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December 31, 2007

Comments

Dianne: That is highly dependent on the age of the woman and other factors.

My info is likely way out of date, so thanks for the clarification. I did specify younger women. As I understand it the risk of DS is 1:800, the risk of losing the baby due to the tests is 1:200 (higher for CVS).

Again, I’m not arguing at all about the legality of abortion. Just where my boundaries are…

But intrinsically no. It turns out that the 27 week gestated preemie is exactly the same as a 27 week gestated fetus.

Not remotely, Sebastian. A premature baby, or "premie", even one that has been gestated for only 27 weeks and has (statistically) only a 70% chance of survival and an 85% chance of survival without severe morbidity, has been born.

A 27-week fetus is still unborn. The differences between a fetus and a baby are considerable, and I would recommend you go look them up before you start trying to claim that a baby is identical to a fetus.

My info is likely way out of date, so thanks for the clarification. I did specify younger women. As I understand it the risk of DS is 1:800, the risk of losing the baby due to the tests is 1:200 (higher for CVS).


OCSteve,

For a healthy persons with no symptoms whatsoever, the risk of serious complications from a brain biopsy is much greater than the risk of dying from a brain tumor. Fortunately, we don't give healthy asymptomatic people brain biopsies.

In the same way, amnio is usually targeted at at-risk populations for whom the risk calculus is very different than your typical healthy 25 year old mother.

Sebastian: That is why partial-birth abortions exist at all. The abortionist has to be sure to kill the 'fetus' before it becomes a 'baby' by exiting the womb.

No, Sebastian, that's not why IDX is performed. IDX is performed because it can be the safest method of aborting a fetus where the intact skull is too large to safely pass the cervix. This can be necessary as early as 13 weeks. The obstetrician who developed IDX as a means of more safely performing abortions did not do so to prevent doctors being prosecuted for murder: only pro-lifers would think up something that nonsensical.

"The differences between a fetus and a baby are considerable, and I would recommend you go look them up before you start trying to claim that a baby is identical to a fetus."

At 27 weeks they are identical in or out of the womb. The fact that out-of-the-womb they are more likely to die is not because of physical differences in the fetus, but rather because medical technology isn't as good at taking care of a 27 week fetus/baby as a mother's body typically is.

I was removed via C-section 10 weeks early (2 lbs. 4 oz.) to keep my mother from bleeding to death; fortunately, for me, my parents lived outside of Hartford, Connecticut, which at the time had one of the most advanced neonatal care facilities in the country.

They were not required to file a birth certificate until one week after the operation, so had I "died" in that period, I presume I would have been listed as a stillbirth or medically necessary abortion, even though I had been alive outside the womb for a short period of time. I think this type of circumstance is what Jes had in mind when she said "let nature take its course."

BTW Jes, are you ok with the 'abortion' Dianne describes: inducing labor and letting the intact baby die of neglect after birth?

Sebastian: At 27 weeks they are identical in or out of the womb.

Oh, go look up the facts in a medical textbook, Sebastian. They're not, and arguing that they are just makes you look ignorant.

Priest: Uh, that was Dianne, not me.

Sebastian: BTW Jes, are you ok with the 'abortion' Dianne describes: inducing labor and letting the intact baby die of neglect after birth?

I would not be OK with inducing labor as a method of abortion unless all other methods of abortion are either legally forbidden or medically advised as unsafe. The decision whether or not to abort has to be down to the pregnant woman in each instance, but I think that although the woman should have a reasonable amount of input into the method used, the final decision as to method ought to be down to the attending physician, who ought to be the person best informed as to which method is safest for their patient, and who ought to use that method.

According to what I have read, inducing labor is rarely the safest method of abortion: when it is, yes, it should be used.

I really don't think there's a terrible lot of point in trying to come up with a one-size-fits-all solution for any abortions after 24 weeks. Each one will be different, each one will be carried out for different reasons and in different circumstances, they are extremely rare, and why again is it that it's not acceptable to go with the individual judgment of the attending physician(s), the woman, and/or her medical proxy? That's my option: what's your problem with it?

Re marrow donation, I don't see anything intrinsically wrong with a system of morals that weighs physical autonomy against human life and decided for human life in this case. Consider a hypo where a swab of the mouth to harvest a few stem cells, not an unpleasant invasive operation, was sufficient to cure a dying patient - would you be opposed to laws mandating such donations?

And of course an important difference here is the often voluntary nature of the genesis of the situation.

There is of course a commonly-held principle saying that one is not obliged to help someone in need - a strong swimmer doesn't need to rescue someone drowning in a puddle - but I tend not to find that convincing.

But if you try to get pregnant and you are high risk for Downs and you then decide to abort in the second trimester based on the test – I do not support that at all. If you are high risk and want to get pregnant but then want a “do-over” I do not support it.

No one is asking you to support it. All pro-choicers are asking you to do is not try to make it against the law--there's a huge freaking gulf between the two.

Jesurgislas: I really don't think there's a terrible lot of point in trying to come up with a one-size-fits-all solution for any abortions after 24 weeks. Each one will be different, each one will be carried out for different reasons and in different circumstances, they are extremely rare, and why again is it that it's not acceptable to go with the individual judgment of the attending physician(s), the woman, and/or her medical proxy? That's my option: what's your problem with it?

I would certainly agree that such cases need to be judged on a case by case basis, but the problem is surely that the needs of two individuals are now in play and one of the two is incapable of acting, speaking and defending its (grammar) rights. The role of the state in this is defense of the rights of those unable to act for themselves.

Rilkefan: Consider a hypo where a swab of the mouth to harvest a few stem cells, not an unpleasant invasive operation, was sufficient to cure a dying patient - would you be opposed to laws mandating such donations?

Yes. Just as I am opposed to a law that would require a person with a rare blood group to show up at a blood center every six weeks and provide a pint. Is mandatory provision of blood something you would support, Rilke? How about mandatory kidney transplant?

Barnabas: but the problem is surely that the needs of two individuals are now in play and one of the two is incapable of acting, speaking and defending its (grammar) rights.

Is that in and of itself a good reason for the state being allowed to remove the right to decide on her own treatment from the one who is capable of using judgement? If a patient in a coma needs a liver transplant to survive, is this a good reason for the state to find the best available donor and force that donor to submit to a live liver transplant?

Rilke: Re marrow donation, I don't see anything intrinsically wrong with a system of morals that weighs physical autonomy against human life and decided for human life in this case.

Okay, so you're explicitly for everyone being available on the marrow donor registry, failure to submit to testing for compatibility a prosecutable offense, failure to provide marrow when a compatible recipient is found also illegal. Given that, I suppose it's needless to inquire if you're on a bone marrow registry, Rilke: you would hardly advocate that it should be criminal not to be unless you were registered yourself.

Consider a hypo where a swab of the mouth to harvest a few stem cells, not an unpleasant invasive operation, was sufficient to cure a dying patient - would you be opposed to laws mandating such donations?

That, alas, is still in the realm of science fiction. Bone marrow donation is a painful, invasive procedure (though less painful than labor*) with a definite morbidity and mortality (though far less of either than pregnancy). Consider that you're suggesting forcing someone to undergo 50-100 bone marrow biopsies, not just a cheek swab. Or, if PBSCT is used, to undergo multiple injections with a drug that may cause bony pain and fever followed by several hours of sitting and getting blood pheresed. Both have a mortality rate of around 1 in 100,000 (compared to 10-15/100,000 for pregnancy). Still up for legally forcing people to donate? Of course, if you say no then you're saying that it's ok if people die from curable diseases, so I must admit that ends up being a "have you stopped beating your husband yet?" questions. Sorry about that, but I'm afraid it's reality.

*Yes, I know what both feel like.

I have a surfiet of imagination and mischief. If there is a need for a contrived analogy to pregancy, consider this: a person inhabits a diving bell under the surface of the ocean. Power, warmth and oxygen supplies are piped from a ship on the surface.

What is then the responsibility of those operating the ship and should the law intervene if they decided for one reason or another to abandon their post?

The decision of the International Criminal Court, in 1999, was that forced pregnancy is a crime against humanity.

yeah. They even defined forced pregnancy: "(f) "Forced pregnancy" means the unlawful confinement of a woman forcibly made pregnant, with the intent of affecting the ethnic composition of any population or carrying out other grave violations of international law. This definition shall not in any way be interpreted as affecting national laws relating to pregnancy;"

Dianne: So if a match is found, the sick person is entirely dependent for their survival on one particular volunteer following through. If the volunteer refuses to donate their marrow or PBSC, the sick person will die. And sometimes they do refuse. They are not compelled to donate after refusal. Should volunteers be compelled to give their marrow/PBSC if they volunteer in the first place? Should all people be compelled to participate?

