Bioethics, healthcare policy, and related issues.
Serge, of LTI Blog, posted a comment to my recent post on the abortion debate. I’ve taken the liberty of moving it up here as a separate post.
Serge asks the following:
One quick question – Should a pregnant woman who is suffering from severe nausea or severe acne be able to take thalidomide or accutane to treat their condition based on their right to bodily autonomy? After all, the fetus has no moral status let alone a right to an environment safe from pathogens. Would that be a morally appropriate choice? (More on this point here.
A simple answer: Yes.
Pregnant women should be free to engage in activities that raise a serious threat of birth defects. They should also be free to choose to abort fetuses with known or potential birth defects (or any other fetuses). In fact, they should be free to do either or both of those things in the course of a given pregnancy.
The reason is a variation on the same reason abortion itself is justified: the fetus, in its early stages at least, is not a person and has no moral interests (just as Serge correctly stated). Hence, it is subject to no moral harms, even if it suffers circumstances that give rise to conditions later in its life that are undesirable. Thus there is no moral duty owed to it to protect it from the harms it is incapable of suffering.
To look at that from a different perspective, we do not say that the birth of an infant with thalidomide-induced defects, or others, is a bad thing in itself, although we try to avoid those defects because a life without them harbors more possibilities than a life with them. A life with them is still better than nothing at all. (This, by the way, is why the US and other countries generally disallow lawsuits for “wrongful birth” – being born cannot in itself be a harm unless your life is literally “worse than death”, so you can’t sue for that by itself.) So such an infant has suffered no harm, even if it is disappointing or frustrating that it could have had a better life. (We all could have had better lives. We are not victims solely because we did not.) This is different from the case of a person who is maimed or otherwise subject to limitations in life after they have entered the moral realm – that person has actual interests that are thereby frustrated. So it is not bad to do to non-persons what it would be bad to do to real persons.
As for whether that would be a “morally appropriate choice”, I’m not sure what that means. I’ve said it’s a morally permissible choice – it falls within the range of things that are subject to personal inclinations only, and not subject to other people’s interference. But not everything you’re allowed to do is something you should do. If a person showed gross indifference to the welfare of their fetus – allowed it to be subject to easily avoidable, and very serious, birth defects, and thus fated it for a much more difficult or limited life than would have been easily possible – we could certainly say that person was very uncaring toward their child’s future. But that’s not the same as saying they harmed that child before the child even existed as a person. We might wonder about their fitness as parents – would they continue to be indifferent to the child’s welfare after it becomes a person and has real, vulnerable interests? But we cannot blame them for bringing a child into the world with birth defects, even intentionally. (We do not blame parents of children with accidentally-acquired birth defects, even when those parents deliberately choose not to abort that fetus. The choice to create birth defects and then bring the fetus to term is essentially the same act.)
The bottom line for this question, and others in the vein of what used to be called “maternal/fetal conflict”, is that the fetus is not a moral person for the largest part of a pregnancy at least, and as such has no moral interests that stand against those of the pregnant woman. That woman is free to do as she chooses during her pregnancy. It should be noted that what virtually all women who choose to bring a pregnancy to term also choose to do during that pregnancy is to protect and nurture the fetus as fully as possible. These scenarios of heartless harlots deliberately crucifying their own children pre-natally are rather suspicious, both in content and in intent. But as for what they tell us about the woman’s obligations, those are, as in all pregnancies, unopposed by the non-existent rights of non-existent persons.
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