Abortion: Science, Religion, and Terminology

April 8, 2010

When Dr. Henry Morgantaler received the Order of Canada in 2008, the issue of abortion was again thrust into the front pages of the Canadian media. The latest scuffle concerned the recently defeated “Maternal Health” motion that was initially sponsored by the Liberals. Partially because of Canada’s health care policies, abortion remains a contentious topic, and many parties in the debate have simply come to the point where they agree to disagree. What is lost in the debate, is the role of religion. Specifically, how organized religion has occluded the facts of the matter, and steadfastly prevents any progress from being made.

To be fair, both the extreme pro-choice and pro-life movements are equally penalized by the pervasive influence of religion, and both suffer a subsequent loss of credibility. The base issues here are simple enough: questions of terminology. When does a dividing cluster of cells officially become a person? At what point does a fetus become entitled to the protection of the state? When does a embryo, growing as a parasite in a woman’s body, become an individual? When does a mass of flesh, acquire a soul, if there is such a thing? Before we delve into answering these questions, let’s summarize the current social, legal, and scientific landscape.

The pro-life positions, depending on the particular advocacy group, endorse a range of time frames. Organized religion, for the most part, puts the beginning of “person-ness” at conception. Pro-choice positions, for the most part, endorse the legal criteria, and stress that a woman’s right to make decisions concerning her body supersedes all other considerations.

Legally, there are no restrictions on abortion in Canada, as a result of Dr. Morgentaler’s 1988 court case. Subsequent case law has identified birth as the critical point between fetus and person. Doctors who perform abortions have some discretion as to when they will refuse an abortion based on the stage of pregnancy, with many only conducting third term abortions if a dire health risk to the mother exists. This makes the end of the second trimester the current de facto limit in Canada, but there is no legal restriction per se for an abortion during any stage of pregnancy. This approximate cut-off is most likely an artificial result of the vast majority of unwanted pregnancies that are detected and terminated in the first trimester. Pregnancies into the late 2nd trimester are presumably planned. Medically, the science concerning fetal viability, based on the current state of the art in premature neonatal care, tells us that the rate of survival drops precipitously before 25 weeks gestation. The physiological reasons for this are well-documented, dealing primarily with the crucial underdevelopment of the neurological and cardiopulmonary systems of the baby.

Let’s pause for a moment and review some of the terminology found in the previous paragraphs: cells, person, fetus, embryo, individual, soul, baby. You will no doubt have noticed how these terms might evoke different reactions from you than they would from other, perhaps, randomly selected people. And therein lies the problem. We, as a society, would not, without benefit of legislation, be able to agree on something so simple as terminology. Even with the common ground of legislation, abortion is still a hotly debated subject, with both sides in the debate unable to find common ground.

The extremist pro-choice movement would have us believe that an unborn child is nothing more than a glorified organ. A pancreas or a spleen that grows over the span of 9 months, and at a point decided on by medical science and the state, inherits the rights of a person, essentially overnight. The extremist pro-life movement, on the other hand, states that a cluster of undifferentiated mammalian cells possesses an immutable human soul from the moment of conception onward. I believe, dear reader, that if you have perceived an editorial sarcasm for the extremist positions on my part, you might infer my equal disdain for both. And you would be correct. To paraphrase Christopher Hitchens, religion poisons the entire debate.

Religion, in one way or another, has strived to define the person in terms of the only concept outside the realm of scientific and medical inquiry: the soul. In ancient times, before the onset of modern medicine, the issues of pregnancy, childbirth, and the identity of the fetus were very clear. Pre-natal interventions were very limited, and premature births had a very high mortality rate, even against a backdrop of high infant mortality in general. The organized religion of the place and time, as in many other aspects of everyday life, answered the questions of parents who sought meaning and resolution in issues of life and death. They supplied the truth of the matter, in an era when truth and fact were interchangeable.

In the present day, personal truth and medical fact are distinctly different, and strive to answer questions in what Stephen J. Gould famously referred to as “non-overlapping magisteria”. Ironically, the precision of current medical fact has only served to illuminate the blurry progression of biological complexity that characterizes human gestation. Legislation, an imprecise but necessary mirror of Canadian society, has chosen an arbitrary, but generally fact-based position, based on a compromise of the diverse mix of legislators we as a society have elected. It is in this poorly defined grey area that religion continues to unnecessarily influence this debate. At the risk of portraying myself as a enthusiastic fan of science fiction, we find ourselves in a similar situation as a Starfleet tribunal, which finds no evidence to decide whether or not the android Commander Data indeed possesses a soul, and hence possess the rights of an individual. As a scientist, I can only offer the same agnostic conclusion: there is no evidence either way. Medical science offers nothing more concrete, and with advancing neonatal technology, the survival threshold for premature infants continues, happily, to decrease.

So where does this leave us? Scientific methodology, and clinical medicine in particular, offers only a slowly moving goalpost. Before this point, this fetus has a less than 50% chance of survival, after this point, more than 50%. And at that point, science hands over interpretation of the data, and rightly so, to society, and what society does with this information is up to the legislators.

The current 2nd trimester limit is an imperfect compromise between the science and the societal mindset, but it is probably the best position we can hope for in the current social climate. How can we improve the dialogue on this issue? Perhaps the first thing we, as a society, must do, is decide precisely which questions we are going to try to answer. And there are many: How do we define the terms cells, person, fetus, embryo, individual, soul, baby ? Should a woman be allowed to use abortion as a primary method of birth control? What about cases of rape, and incest? What about cases where the mother is in medical risk to continue the pregnancy? What about cases where the fetus is suffering from massive, fatal congenital genetic defects? Under what circumstances is it allowable for a physician to overrule the decision of an informed, lucid adult? When does a legally sanctioned medical procedure become murder? If, at some point in the future, the wonders of genetic engineering and synthetic biology can push the survival threshold back before the 13th week, what then? Are we aborting organs, or people with a decent shot at survival? Most importantly, is it allowable to allow the answers to these questions to change our interpretations of the medical data? Do these complications give us, as a society, license to shift our application of legislative mechanisms to a medical procedure?

Again, an emotional response to these questions, based on a theologically-oriented moral compass, only serves to muddy the waters of this crucial debate. I put it to you that legislation should not be a precise mirror of the medical science, but a regularly reviewed dialogue between the science and the society. Critical to the success of this conversation will be the purposeful exclusion of any religious or spiritual proselytizing. Just the facts. Only then can the result be most fair and beneficial to all parties involved, born & unborn.

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Подходит работник сервиса и без слов (кивком) интересуется “Чё?”, муж: “Да жопа ваще...” и показывает пальцем на какую-то штучку.
Работник сервиса склонился и смотрит.
Из противоположного конца зала, другой работник сервиса, прокуренным голосом интересуется у первого: “Чё там?”.
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