas including ethics, religion, politics, law, and medicine.  Ethical theories and principles of the pro-life position and the pro-choice position will be contrasted.  This paper will further discuss the arguments in the context of Roe v. Wade and its impact on laws in the United States.  The general ethics of the pro-life argument and the pro-choice argument are founded on the issues of human rights and freedom.  Three main principles that the pro-life argument argues (the Human Rights Principle, the Mens Rea Principle, and the Harm Principle) will also be discussed.  This account will not include this author’s own prescriptive response (in the form of recommendations, best practices, or similar types of judgments) and therefore, this paper does not go beyond a purely comparative method.  Lastly, the Nuremberg Code, which was created at the Nuremberg Doctors’ Trial, will be discussed.  Specifically, the Nuremberg Code will be correlated in relation to laws in the United States, as well as contemporary bioethical debates, which are misleading when comparing the use of fetal tissue for transplants from abortions to experiments done during the Holocaust and crimes of Nazi biomedical science.

Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License .

Authors who publish with this journal agree to the following terms:

• Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a  Creative Commons Attribution License  that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  
• Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See  The Effect of Open Access ).
• Student authors waive FERPA rights for only the publication of the author submitted works. Specifically: Students of Indiana University East voluntarily agree to submit their own works to The Journal of Student Research at Indiana University East , with full understanding of FERPA rights and in recognition that for this one, specific instance they understand that  The Journal of Student Research at Indiana University East is Public and Open Access. Additionally, the Journal is viewable via the Internet and searchable via Indiana University, Google, and Google-Scholar search engines.

Christina M. Robinson, IUE Graduate

Christina graduated from Indiana University East with a 3.911 GPA in May, 2021 with a B.S. in Psychology and a minor of Neuroscience as well as a minor of Women's and Gender Studies.  She continues her work as a Research Assistant through IUE and is also a Supplemental Instruction Leader.  Christina hopes to continue her education in a graduate school program in the near future!

The Hastings Center

• Bioethics and Policy—A History Daniel Callahan
• The Hastings Center Bioethics Timeline
• Abortion Bonnie Steinbock
• Aging Daniel Callahan
• Brain Injury: Neuroscience and Neuroethics Joseph J. Fins
• Clinical Trials Christine Grady, RN, PhD
• Climate Change David B. Resnik
• Conflict of Interest in Biomedical Research and Clinical Practice Josephine Johnston, Bethany Brumbaugh
• Conscience Clauses, Health Care Providers, and Parents Nancy Berlinger
• Disaster Planning and Public Health Bruce Jennings
• End-of-Life Care Kathy L. Cerminara, Alan Meisel
• Enhancing Humans Cristina J. Kapustij, Mark S. Frankel
• Environment, Ethics, and Human Health David B. Resnik, Christopher J. Portier
• Family Caregiving Carol Levine
• Genomics, Behavior, and Social Outcomes Daphne O. Martschenko, Lucas J. Matthews
• Law Enforcement and Genetic Data James W. Hazel, Ellen Wright Clayton
• Medical Aid-in-Dying Timothy E. Quill, Bernard Sussman
• Nature, Human Nature, and Biotechnology Gregory E. Kaebnick
• Neonatal Care Jennifer McGuirl, Alan R. Fleischman
• Newborn Screening Mary Ann Baily
• Organ Transplantation Arthur Caplan, Brendan Parent
• Pandemics: The Ethics of Mandatory and Voluntary Interventions
• Public Health Ethics and Law Lawrence O. Gostin, Lindsay F. Wiley
• Quality Improvement Methods in Health Care Mary Ann Baily
• Racism and Health Equity Keisha Ray
• Research in Resource-Poor Countries Voo Teck Chuan, G. Owen Schaefer
• Sports Enhancement Thomas H. Murray
• Stem Cells Insoo Hyun
• Torture: The Bioethics Perspective Steven H. Miles

From Bioethics Briefings

• Abortion remains controversial.
• In recent years, several states, including Texas and Oklahoma, have passed abortion bans early in pregnancy.
• For nearly 50 years, there was a Constitutional right to abortion in the United States, established by the Supreme Court in Roe v. Wade in 1973
• The Supreme Court overturned Roe v. Wade in June 2022, eliminating the Constitutional right to abortion.
• A central ethical question in the abortion debate is over the moral status of the fetus.
• Opinions range from the belief that the fetus is a human being with full moral status and rights from conception to the belief that a fetus has no rights, even if it is human in a biological sense. Most Americans’ beliefs fall somewhere in the middle.
• Moral philosophers from various perspectives provide nuanced examinations of the abortion question that go beyond the standard political breakdowns.

Framing the Issue

Abortion has been one of the most divisive and emotionally charged issues in American politics. At one end of the debate are those who regard abortion as murder, a despicable and heinous crime. At the other end of the spectrum are those who regard any attempt to restrict abortion as an egregious violation of women’s rights to make their own decisions about their bodies and what is best for them and their families. Most Americans are somewhere in the middle.

A central philosophical question in the abortion debate concerns the moral status of the embryo and fetus. If the fetus is a person, with the same right to life as any human being who has been born, it would seem that very few, if any, abortions could be justified, because it is not morally permissible to kill children because they are unwanted or illegitimate or disabled. However, the morality of abortion is not settled so straightforwardly. Even if one accepts the argument that the fetus is a person, it does not automatically follow that it has a right to the use of the pregnant woman’s body. Thus, the morality of abortion depends not only on the moral status of the fetus, but also on whether the pregnant woman has an obligation to continue to gestate the fetus.

Ethical Considerations Around Abortion

Public opinion on abortion falls into three camps—conservative, liberal, and moderate (or gradualist)—each of which draws on both science and ethical thinking.

Conservative

Conservative opposition to abortion stems from the conviction that the fetus is a human being, with the same rights as any born human being, from the beginning of pregnancy onward. Some conservative groups—such as the Catholic Church—consider the fetus to be a human being with full moral rights even earlier than the beginning of pregnancy, which occurs when the embryo implants in the uterus. The Church regards the embryo as a full human being from conception (the conjoining of sperm and egg). This is because at conception the embryo receives its own unique genetic code, distinct from that of its mother or father. Therefore, Catholic doctrine regards conception, not implantation, as the beginning of the life of a human being.

Although conservatives concede that the fetus changes dramatically during gestation, they do not accept these changes as relevant to moral standing. Conservatives argue that there is no stage of development at which we can say, now we have a human being, whereas a day or a week or a month earlier we did not. Any attempt to place the onset of humanity at a particular moment—whether it be when brain waves appear, or when the fetus begins to look human, or when quickening, sentience, or viability occur —is bound to be arbitrary because all of these stages will occur if the fetus is allowed to grow and develop.

A secular antiabortion argument given by Don Marquis in 1989 differs from the traditional conservative view in that it is not based on the fetus’s being human, thus avoiding the charge of “speciesism.” Rather, Marquis argues that abortion is wrong for the same reason that killing anyone is wrong—namely, that killing deprives its victim of a valuable future, what he calls “a future like ours.” It is possible that some nonhumans (some animals or aliens) have a future like ours. If so, then killing them is also wrong.

This raises two questions about what it is to have a future like ours. First, what precisely is involved in this notion? Does it essentially belong to rational, future-oriented, plan-making beings? If so, then killing most nonhuman animals would not be wrong, but neither would killing those who are severely developmentally disabled. Second, at what point does the life of a being with a future like ours start? Marquis assumes that we are essentially human animals, so our lives start with the beginning of our organisms. But Jeff McMahan denies this, arguing that we are essentially embodied minds, and not human organisms. On McMahan’s view, our lives do not start until our organism becomes conscious, probably some time in the second trimester. Early abortion, on his view, does not kill someone with a future like ours, but rather prevents that individual from coming into existence – in much the way contraception does.

The pro-choice position on abortion is often referred to as the liberal view. Mary Anne Warren provides a classic statement of the liberal view. Warren does not dispute the conservative’s claim that the fetus is biologically human, but she denies that biological humanity is either necessary or sufficient for personhood and a right to life. She argues that basing moral standing on species membership is arbitrary, and maintains that it is the killing of persons , not humans, that is wrong. Indeed, Warren thinks that the conservative is guilty of a logical mistake: confusing biological humans and persons. Persons are beings with certain psychological traits, including sentience, consciousness, the capacity for rational thought, and the ability to use language. There may be some nonhuman persons (e.g., some animals, extraterrestrial aliens), and there may be biological humans that are not persons, including early gestation fetuses, who have no person-making characteristics. By the end of the second trimester, fetuses are probably sentient, but even late gestation fetuses are less personlike than most mammals who are not considered to be persons.

In 1971, Judith Thomson gave a completely different pro-choice argument from the classic liberal one, in which she maintained that even if the personhood of the fetus were granted, for the sake of the argument, this would not settle the morality of abortion because the fetus’s right to life does not necessarily give it a right to use the pregnant woman’s body. No one, Thomson says, has the right to use your body unless you give him permission—not even if he needs it for life itself. At least in the case of rape, the pregnant woman has not given the fetus the right to use her body. (Thus, Thomson’s argument, somewhat ironically for an article entitled “A Defense of Abortion,” provides those who are generally anti-choice with a rationale for making an exception in the case of rape, as do many pro-lifers—though not the Catholic Church.) Thomson maintains that whether a woman has a moral obligation to allow a fetus to remain in her body is a separate question from whether the fetus is a person with a right to life, and depends instead on the amount of sacrifice or burden it imposes on her.

In 2003, Margaret Little argued that while abortion is not murder, neither is it necessarily moral. A pregnant woman and her fetus are not strangers; she is biologically its mother which provides her with some reason to protect its life. However, she may have duties of care to others, such as her existing children, which would be more difficult to fulfill if she has another child. The typical abortion patient is already a mother, single, and low-income or poor. Although Little does not regard the fetus as a person, it is a “burgeoning human life,” and as such is worthy of respect. But abortion does not necessarily conflict with respect for human life. Many women regard bringing a child into the world when they are not able to care for it properly as itself disrespectful of human life.

The moderate, or gradualist, agrees with the classic liberal that an early fetus, much less a one-celled zygote, is not a person, but agrees with the conservative that the late-gestation fetus merits some moral concern because it is virtually identical to a born infant. Thus, the moderate thinks that early abortions are morally better than late ones and that the reasons for having one should be stronger as the pregnancy progresses. A reason that might justify an early abortion, such as not wanting to become a mother, would not justify an abortion in the seventh month to the moderate.

Fetal Development Timeline (pdf)

The Legal Perspective

In Roe v. Wade , the Supreme Court based its finding of a woman’s constitutional right to abortion prior to fetal viability on two factors: the legal status of the fetus and the woman’s right to privacy. Concluding that outside of abortion law, the unborn had never been treated as full legal persons, the Court then looked to see if there were any state interests compelling enough to override a woman’s right to make this momentous personal decision for herself. It decided that there were none at all in the first trimester of pregnancy. In the second trimester, the state’s interest in protecting maternal health allows for some restrictions, so long as these are actually related to maternal health and not the protection of the life of the fetus. The state’s interest in protecting potential life becomes “compelling,” and trumps the woman’s right to privacy only after the fetus becomes viable, which in 1973 was somewhere between 24 and 28 weeks. Today, some premature infants are being saved as early as 22 weeks. However, it appears that, absent development of an artificial placenta, 22 weeks represents an absolute lower limit on viability. After viability, states may prohibit abortion altogether if they choose, unless continuing the pregnancy would threaten the woman’s life or health.

Planned Parenthood of Southeastern Pennsylvania v. Casey (1992) pitted the Justices who wanted to reverse Roe against those who wished to preserve it. Neither side prevailed and the result was a compromise written by Justices O’Connor, Kennedy, and Souter. It upheld Roe’s central finding, that women have a constitutionally protected right to choose abortion, prior to viability, while rejecting the trimester framework. Casey held that the State’s profound interest in protecting potential life existed at all stages of pregnancy, not just after viability. States may enact procedures and rules reflecting its preference for childbirth over abortion, so long as these rules and procedures do not constitute an “undue burden” on the woman’s choice.

The Court interpreted the undue burden standard as permitting a requirement that required doctors to provide information about the abortion procedure, the relative risks of abortion and childbirth, embryonic and fetal development, and available resources should the woman choose to carry to term, provided the information given to the woman is truthful and not misleading. This qualification has not always been followed. In several states, doctors are required to tell women seeking abortions that having an abortion increases their risk of breast cancer. While not exactly a lie, this is certainly misleading. Having a full term pregnancy can reduce the risk of breast cancer, but having an abortion does not increase a woman’s risk of developing breast cancer. The Court also upheld a waiting period of 24 hours, as its intent is to make the abortion decision more informed and deliberate. Yet the actual effect of waiting periods is often to make abortion access much more difficult, especially in places where women have to travel long distances to find an abortion provider.

After attempts to overturn Roe failed, a new strategy of restricting abortions was developed. This strategy included outlawing particular methods of abortion, such as partial-birth abortion, imposing time limits based on claims of fetal sentience, and imposing restrictions on clinics and doctors who perform abortions in the name of protecting maternal health.

Fetal Sentience

In 2010, Nebraska banned all abortion after 20 weeks, on the ground that the fetus at that stage can feel pain. Subsequently, more than a third of states passed similar laws. In 2015, the Pain-Capable Unborn Child Protection Act passed the House of Representatives; the motion to consider the bill in the Senate was withdrawn. The bill prohibited a physician from performing an abortion after 20 weeks, except where necessary to save the life of a pregnant woman (excluding psychological or emotional conditions) or in cases of rape or incest against a minor.

Are 20-week old fetuses sentient? This claim is rejected by the American College of Obstetricians and Gynecologists, which says it knows of no legitimate scientific information that supports the claim that a 20-week old fetus can feel pain. Other researchers think that while we do not know when fetuses become sentient, it might occur as early as 17 weeks. Utah became the first state to require doctors to give anesthesia to women having an abortion at 20 weeks or later. The law, which went into effect in May 2016, would not apply to women having abortions needed to save their lives, or in cases of rape or incest. An obstetrician-gynecologist in Utah, who spends half of a Saturday each month in an abortion clinic, protested, “You’re asking me to invent a procedure that doesn’t have any research to back it up. You want me to experiment on my patients.”

Protecting Women’s Health

Casey allowed states to restrict abortions based on a concern for women’s health, so long as the restrictions did not impose an undue burden on the choice. A key issue raised by the Supreme Court case Whole Woman’s Health v. Hellerstedt, decided in 2016, was how judges should evaluate such health-justified restrictions. The case concerned a 2013 Texas law that required any physician performing an abortion to have admitting privileges at a hospital not further than 30 miles from the abortion facility, and required any abortion facility to meet the minimum standards for ambulatory surgical centers. The District Court said that the law was unconstitutional because of its impact on access to abortion in Texas. Many abortion facilities would be unable to meet these requirements and would be forced to close, thereby severely limiting access to abortion. Moreover, the law’s provisions were unnecessary to protect women’s health. Abortion is an extremely safe medical procedure with very low rates of complications and virtually no deaths. In fact, although childbirth is 14 times more likely than abortion to result in death, Texas law allows a midwife to oversee childbirth in the patient’s own home. Thus, the new law was a solution to which there was no problem.

The Fifth Circuit reversed the District Court decision. One of its more startling claims was that states are entitled to impose health-justified restrictions, which are not subject to judicial review. In a 5-3 decision, the Supreme Court roundly rejected this claim. Writing for the majority, Justice Breyer said, “. . . the Court, when determining the constitutionality of laws regulating abortion procedures, has placed considerable weight upon evidence and argument presented in judicial procedures.” In other words, states may not simply assert that the restrictions are necessary, but must have factual evidence to show that they are. Moreover, the Court has an independent constitutional duty to review factual findings where constitutional rights are at stake.

Despite new restrictions on abortion, the core principle of  Roe  and  Casey– that the right to abortion is protected by the Constitution — was upheld. But that was soon to change.

The Change in the Composition of the Supreme Court

Between 1991 and 2020, five Justices openly hostile to abortion (Clarence Thomas, Samuel Alito, Neil Gorsuch, Brett Kavanaugh, and Amy Barrett) were appointed to the Court, making the 6-3 decision to reverse Roe possible.

