One of today's greatest controversies is "pro choice" vs. "pro life." Both sides assume that abortion automatically causes the death of the fetus. But that is not necessarily true.
Modern advances in medicine make it likely that most aborted fetuses could survive to become fully functioning children, if the abortion is done carefully with the intention of protecting the fetus.
The most important civil rights and ethical question about abortion today is not whether a woman has a right to terminate an unwanted pregnancy. The obvious answer to that one is "yes." The real questions are: Should a fetus have a right to be protected against being killed? And who should pay the costs of such protection?
This essay will not attempt to answer such questions. The purpose of this essay is to point out that these are the core questions that should be the center of the abortion debate, and to discuss some of the questions' ramifications. A rule will be proposed that would enshrine both the right of a woman to terminate her pregnancy at any time for any reason, and the right of the unborn baby to live. How much value we place on human life would then be measured by our willingness to require any termination of pregnancy to be done by methods that would protect the life of the fetus.
Let's consider the viability of life at both ends of the period of human gestation.
Babies born prematurely can be saved. Great strides have been made in saving premature babies at earlier and earlier lengths of pregnancy. Perhaps the premature baby must be placed in an incubator and given round-the-clock care by specialized nurses. Such treatment might be very expensive. Extreme prematurity might produce birth defects that will be very costly to remedy, or which can never be remedied and will require a lifetime of expensive maintenance. Nevertheless, wealthy parents have sometimes been willing to spend a fortune to preserve their baby's life. Whether society should be obligated to provide such care in the case of indigent parents is a question for moral debate and for political decision-making. Should parents have a right to kill (through action or inaction) a baby that might be as little as one day premature or as much as six months premature? Or should only society have that right? Or should only God have that right? These are matters for debate. But it is crystal clear that what is to be weighed in the balance is the value of the life of a premature baby vs. the cost, inconvenience, and pain necessary to preserve that life.
At the opposite end of human gestation is the creation and maturation of a pregnancy through natural or artificial means. If a couple have been unable to get pregnant they can go to a fertility clinic and undergo various medical procedures to overcome blocked fallopian tubes, low sperm count, etc. A naturally-conceived embryo can be removed from the uterus of a diseased woman and implanted in the uterus of a healthy surrogate mother. A sperm and egg can be brought together in a petrie dish, and the zygote implanted in the the uterus of the woman who donated the egg or in the uterus of a surrogate. As such examples show, even if a woman is at a very early stage in the first month or two of pregnancy, and if she chooses to terminate her pregnancy, the embryo or fetus could be surgically removed and transferred for implantation into the womb of a surrogate mother. In the not-too-distant future it might be possible to do a laboratory "pregnancy" for the entire period from fertilization to delivery without any need for a human surrogate. A woman who wants to terminate her pregnancy, no matter how early or late, could make use of such procedures; but they would be medically risky, painful, and expensive. That's her choice. But once again it is clear that the value of the life of a premature baby must be weighed against the cost, inconvenience, and pain necessary to preserve that life.
A woman should have an absolute right to choose what happens to her own body, provided she pays for her choice with her own money and her own pain. If she wants a tattoo or breast enlargement, she may have it so long as she pays for it. If she wants a tattoo or breast enlargement removed, she may do so and pay for it. The same should be true for creating or terminating a pregnancy. But human life has far greater value than tattoos or breast enlargements. Thus it becomes a matter for religion, morality, law, and politics to decide what restrictions to place on the creation and termination of pregnancy, and also the killing of life; and to what extent the expenses should be paid by society when a woman is indigent.
In making these decisions the issue is not whether a woman has a right to choose what happens to her own body. She definitely has that right. But she does not have the right to kill her unborn baby unless society gives her that right. Granting that right might be based on a belief that the unborn baby is not (yet) human. It could also be based on the belief that it is morally acceptable to kill some humans when they are too inconvenient, too expensive, or at a low level of sentience (such as infants, brain-damaged adults, or elderly people with severe Alzheimers disease or on permanent vegetative life-support). If a woman chooses to end her pregnancy then she might be required by law to do so through a painful and expensive caesarian section to save the life of the fetus. She might be prohibited by law from terminating the pregnancy through methods that are likely to kill or injure the fetus, such as saline injection (poisoning the uterine lining and scalding the fetus), dilation and curettage (using forceps to rip apart the fetus in order to remove the pieces), or partial-birth abortion (crushing the head of an almost-born baby in order to remove it easily from the birth canal). If society refuses to pay for an indigent woman to carry out her choice, then she must take her pregnancy to term just as she must live with an unwanted tattoo.
In Boston about 20 years ago, Norfolk County District Attorney William Delahunt was loudly criticized in the media when he filed manslaughter charges against a doctor who performed a legally allowed abortion in which it turned out that the aborted fetus emerged alive but was then "allowed to die" by being given no care. A little-noticed controversy during the 2008 Presidential campaign was that Senator Barack Obama had voted against a bill to require aborted fetuses born alive to be given lifesaving medical care. The fact that terminating a pregnancy does not necessarily involve terminating the life of the fetus has been known for a long time. It is an uncomfortable topic to discuss, but is becoming more significant as medicine advances.
