Although the merger of the war on abortion and the war on drugs can still be stopped, the odds are that it will proceed, at least until the cost of policing abortion pill bans exceeds pro-life states’ willingness to pay.
This was acceptable for Sensible Med when discussing the similarities between WOA and WOD, but towards the end it goes off the rails with progressive pontification that would be better left elsewhere, in my opinion.
"Homicide is a crime because it is incompatible with peaceful social coexistence and economic prosperity,"
My goodness, I suppose that stance could be arguable, but it has quite the hill to climb. One doesn't have to go far down that logic path to justify gladiatorial prison fights, purge nights, honor killings, etc...
Homicide is immoral because it infringes on the individual right to life, and should be a crime as such. I hope that's why a modern society outlaws it, not for utilitarian social and economic reasons.
I did like the article, but it's not what I come to Sensible Medicine for. There's plenty of other places for those discussions.
However, I think it would be great for Sensible Medicine cover controversial issues impartially from a medical and health systems perspective.
While subsequent articles could debate, I think Sensible Medicine could fill in a hole in in the discourse by first providing information to get both sides on the same page of understanding the medical situations involved.
Abortion should not be used as a prolific birth control option. And let them pay for it themselves and then the mass abortions would stop. Use birth control morons. Rape and incest should use that pill right away. Birth control should be free but not abortion, after the first mistake. These gals walking around saying I had 40 abortions is disgusting. Get sterilized for goodness sakes.
Yea I'm not feeling the exaggeration. Most women aren't using abortion as birth control. According to the CDC, 6 in 10 women are getting an abortion for the first time and only around a quarter have already had one.It's just not true that these women are having "40" abortions. And I'm not even pro abortion necessarily Do you think people just like to get abortions because it's free? It's a medical procedure and many of the women who get them are low income. Let's say they have the kid. Are you going to adopt it and are you in favor of the mother and child receiving government benefits? Birth control isn't 100% effective either. But clearly Donna or Don or whoever you are a troll.
There are certain areas where making something a matter of law rather than relying on cultural norms of behavior and general societal approbation results in an unintended and destructive increase in the activity rather than keeping it at a minimal level. I think that abortion and drug laws have had this effect and the author has done a good job in showing that to be the case.
"By contrast, societies can thrive, as many do, while permitting medical abortions, which typically occur in private and have few consequences for anyone other than the women who have them, their partners, and their immediate families. The analogy between homicide and abortion is a false one, whether life begins at conception or not."
["Because the loss of the unborn child is of no consequence, the loss of the unborn child is of no consequence." Sound logic right there. ]
Republican and democtratic pockets are clustered. Could define these "regions" instead of having states. Here is a thought experiment: Say states were gone and we instead had such "regions". In some regions abortion is banned and in others it is not. Everyone now lives in driving distance of a place that offers abortion. Thus the concept of banning abortion effectively does nothing. Not sure what insights to gain from that. I guess maybe there could be some law that you have to move and stay in that other region for at least some time either before or after having an abortion. This would effectively segregrate society to conceivably positive or negative ends.
More than 50% of humanity believes in reincarnation. The US abortion debate polarizes around materialistic versus Judeo-Christian world views. This is totally unrepresentative of reality, and IMO wrong. Reincarnation allows for an end to black and white everthing.
"Abortion drug bans will have terrible collateral consequences too, including increases in crime, destruction of lives and families, institutionalized racism, loss of civil liberties, and mass incarcerations." I think that the author exaggerates the "terrible consequences" of abortion drug bans. Tossing in "racism" suggests a deep progressive bias on the part of the author. I am a retired pediatrician living in Texas who is strongly pro-life but I do not care for AG Paxton and have never voted for him. The author overlooks the immeasurable and unmeasurable value of unborn humans who are sacrificed on the altar of selfish, lethal convenience. As a society, we need to struggle with an ethic that will eliminate abortions instead of looking the other way which so many do.
Well stated. Having a law against abortions does not prevent abortions. It prevents safe abortions, and ( as the author stated) it opens up the opportunity for black market profit. Our government has an odd fascination with people's sex lives. The rate of fetal deaths in Texas has increased since the implementation of the law. So, who is this law benefiting?
Yea I don't like this approach. Drugs are outlawed and have been for a while. We don't argue in favor of it by saying that it's going to happen regardless and having a law against drugs won't stop people from selling them or buying.
