Friday, April 24, 2009

Ectogenesis and abortion

I am supposed to be writing an essay on HIV and confidentiality at the moment, but the argument is starting to give me a headache. In an attempt to stick vaguely in the bioethical mindset I decided to write a bit about what I might do dissertation-wise.

Early on in the course here at Manchester, it became quite clear that the abortion debate was won. If you have any regard for a woman, her bodily integrity, and her capacity to make decisions about her life, you will most probably be in favour of abortion in some circumstances. To be completely anti-abortion is to miss the point of the debate entirely. There are many reasons why a woman could choose to have an abortion, from something serious and life-threatening brought on by a new medical condition during pregnancy, through to a significant change in circumstances involving finances or family perhaps, to a simple change of mind. Those who allow abortion on medical grounds might not allow it on more trivial grounds. Some would always advocate abortion, if the woman so chooses it. Those who will not allow abortion at all condemn some pregnant women to deaths they need not be subject to, deaths that could be avoided by aborting the foetus.

Some may not quite understand what they are condemning when they condemn abortion. The morning after pill is a form of abortion if a conception has occurred; it induces a period even after an ovum has been fertilised. This sort of ‘contraception’ is permitted by some who would condemn more interventionist abortions. However there are still others who condemn even this.

It is common knowledge that the Catholic Church condemns the use of contraceptives like condoms that prevent fertilisation in the first place. It is groups like this that readily condemn ‘contraceptives’ like the morning after pill.

I said earlier that the debate was won regarding abortion. I realise this is a hastily made and seemingly unconsidered statement, but in all accounts above, any condemnation of the woman’s decision to use barrier methods, take the morning after pill, or abort her foetus must come from how one sees the embryo/foetus. Those that condemn these actions do so because they see this entity as of equal value to the woman carrying it. Clearly one’s opinion of the point at which the value of the embryo/foetus becomes equal to that of the mother affects which actions one would condemn. I am of the opinion that valuing any life is a difficult problem as it raises all sorts of difficult questions as to where the value comes from and how that value compares to the value of other life.

To get around this is simple and it depends on a definition of personhood. I am certainly not going to go into it in depth here but John Harris’s The Value of Life does all the work. It is a fascinating read and outlines a theory that has lasted nearly 30 years, despite some people’s best attempts to dismantle it. The essential nugget of usefulness here is the simple notion that a person is a being that is aware of itself, can communicate this awareness, and is aware that it is aware. Most humans are the sorts of creatures that possess this low threshold capacity, and there are probably a handful of higher primates, and perhaps a couple of elephants that are persons. More importantly for Harris is the capacity for a person to value their own life, and this is how we identify persons and hence the most valuable lives. What this simple and horrendously brief definition of personhood should show is that embryos and foetuses are not the sort of entities that are persons, just in the same way as trees and mice are not persons. It is not the difference between humans and plants & animals that is important, but the difference between persons and non-persons.

Personhood theory, by demonstrating what is and what is not a person, does not then give us a blank check to treat non-persons in whatever way we wish. It merely helps in an assessment of what is more valuable. So, in the burning building scenario, where you can rescue a tray of a thousand frozen embryos or a woman in her 30s, the answer should be a no-brainer. The Catholics, by their value system, should rescue all the embryos. A personhood theorist, who realises the woman has the capacity to value her own life whilst the embryos do not, would rescue her in a flash (but perhaps only after asking if she wanted to be rescued!).

So why all this stuff about abortion? Well, I often hear people who share the disposition towards embryos that Catholics have cry, “But embryos have the potential to become persons, does that not count for anything?” It is easy to say that it does not, at least when dealing with tiny clumps of cells.

My feelings, or intuitions, change somewhat when dealing with third trimester foetuses that share all the capacities of a neonate but are trapped inside a person. It seems a cruel bit of luck that the third trimester foetus can be justifiably killed when the new born baby seemingly cannot. The only bit of argument that supports my discomfort at abortion of third trimester foetuses is probably something like the potentiality argument, an argument that is easily dismissed. I probably feel that the entity in question is so close to fulfilling its potential to be a person that there is something wrong with the abortion. That said, I can see that it is not a person by the standards laid out above, and, so long as it resides inside a person, and that person chooses as much, it can be killed.

Such a position is satisfactory but for the obvious implications for neonates. As they share the same capacities as their third trimester counterparts, they are not persons, and although personhood theory is not at all trying to advocate the wanton destruction of non-persons, it seems that to be as indifferent about a neonate’s death as that of the pet goldfish is somewhat out of kilter what our intuitions scream.

I wonder then what happens when we take out normal motherhood from the moral equation. Consider that instead of using a biological internal womb, all women either have the choice or must use an artificial external womb. This is known as ectogenesis, where, conceivably, after conception an embryo is implanted in an artficial womb and gestated there. A short Google search will show that science fiction is not so far from becoming science fact. In the latter case, where only artificial wombs can be used for whatever reason, would the abortion of embryos be justified?

The answer is not that clear. At first blush it seems to me that abortion would be at least wasteful. Given the fact that the woman’s body is unaffected by the gestating foetus, killing it for whatever reason seems problematic. Perhaps there are parallels in the amount of say men currently have in the abortion of their partner’s foetus, though I expect objections to this are more to do with disrespect of her autonomy than concerns about the foetus. It might be worth considering surrogacy arrangements in different countries, as, off-hand, I believe the law here effectively has the prospective parents adopt the baby from the surrogate, although I would have to check. I do know it has caused quite a few problems. Consider what happens when the surrogate decides she wants to abort or perhaps keep the child.

Back to ecto-world: I keep thinking that there is something to the debunked potential theory. Harris would say it is ridiculous to treat anything as what it potentially might become. I don’t treat you as dead just because you will one day become so. In the same way it is ridiculous to think of treating a foetus as a person just because one day it might become one. I do think though that there is an inherent difference in these two situations. There is something about benefit, in that it is beneficial (to the foetus at least) to treat the foetus as a person, whereas it seems unbeneficial to treat a person as if they were dead. It is here that my curiosity lies. Perhaps it isn’t the potential we are concerned with, but it is in fact the possible, or moreover, the probable consequences of the continued development of the foetus.

Consequentialist’s and utilitarian’s alike often talk in terms of foreseeable consequences and it seems to me, at least in ecto-world, that the foreseeable consequences of not aborting an embryo/foetus is a person. In some abstract way, this seems to be beneficial for future people, but I shan’t delve too far down that road here.

This blog entry has become horrendously long, but I got to where I wanted, which was a summary of the reasoning behind a concern for non-persons whose foreseeable consequence of continued existence is personhood. I think there is something in this. What do you think?

Tuesday, April 21, 2009

Bloggy meanderings

I haven't blogged in well over a year which guarantees one thing: I have certainly not bored anyone. Is absolute lack of content boring? It doesn't matter. Nor does it matter why I haven't written anything in so long.

I guess this post marks the start of another set of posts over the next few weeks. I imagine it will serve mainly as a springboard for ideas I will be using in essays and my dissertation. Expect also general bloggy meanderings regarding other stuff, which will in all likelihood be interesting only to me at some point in the future.

Hopefully a year of exposure to bioethics, law, and a little bit of argumentation will make subsequent posts a little juicier, and perhaps also a little tastier. Time will tell.

Those who find their curiosity piqued can follow me on twitter, leave comments and generally try to get my attention. Otherwise, passively read or simply ignore.

Next post: ectogensis and abortion.