But that, again, is about *giving* something, not about withholding something. Being in the named register I'm well aware of it. But what if I donated bloodmarrow... or no, a clearer example; what if I donated a kidney or a piece of my liver - and once it was in the other persons body I would want it back? Suppose the other person was a kid? So first I made the kid dependent of part of my body, and than I'd want it back?

Do you really feel that the growing fetus is a part of the female's body till it is born? Would it be allright to ... eh... sell it's organs, or bonemarrow, or eggs - as long as those were harvested before birth?

Jes: A premature baby, or "premie", even one that has been gestated for only 27 weeks and has (statistically) only a 70% chance of survival and an 85% chance of survival without severe morbidity

Ah, only a 70% chance of survival. So on average 7 out of every 10 born survives and 6 of those .. eh, don't die? I don't understand what you mean by morbidity.

Jes: IDX is performed because it can be the safest method of aborting a fetus where the intact skull is too large to safely pass the cervix. This can be necessary as early as 13 weeks.

there are not many fetus with intact skulls who are too large to safely pass the cervix. My third one was more than 11 pounds with a biiiiig skull and both he and I survived fine. Dr. Science explained in an earlier post some of the circumstances where an partial birth procedure would be safer, but 'big skull' wasn't among them.

Jes: but I think that although the woman should have a reasonable amount of input into the method used, the final decision as to method ought to be down to the attending physician, who ought to be the person best informed as to which method is safest for their patient, and who ought to use that method.

Butbutbut... shouldn't the pregnant woman decide everything? I thought you didn't want doctor's input in the decision about the pregnant womans body, let alone let him or her have the final say.

Re marrow donation, I don't see anything intrinsically wrong with a system of morals that weighs physical autonomy against human life and decided for human life in this case.

I actually was a bone marrow donor for a sibling.

Prior to the operation, my sibling's physician took me aside to ask me if I was sure I wanted to go through with it. If I did not, he offered to cover for me by manufacturing some medical reason for my not going through with the operation.

This was all in confidence, and it was made absolutely clear to me that had I decided not to go through with it, noone but me and the doctor would be the wiser.

There was some risk to me in being a donor, but that wasn't the issue at hand. It was purely a matter of my comfort level and willingness to proceed.

IMO that was completely the correct thing for my sib's physician to do.

Abortion completely to the side, I'm not sure we want to open the door to coercive surrender of bodily tissue, no matter how good the reason.

Thanks -

I mean bonemarrow, not bloodmarrow. You register via the bloodbank when you donate blood, which may be why I mixed it up. Or I should just go to bed ;).

Dianne: you didn't say sustain someone elses body, you said use someone elses body. If I lift my baby over the balcony of a high flat and hold her there with one hand, should I be entitled to opening my hand just because I feel like opening them? After all it is my hand and my body...

Abortion completely to the side, I'm not sure we want to open the door to coercive surrender of bodily tissue, no matter how good the reason.

I agree. However, abortion can not be to the side when considering this issue because forced pregnancy involves the coercive surrender of bodily tissue and nutrients. So if we restrict abortion in any way at all then we have opened that door. It may be that pregnancy is such a special case that the door would not open any wider without further shoving. Or maybe not. Once a precedent is set...

BTW, I hope I'm not making marrow donation sound unattractive. Actually, it's not either particularly painful or particularly dangerous. I'm in the registry personally (though my chances of being called on are low for a number of reasons). The bone marrow biopsies I mentioned would be done under anesthetic, so they aren't actually painful (though expect a sore hip afterwards) and frankly the risk is probably offset by the benefit of having a thorough physical and having any donor health problems uncovered and treated. (Anecdotally, I know of one person who had a benign tumor discovered during the pre-donation work-up. It was removed and he was told to stop the @#&($ smoking or the next one might be malignant.) In short, voluntary donation is good but coercive donation is bad. I feel much the same way about pregnancy.

there are not many fetus with intact skulls who are too large to safely pass the cervix.

Normal fetuses with normal positioning yes, abnormal no. Consider hydrocephalus. A fetus with severe hydrocephalus can have a skull twice normal size. With no brain. It's not pretty. Also if the fetus is stuck in an abnormal position, its head may not be able to clear the cervix. One could deliver the fetus by c-section, but that would leave the woman's fertility compromised. Only a very slight compromise, true, but to what purpose?

Barnabas: If there is a need for a contrived analogy to pregancy, consider this: a person inhabits a diving bell under the surface of the ocean. Power, warmth and oxygen supplies are piped from a ship on the surface.

It's typical for pro-lifers to come up with "analogies" that avoid the real issue: forced use of a woman's body.

Marbel: there are not many fetus with intact skulls who are too large to safely pass the cervix.

So? The reason for IDX being available is that sometimes a fetal skull is too large to pass the cervix safely.

Ah, only a 70% chance of survival. So on average 7 out of every 10 born survives and 6 of those .. eh, don't die?

Sorry: technical terms. Mortality means just that: the premature baby will die. Severe morbidity means that the premature baby survives with permanent damage, which may result in a severely decreased lifespan. Roughly speaking, at 27 weeks, 7 out of 10 premies will survive - this is highly variable and depends on the baby's weight, as well as how long it has been gestating. (cite) I find the figures for severe morbidity harder to understand, but yes, the earlier birth, and presumably the lower the bodyweight, the more risk that survival past birth won't mean long-term survival.

Rape, sexual slavery, enforced prostitution, forced pregnancy, enforced sterilization, or any other form of sexual violence of comparable gravity;

Yes, the Rome Statute, Article 7. There is an outline here by HRW on how rape came to be recognized as a crime against humanity: I would guess that the forced pregnancies in the Congo will be found to fall under international criminal law: Amnesty International has already recognized forced pregnancy as a humanitarian offense which they will actively campaign against. This will apply in principle only to countries in war zones where women are made pregnant by rape and the governing authorities do not permit abortion under any circumstances: it would most likely, therefore, not apply in the US, though it could ensure that American soldiers in a war zone, if they are raped, are legally entitled to be able to get an abortion from the local military clinic, rather than being forced to travel back to the US and pay for it out of their own pocket and on their own time.

Oh, I agree Dianne, there are circumstances. I've said earlier that I opposed the ban on IDX. But skulls that are too large as from 13 weeks??? AFAIK IDX is mainly performed after 18 weeks, isn't it?

But skulls that are too large as from 13 weeks???

I don't hold to it: I can't find a cite. It comes down to "I remember reading somewhere" - but given normal variation in size of skull and size of cervix, I wouldn't have thought it impossible, especially if the fetus is hydrocephalic.

Jes: you cited the ICC and I quoted their definition for you. Switching to other intstitutions and other definitions makes the original point rather incomprehensible.
We are discussing third trimester abortions aren't we? Since everybody agrees that early abortions should be the womans decision only so they are not part of the controverse.

I have difficulty judging what 'sever morbidity' would mean. Is that being in a wheelchair all your life? Is that a condition that will end your life rather soon? Is that a learning disorder? Wearing thick glasses? But 7 out of 10 and 6 of those without severe disabilities; I'd be pretty miffed if they decided to let my baby die because they thought those chances were too bad. And if the child was still in the womb I'd feel the same way, especially since I have a very vivid image of a 27 week old fetus just after it left the womb - and the 14 months old toddler it grew into (no painfull memories Dianna, but a stressfull period at the time).

Since midnight was more than two hours ago I'm off to bed now.

Since everybody agrees that early abortions should be the womans decision only

Do they? The difficulty in the US is that there are many powerful groups and politicians who profess the belief that women should never be allowed to make the decision to have an abortion, no matter how early: who even oppose the provision of a contraceptive pill, on the (false) grounds that the pill prevents implantation and is therefore an abortifacient, and a woman has no right to abort even by preventing implantation. As you yourself have acknowledged, the reason why late-term abortions have to be allowed in the US is because one strategy for the forced-pregnancy activists is to prevent women having access to means of prevention or early abortion.

I have difficulty judging what 'sever morbidity' would mean.

Well, in another BMJ article I read (which I was trying to find) they point out that "severe morbidity" can mean "dead before their 5th birthday", as well as "never able to walk, talk, feed themselves".