The change in the Court’s composition emboldened several states to pass abortion bans much earlier than viability. One of the most restrictive, signed into law by Texas Governor Greg Abbott in May  2021, prohibits abortions after a fetal heartbeat is detected, usually after six weeks of pregnancy. About a year later, Oklahoma adopted a similar restriction and made illegal abortion a felony punishable by up to 10 years in prison. A bill introduced in Louisiana (House Bill 813) in May 2022 allowed criminal charges for murder to be brought against those who perform or have abortions. Its sponsor, Republican Danny McCormick, justified the bill by saying, “it is actually very simple: Abortion is murder.” Louisiana Right to Life did not support the bill, since their policy is that “abortion-vulnerable women” should not be treated as criminals. The group also called the bill unnecessary since Louisiana already had a trigger law that would outlaw abortion, except when necessary to save the life of the mother, if Roe were overturned. An amended version of HB 813, which removed the language about charging women having abortions with murder and exempted birth control from being outlawed, did pass the House.

Overturning Roe and Casey

Dobbs v. Jackson Women’s Health (June 2022) .  The case concerned a Mississippi law banning all abortions after 15 weeks gestational age except in medical emergencies and in the case of severe fetal abnormality. Characterizing the decisions in Roe and Casey as “egregiously wrong,” the majority held that:

“. . . Roe and Casey must be overruled. The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision, including the one on which the defenders of Roe and Casey now chiefly rely — the Due Process Clause of the Fourteenth Amendment. That provision has been held to guarantee some rights that are not mentioned in the Constitution, but any such right must be “deeply rooted in this Nation’s history and tradition” and “implicit in the concept of ordered liberty.”

With the overturning of Roe and Casey , the matter of abortion has been returned to the states. Most abortions are banned in 14 states, while protected by state law or constitution in 21 states. (For updates, see Kaiser Health News Abortion Policy Tracker .) Abortion providers and advocates have challenged abortion bans in many states as violating the state constitution or another state law.

In his concurrence, Chief Justice Roberts said that while he agreed with the majority’s conclusion to uphold Mississippi’s law, he would have preferred a narrower approach based on the principle of judicial restraint. Instead of “repudiating a constitutional right we have not only previously recognized, but also expressly reaffirmed applying the doctrine of stare decisis “, the Court could simply have rejected viability as the point at which the state’s interest in protecting potential life outweighed the woman’s right to terminate her pregnancy, and upheld Mississippi’s right to ban abortions after 15 weeks. The majority rejected this approach, in part because it “would only put off the day when we would be forced to confront the question we now decide. The turmoil wrought by Roe and Casey would be prolonged. It is far better–for this Court and the country–to face up to the real issue without further delay.”

Abortion After Dobbs

The claim that Dobbs will end the turmoil over abortion is dubious. Abortion rights activists have challenged trigger bans in a dozen states. Some have already been rejected by judges, but other cases continue. Most of the legal challenges nationwide seek to establish that state constitutions protect a right to abortion. President Biden has signed an executive order designed to ensure access to abortion medication and emergency contraception, leaving the details up to the secretary of health and human services.

Court cases have challenged the availability of medication abortion . Another issue likely to result in lawsuits is whether states can prevent their residents from traveling to other states to have abortions. Nor are legal battles necessarily limited to the states. Some anti-abortion activists are pushing for a federal ban on abortion, while some pro-choice advocates are pushing for a federal law to protect the right to abortion. Neither side has the 60 votes necessary, but that could change in the future.

The Supreme Court expressly noted that its opinion “is not based on any view about if and when prenatal life is entitled to any of the rights enjoyed after birth.” That leaves open the question whether states may confer legal personhood on embryos. May they punish women who have abortions under their homicide statutes, even executing them in death penalty states?

The extreme conservative position, taken by the official teachings of the Roman Catholic Church, regards even abortions necessary to save the life of the pregnant woman as illicit, since it is forbidden to kill one innocent human being in order to save the life of another. As of July 2022, all of the state anti-abortion laws and proposed laws make an exception for “medical emergencies,” but nothing in Dobbs requires states to make this exception. Moreover, the determination of what counts as a medical emergency can be extremely subjective. A pregnant woman may develop a condition that might be, but is not definitely, life-threatening. May a doctor perform an abortion in that case? Five women in Texas have filed a lawsuit saying that they were denied medically necessary abortions. Joined by two ob-gyns, they are seeking to clarify when abortion is permissible under state law.

Questions abound. How close to death must a woman be for doctors to act? Will doctors be willing to take the risk of possible jail time if they make a call that is later questioned?

Complications can arise in any pregnancy, but the inability to get an abortion for medical reasons is likely to impose particular burdens on pregnant patients with chronic illnesses and disabilities, including psychiatric conditions, diabetes, and heart conditions. Pregnancy may take years off their lives, but this would not be enough for them to get an abortion in states that provide an exemption only in the case of a “medical emergency” that “necessitate[s] the immediate performance or inducement of an abortion.”

Thus, Dobbs is likely to have a deleterious impact on the ability of doctors to care properly for their pregnant patients, as well as for some women who are not pregnant. The AMA condemned the decision as “an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient-physician relationship, and a brazen violation of patients’ rights to evidence-based reproductive health services.” In the weeks after the Dobbs decision, there were reports of profound changes in other medical care, including for ectopic pregnancies and for women with lupus, which is treated with a medicine that can cause miscarriage.

There are no exceptions for pregnancies that result from rape or incest in Alabama, Arkansas, Florida, Kentucky, Louisiana, Missouri, Oklahoma, Ohio, South Dakota, Tennessee, or Texas. The rationale is that it is unjust to end a pregnancy because its father is a rapist. Those who favor exceptions for rape and incest regard it as equally unjust to force women to continue a pregnancy for which they have no responsibility.

The Impact of Dobbs Beyond Abortion

The loss of abortion rights is real and of great concern to many Americans, not only because of the impact this will have on the lives of women and their families, but also because a rejection of the constitutional right to privacy and substantive due process could have effects beyond abortion. On the face of it, the analysis in Dobbs applies to other rights that the Supreme Court has upheld, including the right of both married and unmarried couples to use contraceptives ( Griswold v. Connecticut , 1965, and Eisenstadt v. Baird , 1972), the right to marry a person of a different race ( Loving v. Virginia , 1967), the right to engage in private, consensual sexual acts ( Lawrence v. Texas , 2003), and the right to marry a person of the same sex ( Obergefell v. Hodges , 2015). None of these rights are mentioned in the Constitution, nor are they deeply rooted in this Nation’s history and tradition. This means, in the words of the dissenters (Breyer, Sotomayor, and Kagan) that “one of two things must be true. Either the majority does not really believe in its own reasoning. Or if it does, all rights that have no history stretching back to the mid-19th century are insecure. Either the mass of the majority’s opinion is hypocrisy, or additional constitutional rights are under threat. It is one or the other.”

The majority insisted that its decision “concerns the constitutional right to abortion and no other right. Nothing in this opinion should be understood to cast doubt on precedents that do not concern abortion.” But if other precedents fail the test for determining constitutional rights provided in Dobbs , why aren’t these cases also wrongly decided?

Same-Sex Marriage

In his separate concurring opinion, Justice Thomas forthrightly accepted this implication, saying, “in future cases, we should reconsider all of this Court’s substantive due process precedents, including Griswold , Lawrence , and Obergefell .” Thomas, unsurprisingly, did not mention Loving , perhaps because he assumes that discrimination based on race is prohibited by the Fourteenth Amendment’s guarantee of equal protection. The dissenters, however, note that the right to marry someone of a different race was not protected at the time of the adoption of the Fourteenth Amendment any more than the rights to abortion, contraception, to engage in private, consensual acts, or to marry a person of the same sex.

While anti-miscegenation laws are unlikely to garner much public support, the same may not be true for LGBTQ rights protected by Lawrence and Obergefell . Some far-right Republicans have expressed an interest in ending same-sex marriage . Texas Attorney General Ken Paxton has said that he would defend the state’s defunct sodomy law if the Supreme Court were to follow Thomas’s suggestion and revisit Lawrence .

Contraception, IVF

It seems unlikely that there would be much enthusiasm in the states for banning contraceptives in general, although some conservatives might favor rolling back the sexual revolution that stemmed from the Pill. Presumably, that would satisfy the rational-basis test that the Court identified as the standard for abortion restrictions or prohibition. Moreover, some forms of contraception, such as IUDs, that prevent a fertilized egg from implanting, might be prohibited under laws like Oklahoma’s that define persons as human beings from conception onwards.

IVF could also be adversely affected by Dobbs , because of the routine practice of discarding embryos. This occurs for two reasons. First, the creation of excess embryos enables fertility doctors to implant only one or two embryos per cycle, and to freeze the remainders for future use. This protects women from having to go through the onerous process of egg retrieval in future pregnancies. Freezing embryos has also facilitated single embryo transfer for good-prognosis patients, which has resulted in fewer twins and higher-multiple births, which are riskier for both mothers and babies than singleton births.

Second, it is now routine in IVF to test embryos for chromosomal defects and to discard affected embryos. This improves the chances for a successful pregnancy since embryos with chromosomal defects are less likely to implant and to miscarry. At this point, embryos created in labs are not explicitly targeted by state laws that ban abortion. Trigger laws in most states are aimed at preventing the termination of pregnancy, not regulating IVF embryos. That could change. A spokeswoman for Students for Life Action, a large national anti-abortion group, says that they are looking at IVF : “Protecting life from the very beginning is our ultimate goal, and in this new legal environment we are researching issues like IVF, especially considering a business model that, by design, ends most of the lives conceived in a lab.”  Ironically, laws intended to prevent the termination of pregnancies might deprive infertile couples from having a successful pregnancy.

On February 16, 2024, the Supreme Court of Alabama held that frozen embryos are children with respect to Alabama’s wrongful-death statutes. Some have claimed that this will disallow the discard of embryos by IVF clinics, but that is not obvious. Wrongful-death suits must demonstrate negligence, not simply causing death. Nevertheless, the implications of the court’s decision are unclear, creating anxiety among IVF providers and patients. The University of Alabama health system is pausing in vitro fertilization treatments while considering the implications of the court’s decision.

Care for Miscarrying Patients

Another area of concern is the medical care given to women with wanted pregnancies who miscarry. In what is known as a “missed miscarriage,” the fetus dies in the womb but is not expelled from the woman’s body. In an “incomplete miscarriage,” not all of the fetal tissue is expelled. These situations can cause infection that poses a threat to the woman’s life. The medical options are waiting and hoping that the woman miscarries naturally or intervening medically with either a surgical procedure (D&C) or abortion medication to remove the fetus or fetal tissue. Because these interventions are also used in abortion procedures, outlawing abortion could have a chilling effect on what doctors are willing to do.

In states with abortion bans, there are reports of doctors declining to perform any procedure that could be seen as an illegal abortion. In some cases, women have had to wait to miscarry, which could take weeks. Not only does this impose added emotional stress on women who have lost a wanted pregnancy, but it could even cost their lives. This happened in Ireland in 2012. Savita Halappanavar, 17 weeks pregnant, was admitted to hospital after a miscarriage was deemed inevitable. When she did not miscarry after her water broke, she discussed having a termination with the attending physician. This was denied because Irish law at the time forbade abortion if a heartbeat was still detectable. While they waited for the fetus’s heart to stop, Savita developed sepsis and died. The case was instrumental in getting abortion legalized in Ireland.

So far, no woman in the U.S. has died as a result of restrictive abortion laws, but some have come close. An ob-gyn in San Antonio, Tx., had to wait until the fetal heartbeat stopped to treat a miscarrying patient who had developed a dangerous womb infection. The delay caused complications which required her to have surgery, lose multiple liters of blood, and be put on a breathing machine. Texas law essentially requires doctors to commit malpractice.

Landmark cases like Quinlan (1976) and Cruzan (1990) relied on a constitutional right of privacy and substantive due process. The rejection by the Court of these principles could threaten well-established rights of patients to refuse life-saving care and to stipulate their wishes in that regard in advance directives.

At this point, it is impossible to predict all of the effects of overturning Roe and Casey . This much is clear: the battle over abortion rights is far from over.

Bonnie Steinbock , PhD, a Hastings Center fellow, is professor emeritus of philosophy at The University at Albany/State University of New York.

• Symposium: Seeking Reproductive Justice in the Next 50 Years. The Journal of Law, Medicine & Ethics, 51 (Fall 2023): 455.
• Linda Greenhouse and Reva Siegel, “Casey and the Clinic Closings: When ‘Protecting Health’ Obstructs Choice,” Yale Law Review 125 (2016): 1428-1531.
• Bonnie Steinbock, Life Before Birth: The Moral and Legal Status of Embryos and Fetuses, 2nd edition (Oxford University Press, 2011).
• Ronald Dworkin, “The Court and Abortion: Worse Than You Think,” New York Review of Books, May 31, 2007.
• Margaret Olivia Little, “The Morality of Abortion,” in Christopher Wellman and R.G. Frey, eds., A Companion to Applied Ethics (Blackwell Publishing, 2003).
• David Boonin, A Defense of Abortion (Cambridge University Press, 2002).
• Jeff McMahan, The Ethics of Killing: Problems at the Margins of Life (Oxford University Press, 2002).
• Susan Dwyer and Joel Feinberg, eds. The Problem of Abortion (Wadsworth Publishing Co., 1996).
• Sidney Callahan and Daniel Callahan, eds. Abortion: Understanding Differences (Plenum, 1984).
• Kristin Luker, Abortion and the Politics of Motherhood (University of California Press, 1984).
• Don Marquis, “Why Abortion Is Immoral,” Journal of Philosophy, April 1984.
• Donald H. Regan, "Rewriting Roe v. Wade." Michigan Law Review, August 1979.
• Mary Anne Warren, “On the Moral and Legal Status of Abortion,” The Monist, January 1973.
• Judith Thomson, “A Defense of Abortion,” Philosophy and Public Affairs, Winter 1971.
• Ethics and Abortion Resources from The Hastings Center
• Bonnie Steinbock, PhD Hastings Center Fellow and professor emeritus of philosophy at The University at Albany/State University of New York [email protected]
• Thomas H. Murray, PhD President Emeritus and Fellow, The Hastings Center [email protected]
• Maggie Little, BPhil, PhD Director, The Kennedy Institute of Ethics; Hastings Center Fellow [email protected]
• What Is Bioethics?
• For the Media
• Hastings Center News
• Diversity, Equity, & Inclusion
• Hastings Center Report
• Focus Areas
• Ethics & Human Research
• Bioethics Careers & Education
• Hastings Bioethics Forum
• FAQs on Human Genomics
• Bioethics Briefings
• Books by Hastings Scholars
• Special Reports
• Ways To Give
• Why We Give
• Gift Planning
• Sign up for Updates

Upcoming Events

Previous events, receive our newsletter.

• Terms of Use

Featured Topics

Featured series.

A series of random questions answered by Harvard experts.

Explore the Gazette

Read the latest.

Had a bad experience meditating? You’re not alone.

Families may remove brain-injured patients from life support too soon

What to do about mental health crisis among Black males

Following the leak of a draft decision by the Supreme Court that would overturn Roe v. Wade, the Medical School’s Louise King discusses how the potential ruling might affect providers.

AP Photo/Alex Brandon

How a bioethicist and doctor sees abortion

Alvin Powell

Harvard Staff Writer

Her work touches questions we can answer and questions we can’t. But her main focus is elsewhere: ‘the patient in front of me.’

With the leak Monday of a draft decision by the Supreme Court that would overturn Roe v. Wade, the future of abortion in the U.S. has been a highly charged topic of conversation all week. Doctors are among those wondering what’s next. Louise King is an assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School and a Brigham and Women’s Hospital physician whose practice includes abortion services. King, who is also the director of reproductive bioethics for the Center for Bioethics at the Medical School, spoke with the Gazette about ethical dimensions of abortion and how a ruling against Roe might affect providers.

Louise King

GAZETTE: In the U.S., abortion is framed in broad ethical terms: life versus death, privacy versus government intrusion, etc. From a medical ethics standpoint, what are the important concerns to be balanced on this issue?

KING: I frame the topic in the context of the patient in front of me. In other words, I look primarily to autonomy and beneficence in the context of doing good for the patient. That might mean upholding that person’s choice not to proceed with what is still a very dangerous proposition, namely carrying a pregnancy to term and delivering. If someone says to me, “I’m pregnant and do not wish to be pregnant,” for a multitude of reasons, I support that decision, because the alternative of carrying to term is risky. I want to protect that person’s bodily autonomy. From a reproductive justice standpoint, I want to support persons who have uteri in making decisions about when they wish to have a family, how they want that to look, whether they want to have a family at all, in expressing their sexuality, and in all kinds of different things.

