Monday, July 13, 2015

Abortion FAQ, continued: reasons for abortion

As one who is "pro-life", I believe that 99% of abortions are uncalled for under any circumstance.
That's a really high number. Let's think about that a bit more. In this 2005 study, 1% of women seeking abortion said one reason they wanted an abortion because they had been raped. If this is the only justification you allow, then you have your 99%.

But most people also say abortion is justified if it is necessary to save the life of the mother. This makes sense, especially when you are look at situations like ectopic pregnancies, where often your choice is to continue with the pregnancy, and have both the mother and the fetus die, or abort the fetus, and at least save one life. The survey above doesn't list cases where the mother's life is at stake, but it does say that 12% of women list concerns for their own health as reasons for abortion. Of these, 4% listed a physical problem with their health as the "most important" reason they were having an abortion. It is not clear, however, how many of these cases are cases where the mother's life is in danger.

There are also cases where the health of the fetus can motivate an abortion. We've already looked at one case like that in this class: Tay-Sachs disease. A baby born with Tay-Sachs disease will live normally for about a year, but after that, their brain will begin to degenerate, and what follows are seizures, blindness and death by age 5. Many people would say that it is better to have not been born than it is to have such a brief life filled with suffering. Again with these studies, we don't have clear number for cases of abortion that are like the Tay-Sachs case. The 2005 study says that for 13% of the women seeking abortions, the future health of the fetus as a motivation, and for 3% of women it was the most important reason.As with the question of the mother's health, it is not clear what medical problems are being considered here.

So it looks like somewhere between 8% and 25% of abortions are in situations that people commonly view as legitimate reasons to have an abortion. (Gallup reports that 70% of Americans believe that abortion is acceptable in some or all circumstances, and rape and health of the mother are the most common exceptions.) Given this information, do you stand by the 99% number?

Saturday, July 11, 2015

Bioethics FAQ, cont.

"A fetus really can feel pain at 8 weeks. I have a citation"

The link you gave is to the testimony of an "expert" before congress. Whenever you encounter expert evidence, there are three basic questions you need to ask.
  1. Does this person have the relevant expertise—are they in a position to know what they say they know?
  2. Is this person biased?
  3. Is this person's claim backed up by other experts?
In this case, the expert, Maureen L. Condic, passes the first test quite well. She is not just a scientist with a Ph.D. If you click through to her academic webpage, you can see she is a neurobiologist who works on fetal neuronal development.

Things start to fall apart a bit more when it comes to the issue of bias. Condic doesn't have any direct conflict of interest, like a financial stake in the outcome of this debate. However, googling around makes it clear that she is an activist. She writes for the conservative religious magazines like First Things and The Public Discourse. This makes it very likely that she is going to slant the facts as much as she possibly can in favor of her political view. Now this alone is no reason to discount her testimony. Almost everyone who writes on an issue like this is going to have strong political views of one sort or another. But this is something to bear in mind when considering her testimony

It is on the third question that the testimony here really falls apart. Condic's claim is not backed by what other experts say; it is contradicted by it. This article, by Susan J. Lee and colleagues, looks at all the relevant research. This is what they call in science a "survey article": It doesn't present original research. Instead it looks at all the research currently available to determine if all the evidence collected so far can give us a conclusion on an important issue. In this case, the authors dug through over a thousand articles in their examination of the evidence. Their conclusion: fetal perception of pain is unlikely before the third trimester."

So how does Condic reach a different conclusion than all the other researchers? The answer is illuminating: she is using different standards for what counts as evidence for the perception of pain. Lee et al. define pain as "a subjective sensory and emotional experience that requires the presence of consciousness to permit recognition of a stimulus as unpleasant." In other words, there has to be a brain present to be conscious of the pain, and there is no evidence of enough brain development for consciousness to happen until the third trimester. Condic, on the other hand, is just looking for a reflex reaction in response to stimulus: " The neural circuitry responsible for the most primitive response to pain, the spinal reflex, is in place by 8 weeks of development. This is the earliest point at which the fetus experiences pain in any capacity."

So the difference here is really philosophical. It is about what counts as pain, and what counts as evidence of pain. Condic is counting reflex responses to stimuli as pain. But even a detached cockroach leg can have a reflex response to a stimulus. This is actually an experiment you can do at home, as this video explains. Click here to skip to the part where a detached roach leg twitches in time to a Beastie Boys song. (You might not want to do that, though, if you are grossed out by roaches.)

Furthermore, the circuitry that is present in this detached cockroach leg is all that has developed in the fetus by 8 weeks gestation. The circuit uses serotonin and something called substance P. Its action is inhibited by endorphins. The machinery—or as philosopher Bernard Rollin put it, the "plumbing of pain"—is the same. It just isn't hooked up to anything. All of this can leave us quite confident that a fetus at 8 weeks gestation cannot feel pain.

(A lot of this is actually covered in Taking Animals Seriously: Mental Life and Moral Status, a book by one of your textbook authors, David DeGrazia. His focus is on the issue of pain in animals, though, not in fetuses.)

Monday, July 06, 2015

Abortion FAQ, continued: Why women have late term abortion

I keep a FAQ on abortion for my bioethics classes. I post the entries here, too, on the theory that if my students have these questions, other people might as well. Here is a post, from a student on the abortion discussion forum who is wondering about women who have late term abortions.

Most women find out they're pregnant at 4-5 weeks, why wait, if they know they're unhappy why not schedule an abortion as soon as possible?
The first thing to note here is that for the most part, women do have the abortion as soon as possible. As I explained in the abortion video, 88% of abortions are in the first trimester, and only 1.3% are in the third trimester.
The next thing to note is that a substantial number of women who have late term abortions are doing so for medical reasons. These are typically women who wanted to be pregnant, but have found out that something has gone wrong. Perhaps the pregnancy is endangering their life, or the child will not be able to survive after birth.
This still leaves a population of women who have abortion after the first trimester for something other than medical reasons. Here is an interesting study published in Perspectives on Sexual and Reproductive Health on women who have abortions after 20 weeks gestation for non-medical reasons. In your question, you state that most women know they are pregnant in the fourth or fifth week. This is not true, however, of the women having abortions after 20 weeks in this study. They report on average, finding out that they are pregnant in the 12th week of pregnanacy.
Interestingly, the authors don't wind up using the late discovery of pregnancy as one of their factors explaining later abortion. They identify five profiles for women who delay abortion after 20 weeks. Together they account for 80% of the women in their sample.
  1. Women suffer from depression or drug addiction
  2. Women who were in conflict with their partner or perhaps experiencing physical abuse
  3. Women who were raising children alone
  4. Women who had trouble deciding and then trouble accessing a provider
  5. women who were young and had never had children before.
These categories overlap, so some women who delay abortion might be depressed and in a physically abusive relationship. I think some of these factors make the delay more understandable.