I'd be pretty miffed if they decided to let my baby die because they thought those chances were too bad.

I'd be outraged on your behalf. You get to decide, not the doctors, if you want them to keep your baby alive at all costs and no matter what the baby's quality of life and length of life might be: while it may constitute a form of child abuse if (to take an extreme example) a mother wants to keep a child alive for five years in permanent pain with no chance of long-term survival, I think in general it's way too risky to give the decision when to give up, to anyone but the child's parents.

I agree. However, abortion can not be to the side when considering this issue because forced pregnancy involves the coercive surrender of bodily tissue and nutrients.

Understood. I'm just loathe to wade in on the topic of abortion per se.

If a fetus is, truly and fully, a human life, abortion is hard to defend. If it's not, then not.

To answer whether a fetus is a human life, and at what point, requires that you define what life is, and what being human is. Those are questions that are, frankly, so far above my pay grade that I can't begin to hazard an answer. So, I try to stay out of it.

I just don't know the answer.

BTW, I hope I'm not making marrow donation sound unattractive. Actually, it's not either particularly painful or particularly dangerous.

FWIW, the procedure was a piece of cake, and that was almost 30 years ago. Nowadays, I'm sure it's a walk in the park. Nobody should be afraid of it.

Since everybody agrees that early abortions should be the womans decision only so they are not part of the controverse.

Unfortunately, there is no such consensus.

Thanks -

Barnabas: If there is a need for a contrived analogy to pregancy, consider this: a person inhabits a diving bell under the surface of the ocean. Power, warmth and oxygen supplies are piped from a ship on the surface.

Let's see how many holes we can poke in this scenario. Was the crew told that they were going out for a pleasure excursion and then trapped against their will into caring for the person in the diving bell? Was the crew denied opportunities to get off the boat before the diving bell was sent below? Did they find themselves on the boat either against their will or as the result of deception? Were they put on the boat because the boat they were originally on sprung a leak?

Here's the real question, though, Barnabas--do you really believe the crap you're writing, or do you just think you're being cute?

russell: If a fetus is, truly and fully, a human life, abortion is hard to defend

Why? Do you feel that women are not, truly and fully, human?

To answer whether a fetus is a human life, and at what point, requires that you define what life is, and what being human is. Those are questions that are, frankly, so far above my pay grade that I can't begin to hazard an answer.

But you feel that the question of whether women are human is within your pay grade?

To answer whether a fetus is a human life, and at what point, requires that you define what life is, and what being human is. Those are questions that are, frankly, so far above my pay grade that I can't begin to hazard an answer. So, I try to stay out of it.

I just don't know the answer.

And what's more important, I don't know the answer for anyone else either. Who am I to push my personal morality on another human being, especially as regards such a personal and painful decision?

Was the crew told that they were going out for a pleasure excursion and then trapped against their will into caring for the person in the diving bell? Was the crew denied opportunities to get off the boat before the diving bell was sent below? Did they find themselves on the boat either against their will or as the result of deception? Were they put on the boat because the boat they were originally on sprung a leak?

Has the boat the crew are on, from which the diving bell is suspended, sprung a leak? Are the crew dependent for their lives on the same supply of oxygen and power that the diving bell is using? When all the crew die and the ship sinks because the diving bell gets priority and the crew were not allowed to decide to cut it loose, won't everyone in the diving bell die along with the crew, whereas if the crew were allowed to decide when to cut it loose, the crew would have survived?

Why? Do you feel that women are not, truly and fully, human?

No, I certainly do not think that.

Look, I'll cut this line of debate short, at least as far as my own involvement.

I, personally, line up politically on the pro-choice end of the spectrum because the issues involved in answering the question of whether a fetus is, or is not, a full human life deserving legal protection are, frankly, matters of private conscience and persuasion. I don't see how they can be legislated fairly other than to leave it as a matter of private conscience.

That said, I also understand the concerns of folks who do consider the fetus to be a human life, because (duh) they consider the fetus to be a human life. It's not an extraordinary position.

I really can't say anything beyond that, because I simply don't know.

That's about the best you're going to get out of me on the topic. I'm not wading in any further, because I have nothing further of value to add.

Thanks -

No, I certainly do not think that.

So, isn't the issue "When is it ever appropriate to make use of a human being's body against her will?"

Ialso understand the concerns of folks who do consider the fetus to be a human life, because (duh) they consider the fetus to be a human life. It's not an extraordinary position.

Sadly, no, it isn't, because if you regard women as human, the issue of when or whether the fetus is human becomes secondary to the question of whether it's ever appropriate to force a human being to risk permanent damage to her body, possible risk to her life, and known risks to her health, against her will.

That pro-lifers prefer to skip right over the question of "Are women human? Is it ever right to treat women like incubators?" and pretend that question has already been settled (and that it is right to treat women as non-human incubators and the only question is the humanity of the fetus) is certainly one of their great rhetorical victories.

I really can't say anything beyond that, because I simply don't know.

Well, if you know women are human, you only have to figure out where you stand on human rights: do you approve of forced organ donation to save lives, or don't you?

The more I read these comments, the more I wonder what common ground the two camps can possibly have.
Almost zero. Fortunately, there are more than two camps. The fallacy of the excluded middle is a nasty one to spot when the middle isn't hogging the megaphones.

Dianne: "That, alas, is still in the realm of science fiction."

Sure. But I take it that you would oppose mandatory cheek swabs, so your bone marrow discussion is irrelevant. Of course this position is consistent with a moral/legal system without an affirmative duty to save a life in the absence of any rational objection (e.g., saving someone by flipping a switch), which is I presume what we have.

'Of course, if you say no then you're saying that it's ok if people die from curable diseases, so I must admit that ends up being a "have you stopped beating your husband yet?" questions. Sorry about that, but I'm afraid it's reality.'

You do know you're arguing (snidely to boot) with yourself here, don't you?

Totally OT: Thomas at RS notes, "Fifth, I want to take a moment to thank Markos Moulitsas Zuniga, Duncan Black, Oliver Willis, the whole crew at Obsidian Wings, and the writers of any other far-left wing moron factory I've inadvertantly omitted, for sending us the waves of cretins who've, between them, managed to make target practice a sport for the whole family again."

Take a bow, everybody.

"Let's see how many holes we can poke in this scenario. Was the crew told that they were going out for a pleasure excursion and then trapped against their will into caring for the person in the diving bell? Was the crew denied opportunities to get off the boat before the diving bell was sent below? Did they find themselves on the boat either against their will or as the result of deception? Were they put on the boat because the boat they were originally on sprung a leak?"

The funny thing is that when you added all these things I thought "wow, it would be really selfish for them to leave those people to die even if they thought it was a pleasure cruise or even if they had been on a leaky boat."

Almost zero. Fortunately, there are more than two camps. The fallacy of the excluded middle is a nasty one to spot when the middle isn't hogging the megaphones.
The fallacy is that there's a middle ground on this. Either you trust women to control their bodies, or you don't. The middle is simply a place where you say "we trust women sometimes, but not all the time."

The funny thing is that when you added all these things I thought "wow, it would be really selfish for them to leave those people to die even if they thought it was a pleasure cruise or even if they had been on a leaky boat."

You find it funny. I find it pathetic. But then again, I'm not out to control the lives of people I disagree with, where you clearly find yourself to be of such superior moral acumen as to make those decisions for others. Must be nice to be so certain of your wown rightness. Ignorance really is bliss.

So, isn't the issue "When is it ever appropriate to make use of a human being's body against her will?"

Yes, I think that is certainly part of the issue.

If the fetus is a human life, its interests arguably deserve consideration. If the woman does not want to bring it to term, there's a conflict between the interests of the fetus and those of the woman.

Diving bells aside, it's a situation for which I do not think there is an analogy.

If you don't think the fetus is a human life, the question is pretty simple.

If you think the fetus is a human life, but the rights of the woman trump those of the fetus in all cases, ditto.

Otherwise, it's not a simple question.

With that, I retire from the field.

Thanks -

Jes:Do they? The difficulty in the US is that there are many powerful groups and politicians who profess the belief that women should never be allowed to make the decision to have an abortion, no matter how early:
I ment here on ObWi, since that is where I have this discussion now.

I'd be outraged on your behalf. You get to decide, not the doctors, if you want them to keep your baby alive at all costs and no matter what the baby's quality of life and length of life might be
That's not true. Doctors decide wether they will perform medical procedures or not, wether they perform risky operations or not, wether they will resussitate or not. Doctors decide when they will try to keep a preemy alive and when not.