I don’t believe that life begins at conception. Among the minority of people in this country who believe that’s the case, some are vocal and aggressive in imposing that belief on others, which may happen with this upcoming decision. But quite a number of students that I meet who believe life begins at conception still don’t believe that they have the right to impose that belief on others. To contextualize what we ask of persons with uteri when we make abortion illegal, it’s helpful to compare instances where we could ask people to undergo very risky procedures to help others. For example, we don’t demand that people give blood. It’s not a big deal and it could save lives every day, but we don’t demand that anybody donate blood or bone marrow. We don’t demand kidney donations, which are less risky than childbirth nowadays.

So we generally don’t ask one human being to give so completely of themselves to another, but we do so when it’s a pregnant person. That, I believe, does not comport with our ethics. But it also doesn’t fully address the concerns of persons who believe life begins at conception. They come to those beliefs honestly, but I think they have to explore them more deeply and figure out whether, even if true — do they hold up to the point where we require somebody to have a forced pregnancy to term? I would say, within my understanding of ethics, no.

“It’s not a big deal and it could save lives every day, but we don’t demand that anybody donate blood or bone marrow. We don’t demand kidney donations, which are less risky than childbirth nowadays.”

GAZETTE: Abortion is one of the most divisive issues in the country. Is the medical profession unified on it one way or another?

KING: That’s hard to say definitively. No study or survey exists to truly quantify this. The American Medical Association and the America College of Obstetricians and Gynecologists say that abortion is health care, and I agree. ACOG is very strong in their wording about supporting the right to access abortion. Unfortunately, only 14 percent of practicing OBGYNs provide abortion care. As a profession, our words and actions don’t match. I think there’s a multitude of reasons for that. One is the stigma associated with providing abortion care in some parts of the country.

I would guess that most providers feel similarly to the majority of Americans — that abortion is health care and should be available. While I’ve met some medical students and practicing physicians in all kinds of disciplines who feel strongly that abortion is unethical, the vast majority that I’ve spoken to feel as I feel: that it’s health care and should be provided.

GAZETTE: A big part of the debate over the decades has centered on viability. Is this an issue for science to determine? Is it an issue for society? Is it an issue for religion?

More like this

Softer language post-leak? Maybe, says Tribe, but ruling will remain an ‘iron fist’

Mothers of stillborns face prison in El Salvador

KING: I don’t think that science can tell us definitively when life begins. Life is a broad term and includes a variety of living entities. I don’t think that religion can define it because we have freedom of religion and religions see this differently. Rabbis will explain that in the Torah, it’s very clear that an embryo is simply an extension of a woman’s body, like a limb, and should not be considered another person until birth. The leaked decision presumes that one version of Christianity’s assessment of this prevails, which seems to violate our understanding of freedom of religion in this country.

Ultimately, “when life begins” isn’t the right question because it’s unanswerable. The question then must be: How do we as a society come up with a compromise that upholds the autonomous rights of the persons in front of us who may become pregnant, who may have excessive risks associated with a pregnancy, or who may simply not wish to be pregnant, that also observes whatever our society’s agreed-upon understanding is of when a protected entity exists.

I think Massachusetts absolutely gets it right. If you read the Roe Act : Abortion is allowed for any reason in the first and second trimesters, and then abortion for medical reasons or lethal fetal anomalies can extend into the third trimester with careful consideration between patient and medical teams. To me, that is an exceptionally well-thought-out compromise. This is a societal decision. It shouldn’t be made by a minority of persons based on their narrow definition of “when life begins.”

GAZETTE: If something like the leaked draft decision emerges, is there a potential for medical providers to get caught in the middle?

KING: Overturning Roe would turn the question over to the states. That would mean that those providers who exist within the states that are clearly going to go forward with legislation to outlaw abortion would be in dire situations. In Massachusetts, we could provide the care we’re already providing and would expect people to travel from out of state to us. I don’t think that the long-arm statutes would reach a provider here, that somebody could come after me from Texas if somebody traveled from Texas to me and I provided care. But if I traveled to Texas, for a conference, it might. Legal experts aren’t sure.

GAZETTE: Have you ever been threatened because you’ve offered abortions?

KING: I haven’t, but many of my colleagues have. I did my training in Texas, so I lived a long time in the South. I’ve not been threatened directly, but spoken sternly to by many people who disagreed with me. I mentioned earlier that there are plenty of people who believe life begins at conception but who do not feel they should impose their viewpoints on others — those are people I met in Texas and Louisiana. There are a lot of people like that, but they can’t speak up for fear of being ostracized. The sense that I have through all the conversations I’ve had over many years is that we are all talking past each other. You started off by saying this is a topic that divides our country, but it doesn’t. The vast majority of people are settled on having abortion as an option, having contraception as an option, and having sex education available. There’s a group of politicians who make it appear that we’re divided and build their political careers off of that. It’s incredibly disheartening and unethical for them to do so.

Share this article

You might like.

Altered states of consciousness through yoga, mindfulness more common than thought and mostly beneficial, study finds — though clinicians ill-equipped to help those who struggle

Of the survivors within one study group, more than 40% recovered at least some independence.

Symposium examines thorny, multifaceted dilemma from systemic racism in policing, healthcare to stigma attached to psychotherapy in community

Six receive honorary degrees

Harvard recognizes educator, conductor, theoretical physicist, advocate for elderly, writer, and Nobel laureate

Five alumni elected to the Board of Overseers

Six others join Alumni Association board

Everything counts!

New study finds step-count and time are equally valid in reducing health risks

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• BMC Med Ethics

Navigating abortion law dilemmas: experiences and attitudes among Ethiopian health care professionals

Demelash bezabih ewnetu.

1 Department of Physiology, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

2 Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway

Viva Combs Thorsen

3 Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway

Jan Helge Solbakk

Morten magelssen, associated data.

The data generated during and analyzed during the current study are not publicly available as individual informants might be identified from the interview transcripts. Any requests about availability of the data should be directed to the corresponding author.

Ethiopia’s 2005 abortion law improved access to legal abortion. In this study we examine the experiences of abortion providers with the revised abortion law, including how they view and resolve perceived moral challenges.

Thirty healthcare professionals involved in abortion provisions in Addis Ababa were interviewed. Transcripts were analyzed using systematic text condensation, a qualitative analysis framework.

Most participants considered the 2005 abortion law a clear improvement—yet it does not solve all problems and has led to new dilemmas. As a main finding, the law appears to have opened a large space for professionals’ individual interpretation and discretion concerning whether criteria for abortion are met or not. Regarding abortion for fetal abnormalities, participants support the woman’s authority in deciding whether to choose abortion or not, although several saw these decisions as moral dilemmas. All thought that abortion was a justified choice when a diagnosis of fetal abnormality had been made.

Ethiopian practitioners experience moral dilemmas in connection with abortion. The law places significant authority, burden and responsibility on each practitioner.

Abortion in Ethiopia

The 2003 Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (the ‘Maputo protocol’) asserts that access to safe abortion is a human right. Following the Maputo protocol, Ethiopia liberalized its abortion law in 2005. Since then, termination is allowed if it endangers the life or physical health of the pregnant woman, in cases of rape or incest, if she is a minor or mentally or physically disabled, or if the fetus has an ‘incurable and serious deformity’ [ 1 ]. Concerning the rape/incest criterion, the law specifically states (art. 552) that ‘the mere statement by the woman is adequate to prove that her pregnancy is the result of rape or incest’.

In Ethiopia, both public and private health institutions offer safe abortion services and healthcare practitioners from different professions are involved in the provision. Private institutions, in which two-thirds of abortions are performed, are often run by non-governmental organizations (NGOs) [ 2 ]. Abortion is performed free of charge in public institutions. At the time of data collection, it cost approximately 400–1500 Ethiopian Birr (9–34 US$) in the private institutions. Studies show that Ethiopian abortion services have both expanded and improved in terms of quality since 2005 [ 3 ]. While abortion services are at the recommended level in some cities and regions, they are poorly developed rurally and in other regions [ 4 ]. In the capital, Addis Ababa, where the abortion rate is the nation’s highest, estimated to be 92 per 1000 women of reproductive age, abortion is performed by institutions ranging from primary health care centers to referral hospitals. Although access to safe abortion has increased since the liberalization of the law, there are still underground unsafe abortion practices. In 2014, an estimated 294,100 induced abortions occurred outside of health care centers in Ethiopia. This is perceived as a significant problem, still contributing to an estimated 10% of maternal mortality [ 5 , 6 ]. In Sub-Saharan Africa in general, unsafe abortion is still a significant concern and maternal deaths due to unsafe abortions are still high [ 7 ].

A recent study with professionals providing abortion in Addis Ababa found that they were familiar with the abortion law but that it gave rise to three main types of moral dilemmas for them: whether abortion should be provided or not; how providers should handle a situation where they suspect that the patient lied in order to qualify for the abortion; and how they should weigh and evaluate different reasons for abortion [ 8 ]. The authors state that providers’ assessment of the patient’s reasons for abortion ‘did not always follow the lines of the law’. Many providers were willing to ‘stretch’ the law’s criteria; as one informant put it, ‘the legal part [i.e., the abortion law] has a slightly open door’.

In a national survey mapping moral dilemmas experienced by physicians from Ethiopian public hospitals, abortion was perceived as an important source of dilemmas [ 9 ]. In particular, some respondents viewed the abortion law as too restrictive, and it was a dilemma when the woman did not meet the legal criteria for abortion. In another study, health care providers with previous experience with induced abortion were 2.5 times more favorable towards the law than those who were inexperienced [ 10 ].

The present study

The present paper is the third and final paper from an extensive interview study with abortion providers in Addis Ababa. The first paper specifically examined participants’ views on the moral status of the fetus , and the impact of their religious views on their work [ 11 ]. In particular, it was highlighted how the participants attempted to reconcile the tension between the demands of their moral and religious views and their professional obligations. It was found that the providers were left to perform this ‘balancing act’ on their own. Whereas some continued to experience a troubled conscience, others had justified participation in abortion through framing it as helping and preventing harm.

The second paper examined participants’ views on and experiences with conscientious objection (CO) to abortion [ 12 ]. Despite being forbidden by government regulations, CO was practiced. Supporters of CO claimed that accommodation could often be achieved when colleagues were available to carry out an abortion and related tasks, while opponents saw CO as a potential threat to patients’ access to abortion services.

In the present paper we aim to shed light on experiences of abortion providers with the revised Ethiopian abortion law, including how they view and resolve any moral challenges and dilemmas both related to the law and unrelated. Moral challenges were defined as situations in which there was doubt or disagreement about the right or best course of action. Views on abortion for fetal abnormalities were examined specifically for two reasons. Firstly, experiences from other countries indicate that this gives rise to particular moral challenges; secondly, the topic had not been explored through interviews with providers in Ethiopia before.

Methods have been described in detail in the two previous papers [ 10 , 11 ]. The most salient features of the approach used are summarized here.

Setting and recruitment

A qualitative design was deemed appropriate for exploring in-depth the experiences and reasoning of healthcare professionals involved in abortion services. The first author recruited practitioners with diverse professional backgrounds working with abortion in a practical and/or administrative capacity in private (NGO) or public healthcare settings in Addis Ababa. Participants worked in one of two public hospitals or seven NGO clinics. The first author approached potential participants by going to their working site, after first getting permission from the local manager. As compensation participants were given 100–200 Ethiopian Birr (equivalent to $2.50–5.00). Informed consent was obtained from each participant.

Data collection

Interviews were semi-structured, aided by an interview guide which contained open-ended questions on views on abortion, abortion law and abortion for fetal abnormalities, the influence of religion, experienced moral challenges, and conscientious objection. Interviews took place between February and July 2017, at the participants’ workplace, where they were interviewed by the first author in Amharic. Interviews were recorded digitally, transcribed verbatim, then translated into English by an independent Ethiopian researcher fluent in English.

Analysis was performed within the systematic text condensation (STC) framework, a qualitative analysis framework developed by Malterud which builds on DiGiorgi’s method [ 13 ]. The method involves four steps:

• From chaos to themes: the transcripts and field notes were read several times to create an overall impression and identify candidates for main themes.
• From themes to codes: each unit of meaning was identified and coded according to topic using the nVivo 11 software package. Codes and sub-codes were created.
• From code to condensation: all units of meaning coded with the same sub-code were then read in order with a view to identifying their meaning and content. This was done by creating so-called ‘artificial quotations’, which are condensed summaries of salient points formulated as if phrased by the participants. All sub-codes were condensed in this way.
• From condensation to analytic text: the artificial quotations then provided the basis for the final analytic text which was then incorporated into the findings section of the paper. In the analytic text, genuine (not artificial) quotations from the transcripts were used to illustrate and confirm the findings.

The first and fourth authors analyzed the data independently following these steps. They then met to discuss and harmonize their analyses. Three main themes were decided on: ‘differing views on abortion law’, ‘experienced dilemmas’, and ‘abortion justified by fetal abnormalities’.

Data were collected in accordance with conditions in the research ethics approvals and thus also the relevant Norwegian guidelines and regulations. The data were analyzed and findings were reported in accordance with recognized standards for qualitative research, as per the STC framework presented above.

Research ethics

Ethical approval was obtained. Informed consent was obtained from all participants after providing detailed information on the study both orally and in writing. As the interviews concerned sensitive topics, we limit demographic and other information about individual informants in order to protect their anonymity.

Participant background

Thirty healthcare professionals agreed to be interviewed. Of these, most (22) provided abortions directly, while the remaining eight participants had managerial roles in abortion provision, and patient-directed work such as providing contraceptives and post-abortion care. Participants had experience with providing abortion that ranged from two months up to 14 years. The sexes were equally represented with 15 being female and 15 being male. Twenty-one participants identified as Ethiopian Orthodox, five as Protestant/Evangelical, and two as Muslim. One was religiously unaffiliated, and one did not want to disclose his/her views.

Differing views on the abortion law

A general finding was that there was a range of viewpoints both on the abortion law and on potential moral challenges. Informants’ viewpoints clearly aligned with their moral views on abortion. For instance, informants who regarded abortion as a moral problem also were critical or ambivalent to aspects of the new abortion law thought to be too liberal/open, whereas informants who did not see abortion as a moral problem welcomed liberal interpretations of the law and sometimes found it to be too restrictive.

A majority of participants, especially from private/NGO clinics, stated that they were content with the law, even though they pointed to some shortcomings. They asserted that the most important consequence of the law was that it reduced the incidence of unsafe abortion, and thus saved women’s lives and reduced the number of complications significantly.

Those days abortion was done by nonskilled individuals. … Even if it was by professionals, it was not by skilled professionals. Many of our sisters, mothers have lost their lives. There are some who [have had to] remove their uterus and lost their chance to ever have children. Whose marriage became unstable, who faced psychological problems (#17, female nurse, public hospital). The good side [of the new law] is that it has helped her to receive a complete treatment by bringing the service to health institutions. It saves many mothers from death (#18, male resident, public hospital).

Other positive effects highlighted were that the law provides freedom of choice to pregnant women, protects patient confidentiality, and reduces delay. It was pointed out as a problem for freedom of choice that many citizens are insufficiently familiar with the law. For several, an important argument in favor of legal access to abortion was that many women with unwanted pregnancies would choose abortion whether it is legal or not, as illustrated in the quote below:

If women have once made up their minds, nothing stops them. Their reason must be respected. That is her right. I have no problem [with that]. Therefore, it is better that we terminate it in a safe way (#20, male resident, public hospital).

Many respondents, while content that the law gives many women access to abortion, would like further liberalization with wider or alternative criteria. Several stated that it was good that they did not have to ask for evidence or witnesses beyond the woman’s statement in relation to the rape criterion.

However, a minority of informants thought that the law went too far in not requiring additional evidence; or in being too liberal, as abortion was still in their view a moral dilemma. They feared that the threshold for seeking abortion had become too low and saw women returning for multiple abortions as a sign of this. They thought that abortion had become de facto accessible on request.

Because we have made it loose, any woman can abort without any check. … What it looks like now is that abortion is legal. It is open. It is not what was intended [when] the law [was passed]. ... Any woman can receive abortion... Even when [it is promoted] the message is that people should not go to private institutions, go to the governmental ones and say that you have been raped (#22, female GYN/OBS resident, public hospital).

The law’s criteria were open to interpretation. This could be seen as an advantage for those who supported liberal access to abortion. For instance, one female health officer from a private/NGO clinic stated:

It can be said that [the health criterion] indirectly has allowed everything. … [Abortion] is not permitted completely, but it is permitted indirectly. For example, if you say mentally, it means that it is allowed if it involves stress. The majority of pregnancies are stressful. They come because they are stressed. When you think like that, [abortion] is allowed (#6, female health officer, private clinic).

