The problem of miscarriage for pro-lifers

FeaturedThe problem of miscarriage for pro-lifers

It isn’t widely known, but a high proportion of human pregnancies end in miscarriage, also known as spontaneous abortion. The majority of these miscarriages occur very soon after pregnancy, often before the pregnancy is known, and for this reason, precise figures are difficult to obtain. Estimates for the rate of miscarriage vary widely, but many are in excess of 60%. These estimates are usually based on some very old studies, together with data obtained by observing in vitro fertilisations (IVF), which may not reflect what occurs in nature.

Let’s tentatively accept a 60% rate of miscarriage. What’s the main issue for the pro-life position? Many philosophers have pointed out that this means hundreds of millions of human beings are dying by miscarriage, and according to pro-lifers, these are all human beings with moral value equivalent to any adult. But these numbers are far in excess of any other cause of death. In fact about 56 million human beings die each year, while perhaps 200 million miscarriages occur. The question has been asked, why don’t pro-lifers care about this huge loss of human life? They are certainly concerned with preventing induced abortions, which account for far few human lives, about 56 million. But their lack of concern about the 200 million deaths from miscarriage seems to indicate they don’t really believe their own claims about the moral value of embryos and fetuses. In fact, their stance has been criticised as ‘morally monstrous’.

It’s an important question for pro-lifers to answer, and the PA and Daniel Rodger have just published a comprehensive reply in The New Bioethics entitled The Problem of Spontaneous Abortion: Is the Pro-Life Position Morally Monstrous?. I’ll summarise our response below. If you don’t have access to academic journals and would like a copy of this paper, please request it from here.

The underlying question is what moral obligation do pro-lifers have towards combating miscarriage, and how does this obligation compare to their obligation to oppose induced abortions. Certainly, on a pure numbers basis, there is a prima facie obligation to do something about miscarriageit certainly seems to trump induced abortion in this regard. But we identify two important considerations that should influence our obligations:  the preventability of death and the moral badness of death. If deaths are not preventable, this reduces our obligation towards these deaths, and if certain deaths are morally worse than others, we should prioritise them.

Preventability of miscarriage

It is too simplistic to directly compare deaths by miscarriage to deaths by, say, cancer, or even induced abortion. Miscarriage is not a cause of death, but rather refers to all natural deaths prior to birth, irrespective of cause. It has a variety of underlying causes, and these must be examined to determine which are the most prevalent. The most common cause of miscarriage turns out to be chromosomal abnormalities, accounting for perhaps 70% of all miscarriages. These abnormalities are mostly aneuploidies, an abnormal number of chromosomes in cells, and they are rarely compatible with life. Aneuplodies cannot be preventedthis would require gene-editing of embryos, which is not currently possible.

There are a variety of other lesser causes of miscarriage, such as uterine abnormalities, thrombophilias, immunological and immunogenetic causes, and acute maternal infections. Certain lifestyle factors have been implicated in increasing the risk of miscarriage, including smoking, alcohol and caffeine consumption, and obesity, and finally increasing maternal age is also a factor.

Killing vs Letting Die

Some pro-lifers have claimed induced abortions are far morally worse than miscarriages, and that this justifies concentrating efforts on fighting induced abortion. The problem with this claim is that even if there is a moral distinction between deliberate killing (induced abortion) and letting someone die (miscarriage), it’s not clear that this matters. To explore this, let’s assume there is a moral difference—that it is far worse for someone to deliberately kill someone rather than letting them die, say by failing to rescue them. The issue for pro-lifers is that as far as they are concerned, it seems that induced abortions are also a case of letting die—they are not directly involved in killing themselves, and so they are bystanders with respect to induced abortions and miscarriages. Unless pro-lifers wish to make nebulous claims about induced abortions contributing to more evil in the world, it seems there is no good reason to prioritise opposing induced abortions over miscarriages on the grounds of moral evil.