If the fetus is a human life, its interests arguably deserve consideration. If the woman does not want to bring it to term, there's a conflict between the interests of the fetus and those of the woman.

And if you believe women are human beings, you have to believe that it's up to the woman to decide. If you think women aren't really human, someone else gets to decide. It's a fairly simple point: as Brian notes, there is no real middle ground here.

Rilkefan: Of course this position is consistent with a moral/legal system without an affirmative duty to save a life in the absence of any rational objection (e.g., saving someone by flipping a switch), which is I presume what we have.

No, Rilke. The position is: does the state - or any other individual with the ability to do it - have the right to force another human being, against her will, to give up the use of her* body to save the life of another? Pro-lifers say yes. Pro-choicers say no.

*I say "her" because you're actually the first pro-lifer I've encountered who was willing to argue that this applied to involuntary use of organs that could be taken from men, too.

Sebastian: The funny thing is that when you added all these things I thought "wow, it would be really selfish for them to leave those people to die even if they thought it was a pleasure cruise or even if they had been on a leaky boat."

I expect you think it's really selfish for airlines to instruct passengers to put on their own oxygen masks first before they help anyone else, too.

And if you believe women are human beings, you have to believe that it's up to the woman to decide. If you think women aren't really human, someone else gets to decide.

I would ask what happens if you think that both women and late-term fetuses are fully human, but it turns out I actually don't care what you think. Convenient for both of us!

Phil: I would ask what happens if you think that both women and late-term fetuses are fully human

Eh, if you were at all interested in the answer, you'd be able to figure it out for yourself. I'm assuming that you are yourself fully human: do you think you have a right to a live liver transplant, should you need one, against the will of the person who currently has the liver that you need half of to save your life. A fetus is in the same position: it needs the use of a woman's body to save its life.

If you argue that because the fetus is human it is therefore entitled to the use of a woman's body against her will, you are either arguing that women are not human - or you are arguing that humans have a right to take from other human bodies against the will of those humans.

I'm not sure we want to open the door to coercive surrender of bodily tissue, no matter how good the reason.

I'm repeating the above quote, from russell, because I really think it cuts through the BS surrounding the debate on third trimester abortion. If you believe, as he does, that it is NEVER ok to demand the surrender of bodily tissue for any cause, including saving another's life, then obviously any restriction on abortion is immoral because it does just that and opens that door. If you don't believe that then the question becomes how much coercion is ok? Is it ok to demand bodily tissue if it is a minor invasion and the danger to the other person is great? Is it ok to force someone to give blood (an almost no-risk procedure for a healthy person)? To donate bone marrow (10X safer than completing a pregnancy for an average risk woman)? To donate a kidney (slightly higher risk than the average pregnancy but far lower risk than some pregnancies that have been declared not dangerous enough to warrant an abortion based on maternal risk)? Part of a liver (dangerous)? Part of a lung (theoretical)?

"I expect you think it's really selfish for airlines to instruct passengers to put on their own oxygen masks first before they help anyone else, too."

Huh? From what I know, they instruct you to do that so you can be sure that you can actually help. It would suck to pass out while trying to get your kid's mask on and have you both die.

Did that response have some connection to what I said? You quote me, but I don't understand. A further hypothetical was given with the idea that it would suggest that the people in the boat should be able to cut off the diving bell and let the people in it die. I suggested that the idea that the people in the boat originally were on a pleasure cruise wouldn’t make me feel like they should abandon the people in the diving bell to die. How does your airline response respond to that?

Also, do we all agree that there is something immoral about aborting a fetus through full delivery and then just letting it die afterwards. I ask, because I would have thought in the framework of “involuntary use of the mother’s body” that the answer would be obvious, but the issue has been raised as if it were unproblematic.

Dianne? Jesurgislac?

From what I know, they instruct you to do that so you can be sure that you can actually help. It would suck to pass out while trying to get your kid's mask on and have you both die.

Yeah. And it would suck to be forced to undergo childbirth against your will and be permanently handicapped, leaving you blind with three children. Pretty selfish of Alicja Tysiac to have wanted to retain her sight to be able to care for the two children she already had, huh?

From what I know, they instruct you to do that so you can be sure that you can actually help. It would suck to pass out while trying to get your kid's mask on and have you both die.

Do you know why you would pass out? Because there isn't enough oxygen at the altitudes that commercial airplanes fly to allow for normal cortical activity. Now, think about the uterine environment. Look up p02 in the umbilical vein if necessary. Do you stand by your statement that there is no difference between a 27 week fetus and a 27 week premie?

A further hypothetical was given with the idea that it would suggest that the people in the boat should be able to cut off the diving bell and let the people in it die. I suggested that the idea that the people in the boat originally were on a pleasure cruise wouldn’t make me feel like they should abandon the people in the diving bell to die.

The final answer to that, though, is that: If the captain of the ship decided that the diving bell was endangering the ship, (and given that for the sake of this stupid analogy there was no way to bring the bell to the surface/allow the people in the bell to escape), the captain would have the right to cut the diving bell loose and let the people in it die. Sea captains have made exactly that kind of judgement in the past, and while they have sometimes had to defend their judgement against a board of enquiry, their right to make that decision is not in question.

The analogy is not perfect because (most of the time) the diving bell is not drawing on resources that everyone aboard ship needs to survive. (And on the other side of the equation, unless you fantasise outright, the bell was a known and planned hazard, and the people in it will be conscious and aware of what is happening to them. The first is not true of an accidental pregnancy, the second is not true of a fetus.)

Also, do we all agree that there is something immoral about aborting a fetus through full delivery and then just letting it die afterwards.

So are you arguing that premature infants should never be treated with comfort care only but should always be treated with the most aggressive treatment avaiable? Even when it won't make any difference? Even when it just means that the baby will die in an incubator or warming bed with a dozen tubes stuck in its body rather than in its parents' arms? Remember, third trimester abortions are usually done because of severe fetal anomolies incompatible with life. I would say that it is inappropriate to intubate an ancephalic baby regardless of whether it was born at 20 weeks or 40, induced or born after natural labor. It won't make any difference and would just torture the parents.

On the other hand, if there were a scenario in which, for some reason, a woman presents for an abortion saying that she is 15 weeks pregnant, labor is induced and the baby is born looking more like 28 weeks gestation (and without gross abnormalities that mean it is going to die regardless), then yes, go for it, at least as far as the initial treatment goes. If, later on, it is clear that it is hopeless then go to comfort care. Also fire your U/S tech who apparently didn't pick up on the 13 week difference between stated dates and fetal size.

"So are you arguing that premature infants should never be treated with comfort care only but should always be treated with the most aggressive treatment avaiable? Even when it won't make any difference? Even when it just means that the baby will die in an incubator or warming bed with a dozen tubes stuck in its body rather than in its parents' arms?"

You're changing the whole tenor of your comment. It was "One method of late abortion is simply induction of labor and allowing nature to take its course after birth." So far as I know that is factually false in the US. But even if it isn't, I am arguing that such a child should be give *exactly the same care any other human being who needed similar levels of support would be given*. Needing a venitlator to breathe is not normally a reason to just let someone die, so it shouldn't be for a preemie either. And at that point, you should probably get an outside conservator for health care to make treatment decisions.

"Remember, third trimester abortions are usually done because of severe fetal anomolies incompatible with life."

You don't know that. You hope that is true. So do I. You may deeply believe that is true. But you can't preface that with 'remember'. Statistics on the reasons for 3rd trimester abortions are not regularly kept in the US. The abortion industry and/or pro-choice lobby has made certain of that.

"I would say that it is inappropriate to intubate an ancephalic baby regardless of whether it was born at 20 weeks or 40, induced or born after natural labor. It won't make any difference and would just torture the parents."

I would say it is always inappropriate to given treatment that won't make any difference. Any baby delivered should get the same treatment whether or not it was a 'preemie' or a 'product of abortion'.

Do you agree with that statement?

"Do you know why you would pass out? Because there isn't enough oxygen at the altitudes that commercial airplanes fly to allow for normal cortical activity. Now, think about the uterine environment. Look up p02 in the umbilical vein if necessary. Do you stand by your statement that there is no difference between a 27 week fetus and a 27 week premie?"

I'm not following the logic here. A 27 week preemie is in fact a 27 week fetus outside of the womb. They are the same. The fact that a 27 week preemie has only a 70% or so chance of survival is because it isn't in the womb. Why drag the aiplane into this? Under your analogy it seems like you are saying that the airplane shouldn't have oxygen masks for people. But I'm pretty sure that isn't what you are saying, so I just don't get it.