Experienced dilemmas

Participants were asked about which moral challenges, if any, they encountered in their work with abortion. Although most had experienced several challengeses, some stated that they had not encountered any significant moral challenges. A few pointed out that the decision whether to choose and perform abortion by its nature is a moral issue: “Abortion is an ethical dilemma both [for the patient] and the one who performs it” (#21, male GYN/OBS, public hospital).

The major moral dilemmas typically involved the interpretation and application of the law’s criteria for abortion. Some admitted that they interpreted the criteria widely. Others appeared to feel burdened by expectations and pressure from patients in cases where criteria were not met, or where they were uncertain whether criteria were met. Sometimes this led to discussions and disagreement among colleagues. In general, participants from public hospitals appeared somewhat less liberal and less comfortable with applying a broad (inclusive) interpretation of the law’s criteria than did participants from the private/NGO sector.

Sometimes they were expected to perform abortions beyond the law’s gestational stage of 28 weeks:

We come across problems quite often, especially, a woman admitted late in the pregnancy in the name of safe abortion. … This is not legal. … I cannot assist in a delivery of [a] 1 kg [child] and call it an abortion. We have had a lot of conflicts over this issue. We know it. Things that are not acceptable for your conscience are done (#22, female GYN/OBS resident, public hospital).

In some cases, the law’s criteria for abortion were not clearly met. A few of the participants would then reject performing abortion, whereas others would sometimes accept it.

If she comes for abortion with no reason, I do not do it because I do not accept it … but I transfer it to one who does it. Because I do not believe that is her right. Many of us do not do it (#22, female GYN/OBS resident, public hospital). To be honest, if she says that she does not want to give birth, … we do not [turn her away]. We perform the abortion. (#1, female nurse, private clinic) There are [criteria] stated in the law. There are also some who approach us because of other factors. Many times, we do not base our service on the law. We base it on the case which the woman who approaches us tells us. We do not assess whether Ethiopian law allows that or not (#4, female nurse, private clinic).

As noted above, some participants remarked that in the case of rape the law does not require further evidence than the woman’s own word that the pregnancy was due to rape. They expressed that this could potentially give women seeking abortion incentives to lie in order to fulfill the law’s criterion. Similarly, a few participants claimed that patients sometimes lied about their age, claiming to be minors when they clearly were not, in order to comply with the law’s age criterion. This led to dilemmas for practitioners.

The bad side [of the law] is that it makes it liberal. If a woman lies intentionally because the law is on her side, she is given the service. That affects us a bit. I have seen some who attempt suicide when they are told it is too late. If she is 40 but claims to be 13, I am obliged to carry it out, even if I know that she is not telling the truth. It opens up for things. Which means any woman as long as she knows where the service is offered, she can get it. I think that makes [the law] a bit liberal. It affects us. Other than that, the good side [i.e., the positive aspects of the law] weighs more (#18, female GYN-OBS resident, public hospital).

Whereas most moral dilemmas experienced were directly related to interpretation and application of the abortion law, some dilemmas were not. Specifically, dilemmas arose when professionals became involved in a patient’s quarrels with partner or family members. Some patients were pressured to abort or to continue the pregnancy against their preference. Furthermore, many pointed to the low level of awareness of family planning and contraception in the population as a moral problem.

Abortion justified by fetal abnormalities

When asked about termination of pregnancy in cases of fetal abnormalities, the majority of the participants said that they believed termination should be performed/offered. They highlighted serious negative consequences of having children with abnormalities for the woman, her family, and also society. A few explicitly pointed to the economic burdens for society, and several cited the shortcomings of the Ethiopian healthcare system which would make it difficult to give the child proper care.

If there is disability, it has to be terminated. If it is early, the mother can also be affected psychologically. It would be difficult. [If] it is early, it is better to terminate quickly. Even [some] mothers who deliver a baby with cleft lip do not want to have another child (#10, female nurse, public hospital). Had the health system of our country been good, [the child] could grow up if delivered. But we do not have [a good health system]. If they are delivered the problem comes to the family, to the society, to the country (#11, male public health specialist, private clinic).

There were only a few who expressed serious ambivalence about termination in case of fetal abnormality:

I want the decision to be taken based on the family situation and economic ability. However, this collides with the rights of the disabled. When you see it from a different angle there needs to be a balance. It needs to be approached from the human right aspect. It is very problematic (#6, female nurse, private clinic).

Many were clear that one should distinguish between lethal malformations and milder abnormalities. Termination was considered the right choice for the former, whereas views differed on the latter. Informants were invited to reflect on Down syndrome as a specific case. Most favored termination, whereas a minority did not or were ambivalent.

I believe that Down syndrome has to be aborted. It is [costly] for the country. … I think it is reasonable to abort that child (#15, male, public health specialist, private clinic). The degree [of being affected by Down syndrome] determines it. If it is severe, it is better that it is not born. But those who are mild or moderate, it is preferred that they live [and receive] training and support. They [can be], to a degree, independent (#9, female nurse, public hospital).

Participants were unanimous in wanting to leave the decision whether to terminate a pregnancy with abnormalities to the woman herself as illustrated in this remark:

It is the mother who takes care of [the child] at the end of the day. ... It means that a decision is made on her. Therefore, in my view, she should have a say (#21, male GYN/OBS, public hospital).

Exploring the ways in which the revised Ethiopian abortion law was being interpreted and experienced among abortion providers shed some light into the nuances of their practices and the resolution of moral challenges and dilemmas [ 14 ]. Most of the moral challenges experienced by the professionals turned out to spring from the interpretation and application of the abortion law, consistent with previous research [ 8 , 9 ].

Interpreting the abortion law’s criteria

The law’s criteria are brief and open to interpretation which has been viewed as problematic in how criteria are applied [ 15 ]. For instance, even though the law does not allow termination of pregnancy due to socioeconomic reasons, this might be taken to be indirectly allowed through the criterion of the mother’s health, since all pregnancies represent a certain risk to the woman’s health. In a study from the Guraghe zone in Southern Ethiopia, 36.7% of women having undergone abortion claimed that the choice of abortion was due to economic reasons [ 16 ].

As a result of the law being broadly open for interpretation, abortion is viewed as de facto available on request, and from a providers’ perspective somewhat burdensome because potentially the clients choose where to draw the line. Both of these findings are in line with McLean’s study [ 8 ].

As Blystad and colleagues also argue, the interplay between law, health policy and implementation is complex, and in the case of Ethiopian abortion regulation this has led to significant room for individual providers’ discretion [ 17 ]. Because some respondents acknowledged practicing ‘abortion on request’ with little regard for whether the law’s criteria were met, it appears that it is the individual practitioner’s stance that could potentially determine whether abortion will be provided or not. This stance might again be influenced by the institution’s policy and the practitioner’s moral values including moral views on abortion.

If the authorities want to avoid such consequences and restrict the space for each practitioner’s interpretation, they could consider making the guidance more precise and less ambiguous, either through amending the law or through providing more detailed guidance in how it should be interpreted. However, this might not succeed if individual providers claim the authority to determine whether an abortion is justified without deference to the law’s criteria.

Abortion in light of fetal abnormalities

None of the participants mentioned abortion for fetal abnormalities as a moral challenge they experienced prior to being prompted to reflect on the issue. They referred to the moral value of the fetus and the rights of the disabled versus values of the woman’s autonomy and the difficulty in providing the child with requirements for a good life. However, abortion was considered a reasonable alternative in the case of fetal abnormality (albeit different attitudes concerning the severity of the disability), and they all appeared to want to leave the choice to the woman. Their main arguments align with Muderedzi and Ingstad’s observations that “[d]isability can cause poverty by preventing the full participation of disabled people in the economic and social life of their communities, especially if the proper supports and accommodations are not available” [ 18 ]. Seen this way, improvements in welfare, health and social care might make it more feasible for Ethiopians to choose to complete the pregnancy in case of fetal abnormality. Such improvements would also improve women’s autonomy, as they would enable a choice between different options that are actually realistic.

In a study of the preferences of pregnant women at an Addis Ababa hospital, 89% would want prenatal testing, and more than 60% of the women reported interest in termination in case of anencephaly, lethal conditions, severe intellectual disability, hemoglobinopathy, and amelia [ 19 ]. Conversely, in a 2013 nationally representative study from South Africa, more than half of the respondents (55%) considered it always wrong to choose abortion for fetal abnormalities [ 20 ]. The attitudes of the Ethiopian population, including health professionals on these issues should also be assessed in surveys.

Strengths and limitations

The qualitative design provided in-depth accounts of moral challenges and dilemmas experienced by providers practicing induced abortion. Only providers in Addis Ababa have been interviewed; experiences in other parts of Ethiopia, including rural settings could be different. Exploring actual practices directly fell out the scope of the current study, and thus we couldn’t verify or triangulate participants’ own accounts. It is likely that patients seeking abortion could be evaluated differently depending on to which institution they go and which practitioner they meet.

Although most abortion practitioners in our study considered the 2005 abortion law a clear improvement, they acknowledge new dilemmas. The large space for abortion participants’ individual interpretation and application of the abortion law’s criteria appears to place a considerable authority, burden and responsibility on each practitioner. For patients, it might conceivably mean that access to abortion is dependent on the views and practices of the practitioner encountered.

Acknowledgements

We would like to thank all the health professionals who contributed to the study as participants.

Abbreviations

Authors' contributions.

All authors contributed to the design of the study. DBE performed and analyzed the interviews and wrote the first draft. MM analyzed the interviews and revised the article. VCT and JHS contributed to analysis and revised the article. All authors read and approved of the final version.

This research was funded by NORAD (Norwegian Agency for Development Cooperation) under the NORHED-Programme, Agreement No. ETH-13/0024.

Availability of data and materials

Declarations.

Ethics approval was obtained from the institutional review board of St Paul’s Hospital Millennium Medical College, Addis Ababa. The study was also evaluated and approved by the Data Protection Official at the Norwegian Centre for Research Data (ref. 53104). Furthermore, the study was evaluated by the research ethics committee of the Southeastern Norway health region and found to be exempt from substantial evaluation (2016/875/REK sør-øst C). Participants were informed orally and in writing and gave written informed consent. The study was carried out in accordance with the Declaration of Helsinki.

Not applicable.

The authors declare that they have no competing interests.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Demelash Bezabih Ewnetu, Email: moc.liamg@91ecnarfoihte .

Viva Combs Thorsen, Email: [email protected] .

Jan Helge Solbakk, Email: [email protected] .

Morten Magelssen, Email: [email protected] .

Log in using your username and password

• Search More Search for this keyword Advanced search
• Latest content
• Current issue
• JME Commentaries
• BMJ Journals More You are viewing from: Google Indexer

You are here

• Volume 27, Issue suppl 2
• Reproductive autonomy and the ethics of abortion
• Article Text
• Article info
• Citation Tools
• Rapid Responses
• Article metrics

• Barbara Hewson
• Littman Chambers, London

Abortion is one of the most controversial issues in today's world. People tend to turn to the law when trying to decide what is the best possible solution to an unwanted pregnancy. Here the author's views on abortion are discussed from a lawyer's and a woman's point of view. By taking into consideration the rights of the fetus an “antagonistic relationship” between the woman and her unborn child may occur. Therefore, women should have more autonomy in the issue. The article concludes with examples of cases in the United States and Ireland where the rights of the fetus are considered more important than those of the mother because of existing laws. This article suggests that a more inclusive ethics of abortion is required rather than a new ethics of abortion when “translating fetal life into law”.

• 1967 Abortion Act

https://doi.org/10.1136/jme.27.suppl_2.ii10

Statistics from Altmetric.com

Request permissions.

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Practising lawyers generally have little time to reflect on matters of ethics. The law is a blunt instrument. Lawyers are often instructed to act for clients wishing to do things that would strike many people as immoral, but which the law entitles them to do. Evicting homeless people from one's property is an example. Lawyers are not expected or invited to pass moral judgments on their client. If they did, the client would probably go elsewhere! The Bar has a rule of conduct called the “cab-rank” rule. This obliges barristers to accept instructions regardless of the identity of the client, or the nature of the cause, or the barrister's own opinions about the client's conduct. Judges, likewise, must decide disputes according to law; their function is not to pass moral judgments on litigants. The reflections that follow, therefore, do not pretend to constitute some systematic overview but rather, some personal thoughts and ideas which may prompt further discussion.

So what can a barrister say on the ethics of abortion? Is a new ethics developing? Should there be one? These are interesting and important questions. As a lawyer with a commitment to autonomy, I see abortion as an issue that overwhelmingly concerns the autonomy and dignity of the pregnant woman herself. “Autonomy” derives from the Greek and means, literally, “self rule”. If a woman who is pregnant wishes to stop being pregnant, why should we prevent her? If we regard her pregnancy as a morally neutral state, there ought to be no satisfactory reason to prevent her. The way that humans reproduce, in common with other mammals, is simply a product of evolution. Biologically, the developing fetus is somewhat like an invading organism; if it were not for a complex system of compensating mechanisms, the woman's body would reject it in the same way as the body rejects a transplanted organ.

Attitudes to pregnancy are, however, inextricably bound up with how society views sex, women, and the fertile woman in particular. Pregnancy and birth are not minor inconveniences, such as having a cold. They constitute a major life event, which even when welcome causes immense discomfort and disruption to many women. Only recently Mrs Blair confessed that she had forgotten what an ordeal the last few hours of labour are. I have a dear friend who spent much of her two (planned) pregnancies being ill and unable to work. There exists a raft of laws to protect pregnant employees from unfair treatment because they are pregnant. Nevertheless, lawyers in the employment field still encounter cases where employers try to rid themselves of their pregnant employees. When a high-profile court case involving maternity rights is decided, leaders of industry often complain that this will have a chilling effect on employers' readiness to employ women of child-bearing age. I mention these factors simply to contextualise some of the difficulties that child-bearing women face.

If one is adamantly opposed to abortion, one is committed to some set of values which requires that women who become pregnant (whether intentionally or unintentionally) must endure the process of pregnancy and birth, no matter how distressing, painful and risky it is for them. The justification given for this is usually based on an abstract notion of the value of “fetal life”, rather than on the ground that suffering is morally improving for the women concerned. Extreme opponents of abortion argue that abortion is equivalent to murder and that, no matter how much women may suffer, they cannot be allowed to “kill their children”. But opposition to abortion entails a demand that women suffer, regardless of the circumstances in which they came to be pregnant, and despite the opportunities for ending pregnancy that exist. For those who believe that fetuses are full human beings, the justification is presumably that the woman's suffering is a lesser evil than terminating fetal life. This raises the question whether they tolerate the taking of “innocent” human life in other circumstances, for example. NATO's attack on Kosovo, or careless driving. Since an unwanted fetus is analogous to an invading organism, even if it is viewed as a human being, an argument can be made that the woman is entitled to refuse to act as a life-support system for it, and to abort in self defence. What about those who do not believe that fetuses are full human beings, but believe that abortion following consensual sexual activity is “wrong”? As the philosopher Janet Radcliffe Richards 1 has pointed out, the only time when we insist that a particular consequence must follow a particular activity, and do not allow people to escape the consequence, is when the consequence is intended as a punishment. 2 Apart from this punitive aspect of anti-abortion belief, it is also objectionable in ethical terms because it treats the pregnant woman as a means to an end: that of producing a baby.

Of course, many women will not accept the suffering which continuing with pregnancy would cause them (or their families), and take steps accordingly. In countries where safe abortion is illegal or unavailable, this results in self-imposed or “back-street” abortions and all the ills that flow from that: injury, infection, infertility, and even death. It is striking that complications from unsafe abortion are estimated to result in 13 per cent of maternal deaths worldwide. 3 It is hard to see how such wastage of female life could be condoned in ethical terms. As Ann Furedi has said: “The issue is not so much whether or when the embryo/fetus is deserving of respect per se, but how much respect and value we accord to a life (that does not even know it is alive) relative to the respect and value we have for the life of the woman who carries it.” 4

If we start from the premise that the promotion of freedom and the prevention of suffering are fundamental goals which society ought to support, then the prospect of women forced into suffering even—death—ought to worry us. Kant says that “a man is not a thing, that is to say, something which can be used merely as a means, but must in all his actions be always considered as an end in himself”. 5 Denying women abortion is, on this analysis, unethical because it subordinates women to a reproductive end.

The present tendency to characterise questions about abortion ethics in terms of concerns about fetuses, or even fetal “rights”, tends to sideline women and the realities of women's lives. Such sidelining of women is not entirely accidental; it is trite that many “fetal rights” proponents are opposed to the present increase in women's freedoms, and want to roll them back. Others who speak of fetuses as having “rights” assume that fetuses either have, or should have, rights, without necessarily explaining why this should be so, or why it should result in another person's loss of autonomy.

