GESTIÓN EN SALUD PÚBLICA: BioEdge: Rara avis in terris: a new abortion argument

sábado, 11 de febrero de 2017

BioEdge: Rara avis in terris: a new abortion argument

Rara avis in terris: a new abortion argument

by Michael Cook | 11 Feb 2017 |

It’s a rare week that sees a new twist in the decades-old abortion debate. But this is that week.

Writing in the journal Bioethics, two researchers from the University of Toronto contend that that women have a right to abortion, but no right to kill a foetus. In support of their startling argument they invoke bioethicists Peter Singer and Judith Jarvis Thompson, two of the most intrepid supporters of abortion rights.

This needs a bit of unpacking, so here goes.

Eric Mathison and Jeremy Davis point out that theorists like Singer and Thompson have distinguished between the right to an abortion (expelling an unborn child from the womb) and the right to kill an independent foetus. Since abortion is nearly always lethal with current technology, abortion is identified with killing. But theoretically, they are distinct.

In a well-known passage Thompson says:

I have argued that you are not morally required to spend nine months in bed, sustaining the life of that violinist; but to say this is by no means to say that if, when you unplug yourself, there is a miracle and he survives, you then have a right to turn round and slit his throat. You may detach yourself even if this costs him his life; you have no right to be guaranteed his death, by some other means, if unplugging yourself does not kill him.

And Singer writes, with Deane Wells

Freedom to choose what is to happen to one's body is one thing; freedom to insist on the death of a being that is capable of living outside one's body is another.

So what if the foetus could survive after removing it from the womb? Mathison and Davis point out that this will become possible someday – perhaps in the not too distant future. Scientists are working on ectogenesis, artificial wombs, in which a foetus could be incubated.

If that ever happens, they ask, will a woman still have a right to kill the foetus? Their conclusion is No.

There are three common reasons to say Yes, which they refute. First, biological links are said to give one a right to determine the destiny of a foetus. However, the status given to sperm and egg donors and surrogate mothers shows that biology is not determinative. Second, it is said to be a violation of genetic privacy for a child with a woman’s genes to exist without her consent, just as it would be a violation for a doctor to use her medical waste. However, a child only has half of her genome. And third, the foetus is said to be her property. But for various reasons, nearly all theorists say that children, even unborn children, are not property.

Mathison and Davies leave many questions unanswered, partly because they refuse to take a position on whether the foetus is a human being. What about frozen IVF embryos? What about “afterbirth abortions” (ie, infanticide)? What about foetuses which survive abortions? Nevertheless, it is a reminder of a distinction which is seldom made in the abortion debate: a woman’s right to evacuate her womb and her right to ensure that the foetus dies.

A child who self-harms must be one of the most agonising experiences a parent can have. But it is relatively common. A study in The Lancet a few years ago found that about 1 in 12 teenagers, mostly girls, engaged in self-harming behaviour, with the most common methods cutting or burning. Most of them stop as adults, but some continue. It is a phenomenon which still seems to baffle the medical profession, despite the abundance of statistics.

In this issue of BioEdge, we report on an interesting response to self-harm, at least for some patients – educate them to minimise the harm, but supply them with razors. Given that harm minimisation is a popular public policy approach in other areas, like drugs, this makes some sense. But I think that most people will regard it as quite confronting. What do you think?