"Do you know why you would pass out? Because there isn't enough oxygen at the altitudes that commercial airplanes fly to allow for normal cortical activity. Now, think about the uterine environment. Look up p02 in the umbilical vein if necessary. Do you stand by your statement that there is no difference between a 27 week fetus and a 27 week premie?"

I'm not following the logic here. A 27 week preemie is in fact a 27 week fetus outside of the womb. They are the same. The fact that a 27 week preemie has only a 70% or so chance of survival is because it isn't in the womb. Why drag the aiplane into this? Under your analogy it seems like you are saying that the airplane shouldn't have oxygen masks for people. But I'm pretty sure that isn't what you are saying, so I just don't get it.

You don't know that[that the vast majority of third trimester abortions are performed for reasons of fetal anomoly]

Five minutes of research netted the following articles on third trimester abortion:

This one, this one, and this one. I'll stop here out of respect for the spam filter. Needless to say, the grounds for abortion was severe fetal abnormalities or (relatively rarely) maternal illness in all cases.

A 27 week preemie is in fact a 27 week fetus outside of the womb. They are the same.

Of course. Just the same. Which is the treatment of premature infants is to attach their umbilical cords to heart/lung machines and let them pretend to be in the uterus for another 5-16 weeks. Hmm...why are they all dying? A number of serious chances in circulation, hematology, oxygenation, and neurology occur at birth. You may consider the differences between a premature infant and a fetus trivial or irrelevant for the purposes of discussing their status, but saying that they are just the same only makes you sound like you don't know biology.

Under your analogy it seems like you are saying that the airplane shouldn't have oxygen masks for people.

People who are hypoxic because they are in a low oxygen environment have had conscious cortical activity before. A fetus has not. It will if all goes well and it is eventually born and exposed to a high oxygen environment, but it never has any more than a sperm cell has (but will, if it is exposed to an egg, allowed to develop, etc).

To switch analogies, suppose you started building an AI. Advances in the understanding of neurology and/or computer science now allow you to build an AI that is essentially the same as a human in terms of its brain function. Suppose you work on it for a while and have tested the basic functions that will support the AI's ability to think, reason, and be self-aware once it is turned on completely. However, you have never turned it on. Would it be immoral of you to now walk away and never turn it on?

If you believe, as he does, that it is NEVER ok to demand the surrender of bodily tissue for any cause, including saving another's life, then obviously any restriction on abortion is immoral because it does just that and opens that door.

That's pretty much where I fall, though I cringe a bit at the use of the word immoral, because it's so abstract and so open to interpretation that it becomes meaningless in these sorts of discussions. It's important to remember that just because I feel this way doesn't mean I would agree with or support someone who decided to have a day-before-birth elective abortion, should one actually take place. It just means that I'd acknowledge the woman's right to have one, even if I found the idea distasteful, which I do. As long as the fetus is inside the woman, it's only a potential life--there are enough cases of things going wrong in what seem to be normal deliveries for me to be comfortable with that definition. It has to get out before it's alive, as far as I'm concerned.

Jes: Pretty selfish of Alicja Tysiac to have wanted to retain her sight to be able to care for the two children she already had, huh?

No, it wasn't. She should have had access to contraception, she should have been able to get sterilized should she want so, she should have had the abortion immediately when she wanted it. Which was quite early in the pregnancy. So what does that have to do with third trimester abortions?

Dianne: Do you know why you would pass out? Because there isn't enough oxygen at the altitudes that commercial airplanes fly to allow for normal cortical activity. Now, think about the uterine environment. Look up p02 in the umbilical vein if necessary. Do you stand by your statement that there is no difference between a 27 week fetus and a 27 week premie?
Is the p02 level your distinction between a lump of flesh and eh... how did you put it... a sentient being where it becomes a big deal terminating its life?

If the fetus is a non-existing entity till birth, is it allright for the pregnant woman to sell its organs, as long as they were harvested before birth? Give away the heart and the kidney, sell the eggs of a female fetus?

Dianne all three of your cites come from countries with dramatically more restrictive rules on abortion in general and late term abortion specifically than are found in the US. This is especially true in countries like Holland that do not allow for elective late term abortions and which have very stringent reporting requirements to authorize late term abortions for medical necessity. It is rather unsurprising that a study of late term abortions in that kind of regime doesn't find elective ones.

You will rather pointedly NOT find similar studies in the US.

"Of course. Just the same. Which is the treatment of premature infants is to attach their umbilical cords to heart/lung machines and let them pretend to be in the uterus for another 5-16 weeks. Hmm...why are they all dying? A number of serious chances in circulation, hematology, oxygenation, and neurology occur at birth. You may consider the differences between a premature infant and a fetus trivial or irrelevant for the purposes of discussing their status, but saying that they are just the same only makes you sound like you don't know biology."

Good grief. Yes the womb provides many things that leaving a baby lying on the ground wouldn't--including breathing and circulation support. That isn't exactly a revelation. The point is that the *fetus* is the same, the environment has changed dramatically. I'm aware that tossing it in the sink or putting it in a freezer wouldn't be great medical practice. The body of a fetus is meant to have the support of the womb. When you remove it from the womb, it doesn't have that support and medical technology tries to half-ass it. That doesn't mean the fetus is different that means the environment is different. Sheesh.

I think you're missing part of what Dianne is saying, Sebastian. I can't verify the truth of what she's saying, though it sounds plausible to me. At any rate, she's saying that the fetus is fundamentally changed by the process of birth, however that may occur. Once exposed to the outside environment, the biology of the baby changes significantly and irreversibly.

Yes the womb provides many things that leaving a baby lying on the ground wouldn't--including breathing and circulation support. That isn't exactly a revelation. The point is that the *fetus* is the same, the environment has changed dramatically.

Ok, this is degenerating, but I'll try it again. What would happen if you shoved a baby back into the uterus? Along, of course, with its placenta? Say you even had a way to reattach the placenta. Here's what would happen: It would die. Once the baby is born and exposed to air its circulation changes and there's no going back. That's why the treatment of premature birth is not simply a simulation of the uterine environment. The ductus arteriosus closes. The uterine vessels atrophy. The beta-hemoglobin shifts from fetal to adult. Things happen. It's not just an extra-uterine fetus it's a baby. A baby can not obtain its oxygen from the maternal circulation. It can not float in liquid without access to air, no matter how ideal that liquid is for a fetus. On the other hand, a baby (as opposed to a fetus) can breathe and maintain its circulation perfectly fine lying on the ground, despite your apparent belief that all newborns need respiratory support--how did you think the human species survived before there were respirators anyway? It'll get into other forms of trouble pretty quickly, but it'd be fine with breathing and circulation. It has changed. I repeat, you can claim that these changes are of no importance to the issue of the personhood, but why are you trying to pretend that they don't exist?

C-section, baby's lungs full of fluid - no question it's human. Tuck it back in the womb and sew up the incision - question?

Another report on third trimester abortion this one from Georgia (the one in the US). Two interesting points from this article: 1. Induced abortion in the third trimester was very overreported: when the records were reviewed, all but 3 of the reported abortions were actually fetal loss or first or second trimester abortions. 2. Of the three true third trimester abortions, two were done for ancephaly. The reason for the third was undetermined, so I suppose that could be your "couldn't fit into the prom dress" anecdote, but there's no particular reason to think that it was anything other than another fetal malformation.

Another report on third trimester abortion this one from Georgia (the one in the US). Two interesting points from this article: 1. Induced abortion in the third trimester was very overreported: when the records were reviewed, all but 3 of the reported abortions were actually fetal loss or first or second trimester abortions. 2. Of the three true third trimester abortions, two were done for ancephaly. The reason for the third was undetermined, so I suppose that could be your "couldn't fit into the prom dress" anecdote, but there's no particular reason to think that it was anything other than another fetal malformation.

According to MMWR of the approximately 9800 legal late abortions (>21 weeks) that occurred in the US in 1998, about 2500 took place in NY. NY restricts third trimester abortions to situations in which the mother's life is in danger. About 1000 more apiece occurred in Texas and Georgia, both of which restrict third trimester abortion to threat to life and health of mother. No other state had over 1000 abortions performed at greater than 21 weeks. Kansas , which restricts abortion after "viability", had about 660, so the majority of abortions at >21 weeks are occurring in states that don't allow elective abortion in the third trimester. So where do these hordes of women who want abortions in the third trimester because they wake up cranky one morning that Sebastian postulates go to get them?