Here Thomas Pogge sheds some light on the issue, stating that with regard to induced abortions ‘we are responsible for helping to bring these deaths about by participating in maintaining and enforcing a legal system that, by permitting abortions, foreseeably results in these extra deaths’ (Pogge 2010, p. 127). Citizens in the United States prior to 1860 were all responsible for laws permitting slavery, irrespective of whether they owned slaves themselves. Similarly, all citizens in a democracy permitting induced abortion bear some moral responsibility for these deaths. So if induced abortions are morally worse than miscarriages and all citizens bear some responsibility for them, this is a strong reason to oppose it.

In ethics, the killing vs letting die distinction is widely debated. Intuitively, most of us feel there is something worse about deliberate killing compared to allowing someone to die, but it is difficult to pin this down. Philosophers are very good at coming up with counter-examples to accounts of this difference. We take the approach of looking at a comparison that is as analogous as possible (on the pro-life view) to most induced abortions and miscarriages: the deliberate killing of a newborn baby who could be expected to live a normal life, and allowing a newborn with a fatal and incurable chromosomal disorder to die. It seems clear that letting the newborn die in this case may not be morally problematic at all, while killing a newborn baby is always gravely wrong. We conclude that similarly, it is far worse morally to deliberately kill a fetus than to fail to save it.

Conclusion

Even though the number of deaths are much higher for miscarriages than induced abortions, they both represent tens of millions of deaths of morally valuable human beings, according to the pro-life position. If we allow that our moral obligations with regard to these deaths are influenced by what can be done to prevent them, and that induced abortions are morally worse than miscarriages, then it seems reasonable for pro-lifers to concentrate on opposing induced abortions. If we consider prenatal deaths by preventable causes, induced abortion is by far the most preventable cause of death.

It is important, however, for pro-lifers not to ignore miscarriages. Although much medical research is dedicated towards the problem, the scale of deaths means the issue should be discussed widely in pro-life circles and consideration given to what might be done.

 

 

 

 

Advertisements

Artificial wombs and violinists

Artificial wombs and violinists

The most well-known argument for the permissibility of abortion is Judith Jarvis Thomson’s violinist analogy, described in ‘A defense of abortion‘. Here, she imagines someone waking up to find themselves kidnapped and a famous, unconscious violinist plugged into their body. The violinist needs the use of their body for nine months to survive, and unplugging the violinist would kill him. Thomson claims the victim would be under no obligation to keep the violinist plugged in, and likewise a pregnant woman is under no obligation to continue providing life support for her fetus. Yes, it would be nice if she did so – performing what Thomson calls a ‘Good Samaritan’ act – but she is not obliged to.

Thomson’s argument is important because it does not rely on the moral status of the fetus. She claims that even if the fetus is regarded as a person in the moral sense – possessing the same moral status as an adult human being – her argument is still valid. Of course, there are various objections to Thomson’s reasoning, and debate is ongoing. A thorough and recent evaluation can be found in Kate Greasley’s excellent Arguments about Abortion: Personhood, Morality, and Law. But for those who rely on Thomson’s violinist as support for their pro-choice position, a distant storm is slowly brewing.

That storm is the relentless advance of new technology: the artificial womb is coming, and it may eventually have a significant impact on Thomson’s violinist. It has been mooted for a long time, but in 2017 it was announced that premature lambs were kept alive for four weeks in bags of fluid. They appeared to develop as normal, and those that were brought to term were removed and bottle-fed, and were doing well. As the technology improves, it should eventually be available for premature human babies. It’s a long way off, but it’s even possible that IVF embryos could be brought to term entirely in artificial wombs, a process known as ectogenesis. No female womb required.

So what? Well, a crucial point of Thomson’s argument is that she does not think there is a right to the death of the fetus. Her argument is that there is a right to extract the fetus to end its use of the mother’s body for its life support. For Thomson, the death of the fetus is an unfortunate byproduct of ending the pregnancy. Ectogenesis alters this situation dramatically. If we assume that the technology also includes the ability to safely extract the fetus at any stage of pregnancy (yes, this is a big assumption), then Thomson’s argument (as far as she is concerned) is no longer an argument for abortion, but rather for ectogenesis. The fetus gets to survive.

