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Hard Choices
By Ann Furedi
11/11/99

This article was first printed in Conscience, Volume 20, Number 3 (Autumn 1999), and appears here with the permission of the author.

The cultural discourse that frames the abortion debate has changed and become more complex with each decade. Throughout the 1970s, in Western societies, the arguments for a woman's right to choose seemed relatively straightforward. The need for "free abortion on demand" was a central tenet of the women's liberation movement and abortion was situated in the context of women's right to social equality. It was understood that if a woman was unable to control her fertility she was unable to participate in society on equal terms with men and that, since contraception is not infallible, if a woman was unable to end an unwanted pregnancy she was unable to enjoy her sexuality. To argue against "the right to choose" was to argue that women should fulfill their traditional domestic destiny as wives and mothers at a time when sexual freedom and women's economic independence were celebrated. To argue for "the right to abortion on demand" was to be radical, to argue against it was to be reactionary. The debate was polarized and the lines clearly drawn. Today the abortion debate is more complex and the arguments are more textured.

The biggest challenges faced by those of us who maintain, without qualification, that every woman should be able to act according to her own conscience and choose whether to continue or end her pregnancy, are the areas where liberal values seem to require contradictory responses.

Our feminism is affronted when we are faced with a couple who decide to end a previously wanted pregnancy because they have discovered that the child would be the wrong gender: a girl. To condone the choice of abortion seems to devalue the lives of girls and lend passive support to a system of cultural values that oppresses women. Yet to deny this woman the right to make her own choice, because we disapprove of the reason for her abortion request, is to mirror the actions of paternalistic doctors who have similarly refused to comply with abortion requests because, in their eyes, women did not have good enough reasons.

Support for abortion on grounds of fetal abnormality seems difficult when advocates of the rights of the disabled claim that what they see as quality control decisions about "the unborn" mirror our attitude to "the born." Increasingly, an argument is made that there is a eugenic intent behind antenatal screening. We feel uneasy when faced with a pregnant woman who says I want a child -- but not this one because it is affected by Down's syndrome or spina bifida or would be deaf or blind. Yet to deny this woman's choice is to condemn her to carry to term and give birth to a child that she may dread and wish dead.

Issues surrounding late abortions seem especially difficult. Techniques in fetal medicine have made it easier to sustain the lives of the severely premature. Society has embraced the concept of the rights of the born child, and yet we continue to maintain that the fetus has no rights. Medical ethicists and lawyers currently speculate about what it is about the passage through the vaginal canal that transforms the status of the fetus so completely. To explain and justify a woman's reasons for requesting an abortion in what would, in any case, be the final months of a normal pregnancy is an argument that many in the prochoice movement have recoiled from.

It is tempting to avoid these debates and dust down well-rehearsed scripts about the need to defend choice that have served us in the past. But the issues have changed and to rely on old slogans is to allow opponents of women's choice to build their camp on the moral high ground, which is precisely the territory we need to occupy.

There seems a strong case for trying to wrest the imperative away from those who assume they have the monopoly on ethical concerns. By acknowledging and exploring our own unease about some aspects of abortion we will prepare ourselves to address the concerns of the public more rigorously. But there are certain ethical principles which, as prochoice individuals, we should not allow our subjective prejudices to compromise.

In the UK, it has been helpful to embrace the notion that the embryo/fetus has a moral status deserving of respect. It is unarguably true that from its earliest stages the embryo has the unique potential to become a human being and that this potential is ended when the embryo/fetus is killed by abortion. The central issue, however, is not whether the embryo is deserving of respect, but how much respect and value we accord to a life (that does not even know it is alive) relative to the to the respect and value we have for the life of a woman who carries it.

The rights of women to abortion can be situated in the context of ethical principles that are fundamental to what we hold valuable in modern democracy.

The ethical principle of "procreative autonomy" - the right of people to control their own role in procreation - has a particularly important place in modern political culture. In his thoughtful exploration of the ethics of life and death, Life's Dominion: An Argument About Abortion and Euthanasia (Alfred A. Knopf, 1993), Ronald Dworkin argues that the important feature of our culture is a belief in individual human dignity (pp.166-167). Central to human dignity is the principle "that people have the moral right - and the moral responsibility - to confront the most fundamental questions about the value and meaning of their own lives for themselves, answering to their own consciences and convictions." Dworkin reminds us that the most powerful arguments against slavery - by both secular and religious abolitionists - were based on the understanding that the cruelest aspect of slavery was the failure to recognize a slave's right to decide issues of value for himself or herself. A civilized society accepts that women are creatures with a moral conscience who are capable of making responsible decisions for themselves.

There is also the crucial issue of the need to defend women's "bodily autonomy." To insist that a woman must support the life of her "unborn child" against her will confers the fetus with greater status than a born child. In no civilized society is a woman coerced into accepting clinical procedures necessary to maintain the life of her child once it has been born. We might think it immoral for a woman to refuse to give blood or bone marrow to save her child's life, but there is no law that compels her to do so. The notion of such coercive legislation flies against such principles as the need for voluntary consent to medical treatment.

These arguments do not imply that we should be morally indifferent to women's decisions about abortion, but to return to Dworkin, "tolerance is a cost we must pay for our adventure in liberty." This principle of tolerance may provide a bridge between recognition of society's genuine concerns about the ethics of abortion and our need to main a robust but sophisticated defense of women's reproductive autonomy.

Ann Furedi is director of communications at the British Pregnancy Advisory Service, the UK's largest provider of abortion services.

Conscience is the quarterly newsjournal of prochoice Catholic opinion, published by Catholics for a Free Choice.
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