Coming into comments too late, but I just wanted to respond to Seb's question why anyone who thinks that "it is not morally relevant" (which I take to mean: the fetus/embryo does not have enough moral standing to make killing it wrong?) would find abortion "tough.

As others have noted, part of the confusion might be that "tough" does not necessarily mean "morally tough". It's not entirely clear which publius meant, but Seb presumably meant "morally tough".

Even so, though: the decision to have an abortion is the decision not to have a child. It's a decision between two very, very different futures, one of which includes a child of yours, and one of which does not. Even leaving aside the moral issues, this would have to be incredibly hard in most cases: kind of like breaking up with someone you've been deeply involved with, only much, much more so. (I mean: breaking up involves kissing an entire possible future, involving someone you (by hypothesis) care a lot about, goodbye: the similarity. It does not involve that person's not existing: why abortion is often much tougher.)

Most breakups of serious relationships are tough, even when you know you're doing the right thing. They are emotionally tough, for obvious reasons. But they are also, a lot of the time, morally tough, even though *none* of the issues about moral standing are involved. You ask yourself: am I just being selfish here? Is it really true that we just can't work this out, or am I just somehow not willing to make the kind of effort it would need? Am I being smart enough to cut my losses, or too shallow and selfish to go the distance?

These are all serious *moral* questions. In cases that do not involve either rape or birth defects so serious as to make the child's life (were it allowed to become a born child) unbearable (e.g., Tay Sachs), I think questions like that have to arise. Imho, they are more than adequate to make decisions about abortion genuinely tough.

I think the decision whether or not to have an abortion is (almost) always tremendously tough. And one of the claims made by people who oppose abortion (not, *not*, including Seb, who said something quite different) that most consistently infuriates me is that the fact that people who have abortions find this decision difficult or tragic or heartbreaking somehow *shows* that they secretly recognize that abortion is murder. Not a lot of things reduce me to sputtering rage, but that claim -- which strikes me as willful self-deception deployed in an unusually heartless way -- does.

I will probably regret weighing on in this, but although I consider women fully human, I feel there is a point towards the end of the pregnancy where it is not moral for the woman to choose an abortion rather than go to the full-term (except if there are pressing medical reasons). And that is something to do loosely with implied consent to use eventually giving a right to use. The issue by eight or nine months (except in places where there are extreme difficulties in obtaining abortions earlier) isn't about a new attempt to force use of the mother's body, it's about continuing use by the fetus of a body that the woman has previously allowed for its use/support. If you want to use an organ donation analogy, it's someone who has offered to make a kidney donation or the like and when the receipient is already opened up on the operating theatre, saying 'No, I don't want to do this.' It seems to me morally wrong to back out at the very end stage if the initial choice had been made freely. In other words, while I support a woman's right to choose, I think there is a cut-off point by which she must exercise this right and I am not in favour of making that cutoff point full-term.

Dianne, there is California with 1/6th of the population, the size of France, and more pregnancies (it is almost certainly in the 1000+ range). It doesn't report at all. Texas has the 'and mental health' exception which was so abused in California in the pre-Roe years and later 70s. And it requires nothing more than a sign off on the form.

I'll look at the Georgia report tonight after volleyball.

Dianne: Another report on third trimester abortion this one from Georgia (the one in the US)

It is 29 years old, this in one report about one clinic and according to the data in the report 33% of the third term abortions (1 in 3) were unaccounted for. Though I agree (as does Sebastian as far as I know) that in all likelyhood most of the third term abortions are because of fetal anomalies (that is not what this discussion is about actually) this report only confirms his statement that there is no trustworthy info about it.

Your other report, from the MMWR, does not specify why the abortions took place. Sebastian's point is that there are no detailed reports available. So far your proving his point for him.

Almost midnight here, so bedtime. But it is probabely clear that I agree with magistra.

magistra: I feel there is a point towards the end of the pregnancy where it is not moral for the woman to choose an abortion rather than go to the full-term (except if there are pressing medical reasons).

Once the pregnancy is past 32 weeks, inducing labor or having a c-sec will (assuming the fetus is alive and healthy) result in a premature baby that, given a developed country's best standards of health care, is as likely to survive and grow up as normally as any other baby. So if there's a need to terminate the pregnancy early, after 32 weeks there's no reason not to do so by inducing labour or having a c-sec. As already noted, however, there is no evidence except in pro-lifer fantasies that women are just randomly going into clinics and having 8th or 9th month abortions because they feel like it.

Texas has the 'and mental health' exception which was so abused in California in the pre-Roe years and later 70s.

Source for the claim that the exception is abused? I've heard that claim before, but not with any particular evidence and given that mental illness kills (20% mortality for untreated major depression, 8% mortality for borderline personality disorder, etc), I don't see why concern for the mental health of the mother should be seen as a sign of weakness.

I agree that California is not listed--embarrassingly, I, um, forgot about its existence and therefore didn't either comment or attempt to dig up figures for it. However, it appears that California bans elective abortion after "viability" so they aren't particularly relevant.

So if there's a need to terminate the pregnancy early, after 32 weeks there's no reason not to do so by inducing labour or having a c-sec.

Not entirely. Some of the more grotesque fetal anomolies can produce situations in which the fetus can't fit through the cervix. For example, hydrocephalus producing a skull twice or more times normal diameter or muscle disorders that leave the fetus in an unrelenting spasm, forcing it into a shape that can not fit through the cervix (and looks even worse than it sounds...not something you ever want to see, even just on ultrasound.) Technically, a c-section is usually possible, but why do major abdominal surgery in order to remove a fetus that is dead already. I know you probably meant no reason not to induce or do a c-section when the fetus is healthy, but, as you said...

As already noted, however, there is no evidence except in pro-lifer fantasies that women are just randomly going into clinics and having 8th or 9th month abortions because they feel like it.

It's not women with healthy fetuses that have 3rd trimester abortions. Does anyone have even anecdotal evidence of anyone attempting or succeeding in getting a 3rd trimester abortion of a healthy fetus when they are also healthy? Why would anyone? After putting up with 7-8 months of fatigue, nausea, weight gain, hormonal fluctuations, constipation, etc to not even get a baby out of it? Yuck. If you didn't want it, what was wrong with getting an abortion 7 months ago and sparing yourself the agony?

'However, it appears that California bans elective abortion after "viability" so they aren't particularly relevant.'

Begs the question.

In other words, while I support a woman's right to choose, I think there is a cut-off point by which she must exercise this right and I am not in favour of making that cutoff point full-term.

And it always comes back to this--if you don't want to have a late term abortion, don't have one. People make decisions that other people find morally repugnant every freaking day, but it seems like on this matter and in one's sexual preference, there's this sense that it's not only acceptable, but proper to impose your personal opinion on someone else. Sorry, but I don't think so--you are welcome to your opinions, but not to someone else's body.

Texas also banned homosexual sodomy for 40 years with exactly one enforcement prosecution. Would you argue that the was precisely one act of homosexual sex in that period?

"Why would anyone? After putting up with 7-8 months of fatigue, nausea, weight gain, hormonal fluctuations, constipation, etc to not even get a baby out of it?"

This is a very odd argument. Why would they go through the entire birthing process and then kill the kid a couple of weeks later? I don't know but they do. Why would they let their boyfriends sexually abuse the kids? I don't know but they do. Why would they cut off their boy's balls? I don't know but some do.

People do bad things. They aren't common but they are still bad. We often make those things illegal. The fact that your average person wouldn't murder anyone isn't an argument against making murder illegal. Neither is the fact that *most* women wouldn't abort late for stupid reasons.

There's no question that people do stupid things, but the question at hand involves someone wanting to do something highly frowned on by society and a doctor willing to participate.

Ok, people apparently convince doctors to amputate healthy limbs because of body-image issues, but I at least have never heard so much as a rumor of a late-term abortion done for non-medical reasons in this country.

And I can imagine that some percentage of abortions have side effects requiring hospitalization, so I would think a few such would have come to light if the rate is non-negligible.

To expand slightly, I would expect most elective-late-term abortions to be sought by women in desperate circumstances - overwhelmed by poverty, suffering emotional problems, or being coerced by the father or other relation (one unlikely to be of good standing in society) - and that's the profile of someone I would expect to find great difficulty in convincing a doctor to perform an act which is considered by some grounds for assassination when done under legal and much less controversial circumstances.

