Abortion

Fetal Reduction in a Multiple Pregnancy: the Case of Identical Twins

Written by Elizabeth Crisp and Roger Crisp

When a woman aborts a single fetus, that abortion can be a morally troubling experience for her. What about a situation in which a woman is pregnant with more than one fetus, perhaps identical twins, and wishes to abort just one of them – that is, engage in what is sometimes called ‘fetal reduction’ in a ‘multiple pregnancy’? Continue reading

Should Abortion be a Matter of Referendum?

Alberto Giubilini
Wellcome Centre for Ethics and Humanities and Oxford Martin School, University of Oxford

I am writing this post on the 25th of May, as the Irish abortion referendum is taking place. However, you will probably be reading it once the results are already known. I am not going to write in support of either side of the debate here anyway. I want to write about the appropriateness (from an ethical point of view) of this referendum itself. I want to suggest that a referendum is not the appropriate way to solve the dispute at stake.

Irish people have been asked whether they wanted to repeal the Eight Amendment of the Irish Constitution, which gives foetuses and pregnant women an “equal right to life”. It is commonly assumed that the Eight Amendment was preventing the Irish Government from legalizing abortion, except in extreme and very rare circumstances in which abortion is necessary to save the life of a pregnant woman. If the majority of Irish people votes “yes”, abortion can become legal in the country. If the majority votes “no”, abortion will remain a crime in the country, with the exception of a few extreme and very rare circumstances. More specifically, voting “no” means voting in favour of the idea that in Ireland a foetus does have a right to life equal to the right to life of the woman. Voting “yes” means voting in favour of the idea that in Ireland the foetus does not have a right to life comparable to the right to life of a woman; in other words, that it can be considered merely as part of the woman’s body for the purpose of attributing it a right to life (though not necessarily for other purposes), and therefore something that a woman can permissibly decide not to keep alive as a matter of bodily autonomy or, in many cases, and depending on what definition of “health” we adopt, as a matter of basic healthcare.

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Bigotry and the Academic Abortion Debate

By Alberto Giubilini
Oxford Martin School and Wellcome Centre for Ethics and Humanitites, University of Oxford

For further discussion on this topic by Dr Giubilini see his oped in The Irish Times

Last month I was invited by Oxford’s Students for Life (OSFL), the pro-life student organisation at the University of Oxford, to take part in a public debate where I was asked to argue against their motion that “Conscientious objection in healthcare, concerning beginning and end of life issues, benefits society as a whole.” Having worked on conscientious objection in healthcare (e.g., doctors not being willing to perform abortions for personal moral or religious reasons) in the past, I thought (and still think) I had some very strong arguments against conscientious objection in healthcare in general, and conscientious objection by religious doctors in particular. I was very keen on challenging the pro-life position on this topic. I therefore accepted the invitation, although I was a bit surprised by it, given that OSFL were presumably aware of my positions on topics that for the pro-life are very sensitive, such as the ethics of abortion or of infanticide.

But I was curious to see and test to what extent the pro-life community was really committed to freedom of speech and would allow me to defend my views, so diametrically opposite to theirs. During the event, I therefore tried to push my arguments to their most extreme conclusions and to be as provocative as possible; for example, at some point I suggested that an unwanted pregnancy is comparable to a disease and that therefore doctors have a duty to medically treat it by performing an abortion. I have to say I saw many people in the audience jolt in their chairs, which I did expect. Nonetheless, after my talk there was a very civil and calm discussion: the pro-life defenders debated my arguments, allowed me to reply, and thanked me at the end of the debate for my participation and what they considered challenging views.

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The Tale of the Ethical Neonatologist – And Why There Shouldn’t Be a Legal Right of Conscientious Objection

Doctors have values. These are sometimes described as their conscience. Those values can conflict with what has evolved to be medical practice. Where that practice is consistent with principles, concept and norms of medical ethics, their values should not compromise patient care. The place for doctors to express their values and seek to revise the practice of medicine is at the level of policy and law, not at the bedside. Because conscientious objection can compromise patient care, there should be no legal right to conscientious objection to medical practice that is consistent with medical ethics. Personal values (“conscience”) can be accommodated by employers under standard labour law as occurs in Sweden and Finland, or candidates selected for medical specialties who have values consistent with ethical medicine, or new professions developed to provide those services.

Doctors may have very defensible values. But just because their values are reasonable does not imply they should be accommodated by medicine. Consider the Conscientious Neonatologist.

The Conscientious Neonatologist

Peter is a thoughtful, reflective specialist caring for premature babies in intensive care. He is a vegetarian for 20 years. He became deeply concerned about the welfare of animals during his university years. He believes in “animal liberation”. Neither he nor his family consume meat or use animal products for clothing.

In his job, he must prescribe “surfactant” – a substance to help the lungs of premature babies function better. The standard, and most effective form is derived from the lungs of pigs. However there is a new artificial form. He considers this a more “ethical” product and considers using it in his medical practice. However, it is not currently used in the newborn intensive care unit because it is more expensive than standard treatment, and there is not clear evidence about its effectiveness.