To put women back centre-stage, we should ask: why do women want abortions? Research has shown that the most commonly reported reason worldwide is that women wish to postpone, or stop, childbearing. 6 Abortion is a form of family planning, though it may not be “politically correct” to say so. What other reasons do women give for wanting abortions, worldwide? They include:

disruption of education or employment;

lack of support from father;

desire to provide for existing children;

poverty, unemployment or inability to afford sadditional children;

relationship problems with husband or partner, and

a woman's perception that she is too young to have a child.

To compel such women to bear unwanted children is in my view a form of ethical despotism: in Mill's words: “compelling each to live as seems good to the rest”. 7 If people are to be free, that freedom must include freedom to make these difficult and extremely personal choices.

Is the law informed by a consistent set of ethical principles? In England, Scotland, and Wales, abortion is permitted by the 1967 Abortion Act (amended by the Human Fertilisation and Embryology Act 1990), when two medical practitioners decide, in good faith, that one of the following grounds applies:

That the pregnancy has not exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family.

That the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.

That the continuance of the pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy were terminated.

That there is a substantial risk that if the child were born it would suffer from such mental or physical abnormalities as to be seriously handicapped.

Grounds 1 and 3 call for balancing exercises. Ground 2, which is based on necessity, does not. Ground 4 calls for an assessment of the likely severity of fetal handicap.

Doctors may take into account the pregnant woman's actual or reasonably foreseeable environment, in assessing the risk of injury to her health. The World Health Organization (WHO) defines health as a “state of complete physical, mental and social wellbeing that does not consist only in the absence of infirmity”. According to evidence-based guideline no 7, issued in March 2000 by the Royal College of Obstetricians and Gynaecologists (RCOG), The Care of Women Requesting Induced Abortion , 8 most doctors apply the WHO definition of “health” in interpreting the Abortion Act. 9 The RCOG's guideline development group views induced abortion as a health care need. 10 It also states that, among information on other topics which should be available to women, “abortion is safer than continuing a pregnancy to term and complications are rare”. 11

Janet Radcliffe Richards criticises the existing law:

“ …as things stand at the moment there is no real concern to estimate the value of the unborn child, or for the degree of suffering which would justify an abortion. All the law does, in effect, is make sure that a woman may not decide for herself whether to have an abortion, and send her to someone else in the position of a suppliant for favours, or even a culprit. It does nothing else ... as the law now stands there is no reason whatever for stopping where we are, and not going forward to a state where all women who want abortions can have them.” 12

If having an abortion is safer than carrying a pregnancy to term, then all pregnant women who wanted a termination below 24 weeks should qualify under ground 1 above. So perhaps the law is not so bad, after all.

In Northern Ireland, however, the 1967 Abortion Act does not apply. Doctors there do perform abortions on the ground of fetal abnormality. They can also perform abortions in cases where the woman's mental or physical health or wellbeing, or her life, are at real and serious risk. In this context, “real and serious” mean, simply, “genuine” and “not minor or trivial”. Thus, a woman does not have to show a life-threatening risk to her health, or even a “very serious” risk, to qualify for a legal abortion. Ironically, in the absence of any prescribed statutory formalities for abortion, Northern Ireland has on the face of it a more liberal abortion regime than the rest of the United Kingdom. In practice, though, the reluctance of the medical profession to perform abortions has a chilling effect. Most women seeking terminations have to travel to England or Scotland, at their own expense.

There are irreconcilable conflicts between what might be called the fundamentalist approach to the issue of abortion, which sees life as starting at conception, and what might be called the sceptical view, by which life begins when we attribute enough value to it to warrant its protection. Under English law, a fetus is not a “person”. Furthermore, a woman may decline medical intervention that would preserve the life of her fetus, and is free to let nature take its course, even where this may cause the death of her fetus. The justification for this is, firstly, that the common law respects the pregnant woman's autonomy; and secondly, that the common law does not coerce people into being “Good Samaritans” and saving others (assuming, for argument's sake, that the fetus is an “other”). The common law tradition is essentially liberal. The vice-chancellor, Sir Robert Megarry, put it like this in 1979: “[England] is a country where everything is permitted except what is expressly forbidden”. 13 If everyone could be compelled by law to do what others considered “right”, we should have no freedom, only moral dictatorship.

The case of St George's Healthcare NHS Trust v S , 14 decided in 1998, was a landmark case involving reproductive autonomy in another context: that of the pregnant woman's freedom to decline invasive treatment. The Court of Appeal upheld the common law rule that competent adults can refuse medical advice and intervention, despite being pregnant. Ms S was compulsorily detained under the Mental Health Act 1983 because she was refusing hospitalisation for pre-eclampsia. She was then forced into an unwanted caesarean, purporting to be authorised by a court order, which was made without any notice to her. She later recovered very substantial damages for trespass. The Court of Appeal stressed the importance of protecting individual autonomy, regardless of sex:

“while pregnancy increases the personal responsibilities of a woman it does not diminish her entitlement to decide whether or not to undergo medical treatment…. Her right is not reduced or diminished merely because her decision to exercise it may appear morally repugnant . . .the autonomy of each individual requires continuing protection even, perhaps particularly, when the motive for interfering with it is readily understandable, and indeed to many would appear commendable ... if it has not already done so, medical science will no doubt advance to the stage where a very minor procedure undergone by an adult would save the life of his or her child, or perhaps the child of a complete stranger . . .if however the adult were compelled to agree, or rendered helpless to resist, the principle of autonomy would be extinguished.”[italics added]

St George's wanted to appeal to the House of Lords to ventilate the arguments (among others) that a fetus was a “person” and that a pregnant woman could be deprived of her autonomy at the stage of fetal viability. These were interesting arguments for a National Health (NHS) trust, which presumably carries out abortions for fetal abnormality and other reasons, to pursue. If such arguments had been upheld on appeal, they would have had momentous implications for abortion law. St George's was refused leave to appeal by the Court of Appeal, and initially began proceedings for leave to appeal in the House of Lords. These were abandoned before the House of Lords had made a final decision on whether to grant leave.

Another interesting feature of the case is that Ms S's detention and forced treatment were prompted by concerns that she was refusing treatment for a disorder of pregnancy, pre-eclampsia. This could have killed her and her fetus, had it deteriorated into full-blown eclampsia. The irony is that Ms S could have sought a late abortion, on the ground that the continuation of her pregnancy posed the risk of grave and irreparable injury to her health and a serious risk to her life (grounds 2 and 3, referred to above). She was not seeking a late termination, but if she had, her situation would have been covered by the Abortion Act. That she wanted to let nature take its course was certainly eccentric, but ethically less troubling (if you dislike the idea of late termination) than if she had sought a late abortion.

Many people attribute a higher value to fetal life when fetuses reach viability. Thus, some people are troubled at the idea of, or opposed to, late terminations, whilst regarding early terminations as unproblematic or at any rate less problematic. But as Justice Ginsberg of the United State Supreme Court has recently pointed out: “the most common method of performing previability second trimester abortions is no less distressing or susceptible to gruesome description”. 15 In practice, late terminations are rare. The majority are done for fetal abnormality in what were otherwise wanted pregnancies; a minority are done to save the woman's life, or to prevent grave permanent damage to her health.

The question is, again, how to assess when life begins, in an ethical sense. Legally, as I have said, the fetus is not a “person”, and does not become a rights-bearing entity until it is born. But attempts to pin down “viability” as a criterion for abortion run into the problem that viability depends partly on where the fetus happens to be; if it is in an area with excellent facilities for the care of very premature babies, then it may be considered “viable” at an earlier gestational age, than if it were somewhere else. On any view, this is arbitrary.

In the United States' constitutional jurisprudence, access to abortion is a constitutionally protected right. Subsequent to fetal viability, the state may regulate and even prohibit abortion as a means of promoting its interest in the potentiality of human life. However, a woman remains constitutionally entitled to an abortion post-viability, where this is necessary to preserve her life or her health. 16 Her interests in preserving her own life and health will “trump” the state's interest. It is also worth noting that fetuses are not recognised as “persons” under the US constitution; if they were, it would be difficult, if not impossible, to derive any right to abortion under the constitution. Even if a pregnant woman's life were at stake, it would be more difficult to argue that this should justify killing fetal “persons”: our response to people who are dangerously ill is not to kill other people. (Otherwise, every time someone needed a life-saving transplant, we could justify killing someone else to provide the needed organ). Some form of “self-defence” argument would have to be invoked.

Some people argue that it is arbitrary not to bestow “personhood” on a fetus until it is born. They ask rhetorically: What is it about the passage through the vagina that makes such a difference? Of course, if you can only envisage a vagina instead of a woman giving birth, you may have difficulty acknowledging the critical role that a woman plays in giving birth, and why (in turn) society views birth as the critical moment. This is, as much as anything, a mark of respect for women's role in giving birth.

Some obstetricians regard pregnant women as “two patients” in the maternity care context. To a blunt lawyer, this is incongruous in the extreme. One wonders, is the fetal “patient” a “person”? Presumably so, because the idea of a patient who is not a person is bizarre. But in legal terms, as I have said earlier, the pregnant woman is only one person. Whom do doctors advise? Who takes the treatment decisions? The woman. Generally, midwives and obstetricians talk about “babies” rather than fetuses, presumably because that is how the women whom they attend regard their fetuses. But is the fetus really a second patient? If it were such, one might expect doctors would have to open up a separate file for the fetus, which is not customary (as far as I know) in maternity hospitals. Perhaps having “two” patients makes an obstetrician a “super-doctor”, which is why the idea has gained ground!

There are conceptual difficulties to do with attributing personhood to an entity which is invisible, inaccessible, physically contained in and attached to the woman, which entirely lacks capacity, and which cannot interact with others at all, prior to birth. In everyday life, such an idea, if given legal effect, would lead to some strange outcomes. Pregnant women might have to purchase two tickets every time they used public transport to avoid being prosecuted for fetal “fare-dodging”. More seriously, if fetuses were “persons”, this would open the way to lawsuits for alleged wrongdoing by pregnant women whose conduct allegedly compromised fetal wellbeing in some way. In the words of a 1993 Canadian Royal Commission on New Reproductive Technologies (cited in the St George's judgment): “each choice made by the woman in relation to her body will affect the fetus and potentially attract tort liability”. 14

One can make a case for saying that a pregnant woman is entitled to be regarded as two persons, not as a means of subordinating her interests and autonomy, but rather to enhance it. (I have problems with this argument, however, and it doesn't work in terms of abortion). Quite simply, one could say that, given the increased needs which pregnancy brings, the pregnant woman is entitled to call for special care and treatment for herself and for her fetus. In theory, the pregnant woman could act as the fetus's proxy, with sole authority to advocate on its behalf, and to determine what happens to it. The problem with translating the idea of “two patients” into legal terms, however, is that “fetal rights” proponents have deployed this concept not as a means of improving care for pregnant women, but as a pretext for coercion: state intervention which forces pregnant woman into an antagonistic relationship with their fetuses. In other words, state control of pregnant women.

An illustration of the coercion to which this can give rise, is provided by certain US states. In South Carolina and California, drug-addicted pregnant women attending antenatal clinics have been arrested and charged with criminal offences, after they tested positive for drugs whilst pregnant. The MSUC hospital in Charleston, South Carolina pursued a particularly punitive policy against addicted African-American women in the 1980s and early 1990s. Pregnant women attending for antenatal care were tested for drugs without their knowledge and, if the tests were positive, the women were arrested and taken into custody by the police. An appeal to the US Supreme Court, in a case called Ferguson v City of Charleston , recently succeeded: the Supreme Court decided in March 2001 that covert drug-testing was unconstitutional. 18

The South Carolina Supreme Court gave a ruling in 1997, in a case concerning another drug-addicted pregnant woman, Whitner v State . 19 She was convicted of criminal child neglect for (in the words of prosecutors) failing to provide proper medical care for her unborn child, and jailed for eight years. He was born healthy, but a test showed prenatal exposure to cocaine. The ruling is that a viable fetus is a “person”, and that acts which endanger fetal health—including drinking and smoking—can be prosecuted under child abuse laws. After this ruling, the Attorney-General's office in South Carolina announced that anyone who had, or who took part in, a post-viability abortion could be prosecuted for murder and receive the death penalty. 20 Here are some examples of how the decision has been applied:

“ Whitner has not been limited to women who use illegal drugs. Following the decision a pregnant woman in South Carolina was arrested because she was pregnant and used alcohol. When a thirteen-year-old girl experienced a stillbirth her parents were arrested: one charge was for unlawful conduct to a child because the girl's parents had allegedly ‘failed to get proper care for the fetus’. A woman who suffered a miscarriage was arrested and charged with homicide by child abuse. The prosecutor admitted there was no evidence of drug use but nevertheless insisted that the miscarriage was a ‘crime’ for which the woman had to take responsibility.” (L M Paltrow, personal communication, 4 May 2000)

Another example of state control is provided by the Republic of Ireland, where the constitution gives the “unborn” a right to life equal to that of the “mother”. Even rape is not recognised as a legal basis for abortion, though this could be the subject of a challenge before the European Court of Human Rights in Strasbourg. In two dramatic cases involving child victims of sexual assault, the X and C cases, 21 , 22 Irish courts have become involved in the question whether such victims are free to travel to England for lawful abortions. Where children become pregnant, and family courts have to consider their welfare, the Irish courts will only permit travel abroad for abortions when the children can show their lives are in danger. This is surprising, given that the Irish people voted to give women freedom to travel in 1992. So there are some stark examples from both sides of the Atlantic of problems that arise when ethical absolutes about fetal life are translated into law. Perhaps it is not so much a new ethics of abortion that is required, as a more inclusive one.

• ↵ Radcliffe Richards J. The sceptical feminist. London : Penguin, 1994.
• ↵ See reference 1: 279.
• ↵ A Joint World Health Organisation/UNFPA/UNICEF/World Bank statement. Reduction of maternal mortality. Geneva: World Health Organization, 1999: 14.
• ↵ Furedi A. Women versus babies: comment & analysis. The Guardian 2000 Feb 22: .
• ↵ Kant I. Fundamental principles of the metaphysic of morals. In Cahn SM, Markie P, eds. Ethics: history, theory and contemporary issues . New York: Oxford University Press, 1998: 297.
• ↵ Smith C. Contraception and the need for abortion. A quest for abortion: new research about obstacles, delays and negative attitudes . London: Voice for Choice, 1999: 3-4.
• ↵ Mill JS. On liberty. Three Essays London: Oxford University Press, 1975: 18.
• ↵ Royal College of Obstetricians and Gynaecologists. The care of women requesting induced abortion. London: Royal College of Obstetricians and Gynaecologists, 2000.
• ↵ See reference 8: 16: para 2.1
• ↵ See reference 8: 36.
• ↵ See reference 8: 26.
• ↵ See reference 1: 289.
• ↵ Malone v Metropolitan Police Commr, (1979)ch 344,537.
• ↵ St George's Healthcare NHS Trust v S [1999] Fam; 26 :46-7.
• ↵ Stenberg v Carhart US Supreme Court, June 28, 2000.
• ↵ Planned Parenthood v Casey (1992) 505 US 833.
• See reference 14: 49-50.
• ↵ Ferguson v City of Charleston , US Supreme Court 21 March 2001.
• ↵ Whitner v South Carolina , 492 SE2d 777 (SC 1997).
• ↵ Paltrow L. Pregnant drug users, fetal persons and the threat to Roe v Wade. Albany Law Review 1999 ; 62 : 999 –1014. OpenUrl
• ↵ Attorney-General v X [1992] 1 IR 1.
• ↵ A & B v Eastern Health Board [1998] 1 IR 464.

Barbara Hewson is a Barrister at Littman Chambers, 12 Gray's Inn Square, London WC1R 5JP.

Read the full text or download the PDF:

Other content recommended for you.

• Is current practice around late termination of pregnancy eugenic and discriminatory? Maternal interests and abortion Julian Savulescu, Journal of Medical Ethics, 2001
• About abortion in Britain , Journal of Medical Ethics, 2001
• Conscientious objection in medicine Julian Savulescu, BMJ, 2006
• The new ethics of abortion Joan Greenwood, Journal of Medical Ethics, 2001
• After 50 years of legal abortion in Great Britain, calls grow for further liberalisation Sally Howard, BMJ, 2017
• Terminating pregnancy after prenatal diagnosis—with a little help of professional ethics? Dagmar Schmitz, Journal of Medical Ethics, 2012
• ‘A disastrous blow’: psychiatric risk, social indicators and medical authority in abortion reform in post-war Britain Sarah Crook, Medical Humanities, 2019
• Questionable benefits and unavoidable personal beliefs: defending conscientious objection for abortion Bruce Philip Blackshaw et al., Journal of Medical Ethics, 2019
• Ethics briefings Martin Davies et al., Journal of Medical Ethics, 2013
• New abortion guidance in Northern Ireland places greater emphasis on women’s health Clare Dyer, BMJ, 2016

Ethics and Morality

Ethics and abortion, two opposing arguments on the morality of abortion..