Ok, say there are women in such circumstances who managed to find a willing doctor - I would expect that we'd hear from them (selling their story of repentance to CBN, telling their therapist when lucid or not, telling the police when the boyfriend's in the drunk tank). Or we'd hear from the doctor's disgruntled secretary or from the IRS or ...

To be fair, if you come up with such testimony I'll probably argue that much or all of it is expected from confabulation.

"Ok, people apparently convince doctors to amputate healthy limbs because of body-image issues, but I at least have never heard so much as a rumor of a late-term abortion done for non-medical reasons in this country."

I've heard of a number of late term abortions for cleft palate and Down's Syndrome, neither or which are so debilitating as to necessitate death.

We had a discussion about a nurse who reported elective late term abortion in I think Indiana about two years ago but since she had joined Operation Rescue afterwards you all didn't consider her reliable. Hmm, what search term could dredge that thread up. Was it Dr. Death or something.

It was the state that they were trying to subpoena records in....or am I getting discussions confused?

All this back and forth seems to overlook the fundamental potential for common ground here: early and mid-term abortions being legal while late-term abortions are not. One side of course will argue that this is unacceptable because murder is murder while the other will argue that it's just the legal camel's nose, an level to completely pry reproductive rights from women's hands.

The majority of Americans realize that it is rather monstrous to pretend that an infant moments from birth is, legally, a nonperson who should be able to be killed without legal penalty. On the flip side, though, the majority of people realize that it is just as absurd and monstrous in its repercussions to pretend that a cluster of cells is deserving of legal personhood because its genetic code can be classified as 'human,' while its living mother is SOL.

The damage wrought by both extremes should be obvious: our cultural landscape is polarized, cratered with the aftermath of decades of frenzied rhetorical and legal battles. Still, the majority understands that the difficult answer lies somewhere in the middle, and that no amount of chest-thumping, sign-waving, and slogan-chanting will change the fact. Even the church, for the vast majority of its history, understood and embraced this: the concept of "Quickening" was fundamental to the idea of life.

It seems that accepting this compromise and working to marginalize both extremes is wiser than conducting a bitterly fought 'culture war' in which only the most absurd and extreme position is considered Righteous And Acceptable.

"All this back and forth seems to overlook the fundamental potential for common ground here: early and mid-term abortions being legal while late-term abortions are not."

I thought this was called "Roe v. Wade"?

To be sure, I've pretty much skipped doing more than the lightest skim of this thread as it has progressed, but I'm not clear that that's relevant to my observation.

Roe vs. Wade in theory or as applied?

I thought this was called "Roe v. Wade"?
The legal details of Roe have long since been eclipsed by its totemic BIG MEANING for both camps.

There is already another situation in which people do not have an absolute legal right to decide what to do with their own body IF they require a doctor to be involved: assisted suicide. (This is therefore different from cases involving e.g. masochistic consensual sex, where there is no medical intervention required). I don't think even those who support euthenasia argue that it should be available in every circumstance: that if you feel suicidal (but are otherwise healthy) you should be able to expect a doctor to help you die.

In other words, very few people think that bodily autonomy which makes demands on doctors is an absolute right under all circumstances and those who make that pro-choice argument are not going to win much support.

To get to a specific example. The current English system has a number of loosely worded criteria for abortion before 24 weeks, that in practice come near to allowing abortion on demand. The procedure is also widely available and cheap/free, although there are still debates about whether the mechanics of the procedure are right. Abortion after 24 weeks is allowed if there is risk of severe permanent injury or death to the mother or the child if born is likely to be severely handicapped. How many pro-choicers on this blog think that these restrictions on late abortions are excessively harsh? I certainly wouldn't and I gather dutchmarbel wouldn't. What about others here?

I note in passing that Sebastian has once again brought forth his Secret Abortions Conspiracy Theory. As this point is not amenable to rational discourse, I will not attempt to reason with him about it.

Jeff: The majority of Americans realize that it is rather monstrous to pretend that an infant moments from birth is, legally, a nonperson who should be able to be killed without legal penalty.

Pro-lifers tend to do a bait-and-switch, though. You can point out that there is no evidence that anyone ever has a late-term abortion without medical need: that the claim that people have abortions "moments from birth" is such nonsense one wonders even pro-lifers can bear to repeat it. This makes no difference to people who really are locked into the fantasy that women are evil and must be stopped, but I've seen pro-lifers, arguing that "babies minutes from birth ought not to be killed", respond to the available evidence that late-term abortions are carried out only for medical reasons, not as a spontaneous "I just don't want to be pregnant" choice with the argument that the vast majority of abortions are carried out just because the woman doesn't want to be pregnant. True, and the vast majority of abortions are carried out in the first trimester - indeed, given how fast a woman can find out she's pregnant these days, a large majority at >6 weeks.

But that women should have the right to decide for themselves at any stage in their pregnancy: this should be uncontroversial. This isn't a demand for abortions "moments from birth" - this is a demand that women are treated as humans and not as incubators.

Now, the interesting points that make clear that the goal of the pro-life movement is not to prevent abortions:

Where access to early abortion is immediately available on demand and either free or low-cost to anyone, most women who just don't want to be pregnant will go for an early abortion. Where access to contraception is free or low cost and immediately available on demand without having to justify it, no matter what your age, fewer women become pregnant without planning it, especially where access to contraception is backed up by sensible and informative sex education in schools.

Obvious, common-sense points. No pro-life organization in the US supports any of them, and pro-lifers in general line up against all of them. It is not the pro-choice side that radicalizes the debate: it is people who expect their pretended concern for "babies being killed" to be taken seriously, while actively working to ensure that the abortion rate in the US remains high and that women have later abortions because they cannot access medical services early.

Touching post, but a tad naive. The anti-choice movement is based on the control of female sexuality. If you remove the control part, there's not really anything to get them out of bed in the mornings, right? I do realize that there's a widespread, non-active "abortion is icky" crowd, but the anti-choice movement, at its core, doesn't have a whit of respect for those people, who they rightly see as contracepting, fornicating freedom-lovers.

Reading back through scroll, I'm suddenly struck by the phrase "If you think . . ."

People talk a lot about various perspectives on what the fetus is, etcetera.

But, you know, we choose how we conceptualize the fetus. It's not a matter of "well, if we decide that it's one thing, we really can't help it, you know?"

Deciding that the fetus is a person is a political act. Deciding that the fetus *might* be a person is a political act. It's part of defining a theory of personhood and natural rights. It's not a scientific statement or the personal solution to a philosophical and existential dilemma.

We can ask empirically about stuff like the feeling of pain (sort of), or the level of brain development, or the ability to survive outside the womb. We can imagine backwards from babies or imagine forwards from little parasites latching onto the uterine wall. But we don't get to just kind of *think* that, you know, what if it's "alive" or what if it's "a person" or whatever?

Personhood is created by consciousness---it is in the eye of the beholder, even when that beholder is the self. Deciding that a fetus in somebody else's womb is a person has *consequences*.

And, yes, this cuts both ways. I *decide* not to categorize fetuses in other people's wombs as independent people. I *decide* not to tell my story of the world such that they are people. It is not a matter of proof but of choice. And I make that decision because I think that doing so leaves me better equipped to fight the suffering in this world. I think that it is better to want to see female-bodied human beings prosper and have autonomy and opportunities than to eclipse or shatter that potential in the name of the life, liberty, and personal power of an undifferentiated agencyless potential that is growing within them. That is my decision.

I remember the first time I saw a woman post on how offended she was that someone would think more highly of a zygote than of herself. And I thought at the time, being young and having a rather unformed picture of the world, that she was pushing the point a bit strongly---that nobody was trying to prize zygotes above women, they were just wrestling with what personhood meant. I later realized I was wrong; wrestling with what personhood means, in this context, is exactly an attempt to value the pregnancy (the split cell, the zygote, the fetus, the embryo, the condition, the potential human, the pregnancy, the heir, the unborn baby, the future life) in the same coin as the woman, and to her detriment.

I've heard of a number of late term abortions for cleft palate and Down's Syndrome, neither or which are so debilitating as to necessitate death.

Can you provide a citation demonstrating that either has happened? I've also heard of a number of alien landings, but I somehow doubt that they really occurred. Even so, DS, while not usually lethal in the first years of life, can be associated with fatal and sometimes uncorrectable cardiac defects which can cause death within days. Cleft palate in itself is not lethal, but can be associated with other defects, including neurological defects, that are. Was the abortion you heard about really for cleft palate or was cleft palate just the most obvious external sign of a complex and fatal congenital abnormality?

