DISCLAIMER: These notes do not reflect my or my professor’s opinions on the issue of abortion. These notes are not meant to provide any opinion on the issue. These notes are just meant to provide an overview of the ethical considerations of bioethics

• Not only an important ethical issue but also a political issue- mostly focus on ethics here but can’t ignore law and politics

• Abortion- termination of pregnancy by removing embryo/fetus usually through medical means

  • Very safe when carried out properly

  • Can use medication, surgical removal

  • Heavily debated

• Is abortion ethical and in what circumstances?

  • Brings up issues of autonomy, beneficence

    • Does the fetus constitute a person?

    • Is abortion legal and under what conditions?

      • Different across states

    • When and how should abortion be accessed?

    • Is Plan B even abortion?

• Reasons why someone may get abortion

  • Don’t desire children/additional children

  • Unable to care for a child due to financial/social reasons- not enough income or in college

  • Fetus not viable or would die shortly after birth

  • Fetus would be born with significant disability

    • Debate between feminist bioethicists & disability bioethicists

    • Feminist bioethicists say women have right to create families of own choosing and might not have resources to raise children with severe disabilities

    • Honors autonomy of woman and does beneficence

    • Disability bioethicists concerned bc there are people with Down syndrome and other heritable conditions that live happy lives

    • Is this a form of eugenics?

    • Not necessarily anti-abortion

    • Person is carrying too many fetuses at once- often in IVF

    • rape/incest

    • Sex selection of fetuses, selecting for other genetic traits

      • Bioethics very future-facing- looking towards when technologies that could find every single feature be developed

• Language changed around pro-choice- modified to reproductive rights because this should be considered as a normal medical procedure

• Roe v. Wade (1973) SCOTUS decision protecting rights to abortion within 1st trimester- states can’t prohibit abortions

  • Can place limits on 2nd/3rd trimester unless mother’s life is at risk

  • “Jane Roe”- woman in Texas who wanted an abortion, but they were only offered when mother’s life was at risk

  • Decision/legal reasoning- abortion is legal because of constitutional right to privacy because pregnant woman has the right to choose their own path with limited interference

  • Issue of autonomy and beneficence ethically

• Main arguments in favor of abortion

  • People have autonomy over their own body

  • Person’s right over their own body has more importance than the rights of fetus that isn’t a “person” yet

    • Spectrum of beliefs of parameters of abortion

  • May be necessary for many medical reasons

    • May not able to understand care for child or other testing

    • Mental health reasons

    • On medication where they can’t be pregnant

  • Legal, safe abortion reduce harm of unsafe abortions - public health standpoint

  • Legalizing abortion means people can choose whether to (not) access it depending on beliefs

• 1 major ethical/public health concern- unsafe abortions

  • people may seek illicit services from untrained professionals/unsterile environments

  • Common in developing countries and places with restrictive laws that prohibit abortion entirely

  • 47,000 deaths & 5 million hospital admissions annually across the world from unsafe abortions

  • Between 2010-14, 45% or 25 mil abortions across the world were considered “unsafe”

  • Poverty also another barrier

• Main arguments against abortion

  • Abortion = murder

    • Because of fetal personhood

    • Violates religious beliefs

    • Has negative mental health effects

      • This kind of goes back and forth

    • A medical procedure with some degree of risk

      • Abortion itself may harm health

    • Pregnant people should “live with the consequences” of sex

    • If you consent to sex you consent to possibility of bringing new life

    • Part of responsibility you take on

• Fetal personhood- notion that fetus is a “person” with same rights as someone who has already been born

  • 3 principles that come into factor- beneficence, non-maleficence, justice

  • Often aligned with religious beliefs

    • Usually considered to be at conception

  • However, do rights of the fetus come before the rights of the biological mother?

  • Destruction of unused IVF embryos a major issue- Is this murder?

    • Are embryos people?

• Other beliefs against abortion`

  • Rape/incest

    • abortion shouldn’t be viewed as the “fix” for these violations of people’s autonomy

      • These shouldn’t happen in the first place

    • Adoption- better option than abortion if someone cannot parent

    • Social programs- invest in social programs (better healthcare, education, child care) → reduces abortions for financial reasons

    • Responsibility- abortion “enables” men to engage in sex without consequences, is “anti-feminist”

• Not as simple as “pro-choice”/”pro-life”

• “Late term abortions” or abortions after fetal viability

  • occur after 24 weeks

  • ~1% of abortions

  • When should these occur? Should they occur?

    • If fetus has serious disability/terminal condition?

    • If fetus has other undesired qualities that are non-medical?

    • If person didn’t realize they were pregnant until later?

    • If pregnant person simply chooses this option?

  • Other considerations

    • If the father offers to care for the baby should the mother still be able to abort the fetus?

    • Is abortion affordable and accessible?

    • Is it a form of eugenics to tell women who might have trouble affording a child that they can’t have one?

    • Can only the wealthy elite have children?

• Debate about morning after pill

  • Prevents implantation of embryo into uterus

  • Used when contraception not used/failed during use Is this a form of abortion or birth control?

  • Must be taken within 72 hours of unprotected sex

    • What if a person can’t access it?

• Numerous legal debates

  • Heartbeat bills- prohibit abortion once heartbeat can be detected

    • Can be heard at 6 weeks- before person even knows they’re pregnant

    • Effectively outlaws abortion

  • Requiring ultrasounds before abortion to “see” fetus

    • is this medically necessary?

• Other laws seek to indirectly prohibit abortion

  • TRAP (targeted regulation of abortion providers) laws

    • Example- physicians need to have admission privileges to hospitals

• Clinician conscientious objection to abortion

  • Under what circumstances should clinicians be allowed to refuse performing abortion/giving emergency contraception due to personal beliefs?

    • In religious hospital systems

    • Can the clinician object if they can connect patient to another physician who can carry out procedure?

    • Laws differ from state to state

• Abortion in other countries

  • India, Ethiopia, Japan, and the UK widely permit abortion

  • Many countries permit it as it preserves a woman’s health

• Overall, the abortion debate is complex and multi-faceted debate with many ethical and legal dimensions