Gov needs to stay the hell out of people’s health. Period. Won’t happen, because there is too much $ in it for the GOV - be it the lobbyists, politicians, the like. Whether I believe abortion is murder or not is nobody’s business.
You might be correct. After all, men largely already bear pretty much every other cost of sustaining society with relatively little complaint or attention, so what's one more responsibility on top of everything else?
OTOH, I suspect that we still might argue. In the course of several discussions on abortions one of the hypotheticals I've repeatedly asked about is something like "What if we had the technology to safely, easily, and without side effects to the mother or child, remove and sustain the child to live birth via artificial wombs earlier in the pregnancy, even before the point where most women realize that they are pregnant, with the whole process offered completely free to the mother?"
Overwhelmingly, abortion advocates STILL tell me they would choose to kill their child rather than allow adoption, even if they didn't need to actually go through literally ANY noticeable pregnancy time. At that point I can't take seriously whatever arguments they make that the pregnancy itself interferes with their health, education, finances, or vocation so they MUST kill the child; the hypothetical offered specifically allows them to "terminate the pregnancy" WITHOUT killing the child, on the same timeline abortion offers, yet they nonetheless demand to kill their children anyway. So I'm left thinking that even if men were the ones who got pregnant instead of women, if all else is still somehow the same in our society, those women would still be demanding a veto over men giving birth to their children. You can bet that Fathers would argue against THAT!
In our society, having biological offspring is an inescapable tether. Whether the offspring is a product of your egg/sperm donation, your closed adoption, the hypothetical above, or any other scenario involving your genetic material, 18 years from now you will start living your life with the possibility that your offspring show up on your doorstep, bearing at best a litany of expectations. Men are more at risk of this possibility because they have less biological control of procreation.
The argument that practicality should prevail over morality is a slippery slope. History has plenty of examples of what happens when the value of human life is not upheld. Industry (and illegal trade) are always looking for the next best thing to line their pockets. Today parents are attempting to save their children from the monstrous industry of transgender medicine, an industry based wholly on a lie that humans can 'choose' their sex. A 'Gender Liberation for Bodily Autonomy' march in Washington happened in September where activists (believing the lie) linked abortion to trans rights in their fight against the multitude 'anti-trans' bills that happen to prevail from the same states restricting abortion rights. Implementing the laws to ban puberty blockers and cross sex hormones for children will come at a cost. This is true especially because hospital systems are raking in money for this and for the potential in artificial reproduction, IVF and more.
Many SM commenters seem to be forgetting about self-defence in their attempts to separate morality from utility. A fetus/baby is pretty much always an added threat to the mother in the short term. One could assert that having a child is also always a threat to one’s own liberty, even if at the same time the child in question is always innocent of malicious intent. Therefore, IF abortion is murder, then it must always be immoral, even in the cases of serious medical threat to the mother. Are we saying she has no right to defend herself against such threat? I bet anyone who says so would not feel the same about an attacker on the street.
Any attempt to separate morality from utility when it comes to abortion is a futile attempt to free abortion from degrees of complications versus reinstated opportunities.
Medical triage ethics are well-established. Similarly, medical ethics also cover a variety of other situations of Innocent patients who present an involuntary threat to the health of others (mentally ill patient, carrier of a contagious disease, etc). Even at the height of COVID panic, when concentration camps were seriously being planned, I don't recall ANY medical authority arguing that it would be potentially justified to actively execute the infected for the safety of others.
Likewise, self-defense ethics are also pretty clear cut in law. Use of lethal force is generally only acceptable under conditions where a reasonable person believes they are in imminent danger from a lethal threat that cannot reasonably or reliably be stopped with less than lethal means available. Even if we accepted the rather dubious argument that pregnancy by itself represents a potentially lethal threat to the mother, it would very rarely meet the requirement of immediate lethal threat unless there are other medical complications actively happening (in which case triage protocols would be appropriate) and all other treatment options that preserve BOTH patients (reasonable and reliable less than lethal alternatives are available) would be legally mandated for attempt before escalating to lethal force.