This possibility is rather awkward for the pro-choice position. There aren’t any other significant arguments that grant the permissibility of abortion in the case that the fetus is regarded as morally equivalent to an adult. Thomson’s argument has allowed pro-choice advocates to sidestep arguments about moral status. Ectogenesis will bring these arguments to the forefront, and they are controversial. Moreover, even if the fetus is not regarded as having the same moral status as an adult, killing a viable human being that is not reliant on its human mother is very different to abortion. Ectogenesis might mean a seismic shift in the abortion debate.

Some philosophers have anticipated this possibility, and tried to counter it by claiming that there is, in fact, a right to the death of the fetus. We (the PA and Daniel Rodger) examine (and reject) three of the most popular arguments in our recent paper published in Bioethics.  This paper also provides a detailed look at Thomson’s violinist and ectogenesis for those who are interested. Contact the PA if you’d like a copy.

 

Abortion legalised in Queensland

Abortion legalised in Queensland

Sadly, the state parliament in Queensland, Australia, has voted 50-41 to legalise abortion. Abortion is now legal for any reason up to 22 weeks gestation, and at any stage provided two doctors can be found who agree it can be performed. As we have previously discussed, this gives Queensland some of the most liberal abortion laws in the world. It is a significant change in what was once regarded as a very conservative state. We must now wait to see what impact this has on abortion rates.

There’s three aspects of the reaction to this decision that I want to comment on.

Firstly, the cheering. According to this report, there was ‘loud cheers in the legislative assembly chamber’ when the vote succeeded. I suppose if you are convinced that a woman’s right to end the life of her child is crucial, then the vote is something to celebrate, but this should be tempered with sadness that firstly, many women are forced to make this decision, secondly that abortion is used worldwide to discriminate against women by sex selection, and finally, that abortion kills innocent human beings. Unless you think a fetus is a bunch of cells no more important than a fingernail (and hardly anyone does), that last fact should result in sober reflection. It is likely this decision will increase the numbers of abortions in Queensland. Cheering seems inappropriate for a decision that has such serious consequences.

Secondly, the references to the age of the previous laws. They have been variously referred to as ‘archaic’, needing ‘reform’ and being ‘119 years old’ in an attempt to cast them as hopelessly outdated. This was an important part of the campaign to remove them. And yet the vast majority of our criminal code is old. The age of legislation does not necessarily mean it needs to be jettisoned. Our 119 year old code also includes section 201, ‘Indecent treatment of children under 16’, section 219, ‘Taking child for immoral purposes’ and section 242, ‘Serious animal cruelty’. Are these also archaic? Traditionally, the law is meant to protect the most vulnerable members of society. In Queensland, this is no longer the case.

Finally, the references to abortion as ‘access to healthcare’. Abortion is not healthcare. The vast majority of the time it kills healthy human beings in a healthy mother, and provides no health benefits. It is expensive, and forces many healthcare providers to be complicit against their moral convictions, even if it is by referral. By almost any definition of healthcare, abortion does not qualify¹.

Of course, this setback does not mean pro-life supporters will give up. Laws have been changed, but they can be changed again. I’ve recently been reading William Hague’s excellent political biography of William Wilberforce, the anti-slavery campaigner. Wilberforce was a consumate politician who fought for 18 years against sometimes overwhelming odds to pass his bill abolishing the British slave trade, and then for the rest of his life to abolish slavery altogether. His opening speech to parliament in 1789 is regarded as ‘one of the greatest ever in an age of eloquence’. It’s an inspiring read, and lends hope after a such demoralising defeat for the pro-life cause this week.

 

1. Thanks to Calum Miller for this argument.

What is metaethics?

What is metaethics?

The word ‘meta’ means ‘beyond’ or ‘about’, and as a prefix means a higher level of abstraction of the topic at hand, which is ethics. So metaethics is not concerned with making moral claims – that’s the realm of normative ethics. Metaethics involves making claims about the nature of moral claims.

Let’s take the claim that ‘we ought to keep our promises’. This could be expressed as a moral fact: ‘it is the case that breaking our promises is wrong’. Metaethics asks if moral facts such as these actually exist, or are they merely statements about how we feel about moral issues? If they do exist, what kind of thing are they? Moreover, can we ever know what these facts are? Of course, there is all manner of views about the answers to these questions, and the purpose of this post is to classify them in a way that is comprehensible.