Posted June 7, 2019 | Reviewed by Jessica Schrader

Abortion is, once again, center stage in our political debates. According to the Guttmacher Institute, over 350 pieces of legislation restricting abortion have been introduced. Ten states have signed bans of some sort, but these are all being challenged. None of these, including "heartbeat" laws, are currently in effect. 1

Much has been written about abortion from a philosophical perspective. Here, I'd like to summarize what I believe to be the best argument on each side of the abortion debate. To be clear, I'm not advocating either position here; I'm simply trying to bring some clarity to the issues. The focus of these arguments is on the morality of abortion, not its constitutional or legal status. This is important. One might believe, as many do, that at least some abortions are immoral but that the law should not restrict choice in this realm of life. Others, of course, argue that abortion is immoral and should be illegal in most or all cases.

"Personhood"

Personhood refers to the moral status of an entity. If an entity is a person , in this particular sense, it has full moral status . A person, then, has rights , and we have obligations to that person. This includes the right to life. Both of the arguments I summarize here focus on the question of whether or not the fetus is a person, or whether or not it is the type of entity that has the right to life. This is an important aspect to focus on, because what a thing is determines how we should treat it, morally speaking. For example, if I break a leg off of a table, I haven't done anything wrong. But if I break a puppy's leg, I surely have done something wrong. I have obligations to the puppy, given what kind of creature it is, that I don't have to a table, or any other inanimate object. The issue, then, is what kind of thing a fetus is, and what that entails for how we ought to treat it.

A Pro-Choice Argument

I believe that the best type of pro-choice argument focuses on the personhood of the fetus. Mary Ann Warren has argued that fetuses are not persons; they do not have the right to life. 2 Therefore, abortion is morally permissible throughout the entire pregnancy . To see why, Warren argues that persons have the following traits:

• Consciousness: awareness of oneself, the external world, the ability to feel pain.
• Reasoning: a developed ability to solve fairly complex problems.
• Ability to communicate: on a variety of topics, with some depth.
• Self-motivated activity: ability to choose what to do (or not to do) in a way that is not determined by genetics or the environment .
• Self-concept : see themselves as _____; e.g. Kenyan, female, athlete , Muslim, Christian, atheist, etc.

The key point for Warren is that fetuses do not have any of these traits. Therefore, they are not persons. They do not have a right to life, and abortion is morally permissible. You and I do have these traits, therefore we are persons. We do have rights, including the right to life.

One problem with this argument is that we now know that fetuses are conscious at roughly the midpoint of a pregnancy, given the development timeline of fetal brain activity. Given this, some have modified Warren's argument so that it only applies to the first half of a pregnancy. This still covers the vast majority of abortions that occur in the United States, however.

A Pro-Life Argument

The following pro-life argument shares the same approach, focusing on the personhood of the fetus. However, this argument contends that fetuses are persons because in an important sense they possess all of the traits Warren lists. 3

At first glance, this sounds ridiculous. At 12 weeks, for example, fetuses are not able to engage in reasoning, they don't have a self-concept, nor are they conscious. In fact, they don't possess any of these traits.

Or do they?

In one sense, they do. To see how, consider an important distinction, the distinction between latent capacities vs. actualized capacities. Right now, I have the actualized capacity to communicate in English about the ethics of abortion. I'm demonstrating that capacity right now. I do not, however, have the actualized capacity to communicate in Spanish on this issue. I do, however, have the latent capacity to do so. If I studied Spanish, practiced it with others, or even lived in a Spanish-speaking nation for a while, I would likely be able to do so. The latent capacity I have now to communicate in Spanish would become actualized.

Here is the key point for this argument: Given the type of entities that human fetuses are, they have all of the traits of persons laid out by Mary Anne Warren. They do not possess these traits in their actualized form. But they have them in their latent form, because of their human nature. Proponents of this argument claim that possessing the traits of personhood, in their latent form, is sufficient for being a person, for having full moral status, including the right to life. They say that fetuses are not potential persons, but persons with potential. In contrast to this, Warren and others maintain that the capacities must be actualized before one is person.

The Abortion Debate

There is much confusion in the abortion debate. The existence of a heartbeat is not enough, on its own, to confer a right to life. On this, I believe many pro-lifers are mistaken. But on the pro-choice side, is it ethical to abort fetuses as a way to select the gender of one's child, for instance?

We should not focus solely on the fetus, of course, but also on the interests of the mother, father, and society as a whole. Many believe that in order to achieve this goal, we need to provide much greater support to women who may want to give birth and raise their children, but choose not to for financial, psychological, health, or relationship reasons; that adoption should be much less expensive, so that it is a live option for more qualified parents; and that quality health care should be accessible to all.

I fear , however, that one thing that gets lost in all of the dialogue, debate, and rhetoric surrounding the abortion issue is the nature of the human fetus. This is certainly not the only issue. But it is crucial to determining the morality of abortion, one way or the other. People on both sides of the debate would do well to build their views with this in mind.

https://abcnews.go.com/US/state-abortion-bans-2019-signed-effect/story?id=63172532

Mary Ann Warren, "On the Moral and Legal Status of Abortion," originally in Monist 57:1 (1973), pp. 43-61. Widely anthologized.

This is a synthesis of several pro-life arguments. For more, see the work of Robert George and Francis Beckwith on these issues.

Michael W. Austin, Ph.D. , is a professor of philosophy at Eastern Kentucky University.

• Find a Therapist
• Find a Treatment Center
• Find a Psychiatrist
• Find a Support Group
• Find Online Therapy
• United States
• Brooklyn, NY
• Chicago, IL
• Houston, TX
• Los Angeles, CA
• New York, NY
• Portland, OR
• San Diego, CA
• San Francisco, CA
• Seattle, WA
• Washington, DC
• Asperger's
• Bipolar Disorder
• Chronic Pain
• Eating Disorders
• Passive Aggression
• Personality
• Goal Setting
• Positive Psychology
• Stopping Smoking
• Low Sexual Desire
• Relationships
• Child Development
• Self Tests NEW
• Therapy Center
• Diagnosis Dictionary
• Types of Therapy

At any moment, someone’s aggravating behavior or our own bad luck can set us off on an emotional spiral that threatens to derail our entire day. Here’s how we can face our triggers with less reactivity so that we can get on with our lives.

• Emotional Intelligence
• Gaslighting
• Affective Forecasting
• Neuroscience

• Share full article

Advertisement

Supported by

The Morning Newsletter

How Abortion Views Are Different

With the Supreme Court set to hear a major abortion case, we look at the state of public opinion.

By David Leonhardt

For nearly 50 years, public opinion has had only a limited effect on abortion policy. The Roe v. Wade decision, which the Supreme Court issued in 1973, established a constitutional right to abortion in many situations and struck down restrictions in dozens of states.

But now that the court has agreed to hear a case that could lead to the overturning of Roe , voters and legislators may soon again be determining abortion laws, state by state. This morning’s newsletter offers a guide to public opinion on the subject.

Americans’ views on abortion are sufficiently complex that both sides in the debate are able to point to survey data that suggests majority opinion is on their side — and then to argue that the data friendly to their own side is the “right” data. These competing claims can be confusing. But when you dig into the data, you discover there are some clear patterns and objective truths.

Here are five.

1. A pro-Roe majority …

Polls consistently show that a majority of Americans — 60 percent to 70 percent, in recent polls by both Gallup and Pew — say they do not want the Supreme Court to overturn Roe. Similarly, close to 60 percent of Americans say they favor abortion access in either all or most circumstances, according to Pew.

These are the numbers that abortion rights advocates often emphasize.

2. … and a pro-restriction majority

The most confounding aspect of public opinion is a contradiction between Americans’ views on Roe itself and their views on specific abortion policies: Even as most people say they support the ruling, most also say they favor restrictions that Roe does not permit .

Roe, for example, allows only limited restrictions on abortion during the second trimester, mostly involving a mother’s health. But less than 30 percent of Americans say that abortion should “generally be legal” in the second trimester, according to Gallup. Many people also oppose abortion in specific circumstances — because a fetus has Down syndrome, for example — even during the first trimester.

One sign that many Americans favor significant restrictions is in the Gallup data. Gallup uses slightly different wording from Pew, creating an option that allows people to say that abortion should be legal “in only a few” circumstances. And that is the most popular answer — with 35 percent of respondents giving it (in addition to the 20 percent who say abortion should be illegal in all circumstances).

This helps explain why many abortion rights advocates are worried that the Supreme Court will gut Roe without officially overturning it. Yes, the justices are often influenced by public opinion .

3. Remarkable stability

Opinion on some major political issues has changed substantially over the last half-century. On taxes and regulation, people’s views have ebbed and flowed. On some cultural issues — like same-sex marriage and marijuana legalization — views have moved sharply in one direction.

But opinion on abortion has barely budged . Here is Gallup’s four-category breakdown, going back to 1994:

Other survey questions show a similar pattern, with the stability stretching back to the 1970s , just after the Roe ruling.

A key reason is that abortion opinion differs only modestly by age group. Americans under 30 support abortion rights more strongly than Americans over 50, but the gap is not huge. The age gaps on marijuana legalization , same-sex marriage and climate change are all larger.

Abortion remains a vexing issue for large numbers of Americans in every generation — which suggests the debate is not likely to be resolved anytime soon.

4. A modest gender gap …

Gender plays a major role in American politics. Most women voted for Joe Biden, while most men voted for Donald Trump. On many issues, like gun control and the minimum wage , there is a large gender gap.

But the gap on abortion is not so large. If anything, it seems to be smaller than the partisan gap . That suggests, perhaps surprisingly, that there are more Democratic-voting women who favor significant abortion restrictions than Republican-voting women who favor almost universal access — while the opposite is true for men.

(One note: When people are asked whether they identify as “pro-choice” or “pro-life,” both the gender and age gaps grow. Those terms appear to prime people to think as Democrats or Republicans, rather than thinking through the details of their own policy views.)

5. … and a big class gap

One of the strongest predictors of a person’s view on abortion is educational attainment, as you can see in the chart above. Working-class Americans often favor restrictions. Many religiously observant people also favor restrictions.

It’s yet another way in which the Democratic coalition is becoming tilted toward college graduates and the Republican coalition is going in the other direction.

The bottom line

Both advocates and opponents of abortion access believe the issue is too important to be decided by public opinion. For advocates, women should have control over their bodies; after all, no major decision of men’s health is subject to a veto by politicians or other voters. And for opponents of abortion access, the life of an unborn child is too important to be subject to almost any other consideration.

If the Supreme Court overrules or substantially weakens Roe, this intense debate will play out state by state. Many states are likely to restrict abortion access substantially.

For more: Pew’s Jeff Diamant and Aleksandra Sandstrom look at opinion in each state . And The Upshot looks in detail at how and where laws may change if Roe falls .

THE LATEST NEWS

New C.D.C. mask guidelines have Americans wondering whether they can trust one another .

Republican-controlled states are cutting off federal pandemic unemployment benefits , arguing that they are making it hard for businesses to hire.

An estimated 40 percent of doctors in India have gotten Covid, and more than 250 have died since early April.

Many New York businesses are allowed to fully reopen today . Parts of Europe are also lifting restrictions .

Virus resources: How should you think about virus variants if you’re vaccinated ?

“The future of the auto industry is electric,” President Biden said during a visit to a Ford plant in Michigan.

The House passed a bill to help law enforcement agencies review hate crimes against Asian-Americans, sending it to Biden .

New York’s attorney general joined the Manhattan district attorney’s criminal inquiry into the Trump Organization .

House Republican leaders oppose creating a bipartisan commission to investigate the Jan. 6 Capitol attack.

Israeli-Palestinian Conflict

Diplomatic efforts to end the violence are gaining urgency , with the E.U., the U.N., and others calling on the Israeli military and Hamas militants to lay down their weapons.

Israeli airstrikes have damaged Gaza’s health and sewage systems and displaced tens of thousands of people, deepening a humanitarian crisis .

Biden was said to have sharpened his tone with Prime Minister Benjamin Netanyahu of Israel in a private call.

Palestinians across the West Bank, Gaza and Israel went on strike .

Other Big Stories

Climate change is forcing the National Park Service to decide which species and landscapes to save — and which to let slip away.

A North Carolina prosecutor said sheriff’s deputies were “justified” in the killing of Andrew Brown Jr., a Black man.

In Japan, a woman who overstayed her visa got sick and died alone in detention , causing criticism of the country’s treatment of migrants.

Darwin’s Arch, a rock formation in the Galápagos Islands, collapsed because of natural erosion .

Spain is trying a new solution for officials who can’t stop stealing: corruption rehab .

Why are people in your state not getting vaccinated ?

“To me it represents everything that is beautiful and possible”: Dr. Adam Lee Goldstein writes about his hospital near Tel Aviv, where Jews and Muslims, side by side, treat the wounded.

Morning Reads

Anonymous no more: In 1944, they were children on a train to a Nazi death camp. Researchers identified them, and they’re still alive .

A Times classic: Eight things worth your time .

Lives Lived: With deadpan comedy and Everyman good looks, Charles Grodin first drew notice on Broadway. He went on to star onscreen in “The Heartbreak Kid,” “Midnight Run” and “Beethoven.” He died at 86 .

ARTS AND IDEAS

‘shrek’ at 20.

Nobody at DreamWorks, then a relatively new animation studio, expected “Shrek” to be a hit. “Getting sent to ‘Shrek’ felt like being sent to Siberia,” the director Vicky Jenson said.

Released 20 years ago, the movie was a departure from other animated features of the time. Its hero was a misanthropic ogre. The cheeky and crude humor made fun of fairy-tale tropes. And the film was loaded with pop culture references and contemporary songs .

Yet “Shrek” went on to spawn a billion-dollar franchise and win the first Academy Award for best animated feature. It “defined the kind of films the studio would go on to make: offbeat stories that, unlike Disney fairy tales, had more of an edge to them,” as Gina Cherelus writes in The Times .

Today, Shrek-related content is ubiquitous in memes and on social media, introducing the film to a new generation . At a sushi restaurant years ago, Jenson was delighted to overhear nearby diners talking about it. “One of them says, ‘Have you seen “Shrek”?’ And the other one is like, ‘No, no, I don’t go see kids’ stuff,’ and they go: ‘No, no, it’s not for kids. You have to go see it.’” — Sanam Yar, a Morning writer

PLAY, WATCH, EAT

What to cook.

This fried snapper is topped with thyme-laced Creole sauce. Eat it while reading Pete Wells on New York City’s return to full-scale indoor dining.

What to Read

The mainstream narrative is that Sinead O’Connor ripped up a photo of the pope on “Saturday Night Live” and derailed her music career. She’d like to set the record straight .

Virtual Travel

See a ghost town on a Norwegian archipelago in the High Arctic.

The hosts discussed the Giulianis .

Now Time to Play

The pangram from yesterday’s Spelling Bee was jocular . Here is today’s puzzle — or you can play online .

Here’s today’s Mini Crossword , and a clue: Euphoric feeling (four letters).

If you’re in the mood to play more, find all our games here .

Thanks for spending part of your morning with The Times. See you tomorrow. — David

P.S. Three of our colleagues’ stories appear in The Best American Food Writing 2020 : Amelia Nierenberg’s article on Hatch chiles , Kim Severson’s profile of Jamie Oliver and Pete Wells’s viral review of Peter Luger .

You can see today’s print front page here .

“ The Daily ” is about Gaza. On “ The Argument ,” a debate about critical race theory.

Lalena Fisher, Claire Moses, Ian Prasad Philbrick and Sanam Yar contributed to The Morning. You can reach the team at [email protected] .

Sign up here to get this newsletter in your inbox .

David Leonhardt writes The Morning, The Times's main daily newsletter. Previously at The Times, he was the Washington bureau chief, the founding editor of The Upshot, an Op-Ed columnist, and the head of The 2020 Project, on the future of the Times newsroom. He won the 2011 Pulitzer Prize for commentary. More about David Leonhardt

Abortion: An Ethical Dilemma

There are many reasons as to why abortion poses an ethical dilemma for most women. Reasons such as religious beliefs, medical concerns are easily resolved by reason and need. While other cases, such as pregnancies resulting from criminal acts, are more often debated and considered an ethical dilemma.