AFAICT every "abortion ban" proposed or implemented in any State of the US already includes exceptions for medical triage situations. I've read the "Doctors told me 'your condition needs to get worse before we can legally kill your baby'" 'horror stories' about "further endangering women" by waiting until the threat is imminent before taking a life. It's unpleasant reading, sure, but not nearly as horrific to me as the accounts of partial-birth abortions. I've also read several rebuttals by legal and medical professionals pointing out that those doctors were either ignorant of the law or deliberately spreading BS, because they absolutely could have legally acted sooner if they genuinely had a reasonable basis that the abortion was inevitably medically necessary to save the mother rather than treatable by other means. The self-defense argument isn't so much ignored as already solved for.
You can't morally choose to kill somebody until the situation forces you to choose WHICH person dies, not IF somebody dies. Frankly, depending on your preferred answer to the Trolley Problem, you might not be morally allowed to deliberately kill someone even then. Most people regard acts of commission morally worse than functionally equivalent acts of ommission. Likewise, most people will recognize that an act that merely has a low probability of a negative outcome is not equivalent to an act that has a high probability of a negative outcome, much less equal to an act with a guaranteed negative outcome. Allowing the child to be born naturally (act of omission) may present a low probability of negative outcome for the mother, whereas killing the unborn child (act of commission) has a guaranteed chance of negative outcome for the child. I know quite a few philosophical and ethical frameworks, but none that can both admit the child is a human being morally equal to the mother AND support allowing the mother to electively kill her child (at least, no philosophical framework that doesn't likewise allow parents to electively murder their children at any age).
There is no such thing as “well established medical ethics.” I believe that is the very reason for publications like Sensible Medicine? We are talking about humans making decisions with and for other humans. Not to mention continued advancements in medical technology, particularly fertility and genetic screenings, have made things quite gray.
The notion that any one person can predict an exact timeline of when a situation becomes critical is also a false premise. I may sincerely believe that I am about to die and that can be true or false but only one of those realities plays out and we can’t live out the other infinite possibilities. I might choose to use lethal force on an attacker even though that might not have been “necessary.” It will be other flawed humans who make that judgment for me as well.
Hey Google, "Is medical ethics a required course in medical school?"
Yes, medical ethics is considered a required course for medical school in the United States, with all accredited medical schools incorporating ethics training as part of their core curriculum due to the Association of American Medical Colleges (AAMC) mandating adherence to ethical principles for graduates; meaning every medical student will take a formal ethics course.
Key points about medical ethics in medical school:
Mandatory: All U.S. medical schools require medical ethics training.
AAMC requirement: The AAMC mandates that medical school graduates demonstrate a commitment to ethical principles.
The oldest recognized treatise on medical ethics is considered to be the "Hippocratic Oath," attributed to the ancient Greek physician Hippocrates, which outlines ethical principles for doctors and is considered the earliest expression of medical ethics in the Western world. The Hippocratic Oath is over 2,500 years old. Yes, medical ethics are 'well-established'. They're much older than most countries, older than the entire concept of "nations", quite literally "older than feudalism", older even than "Anno Domini". I'm not trying to be sarcastic here, but that's like saying "I don't think this whole "United States of America" thing is "well-established" in history, only an entire magnitude less accurate.
And yet, here we are existing in a world of constantly evolving treatments and protocols and ways of looking at life and quality of life, and death.
To ‘first, do no harm’ - we can all clearly define what that means in every medical situation that arises? It might be ethical to have the stated goal, but if one has a narrow view of what constitutes harm, then we do actually have to look beyond morality to utility (which was the basis of this author’s thesis).
Your “sarcastic” (read: condescending) tone is wildly unnecessary, so I felt somewhat compelled to respond in kind while also wondering why this conversation has to be so…
This argument shows a misunderstanding of what ethics are and do for us. We can debate what the facts are all day, known facts can change over time, but that doesn't change the ethical framework used to evaluate them. You're confusing the inputs to a process with the process itself.
For a comparison, the scientific method is also a well-established methodology. Do constantly evolving technologies and protocols and ways of looking at reality and the nature of reality ever invalidate or require an update to the scientific method? No, of course not. The scientific method works today just as it did in the past and just as it will in the future.
"First, do no harm" is fairly straightforward.
The saying “first do no harm” (\(primumnonnocere\) in Latin) is associated with the ethical principle of nonmaleficence. Nonmaleficence is the obligation to not cause harm to others.
Nonmaleficence is a fundamental principle of medical ethics in the Western world. It's often considered the first rule of medicine.
It's closely associated with the principle of beneficence, which is the obligation to do good.
Physicians must weigh the benefits and burdens of any treatment or intervention.