Peter conscientiously objects to the use of animals in medicine and medical research. How should his personal values influence his professional practice?

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CONSENSUS STATEMENT ON CONSCIENTIOUS OBJECTION IN HEALTHCARE

On the 7th, 8th, and 9th of June 2016 a group of philosophers and bioethicists gathered at the Brocher Foundation in Geneva, Switzerland, to participate in a workshop on healthcare practitioners’ conscience and conscientious objection in healthcare. Conscientious objection is the refusal by a healthcare practitioner to provide a certain medical service, for example an abortion or medical assistance in dying, because it conflicts with the practitioner’s moral views. Aim of the workshop was to discuss the ethical and legal aspects of conscientious objection in healthcare, in view of proposing some guidelines for the regulation of conscientious objection in healthcare in the future.

At the end of the workshop, the participants formulated a consensus statement of 10 points, which are here proposed as ethical guidelines that should inform, at the level of legislations and institutional policies, the way conscientious objections in healthcare is regulated. The 10 points are the following:

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Abortion Should Be Decriminalised

Abortion remains a crime in Queensland and NSW in Australia. Queensland Parliament has just decided against decriminalising abortion. However, laws are obsolete and unclear, dating back over 100 years. Around 100,000 abortions are performed around Australia every year. In practice, early abortion is available on demand.

Abortion should be decriminalised. Early abortion should be freely and easily available on request. Late abortion should be freely and easily available at least for those who have a valid justification: significant fetal abnormality, threat to woman’s health or serious social reason, for example child pregnancy or rape. Family planning, including safe, free and open abortion services, is an essential part of a civilized society.

Failure to regulate abortion properly results in women being denied safe, effective abortion services, affecting their mental health and social welfare, as well as those of their family and society. It is stigmatising to women and health professionals to allow abortion to occur, while retaining it as a criminal offence. It is also moral hypocrisy.

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Video Series: Dominic Wilkinson on Conscientious Objection in Healthcare

Associate Professor and Consultant Neonatologist Dominic Wilkinson (Oxford Uehiro Centre for Practical Ethics) argues that medical doctors should not always listen to their own conscience and that often they should do what the patient requests, even when this conflicts with their own values.

Guest Post: Abortion, punishment and moral consistency

Written by: Rajiv Shah, PhD Candidate, Faculty of Law, University of Cambridge

Donald Trump suggested that women who have abortions should face punishment. For that he was criticised by both the pro-choice side and the pro-life side. The latter claimed that their view is that women should not face punishment for having abortions but that only providers should. This raises the interesting question of whether the pro-life position is coherent. It would seem that it is not. If the foetus has the right to life then having an abortion is like murder and so those who abort should be treated as such. This post argues that the pro-lifer can coherently reject this implication whilst still holding that the foetus has the right to life. Since it considers the responses a pro-lifer could make this post will assume for the sake of argument that the foetus does have a right to life. Continue reading

Brain in a Vat: 5 Challenges for the In Vitro Brain

Julian Savulescu

@juliansavulescu

In Roald Dahl’s short story, William and Mary, William dies of cancer. But a novel procedure allows his brain, with one eye attached, to be kept functioning in a clear plastic vat. His wife convinces William’s neurosurgeon to allow her to take William (or rather his brain and eye) home with her.

When home, Mary places William in a prominent place in the sitting room from where he can survey all her actions. He had been a domineering and controlling husband. He forbade her to have a TV and to smoke. Now, Mary purchases a TV and takes up smoking, blowing smoke in the direction of William. She will punish him for his abuse and his brain may stay alive, utterly powerless, for up to 200 years.

This story was science fiction. But yesterday, the first step to creating the brain in a vat was reported in the US. Back in July 2013, scientists reported the first organ grown from stem cells: a liver. A kidney, heart and other organs have followed. The potential of these technologies to eventually provide replacement organs is also an opportunity to sweep away complex ethical issues: most obviously in avoiding the need for organ donation, but also in enhancing the ability to test drugs on lab grown organs before testing in humans- reducing the risk of harm to research participants, hopefully some day to a negligible amount.

Now, just 2 years later, the first brain has been grown in a laboratory. The organoid has been grown for 12 weeks, the equivalent of a 5 week old foetus.

Lead researcher Professor Rene Anand, from Ohio State University in the US,
said:

“It not only looks like the developing brain, its diverse cell types express nearly all genes like a brain.”

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Self-consciousness and moral status

Many share an intuition that self-consciousness is highly morally significant. Some hold that self-consciousness significantly enhances an entity’s moral status. Others hold self-consciousness underwrites the attribution of so-called personhood (or full moral status) to self-conscious entities. On such views, self-consciousness is highly morally significant: the fact that an entity is self-conscious generates strong moral reasons to treat that entity in certain ways (reasons that, for example, make killing such entities a very serious matter).

Why believe that? Continue reading

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