It is not difficult to see why abortion is a hotly debated topic. Any discussion that involves the ending of a life, a life that never asked to be conceived in the first place, leaves the woman with the problem of deciding when it is right to continue or end that life cycle.

The religious believe that such an important decision should be left only in the hands of God. But because of abortion, women, and men have taken on the role of God as well, dictating when and who shall live even before that person becomes a part of the real world.

Medical science has become so far advanced that doctors now have the ability to discover when a wanted pregnancy shall endanger the life of the mother. In such cases, they leave the decision to continue the pregnancy in the hands of the parents.

Again, asking them to play God and decide if they love themselves more than the life that they brought into being. In such cases, an abortive procedure may be acceptable. But then again, if it is something that occurs too late in the pregnancy, it leaves the soon to be parents at a crossroads. Unable to decide upon which decision would be best for them and their unborn child.

In the case of pregnancy resulting from rape, the fetus is definitely unwanted and unloved. Most women who find themselves in such a situation would most likely opt for an abortion. If we think about it, such a decision will fall within reason. The woman neither knows the father of the child, nor what to expect of the child once it is born.

She will be unable to love the child mainly because of the circumstances surrounding its conception and birth. However, it is in such situations that abortion should not be an option. Allowing the child to come to full term and undergoing a legal adoption procedure would be the most logical step of action because the unwanted child of another can always be loved by someone else as if she were the one who breathed life into the child.

In my opinion, abortion is a procedure that should be legally accepted as part of a woman’s basic right. I am not advocating that women undergo abortion like they do plastic surgery, but rather, I am advocating that abortion be discussed with women as something that they can choose to do if they find themselves in such a situation that calls for it.

Most women who undergo abortions do not really understand much about it because it is a taboo topic in society. An open discussion will help women come to informed decisions and help in government regulation of abortion clinics. This, in turn, will lead to more open discussions and acceptance of abortions for what it is, a way of fixing a life-altering problem for most women.

There is no wrong or right answer when it comes to abortion, mainly because each abortion case is unique in its circumstances. No woman should be held with a stigma for undergoing the procedure. It is only an ethical dilemma because society refuses to see the benefits of abortion in the lives of women. Once the benefits are more clearly spelled out, the dilemma will be over for most women.

Cite this paper

• Chicago (N-B)
• Chicago (A-D)

StudyCorgi. (2020, January 12). Abortion: An Ethical Dilemma. https://studycorgi.com/abortion-an-ethical-dilemma/

"Abortion: An Ethical Dilemma." StudyCorgi , 12 Jan. 2020, studycorgi.com/abortion-an-ethical-dilemma/.

StudyCorgi . (2020) 'Abortion: An Ethical Dilemma'. 12 January.

1. StudyCorgi . "Abortion: An Ethical Dilemma." January 12, 2020. https://studycorgi.com/abortion-an-ethical-dilemma/.

Bibliography

StudyCorgi . "Abortion: An Ethical Dilemma." January 12, 2020. https://studycorgi.com/abortion-an-ethical-dilemma/.

StudyCorgi . 2020. "Abortion: An Ethical Dilemma." January 12, 2020. https://studycorgi.com/abortion-an-ethical-dilemma/.

This paper, “Abortion: An Ethical Dilemma”, was written and voluntary submitted to our free essay database by a straight-A student. Please ensure you properly reference the paper if you're using it to write your assignment.

Before publication, the StudyCorgi editorial team proofread and checked the paper to make sure it meets the highest standards in terms of grammar, punctuation, style, fact accuracy, copyright issues, and inclusive language. Last updated: January 12, 2020 .

If you are the author of this paper and no longer wish to have it published on StudyCorgi, request the removal . Please use the “ Donate your paper ” form to submit an essay.

1000-Word Philosophy: An Introductory Anthology

Philosophy, One Thousand Words at a Time

The Ethics of Abortion

Author: Nathan Nobis Category: Ethics Word Count: 1000

Listen here

Abortion involves the killing of a fetus to end a pregnancy. These fetuses are human , biologically. 1 It seems that fetuses are beings , although completely dependent beings: what else would they be?

So, abortion involves the killing of a being that is biologically human . Killing human beings is often deeply wrong, so is abortion wrong? If so, when? And w hy ?

Here we will review some influential philosophical answers to these questions.

1. Human Organisms?

Fetuses are not just biologically alive. And they aren’t just biologically human either, like skin cells or organs. They are biologically human organisms .

Some thinkers argue that our being human organisms physically continuous with fetuses that were human organisms makes abortion wrong. 2 They seem to argue that since it is wrong to kill us  now , i.e., we have properties that make it wrong to kill us  now ( prima facie wrong to kill: wrong unless extreme circumstances justify the killing), it was wrong to kill us at any stage of our development, since we’ve been the same organism, the same being, throughout our existence.

While this argument is influential in some circles, it is nevertheless dubious. You are likely over three feet tall now, but weren’t always. You can reason morally, but couldn’t always. You have the right to make autonomous decisions about your own life, but didn’t always. Many examples show that just because we have some characteristic, including a moral right now, that doesn’t entail that we (or our bodies?) have always had that characteristic or right. This argument’s advocates need to plausibly explain why that’d be different with, say, the right to life. 3

2. (Human) Persons?

We, readers of this essay, are human organisms (unless there are any divine or extraterrestrial readers!), and it is prima facie wrong to kill us. Is the reason why it wrong to kill us  because we are human organisms?

Perhaps not. It is wrong to kill us, arguably, because killing us prevents us from experiencing the goods of our future: accomplishments, relationships, enjoying our lives and so on, which is distinct from being a human organism.

Many philosophers describe these capacities needed for experiencing our lives, present and future, in terms of us being persons . 4 A theory present from at least the time of John Locke can be expressed roughly as:  persons are beings with personalities : persons are conscious beings with thoughts, feelings, memories, anticipations and other psychological states. (When some people insist that fetuses aren’t human beings , they might be claiming that they are not human persons ). If we die or even become permanently comatose, we cease to be persons, since we permanently lose consciousness.

This theory of personhood has explanatory power: it helps us understand why we are persons and how we (or our bodies) can cease to be persons. It justifies a growing belief that some non-human animals are (non-human) persons. It explains why rational space aliens, if there are any, would be (non-human) persons. It explains why divine or spiritual beings are or would be (non-human) persons.

On this theory of personhood, beginning fetuses are not persons. This is because their brains and nervous systems aren’t sufficiently developed and complexly interconnected enough for consciousness and personhood. The medical and scientific research reports that this developmental stage isn’t reached until after the first trimester, or, more likely, until mid-pregnancy. 5 Nearly all abortions occur very early in pregnancy, killing fetuses that are not yet conscious, and so are not yet persons on this theory of personhood.

Any later abortions, affecting conscious and feeling fetuses who are persons or close to it, however, would likely be wrong on this theory unless done for a justifying medical reason.

3. Potential Personhood?

But just because something (or someone) is not a person, that doesn’t obviously mean that it is  not wrong to kill it.

If fetuses aren’t persons, they are still potential persons. (And merely potential persons  are never actual persons ).  Does that potential give fetuses, say, the right to life or otherwise make it wrong to kill them?

If potential things  have the rights of  actual things , then potential adults, spouses, criminals, doctors, and judges would have the rights of actual ones. Since they don’t, it is plausible that  potential personhood doesn’t yield the rights of actual personhood . At least, we are due an explanation of why it would, since potentiality never does that for anything else.

4. Valuable Futures?

Abortion might seem to prevent a fetus from experiencing its valuable future, just like killing us does, even if it is not yet a person. 6 But our futures might be valuable, in part, because we can, presently, look forward to them. Fetuses have no awareness of their futures whatsoever, and this is one important difference between their futures and our futures.

Further, an egg-and-a-sperm-that-would-fertilize-it  arguably has a future akin to that of a fetus. Contraception (even by abstinence!) keeps this future from materializing. 7 But contraception and abstinence aren’t wrong. Thus, it is not wrong to perform some action that prevents such a future from materializing.

5. The Right to Life?

Finally, suppose all fetuses are indeed persons with the right to life. Does that make abortion wrong?

Not necessarily, Judith Thomson famously argued in her 1971 “A Defense of Abortion.” 8 If I must use your kidney to stay alive, do I have a right to your kidney? No, and you don’t violate my rights if you don’t let me use it and I die. This shows that the right to life is not a right to the bodies of others, even if those bodies are necessary for our lives to continue .

Fetuses, then, might not have a right to the pregnant woman’s body and so she doesn’t violate their rights by not allowing a fetus to use it. If so, abortion wouldn’t violate any rights of fetuses and so it might be permissible.

6. Conclusion

The philosophical issue of the moral status of abortion is complex: these are just a few philosophical arguments on the issue. Each argument, and many others, are worthy of further discussion and reasoned debate. 9

1 Unless we are doing veterinary ethics and are thinking about aborting feline or canine or other non-human fetuses.

2  This argument is developed in Beckwith (2007), and in George and Tollefsen (2008). This presentation here is based on Beckwith’s emphasis that fetuses and the adults they often later become are the “same being.” These arguments, however, can be interpreted in a more complex way, in which we understand them as arguing that having rights, or the properties that result in having rights, is essential to living human organisms, and that we are, in essence, living human organisms (and not, in essence, say, either minds or souls), and so we have rights whenever living human organisms exist (and so since a fetus and the later adult are the “same being” they have rights whenever they exist). This more sophisticated argument is not discussed here. 

3 This response is developed in Boonin (2003) and in Nobis (2011)

4 This influential theory of personhood is developed in Warren (1973).

5 Lee, Susan J., et al. (2005) and Benatar and Benatar (2001)

6 This argument is developed in Marquis (1989).

7 For development of these arguments, see Norcross (1990).

8  Thomson (1971)

9 While abortion is, of course, a controversial issue, it is worth noting that 82% of professional philosophers surveyed “accept or lean towards” believing that first-trimester abortions are generally permissible, whereas 13% “accept or lean towards” believing they are impermissible. For philosophers who specialize in applied ethics, those numbers shift to 86% and 11%. See the 2020 PhilPapers Survey. A question is what explains these results: do philosophers tend to have these views about abortion because they better understand the issues and have trained abilities to rigorously evaluate ethical arguments? Or are these results better explained by something else? 

Beckwith, Francis J.  Defending Life: A Moral and Legal Case against Abortion Choice . Cambridge University Press, 2007

Benatar, David, and Michael Benatar. “A Pain in the Fetus: Toward Ending Confusion about Fetal Pain.”  Bioethics  15 (2001): 57-76

Boonin, David.  A Defense of Abortion . Cambridge University Press, 2003

George, Robert P. and Christopher Tollefsen. Embryo: A Defense of Human Life. Doubleday, 2008

Lee, Susan J., et al. “Fetal Pain: A Systematic Multidisciplinary Review of the Evidence.”  Jama  294.8 (2005): 947-954

Marquis, Don. “Why Abortion is Immoral.”  The Journal of Philosophy  86.4 (1989): 183-202

Nobis, Nathan. “Abortion, Metaphysics and Morality: A Review of Francis Beckwith’s Defending Life: A Moral and Legal Case Against Abortion Choice.”  Journal of Medicine and Philosophy  36.3 (2011): 261-273

Norcross, Alastair. “Killing, Abortion, and Contraception: A Reply to Marquis.”  The Journal of Philosophy  (1990): 268-277

Philpapers. (N.d.). Survey results: Philosophical questions 

Thomson, Judith Jarvis. “A Defense of Abortion.”  Philosophy & Public Affairs (1971): 47-66

Warren, Mary Anne. “On the Moral and Legal Status of Abortion.”  The Monist (1973): 43-61

Related Essays

Theories of Moral Considerability: Who and What Matters Morally? by Jonathan Spelman

The Doctrine of Double Effect: Do Intentions Matter to Ethics? by Gabriel Andrade

Personal Identity  by Chad Vance

Psychological Approaches to Personal Identity: Do Memories and Consciousness Make Us Who We Are?  by Kristin Seemuth Whaley

Animalism and Personal Identity: Are We Animals? by Kristin Seemuth Whaley

The Mind-Body Problem: What Are Minds? by Jacob Berger

Is Death Bad? Epicurus and Lucretius on the Fear of Death by Frederik Kaufman

The Badness of Death  by Duncan Purves

The Non-Identity Problem  by Duncan Purves

Applied Ethics  by Chelsea Haramia

Principlism in Biomedical Ethics: Respect for Autonomy, Non-Maleficence, Beneficence, and Justice  by G. M. Trujillo, Jr.

What Is Misogyny?  by Odelia Zuckerman and Clair Morrissey

Audio and Video

About the author.

Nathan Nobis is a Professor of Philosophy at Morehouse College, Atlanta, GA. He is the author of Animals & Ethics 101 , co-author of  Thinking Critically About Abortion , a co-author of  Chimpanzee Rights ,  and author or co-author of many other articles, chapters, and reviews in philosophy and ethics.  www.NathanNobis.com

Follow 1000-Word Philosophy on Facebook , Twitter and subscribe to receive email notifications of new essays at the bottom of 1000WordPhilosophy.com

Share this:, 19 thoughts on “ the ethics of abortion ”.

• Pingback: The Mind-Body Problem: What Are Minds? – 1000-Word Philosophy: An Introductory Anthology
• Pingback: The Doctrine of Double Effect: Do Intentions Matter to Ethics? – 1000-Word Philosophy: An Introductory Anthology
• Pingback: What Is Misogyny? – 1000-Word Philosophy: An Introductory Anthology
• Pingback: Psychological Approaches to Personal Identity: Do Memories and Consciousness Make Us Who We Are? – 1000-Word Philosophy: An Introductory Anthology
• Pingback: Theories of Moral Considerability: Who and What Matters Morally? – 1000-Word Philosophy: An Introductory Anthology
• Pingback: Are We Animals? Animalism and Personal Identity – 1000-Word Philosophy: An Introductory Anthology
• Pingback: Principlism in Biomedical Ethics: Respect for Autonomy, Non-Maleficence, Beneficence, and Justice – 1000-Word Philosophy: An Introductory Anthology
• Pingback: Is Death Bad? Epicurus and Lucretius on the Fear of Death – 1000-Word Philosophy: An Introductory Anthology
• Pingback: Ethics: A Collection of Online Resources and Key Quotes - The Daily Idea
• Pingback: Personal Identity – 1000-Word Philosophy: An Introductory Anthology
• Pingback: Ethics: A Collection of Online Resources and Key Quotes – The Daily Idea
• Pingback: Speciesism – 1000-Word Philosophy: An Introductory Anthology
• Pingback: Applied Ethics – 1000-Word Philosophy: An Introductory Anthology
• Pingback: 1,000-Word Philosophy: Philosophy for Everyone | Blog of the APA
• Pingback: Origin Essentialism – 1000-Word Philosophy: An Introductory Anthology
• Pingback: The Non-Identity Problem – 1000-Word Philosophy: An Introductory Anthology
• Pingback: The Badness of Death – 1000-Word Philosophy: An Introductory Anthology
• Pingback: 千字哲學部落格中的幾篇新介紹（New Essays on 1000-Word Philosophy） | 法哲學、生活與實踐
• Pingback: Pro-life or Pro-choice? – ishwarhegde

Comments are closed.

Numbers, Facts and Trends Shaping Your World

Read our research on:

Full Topic List

Regions & Countries

• Publications
• Our Methods
• Short Reads
• Tools & Resources

Read Our Research On:

• America’s Abortion Quandary

1. Americans’ views on whether, and in what circumstances, abortion should be legal

Table of contents.

• Abortion at various stages of pregnancy 
• Abortion and circumstances of pregnancy 
• Parental notification for minors seeking abortion
• Penalties for abortions performed illegally 
• Public views of what would change the number of abortions in the U.S.
• A majority of Americans say women should have more say in setting abortion policy in the U.S.
• How do certain arguments about abortion resonate with Americans?
• In their own words: How Americans feel about abortion 
• Personal connections to abortion 
• Religion’s impact on views about abortion
• Acknowledgments
• The American Trends Panel survey methodology

As the long-running debate over abortion reaches another  key moment at the Supreme Court  and in  state legislatures across the country , a majority of U.S. adults continue to say that abortion should be legal in all or most cases. About six-in-ten Americans (61%) say abortion should be legal in “all” or “most” cases, while 37% think abortion should be  illegal  in all or most cases. These views have changed little over the past several years: In 2019, for example, 61% of adults said abortion should be legal in all or most cases, while 38% said it should be illegal in all or most cases.    Most respondents in the new survey took one of the middle options when first asked about their views on abortion, saying either that abortion should be legal in  most  cases (36%) or illegal in  most  cases (27%). 