They must choose the best course of action for the patient.
Patients have the right to be free from harm and to have the risk of harm minimized.
Let's start from the inputs: the mother and child are BOTH 'patients'.
The child, as a patient, has the right to be free from harm. Abortion is death for the patient, the worst possible harm. The child therefore has a right to not be aborted.
The physician must choose the best course of action for the patient. Again, death is by definition the worst possible medical outcome, it literally CANNOT be the "best" course of action for the patient, therefore a course that does not unnecessarily harm the child must be chosen.
Physicians must weigh the benefits and burdens of any treatment or intervention. Death is the worst possible outcome for a patient, therefore literally ANY outcome for the mother short of her dying is necessarily a better outcome than the child dying.
There's logically no possible input other than a Trolley Program scenario (someone will die no matter what and intervention can only determine which person will die) aka medical triage, where the deliberate choice to even allow the child to die (much less actively seek the child's death) is at all compatible with the Hippocratic Oath. Abortionists are blatantly Hypocritical rather than Hippocratic.
You have certainly highlighted an imperative for a mother and fetus to have separate physician advocates. Except in such a limited ethical lens, the certain death of a fetus by abortion wins out every time - there is no scenario in which a mother with competing rights to life gets to choose a CHANCE for survival. It doesn’t matter if she is rearing other children, if she is a physician herself in a role of saving lives, etc.
Your framework also assumes that death is always the worst case scenario rather than cumulative human suffering. Death is simple to define so it’s easy to use it as an ethical benchmark. I don’t know how I would be convinced that physicians aren’t in the business of limiting human suffering.
Please clarify. A threat to the mother? If a woman cannot survive a pregnancy due to a medical condition, why has she not been sterilized? Why is absolute prevention of pregnancy not secured? Uh oh I screwed up hardly qualifies as a justification for murder.
It’s great you think that women should die in childbirth. My mother was a healthy, physically active, Physical Education teacher. Until pre-eclampsia escalated and caused her death when she was 32 weeks pregnant with me. Now we need to sterilize women? Come on. Just say you value potential life MORE than the woman carrying it.
How would you have solved the issue for your other? She apparently loved you more than her own life. I am sorry for your loss.
Hypertension in pregnancy is a real issue and should be addressed promptly and diligently. Pre-eclampsia and HELLP syndrome need to be treated aggressively and go to early c-section if inadequate response to treatment.
So please clarify how this justifies abortion , in particular since pre-eclampsia occurs 90% of the time at 34+ weeks gestation, and never prior to 20 weeks gestation.
It wouldn’t have. But if something comes up in pregnancy, a woman should absolutely be able to save her life, even if her baby dies. Why does it matter to you so much that babies enter this world? I have never understood this. Why does it matter what other people do with their bodies? I would have terminated my pregnancies in a heartbeat had my life been at risk. I will never know her love, and it is a pain that you, judging others behind your keyboard, cannot fathom.
There are indeed very few situations where the risk in pregnancy is guaranteed death or permanent disability, but that is the case in virtually all medical conditions. The point is that calling abortion murder automatically assumes there is no risk threshold under 100% for which a mother can decide the risk is too great.
Pregnancy is nearly 100% preventable with conscientious application of contraception; certainly 100% with permanent sterilization. It would appear that self defense should occur prior to becoming pregnant. Self control is part of self defense.
Key word is “nearly” - and in cases of rape or coercion or paternal abandonment? The whole point of these discussions is that we are asking philosophical questions that take into account all possibilities. If abortion is “murder” then it must be so in all cases because the fetus that results knows no difference.
Importantly, life-threatening conditions can arise after and as a result of pregnancy. I’m not sure how one can expect to “secure” the avoidance of things like cancer, infections, eclampsia, or catastrophic accidents.
In cases of rape there is ready availability of “Plan B” OTC to prevent implantation of a fertilized ovum. In 2023 there were 1,037,000 elective abortions in the U.S. How many were due to factors outside of the female’s control?
Plan B is also not 100% effective. Anyway you have taken my original comment, and its argument against abortion as murder, in another direction. If you feel that a pregnant woman in a catastrophic car accident having an abortion to help save her own life is murder, I don’t know that we have much else to discuss.
I'm so sorry you lost your mother. I have witnessed more than my share of maternal deaths and it is horrible in every way imaginable. But if you ever believe for one minute that you are responsible, please take it from this OBGYN that more often than not, mothers struggle for their babies much longer than it would seem to be humanly possible.