Moral realism

The most important question is whether moral facts exist at all. Moral realists think they do, and so these moral facts make our moral judgments true or false. If I claim that it’s okay to break my promise, and it is a moral fact that ‘it is the case that breaking our promises is wrong’, then my claim is false. Conversely, moral anti-realists reject that there are such things as moral facts (sometime they are called irrealists).

Moral realism is a broad church – there are a wide variety of opinions about what kind of thing moral facts are, and disagreement about the facts themselves. It might even be that moral facts exist, but we have no way to determine what they are – a position known as moral skepticism.

The most important question for moral realists is whether moral facts are objective: whether they exist independently of human beings or not. Moral relativism says moral facts are true or false relative to some human standard. Relativists point to the diversity of moral values across cultures as evidence for their views, and believe that this diversity shows objective moral facts are unlikely. If moral facts aren’t objective, is moral relativism really a form of moral realism? Some philosophers believe it is, while others argue that moral relativism is actually an anti-realist position.

If moral facts are objective, a position sometimes called moral absolutism, what kind of thing are moral facts? Those who hold to naturalism – the belief that only features of our universe exist are natural ones, i.e. those amenable to study by empirical science – must believe moral facts are natural, a position called naturalistic moral realism. There’s a problem with this view though, which faces an objection known as Moore’s Open Question Argument. This argument led Moore to non-naturalistic moral realism, which concludes we must admit the existence of unique non-natural properties such as goodness. There are two options here: either these properties are supernatural, attributable to God or gods in some manner, or they are non-natural and non-supernatural, a position known as non-natural non-theistic moral realism and ably supported by Erik J. Wielenberg. I discuss Wielenberg’s ideas here.

It’s time to mention cognitivism, a term often encountered in metaethics. It’s a theory that says moral claims are expressions of beliefs that can be true or false. This sounds like moral realism, but it’s broader than this (especially if you think moral relativists are not realists). Moral relativists are cognitivists, yes, because they believe moral claims can be true or false. But you can be a cognitivist and believe all moral claims are false. In this case you are what’s called an error theorist – there are no moral facts, it’s all nonsense and you believe all talk of morals is hugely in error. J. L. Mackie is the most famous advocate of this view.

Moral anti-realism

Recall that anti-realists reject that there are things such as moral facts, and so error theorists are also anti-realists as well as being cognitivists! But most anti-realists are noncognitivists: like error theorists, they don’t believe there are such things as moral facts. But unlike error theorists, noncognitivists thinks people who accept moral claims don’t actually have real beliefs about these moral claims, but instead are expressing their attitudes or desires. One form of noncognitivism is called emotivism, where moral claims are said to express our emotions. For this reason it is sometimes known as hurrah/boo theory. and is also a form of expressivism.

I haven’t yet mentioned an important anti-realist position known as moral nihilism, which is that nothing is morally wrong. Nihilism is most often associated with Friedrich Nietzsche, who was not only a moral nihilist but a nihilist about any values at all. This doesn’t sound much different to error theorists, and indeed error theorists are often thought of as moral nihilists.

It should be apparent by now that metaethics is a deep rabbit hole to explore. One useful tool for navigating the topic is the chart shown below, which I believe is the work of David Faraci. You’ll see that there are numerous other metaethical views not mentioned in this overview.  Fortunately, there are many good introductory texts on metaethics, one being Alex Miller’s An Introduction to Contemporary Metaethics which I have seen recommended, as well as Metaethics: An Introduction by Andrew Fisher.

metaethics

 

 

What is ethics?

What is ethics?

Ethics is a field of study that attempts to answer questions of how we should live and act.  As rational creatures who make conscious choices in our actions, we use ethics to decide what is the right and wrong thing to do in particular situations. It’s a vast and important area of enquiry, and involves a wide range of questions. To understand ethics, it’s helpful to divide ethical questions into three main categories.

Metaethics examines the nature of our moral judgments. What do we mean by right and wrong? Are moral judgments statements of fact, or are they just our preferences?  If they are facts, what kind of facts are they? Can we even know what they are?