Dianne: Can you provide a citation demonstrating that either has happened?

Well, there was certainly one incident in England in 2000 where an abortion was carried out on or after the 24th week (no other information could be released, to protect the privacy of the patient) because the fetus had a cleft palate. A Church of England curate attempted to have the two doctors responsible prosecuted for unlawful killing. BBC. The incident evidently was more famous on pro-life sites in North America than it ever was here. While the curate - who had herself been born with mild, and surgically remedied, facial deformities - seemed not to understand that a cleft palate can be extremely serious and unfixable, the medical evidence seems to have convinced the courts that when a fetus has a disability that the pregnant woman and two doctors agree is serious, the law allows a post-24 week abortion.

Dianne: Can you provide a citation demonstrating that either has happened?

Well, there was certainly one incident in England in 2000 where an abortion was carried out on or after the 24th week (no other information could be released, to protect the privacy of the patient) because the fetus had a cleft palate. A Church of England curate attempted to have the two doctors responsible prosecuted for unlawful killing. BBC. The incident evidently was more famous on pro-life sites in North America than it ever was here. While the curate - who had herself been born with mild, and surgically remedied, facial deformities - seemed not to understand that a cleft palate can be extremely serious and unfixable, the medical evidence seems to have convinced the courts that when a fetus has a disability that the pregnant woman and two doctors agree is serious, the law allows a post-24 week abortion.

Abortion after 24 weeks is allowed if there is risk of severe permanent injury or death to the mother or the child if born is likely to be severely handicapped. How many pro-choicers on this blog think that these restrictions on late abortions are excessively harsh?

As a practical matter, no. In theory, however, I do worry about the implications of saying that one person (assuming that the fetus is something that can reasonably be called a person) is allowed to use the organs and tissues of another for his/her support against the will of the "host". If it is allowed, why not also allow forced blood donation and forced bone marrow donation? Both are potentially saving and both are far safer than completing a pregnancy. Yet at least one commenter on this thread responded with absolute horror at the idea. Why do people not respond with equal horror to the idea of restricting abortion, i.e. forcing a woman to allow a fetus to parasitize off of her body, at moderate risk to her health and life?

Jes: Thanks. I would guess that in that case the cleft palate was associated with other problems that were more serious since the courts were apparently convinced that it was not an unlawful killing and I doubt that they would have been if it were simply a case where the mother was afraid of what people would think if she had a "deformed" baby or whatever. However, it does seem that SH is right and there has been at least one incident of third trimester abortion for a cleft palate in the last 8 years. Quite the epidemic.

Where access to early abortion is immediately available on demand and either free or low-cost to anyone, most women who just don't want to be pregnant will go for an early abortion. Where access to contraception is free or low cost and immediately available on demand without having to justify it, no matter what your age, fewer women become pregnant without planning it, especially where access to contraception is backed up by sensible and informative sex education in schools.
On this relatively uncontroversial (in any sane world) point, we can most certainly agree, Jes.

Dianne: In theory, however, I do worry about the implications of saying that one person (assuming that the fetus is something that can reasonably be called a person) is allowed to use the organs and tissues of another for his/her support against the will of the "host".

The organs were used for more than 24-27 weeks by the time I start to worry about wether an elective abortion ought to be limited. That is not forced organdonation, that is giving your kidney away and demanding it back after 7 months.

Rebecca: And, yes, this cuts both ways. I *decide* not to categorize fetuses in other people's wombs as independent people. I *decide* not to tell my story of the world such that they are people. It is not a matter of proof but of choice. And I make that decision because I think that doing so leaves me better equipped to fight the suffering in this world.
Yes it is a political choice to decide when a new life becomes a person. There were (and maybe still are) cultures where they only do it after the father accepts it. Or after it survived the first year. If I had a discussion with any of those people they might feel that the position of the woman improves enormously if she can just decide to kill her baby before it became an official person.

In the Netherlands a fetus actually becomes a person after 24 weeks. It has to be officially registered in the communal administration, it has to be officially burried if it is born death and when it dies forms will be filled in and sent to the health inspectors.

I don't have a problem agreeing that women in the US, due to the circumstances there, should have less limits and more freedom - as I've repeatedly said I think it is a matter of weighing the intrests of the woman against those of the fetus/baby. I *do* have a problem with people who assume that the fetus/baby even in third trimester is comparable to a myoma untill it leaves the womb.

"However, it does seem that SH is right and there has been at least one incident of third trimester abortion for a cleft palate in the last 8 years. Quite the epidemic."

Yup, and exactly one case of homosexual sodomy in Texas in the years it was illegal.

And probably almost no marital rape before the early 20th century.

Heck, I note an extreme uptick in rape reporting in the 1960s and 1970s. That must be because rape was incredibly rare before then.

You believe all that right?

Yup, and exactly one case of homosexual sodomy in Texas in the years it was illegal.

And probably almost no marital rape before the early 20th century.

Heck, I note an extreme uptick in rape reporting in the 1960s and 1970s. That must be because rape was incredibly rare before then.

You believe all that right?

Do you actually think you're making a legitimate argument here, Sebastian? Do you think you're making an accurate analogy? I don't think you're stupid, so I have to come to the conclusion that you're incredibly dishonest when it comes to this issue.

Incertus (Brian), check the posting rules. You can say you think SH's analogy is wrong, but the above is in my view over the line here.

E.g., I think you're committing an obvious logical fallacy, but I have no reason to think you're dishonest.

That is not forced organdonation, that is giving your kidney away and demanding it back after 7 months.

The kidney, once donated, is out of your body and no longer yours any more than the Christmas presents you bought and gave to someone else are still yours. A closer analogy and one that could actually occur, might be this: People who require chronic platelet transfusions for one reason or another often develop antibodies against the transfusions. This problem can be limited by giving platelets from a single donor (a typical platelet transfusion contains platelets pooled from 8-10 donors, each of whom donated a pint of whole blood, whereas a single donor unit comes from a single person who was pheresed for platelets--an ultra-low risk procedure but one that is time consuming). Quite frequently, platelets from one particular donor produce much better results than platelets from any other donor. As far as I know, no one's really sure why: it doesn't correlate with blood or tissue type particularly well. Anyway, suppose a person with a chronic need for platelets has one donor who has been willing to give platelets as needed for 7 months. Does that imply that the donor has agreed to give platelets for life? Does the recipient have the right to force the donor legally if he/she refuses? What if the patient had a terminal illness such as MDS and had a life expectancy of 2 months? Would it be ok to force the donor for just the next two months (the recipient would die within days, probably from internal bleeding, without the platelets)? If it should be acceptable (legally, if not morally) for the donor to refuse, then why should a woman not have the same right to refuse to share her uterus?

In the Netherlands a fetus actually becomes a person after 24 weeks. It has to be officially registered in the communal administration, it has to be officially burried if it is born death and when it dies forms will be filled in and sent to the health inspectors.

Really? Do you get an income tax credit for the "baby" starting at 24 weeks gestation as well (do you even get income tax credit for kids in the Netherlands)? (Not particularly related to the debate at hand, I'm just curious.) Does that also imply a hard line at 24 weeks, i.e. if a 23 week premie is born alive does it get full NICU treatment or comfort care only? I've heard people claim that in the Netherlands no premie under 27 weeks gets NICU care, but your comment strongly implies that that is not true.

At some point, I find the analogies to pregnancy/abortion tiresome. It's not as if we don't know what pregnancy is and need the kind of clarification such analogies might provide. The situations analogized, as always, are different and distinct. It's entirely possible and legitimate to think diffrently about pregnancy than about some absurd organ donation scenario or whatever one might come up with.

I suppose we could spend lots of time discussing all the ways each analogized situation is different, but why? We know what it means to be pregnant. Why not simply talk about that?

"Do you actually think you're making a legitimate argument here, Sebastian?"

Yes.

Crimes are often underreported. Things that aren't crimes and which aren't likely to be reported by the fetus don't strike me as likely to be well reported. If marital rapes are underreported by women who survive them--and all signs point to the fact that they are--how much less likely to be reported are abortions which kill the most likely person to report?

But, Sebastian, as has been pointed out before, a woman can't simply sneak into a dark alley alone and give herself an undetected, late-term abortion. It requires a team of qualified people and proper facilities, thus the "conspiracy theory" label that been applied to this particular argument of yours.

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