Within scope, IMHO, but then Charlie Silver is a regular coauthor of mine, so I might be biased.
This was acceptable for Sensible Med when discussing the similarities between WOA and WOD, but towards the end it goes off the rails with progressive pontification that would be better left elsewhere, in my opinion.
"Homicide is a crime because it is incompatible with peaceful social coexistence and economic prosperity,"
My goodness, I suppose that stance could be arguable, but it has quite the hill to climb. One doesn't have to go far down that logic path to justify gladiatorial prison fights, purge nights, honor killings, etc...
Homicide is immoral because it infringes on the individual right to life, and should be a crime as such. I hope that's why a modern society outlaws it, not for utilitarian social and economic reasons.
I did like the article, but it's not what I come to Sensible Medicine for. There's plenty of other places for those discussions.
However, I think it would be great for Sensible Medicine cover controversial issues impartially from a medical and health systems perspective.
While subsequent articles could debate, I think Sensible Medicine could fill in a hole in in the discourse by first providing information to get both sides on the same page of understanding the medical situations involved.
As Bill Clinton opined " abortion should be legal safe and rare. I think our rate is at least doubled triple Europe. Why is it different?
Abortion should not be used as a prolific birth control option. And let them pay for it themselves and then the mass abortions would stop. Use birth control morons. Rape and incest should use that pill right away. Birth control should be free but not abortion, after the first mistake. These gals walking around saying I had 40 abortions is disgusting. Get sterilized for goodness sakes.
Yea I'm not feeling the exaggeration. Most women aren't using abortion as birth control. According to the CDC, 6 in 10 women are getting an abortion for the first time and only around a quarter have already had one.It's just not true that these women are having "40" abortions. And I'm not even pro abortion necessarily Do you think people just like to get abortions because it's free? It's a medical procedure and many of the women who get them are low income. Let's say they have the kid. Are you going to adopt it and are you in favor of the mother and child receiving government benefits? Birth control isn't 100% effective either. But clearly Donna or Don or whoever you are a troll.
There are certain areas where making something a matter of law rather than relying on cultural norms of behavior and general societal approbation results in an unintended and destructive increase in the activity rather than keeping it at a minimal level. I think that abortion and drug laws have had this effect and the author has done a good job in showing that to be the case.
"By contrast, societies can thrive, as many do, while permitting medical abortions, which typically occur in private and have few consequences for anyone other than the women who have them, their partners, and their immediate families. The analogy between homicide and abortion is a false one, whether life begins at conception or not."
["Because the loss of the unborn child is of no consequence, the loss of the unborn child is of no consequence." Sound logic right there. ]
https://metatron.substack.com/p/division-is-not-always-a-bad-thing/comments
Republican and democtratic pockets are clustered. Could define these "regions" instead of having states. Here is a thought experiment: Say states were gone and we instead had such "regions". In some regions abortion is banned and in others it is not. Everyone now lives in driving distance of a place that offers abortion. Thus the concept of banning abortion effectively does nothing. Not sure what insights to gain from that. I guess maybe there could be some law that you have to move and stay in that other region for at least some time either before or after having an abortion. This would effectively segregrate society to conceivably positive or negative ends.
More than 50% of humanity believes in reincarnation. The US abortion debate polarizes around materialistic versus Judeo-Christian world views. This is totally unrepresentative of reality, and IMO wrong. Reincarnation allows for an end to black and white everthing.
Not a fan of mixing politics and medicine. Keep it “sensible medicine”.
"Abortion drug bans will have terrible collateral consequences too, including increases in crime, destruction of lives and families, institutionalized racism, loss of civil liberties, and mass incarcerations." I think that the author exaggerates the "terrible consequences" of abortion drug bans. Tossing in "racism" suggests a deep progressive bias on the part of the author. I am a retired pediatrician living in Texas who is strongly pro-life but I do not care for AG Paxton and have never voted for him. The author overlooks the immeasurable and unmeasurable value of unborn humans who are sacrificed on the altar of selfish, lethal convenience. As a society, we need to struggle with an ethic that will eliminate abortions instead of looking the other way which so many do.
Well stated. Having a law against abortions does not prevent abortions. It prevents safe abortions, and ( as the author stated) it opens up the opportunity for black market profit. Our government has an odd fascination with people's sex lives. The rate of fetal deaths in Texas has increased since the implementation of the law. So, who is this law benefiting?