Normative ethics is the study of moral theories that tell us how we should act – they help us determine whether our actions are right or wrong. There are many moral theories, and they don’t always give the same results. Virtue ethics emphasizes the importance of our moral character, while consequentialism evaluates actions on the basis of their consequences. Deontology is based on rules that we should follow rather than considering the consequences of our actions.

Finally practical ethics, or applied ethics, is concerned with how we should act in real-life situations. This can range from bioethics, which examines the ethical issues associated with advances in medicine and biology, such as abortion, euthanasia and cloning, to environmental ethics, which ask how we should act to preserve our planet.

In my next post, I’ll be looking at metaethics. I’ll try to classify the better known metaethical theories that are out there, and explain how they differ from each other.

Why I oppose capital punishment

Why I oppose capital punishment

I oppose the use of capital punishment. I don’t live in a country that uses it: I’ve lived the majority of my life in Australia, which abolished capital punishment in all states by 1984, and last executed someone in 1967. I’ve also lived for many years in the United Kingdom, which abolished it in 1998, and last executed someone in 1964. But the death penalty is still widely used in some other countries. The United States executed 1,477 people between 1976 and 2018, and it is legal in 31 states. China executes several thousand people each year, although this is down from over 10,000 in 2002.

I don’t actually oppose capital punishment itself. It seems reasonable that some crimes might be so heinous that the death penalty is warranted, although I’m unsure what criteria should be used to decide. Certainly, the main theistic religions have historically permitted the death penalty. The Old Testament mandated it for certain crimes, provided two witnesses could testify to the accused’s guilt. There doesn’t seem to be a strong theological case against the concept as far as theists are concerned. Capital punishment seems against the precepts of Hinduism and Buddhism, but India uses it and so does Thailand.

What about pro-life beliefs and capital punishment? I am strongly pro-life with regard to abortion, but I don’t think pro-lifers who support the use of capital punishment are being inconsistent. You can, I think, oppose the killing of innocent human beings while supporting the killing of guilty ones. People can forfeit their right to life – for example, I accept that an assailant can be killed if self-defense requires it for preservation of one’s life.

So what’s my issue? It’s the use of capital punishment that worries me.  Fundamentally, I don’t trust governments with the power to take their citizens’ lives. After all, I have difficulty trusting the government to spend my taxes wisely.  I don’t trust the government to secure the data they have collected on me, much of which I didn’t even know about until Snowden alerted us to the extent of government surveillance. I don’t trust the government not to use that data against me in the future, either. And finally, I don’t trust the government to tell me the truth about matters that might put the government in a negative light. So no, I don’t think it wise to trust the government to administer the death penalty.

Americans share my distrust of government. A recent survey showed that only 18% trusted the government to do the right thing most of the time.  Curiously, though, a majority of Americans still support the death penalty, which seems strange given their low level of trust in government. Perhaps they have a greater trust in the judicial branch?

Let me break down this lack of trust a little.

Firstly, I don’t trust the government to administer the death penalty without making mistakes. And mistakes are sometimes made. Since 1973, there have been 163 exonerations from the death penalty. I suppose you could say the system is working because people are being exonerated. But sadly, numerous people have been executed who are thought to be possibly innocent. We’ll never know for sure, because once they have been executed, there isn’t a clear path to establishing their innocence – courts and defense attorneys aren’t interested in defendants who are dead. It’s worth noting that for wrongful convictions we know about (in general, not specifically for death penalty cases), the leading contributory cause (over 80%) was due to official misconduct. Another major contributory cause was perjury or false accusation. So there is significant scope for miscarriages of justice with the death penalty, and once carried out, there is of course no way to compensate the defendant.

Secondly, I don’t trust the government to administer the death penalty fairly. You’d expect it to be applied consistently for similar crimes. It doesn’t seem to be. In fact, there is evidence that whether or not a defendant receives the death penalty for a particular crime is dependent on geography, race, mental illness, and poverty – factors that should not have any influence in a just process, particularly one that results in the defendant losing their life.