Respondents who said abortion should either be legal in  all  cases or illegal in  all  cases received a follow-up question asking whether there should be any exceptions to such laws. Overall, 25% of adults initially said abortion should be legal in all cases, but about a quarter of this group (6% of all U.S. adults) went on to say that there should be some exceptions when abortion should be against the law.

One-in-ten adults initially answered that abortion should be illegal in all cases, but about one-in-five of these respondents (2% of all U.S. adults) followed up by saying that there are some exceptions when abortion should be permitted. 

Altogether, seven-in-ten Americans say abortion should be legal in some cases and illegal in others, including 42% who say abortion should be generally legal, but with some exceptions, and 29% who say it should be generally illegal, except in certain cases. Much smaller shares take absolutist views when it comes to the legality of abortion in the U.S., maintaining that abortion should be legal in all cases with no exceptions (19%) or illegal in all circumstances (8%). 

There is a modest gender gap in views of whether abortion should be legal, with women slightly more likely than men to say abortion should be legal in all cases or in all cases but with some exceptions (63% vs. 58%). 

Younger adults are considerably more likely than older adults to say abortion should be legal: Three-quarters of adults under 30 (74%) say abortion should be generally legal, including 30% who say it should be legal in all cases without exception. 

But there is an even larger gap in views toward abortion by partisanship: 80% of Democrats and Democratic-leaning independents say abortion should be legal in all or most cases, compared with 38% of Republicans and GOP leaners.  Previous Center research  has shown this gap widening over the past 15 years. 

Still, while partisans diverge in views of whether abortion should mostly be legal or illegal, most Democrats and Republicans do not view abortion in absolutist terms. Just 13% of Republicans say abortion should be against the law in all cases without exception; 47% say it should be illegal with some exceptions. And while three-in-ten Democrats say abortion should be permitted in all circumstances, half say it should mostly be legal – but with some exceptions. 

There also are sizable divisions within both partisan coalitions by ideology. For instance, while a majority of moderate and liberal Republicans say abortion should mostly be legal (60%), just 27% of conservative Republicans say the same. Among Democrats, self-described liberals are twice as apt as moderates and conservatives to say abortion should be legal in all cases without exception (42% vs. 20%).

Regardless of partisan affiliation, adults who say they personally know someone who has had an abortion – such as a friend, relative or themselves – are more likely to say abortion should be legal than those who say they do not know anyone who had an abortion.

Views toward abortion also vary considerably by religious affiliation – specifically among large Christian subgroups and religiously unaffiliated Americans. 

For example, roughly three-quarters of White evangelical Protestants say abortion should be illegal in all or most cases. This is far higher than the share of White non-evangelical Protestants (38%) or Black Protestants (28%) who say the same. 

Despite  Catholic teaching on abortion , a slim majority of U.S. Catholics (56%) say abortion should be legal. This includes 13% who say it should be legal in all cases without exception, and 43% who say it should be legal, but with some exceptions. 

Compared with Christians, religiously unaffiliated adults are far more likely to say abortion should be legal overall – and significantly more inclined to say it should be legal in all cases without exception. Within this group, atheists stand out: 97% say abortion should be legal, including 53% who say it should be legal in all cases without exception. Agnostics and those who describe their religion as “nothing in particular” also overwhelmingly say that abortion should be legal, but they are more likely than atheists to say there are some circumstances when abortion should be against the law.

Although the survey was conducted among Americans of many religious backgrounds, including Jews, Muslims, Buddhists and Hindus, it did not obtain enough respondents from non-Christian groups to report separately on their responses.

As a  growing number of states  debate legislation to restrict abortion – often after a certain stage of pregnancy – Americans express complex views about when   abortion should generally be legal and when it should be against the law. Overall, a majority of adults (56%) say that how long a woman has been pregnant should matter in determining when abortion should be legal, while far fewer (14%) say that this should  not  be a factor. An additional one-quarter of the public says that abortion should either be legal (19%) or illegal (8%) in all circumstances without exception; these respondents did not receive this question.

Among men and women, Republicans and Democrats, and Christians and religious “nones” who do not take absolutist positions about abortion on either side of the debate, the prevailing view is that the stage of the pregnancy should be a factor in determining whether abortion should be legal.

Americans broadly are more likely to favor restrictions on abortion later in pregnancy than earlier in pregnancy. Many adults also say the legality of abortion depends on other factors at every stage of pregnancy. 

Overall, a plurality of adults (44%) say that abortion should be legal six weeks into a pregnancy, which is about when cardiac activity (sometimes called a fetal heartbeat) may be detected and before many women know they are pregnant; this includes 19% of adults who say abortion should be legal in all cases without exception, as well as 25% of adults who say it should be legal at that point in a pregnancy. An additional 7% say abortion generally should be legal in most cases, but that the stage of the pregnancy should not matter in determining legality. 1

One-in-five Americans (21%) say abortion should be  illegal  at six weeks. This includes 8% of adults who say abortion should be illegal in all cases without exception as well as 12% of adults who say that abortion should be illegal at this point. Additionally, 6% say abortion should be illegal in most cases and how long a woman has been pregnant should not matter in determining abortion’s legality. Nearly one-in-five respondents, when asked whether abortion should be legal six weeks into a pregnancy, say “it depends.” 

Americans are more divided about what should be permitted 14 weeks into a pregnancy – roughly at the end of the first trimester – although still, more people say abortion should be legal at this stage (34%) than illegal (27%), and about one-in-five say “it depends.”

Fewer adults say abortion should be legal 24 weeks into a pregnancy – about when a healthy fetus could survive outside the womb with medical care. At this stage, 22% of adults say abortion should be legal, while nearly twice as many (43%) say it should be  illegal . Again, about one-in-five adults (18%) say whether abortion should be legal at 24 weeks depends on other factors. 

Respondents who said that abortion should be illegal 24 weeks into a pregnancy or that “it depends” were asked a follow-up question about whether abortion at that point should be legal if the pregnant woman’s life is in danger or the baby would be born with severe disabilities. Most who received this question say abortion in these circumstances should be legal (54%) or that it depends on other factors (40%). Just 4% of this group maintained that abortion should be illegal in this case.

This pattern in views of abortion – whereby more favor greater restrictions on abortion as a pregnancy progresses – is evident across a variety of demographic and political groups. 

Democrats are far more likely than Republicans to say that abortion should be legal at each of the three stages of pregnancy asked about on the survey. For example, while 26% of Republicans say abortion should be legal at six weeks of pregnancy, more than twice as many Democrats say the same (61%). Similarly, while about a third of Democrats say abortion should be legal at 24 weeks of pregnancy, just 8% of Republicans say the same. 

However, neither Republicans nor Democrats uniformly express absolutist views about abortion throughout a pregnancy. Republicans are divided on abortion at six weeks: Roughly a quarter say it should be legal (26%), while a similar share say it depends (24%). A third say it should be illegal. 

Democrats are divided about whether abortion should be legal or illegal at 24 weeks, with 34% saying it should be legal, 29% saying it should be illegal, and 21% saying it depends. 

There also is considerable division among each partisan group by ideology. At six weeks of pregnancy, just one-in-five conservative Republicans (19%) say that abortion should be legal; moderate and liberal Republicans are twice as likely as their conservative counterparts to say this (39%). 

At the same time, about half of liberal Democrats (48%) say abortion at 24 weeks should be legal, while 17% say it should be illegal. Among conservative and moderate Democrats, the pattern is reversed: A plurality (39%) say abortion at this stage should be illegal, while 24% say it should be legal. 

Christian adults are far less likely than religiously unaffiliated Americans to say abortion should be legal at each stage of pregnancy.  

Among Protestants, White evangelicals stand out for their opposition to abortion. At six weeks of pregnancy, for example, 44% say abortion should be illegal, compared with 17% of White non-evangelical Protestants and 15% of Black Protestants. This pattern also is evident at 14 and 24 weeks of pregnancy, when half or more of White evangelicals say abortion should be illegal.

At six weeks, a plurality of Catholics (41%) say abortion should be legal, while smaller shares say it depends or it should be illegal. But by 24 weeks, about half of Catholics (49%) say abortion should be illegal. 

Among adults who are religiously unaffiliated, atheists stand out for their views. They are the only group in which a sizable majority says abortion should be  legal  at each point in a pregnancy. Even at 24 weeks, 62% of self-described atheists say abortion should be legal, compared with smaller shares of agnostics (43%) and those who say their religion is “nothing in particular” (31%). 

As is the case with adults overall, most religiously affiliated and religiously unaffiliated adults who originally say that abortion should be illegal or “it depends” at 24 weeks go on to say either it should be legal or it depends if the pregnant woman’s life is in danger or the baby would be born with severe disabilities. Few (4% and 5%, respectively) say abortion should be illegal at 24 weeks in these situations.

The stage of the pregnancy is not the only factor that shapes people’s views of when abortion should be legal. Sizable majorities of U.S. adults say that abortion should be legal if the pregnancy threatens the life or health of the pregnant woman (73%) or if pregnancy is the result of rape (69%). 

There is less consensus when it comes to circumstances in which a baby may be born with severe disabilities or health problems: 53% of Americans overall say abortion should be legal in such circumstances, including 19% who say abortion should be legal in all cases and 35% who say there are some situations where abortions should be illegal, but that it should be legal in this specific type of case. A quarter of adults say “it depends” in this situation, and about one-in-five say it should be illegal (10% who say illegal in this specific circumstance and 8% who say illegal in all circumstances). 

There are sizable divides between and among partisans when it comes to views of abortion in these situations. Overall, Republicans are less likely than Democrats to say abortion should be legal in each of the three circumstances outlined in the survey. However, both partisan groups are less likely to say abortion should be legal when the baby may be born with severe disabilities or health problems than when the woman’s life is in danger or the pregnancy is the result of rape. 

Just as there are wide gaps among Republicans by ideology on whether how long a woman has been pregnant should be a factor in determining abortion’s legality, there are large gaps when it comes to circumstances in which abortions should be legal. For example, while a clear majority of moderate and liberal Republicans (71%) say abortion should be permitted when the pregnancy is the result of rape, conservative Republicans are more divided. About half (48%) say it should be legal in this situation, while 29% say it should be illegal and 21% say it depends.

The ideological gaps among Democrats are slightly less pronounced. Most Democrats say abortion should be legal in each of the three circumstances – just to varying degrees. While 77% of liberal Democrats say abortion should be legal if a baby will be born with severe disabilities or health problems, for example, a smaller majority of conservative and moderate Democrats (60%) say the same. 

White evangelical Protestants again stand out for their views on abortion in various circumstances; they are far less likely than White non-evangelical or Black Protestants to say abortion should be legal across each of the three circumstances described in the survey. 

While about half of White evangelical Protestants (51%) say abortion should be legal if a pregnancy threatens the woman’s life or health, clear majorities of other Protestant groups and Catholics say this should be the case. The same pattern holds in views of whether abortion should be legal if the pregnancy is the result of rape. Most White non-evangelical Protestants (75%), Black Protestants (71%) and Catholics (66%) say abortion should be permitted in this instance, while White evangelicals are more divided: 40% say it should be legal, while 34% say it should be  illegal  and about a quarter say it depends. 

Mirroring the pattern seen among adults overall, opinions are more varied about a situation where a baby might be born with severe disabilities or health issues. For instance, half of Catholics say abortion should be legal in such cases, while 21% say it should be illegal and 27% say it depends on the situation. 

Most religiously unaffiliated adults – including overwhelming majorities of self-described atheists – say abortion should be legal in each of the three circumstances. 

Seven-in-ten U.S. adults say that doctors or other health care providers should be required to notify a parent or legal guardian if the pregnant woman seeking an abortion is under 18, while 28% say they should not be required to do so.  

Women are slightly less likely than men to say this should be a requirement (67% vs. 74%). And younger adults are far less likely than those who are older to say a parent or guardian should be notified before a doctor performs an abortion on a pregnant woman who is under 18. In fact, about half of adults ages 18 to 24 (53%) say a doctor should  not  be required to notify a parent. By contrast, 64% of adults ages 25 to 29 say doctors  should  be required to notify parents of minors seeking an abortion, as do 68% of adults ages 30 to 49 and 78% of those 50 and older. 

A large majority of Republicans (85%) say that a doctor should be required to notify the parents of a minor before an abortion, though conservative Republicans are somewhat more likely than moderate and liberal Republicans to take this position (90% vs. 77%). 

The ideological divide is even more pronounced among Democrats. Overall, a slim majority of Democrats (57%) say a parent should be notified in this circumstance, but while 72% of conservative and moderate Democrats hold this view, just 39% of liberal Democrats agree. 

By and large, most Protestant (81%) and Catholic (78%) adults say doctors should be required to notify parents of minors before an abortion. But religiously unaffiliated Americans are more divided. Majorities of both atheists (71%) and agnostics (58%) say doctors should  not  be required to notify parents of minors seeking an abortion, while six-in-ten of those who describe their religion as “nothing in particular” say such notification should be required. 

Americans are divided over who should be penalized – and what that penalty should be – in a situation where an abortion occurs illegally. 

Overall, a 60% majority of adults say that if a doctor or provider performs an abortion in a situation where it is illegal, they should face a penalty. But there is less agreement when it comes to others who may have been involved in the procedure. 

While about half of the public (47%) says a woman who has an illegal abortion should face a penalty, a nearly identical share (50%) says she should not. And adults are more likely to say people who help find and schedule or pay for an abortion in a situation where it is illegal should  not  face a penalty than they are to say they should.

Views about penalties are closely correlated with overall attitudes about whether abortion should be legal or illegal. For example, just 20% of adults who say abortion should be legal in all cases without exception think doctors or providers should face a penalty if an abortion were carried out in a situation where it was illegal. This compares with 91% of those who think abortion should be illegal in all cases without exceptions. Still, regardless of how they feel about whether abortion should be legal or not, Americans are more likely to say a doctor or provider should face a penalty compared with others involved in the procedure. 

Among those who say medical providers and/or women should face penalties for illegal abortions, there is no consensus about whether they should get jail time or a less severe punishment. Among U.S. adults overall, 14% say women should serve jail time if they have an abortion in a situation where it is illegal, while 16% say they should receive a fine or community service and 17% say they are not sure what the penalty should be. 

A somewhat larger share of Americans (25%) say doctors or other medical providers should face jail time for providing illegal abortion services, while 18% say they should face fines or community service and 17% are not sure. About three-in-ten U.S. adults (31%) say doctors should lose their medical license if they perform an abortion in a situation where it is illegal.

Men are more likely than women to favor penalties for the woman or doctor in situations where abortion is illegal. About half of men (52%) say women should face a penalty, while just 43% of women say the same. Similarly, about two-thirds of men (64%) say a doctor should face a penalty, while 56% of women agree.

Republicans are considerably more likely than Democrats to say both women and doctors should face penalties – including jail time. For example, 21% of Republicans say the woman who had the abortion should face jail time, and 40% say this about the doctor who performed the abortion. Among Democrats, far smaller shares say the woman (8%) or doctor (13%) should serve jail time.  

White evangelical Protestants are more likely than other Protestant groups to favor penalties for abortions in situations where they are illegal. Fully 24% say the woman who had the abortion should serve time in jail, compared with just 12% of White non-evangelical Protestants or Black Protestants. And while about half of White evangelicals (48%) say doctors who perform illegal abortions should serve jail time, just 26% of White non-evangelical Protestants and 18% of Black Protestants share this view.

• Only respondents who said that abortion should be legal in some cases but not others and that how long a woman has been pregnant should matter in determining whether abortion should be legal received questions about abortion’s legality at specific points in the pregnancy.  ↩

Sign up for our weekly newsletter

Fresh data delivery Saturday mornings

Sign up for The Briefing

Weekly updates on the world of news & information

• Christianity
• Evangelicalism
• Political Issues
• Politics & Policy
• Protestantism
• Religion & Abortion
• Religion & Politics
• Religion & Social Values

Public’s Positive Economic Ratings Slip; Inflation Still Widely Viewed as Major Problem

Americans have mixed views about how the news media cover biden’s, trump’s ages, an early look at black voters’ views on biden, trump and election 2024, support for legal abortion is widespread in many places, especially in europe, public opinion on abortion, most popular, report materials.

1615 L St. NW, Suite 800 Washington, DC 20036 USA (+1) 202-419-4300 | Main (+1) 202-857-8562 | Fax (+1) 202-419-4372 |  Media Inquiries

Research Topics

• Email Newsletters

ABOUT PEW RESEARCH CENTER  Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of  The Pew Charitable Trusts .

Copyright 2024 Pew Research Center