MELBOURNE – In the Dominican Republic last month, a pregnant teenager suffering from leukemia had her chemotherapy delayed, because doctors feared that the treatment could terminate her pregnancy and therefore violate the nation’s strict anti-abortion law. After consultations between doctors, lawyers, and the girl’s family, chemotherapy eventually was begun, but not before attention had again been focused on the rigidity of many developing countries’ abortion laws.
Abortion receives extensive media coverage in developed countries, especially in the United States, where Republicans have used opposition to it to rally voters. Recently, President Barack Obama’s re-election campaign counter-attacked, releasing a television advertisement in which a woman says that it is “a scary time to be a woman,” because Mitt Romney has said that he supports outlawing abortion.
But much less attention is given to the 86% of all abortions that occur in the developing world. Although a majority of countries in Africa and Latin America have laws prohibiting abortion in most circumstances, official bans do not prevent high abortion rates.
In Africa, there are 29 abortions per 1,000 women and 32 per 1,000 in Latin America. The comparable figure for Western Europe, where abortion is generally permitted in most circumstances, is 12. According to a recent report by the World Health Organization, unsafe abortions lead to the death of 47,000 women every year, with almost all of these deaths occurring in developing countries. A further five million women are injured each year, sometimes permanently.
Almost all of these deaths and injuries could be prevented, the WHO says, by meeting the need for sex education and information about family planning and contraception, and by providing safe, legal induced abortion, as well as follow-up care to prevent or treat medical complications. An estimated 220 million women in the developing world say that they want to prevent pregnancy, but lack either knowledge of, or access to, effective contraception.
That is a huge tragedy for individuals and for the future of our already very heavily populated planet. Last month, the London Summit on Family Planning, hosted by the British government’s Department for International Development and the Gates Foundation, announced commitments to reach 120 million of these women by 2020.
The Vatican newspaper responded by criticizing Melinda Gates, whose efforts in organizing and partly funding this initiative will, it is estimated, lead to nearly three million fewer babies dying in their first year of life, and to 50 million fewer abortions. One would have thought that Roman Catholics would see these outcomes as desirable. (Gates is herself a practicing Catholic who has seen what happens when women cannot feed their children, or are maimed by unsafe abortions.)
Restricting access to legal abortion leads many poor women to seek abortion from unsafe providers. The legalization of abortion on request in South Africa in 1998 saw abortion-related deaths drop by 91%. And the development of the drugs misoprostol and mifepristone, which can be provided by pharmacists, makes relatively safe and inexpensive abortion possible in developing countries.
Opponents will respond that abortion is, by its very nature, unsafe – for the fetus. They point out that abortion kills a unique, living human individual. That claim is difficult to deny, at least if by “human” we mean “member of the species Homo sapiens.”
It is also true that we cannot simply invoke a woman’s “right to choose” in order to avoid the ethical issue of the moral status of the fetus. If the fetus really did have the moral status of any other human being, it would be difficult to argue that a pregnant woman’s right to choose includes the right to bring about the death of the fetus, except perhaps when the woman’s life is at stake.
The fallacy in the anti-abortion argument lies in the shift from the scientifically accurate claim that the fetus is a living individual of the species Homo sapiens to the ethical claim that the fetus therefore has the same right to life as any other human being. Membership of the species Homo sapiens is not enough to confer a right to life on a being. Nor can something like self-awareness or rationality warrant greater protection for the fetus than for, say, a cow, because the fetus has mental capacities that are inferior to those of cows. Yet “pro-life” groups that picket abortion clinics are rarely seen picketing slaughterhouses.
We can plausibly argue that we ought not to kill, against their will, self-aware beings who want to continue to live. We can see this as a violation of their autonomy, or a thwarting of their preferences. But why should a being’s potential to become rationally self-aware make it wrong to end its life before it actually has the capacity for rationality or self-awareness?
We have no obligation to allow every being with the potential to become a rational being to realize that potential. If it comes to a clash between the supposed interests of potentially rational but not yet even conscious beings and the vital interests of actually rational women, we should give preference to the women every time.
Peter Singer is Professor of Bioethics at Princeton University and Laureate Professor at the University of Melbourne. His books include Animal Liberation, Practical Ethics, Rethinking Life and Death, and The Life You Can Save.
Copyright: Project Syndicate, 2012.