The error-prone and arbitrary nature of how the death penalty is applied should concern everyone who favors its use. Of course, these characteristics aren’t unique to capital cases – they are equally applicable throughout the justice system. But the consequences are particularly grave in capital cases, and once carried out, can’t be reversed or atoned for. Eliminating these flaws seems unlikely to be achieved. Given that life in prison without parole should be equally effective at preventing re-offending, offers more opportunities for rehabilitation, and is likely to be cheaper, there doesn’t seem to be a strong case for using it.

 

 

A simple argument against abortion: possible replies

A simple argument against abortion: possible replies

I recently posted a simple argument against abortion for pro-choice advocates to consider. I challenged them as to how certain they were of their conclusions, comparing this to the certainty associated with applying the death penalty, and noting the dismay most people feel when someone who is on death row is exonerated.

I’d now like to examine the most common replies to the first premise: it is morally wrong to kill innocent human beings. Rejecting this premise seems the only possible defense against this argument, unless the humanity of the fetus is denied, an extremely dubious proposition.

But how can this premise be rejected? Isn’t it always wrong to kill innocent human beings? Certainly, the onus is on pro-choice advocates to find good reasons why this may not be the case. Innocent people are sometimes killed in war, but no-one thinks this is permissible, but rather deeply regrettable: deliberately targeting the innocent in war is morally wrong. There are two general approaches, and I’ll briefly examine them both.

Bodily autonomy

The first approach is to claim that in some situations, innocent human beings can be killed. Usually, these situations involve a reference to a woman’s bodily autonomy, and come in two forms. One is to argue that a women has sovereign control over her body, and can whatever she likes with anything within her body. This doesn’t seem to be true, as it doesn’t seem permissible for a pregnant woman to deliberately ingest a drug that will result in a deformed child. More generally, having sovereign control of a space doesn’t usually confer the automatic right to kill people who enter it, say our private property.

Judith Jarvis Thomson presents the more sophisticated version of bodily autonomy in her famous article ‘A defense of abortion‘. She constructs a rather bizarre analogy about someone waking up to find a famous, unconscious violinist plugged into their body. The violinist needs the use of their body for nine months to survive, and unplugging the violinist would kill him. Thomson claims the victim would be under no obligation to keep the violinist plugged in, and likewise a pregnant woman is under no obligation to continue providing life support for the fetus.

There has been a lot of ink spilled over Thomson’s argument, and debate among philosophers continues to this day. We cannot examine it in detail here. But it’s worth noting some important points. Firstly, the argument is controversial, and not even all pro-choice advocates agree it is a valid defense for abortion in all circumstances (e.g. Kate Greasley). For example, the violinist is attached involuntarily, but some philosophers contend that voluntarily engaging in sexual intercourse implies consenting to pregnancy, should it occur. Others claim a mother has special obligations to her child. Secondly, Thomson never intended her argument to mean abortion is permissible in all circumstances, especially late-term abortions. In fact Thomson notes that she is not arguing for the death of the fetus at all, but rather its removal, which currently inevitably means its death. Artificial wombs could change this. So Thomson’s reasoning isn’t a slam-dunk argument for rejecting the first premise of our simple argument against abortion.

Persons, not human beings

The second approach is to modify the first premise to remove the reference to human beings, replacing it with ‘persons’: it is morally wrong to kill innocent persons. Here,  person is a moral term, meaning an entity with certain rights, in particular the right to life. So the modified premise is really saying it is wrong to kill human beings who have a right to life. Because it is claimed that a fetus does not meet the criteria for being a person, it does not have a right to life, and consequently it can be permissibly killed.

Defining persons also occupies a lot of space in philosophy journals, but it usually involves possessing certain rational capacities such as being conscious and self-aware. Herein lies the problem for this approach: these definitions of person invariably exclude infants. If the ‘personhood’ approach is taken, it is implicitly granting that infanticide is permissible in addition to abortion. For most people, that’s a bridge too far. And if it isn’t, there are implications beyond infanticide.

Conclusion

So there we have it. If the simple argument against abortion is to fail, it will have to fail at the first premise: it is morally wrong to kill innocent human beings. The two main options are rejecting it, via Thomson’s rather controversial argument, or changing the premise to refer to persons, not human beings, and all that implies for infanticide. Are these compelling enough to confidently reject the simple argument against abortion? You decide.