Here is a proposition that needs to be debated until it is either rejected or else established in law and custom: A woman may choose to terminate her pregnancy at any stage of gestation and for any reason, provided that she and her doctor must use all the same medical procedures to protect the life of the fetus that would be used by any prudent parent and doctor who strongly desire to sustain a life at that stage of pregnancy. Thus a woman could choose to have an abortion one week before her expected delivery date provided that she does it by methods commonly used to induce labor or by caesarian section. A woman could choose to have an abortion when a pregnancy is only a few weeks old provided that the zygote or embryo is rescued by methods similar to those used for harvesting eggs from donors for implantation into surrogate mothers. The proposition in its general form can be rejected only by saying that every zygote, embryo, or fetus is not (yet) human, or by saying that some human life has such little value that it is outweighed by cost or convenience.
Different societies have made very different decisions about these matters depending on religion, culture, and economic circumstances. Killing of newborn babies was acceptable in ancient Rome when the baby was deformed or merely unwanted. Communist China tried to control its exploding population through a policy of allowing only one child per woman, and enforced that policy by mandating abortion (or even forced sterilization for repeat offenders). In both China and India there is a widening gap between the number of boys and the number of girls because pregnant women have been getting ultrasounds to determine the gender of their fetuses and then aborting girls (it's expensive for parents to provide a dowry to marry off a girl, and boys are the ones who grow up to provide money to take care of their elderly parents).
In the U.S. it is now commonplace for women in the early stages of pregnancy to have the fetus tested for Down syndrome or deformities for the purpose of aborting unwanted babies -- Vice Presidential candidate Sarah Palin was loudly applauded by Christian conservatives for her decision to carry such a pregnancy to term. Teenage girls, or young women in demanding professional careers, often unhesitatingly choose abortion for the specific purpose of killing an unwanted or inconvenient baby -- they would be horrified by the thought that they could terminate their pregnancy but would be required to do so by undergoing caesarian section and then paying for special medical care for the premature baby and for raising the child to maturity. Such cases make it abundantly clear that for many women abortion has little to do with controlling their own body and everything to do with killing an unwanted baby while it is still legal to do so (i.e., before it has been born). If a man who impregnates a woman in a moment of passion is forced by law to provide 18 years of financial support for a baby he never wanted when the woman refuses to have an abortion, then shouldn't a woman who chooses abortion also be required to pay for protecting the fetus, and for a surrogate pregnancy, plus 18 years of child support?
The question is whether a woman or society has the right to kill an embryo, fetus, or unborn baby; or even a baby after it has been born and during the early stages of life. We should be honest enough to face that question squarely and to answer it decisively. The issue is not abortion, but right to life.
There are a host of related issues. Should an individual have a right to choose death for himself or for a close relative unable to make the choice? Should society be able to prevent such a choice, to keep someone alive who prefers to die? Should society be able to require the killing of murderers or even of merely unproductive or inconvenient people? Should society, or individual people, have any right to make decisions about life and death; or should such decisions be left in the hands of God? There is a spectrum of stages of human life, from before conception to death; and the larger moral issues reverberate in different ways at different stages. It is also relevant to consider animal rights, because it might be that all sentient beings have fundamental rights; and the rights of human beings should be considered within that broader context. Perhaps there is a continuum where the right to life for any creature is proportional to its degree of sentience and/or the net amount of value it is likely to add to the world. Perhaps an intelligent chimpanzee or porpoise has greater sentience and productivity, and therefore greater right to life, than a "human vegetable." Or perhaps not.
Such questions need to be taken seriously. They are all interconnected. They are civil rights issues affecting the rights of pregnant women, the men who impregnated them, and the babies awaiting birth. These issues should be decided by each person and by society, on the basis of logical deduction from fundamental principles and after thoughtful meditation and prayer. See an essay which clarifies the questions and their interconnections, without presuming to provide answers: "Life and Death -- Moral Shades of Gray" at
Congress is currently considering legislation to make fundamental change in the way healthcare is delivered and paid for. Currently society rations healthcare by providing greater quantity and quality to people who can pay more for it, while low-income people often get no regular healthcare and rely on hospital emergency rooms when necessary.
If we decide to make healthcare available to everyone regardless of economic status, but if the number of doctors and facilities remain the same, then it will be necessary to set up a system where government officials ration healthcare according to a calculus of social worthiness and cost/benefit analysis. Elderly people with short life expectancy and low productivity will be given only inexpensive palliative care so that more resources can be used for young, productive people. Babies with disabilities will be too expensive and might best be detected and killed before they are born.
Should we adopt a system where government officials, enmeshed in the political process, decide who is worthy to receive how much medical care? Or should we continue letting social class and wealth determine who gets how much care? Perhaps wealth, especially when it is earned and not inherited, is the best measure of a person's value to society. These are very difficult things to think about. The time has come when we must begin to do so. A woman's right to choose and a baby's right to live are elements in a much needed civil rights debate underlying current efforts to reform our system of medical care and payments.
(c) Copyright August 1, 2009
Kenneth R. Conklin, Ph.D.
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** A note about Dr. Conklin's other writings:
Dr. Conklin's Ph.D. is in Philosophy with a focus on epistemology, education, and ethics. He occasionally ventures outside his now-usual topic of Hawaiian sovereignty to think carefully about other controversial topics and especially civil rights issues.
For essays since 2004 on topics other than Hawaiian sovereignty, see
For some of his scholarly articles published in refereed academic journals before 1990 see
For a collection of more than 600 webpages by Ken Conklin about Hawaiian sovereignty, see