Yea I don't like this approach. Drugs are outlawed and have been for a while. We don't argue in favor of it by saying that it's going to happen regardless and having a law against drugs won't stop people from selling them or buying.
This is an opinion piece with no factual basis..... so take it for that.
Gov needs to stay the hell out of people’s health. Period. Won’t happen, because there is too much $ in it for the GOV - be it the lobbyists, politicians, the like. Whether I believe abortion is murder or not is nobody’s business.
If men were the gender gestating babies this would not even be a topic for discussion.
You might be correct. After all, men largely already bear pretty much every other cost of sustaining society with relatively little complaint or attention, so what's one more responsibility on top of everything else?
OTOH, I suspect that we still might argue. In the course of several discussions on abortions one of the hypotheticals I've repeatedly asked about is something like "What if we had the technology to safely, easily, and without side effects to the mother or child, remove and sustain the child to live birth via artificial wombs earlier in the pregnancy, even before the point where most women realize that they are pregnant, with the whole process offered completely free to the mother?"
Overwhelmingly, abortion advocates STILL tell me they would choose to kill their child rather than allow adoption, even if they didn't need to actually go through literally ANY noticeable pregnancy time. At that point I can't take seriously whatever arguments they make that the pregnancy itself interferes with their health, education, finances, or vocation so they MUST kill the child; the hypothetical offered specifically allows them to "terminate the pregnancy" WITHOUT killing the child, on the same timeline abortion offers, yet they nonetheless demand to kill their children anyway. So I'm left thinking that even if men were the ones who got pregnant instead of women, if all else is still somehow the same in our society, those women would still be demanding a veto over men giving birth to their children. You can bet that Fathers would argue against THAT!
In our society, having biological offspring is an inescapable tether. Whether the offspring is a product of your egg/sperm donation, your closed adoption, the hypothetical above, or any other scenario involving your genetic material, 18 years from now you will start living your life with the possibility that your offspring show up on your doorstep, bearing at best a litany of expectations. Men are more at risk of this possibility because they have less biological control of procreation.
Very interesting and compelling article.
The argument that practicality should prevail over morality is a slippery slope. History has plenty of examples of what happens when the value of human life is not upheld. Industry (and illegal trade) are always looking for the next best thing to line their pockets. Today parents are attempting to save their children from the monstrous industry of transgender medicine, an industry based wholly on a lie that humans can 'choose' their sex. A 'Gender Liberation for Bodily Autonomy' march in Washington happened in September where activists (believing the lie) linked abortion to trans rights in their fight against the multitude 'anti-trans' bills that happen to prevail from the same states restricting abortion rights. Implementing the laws to ban puberty blockers and cross sex hormones for children will come at a cost. This is true especially because hospital systems are raking in money for this and for the potential in artificial reproduction, IVF and more.
article on the march:
https://time.com/7021378/gender-liberation-march-abortion-transgender/
Many SM commenters seem to be forgetting about self-defence in their attempts to separate morality from utility. A fetus/baby is pretty much always an added threat to the mother in the short term. One could assert that having a child is also always a threat to one’s own liberty, even if at the same time the child in question is always innocent of malicious intent. Therefore, IF abortion is murder, then it must always be immoral, even in the cases of serious medical threat to the mother. Are we saying she has no right to defend herself against such threat? I bet anyone who says so would not feel the same about an attacker on the street.
Any attempt to separate morality from utility when it comes to abortion is a futile attempt to free abortion from degrees of complications versus reinstated opportunities.
Medical triage ethics are well-established. Similarly, medical ethics also cover a variety of other situations of Innocent patients who present an involuntary threat to the health of others (mentally ill patient, carrier of a contagious disease, etc). Even at the height of COVID panic, when concentration camps were seriously being planned, I don't recall ANY medical authority arguing that it would be potentially justified to actively execute the infected for the safety of others.
Likewise, self-defense ethics are also pretty clear cut in law. Use of lethal force is generally only acceptable under conditions where a reasonable person believes they are in imminent danger from a lethal threat that cannot reasonably or reliably be stopped with less than lethal means available. Even if we accepted the rather dubious argument that pregnancy by itself represents a potentially lethal threat to the mother, it would very rarely meet the requirement of immediate lethal threat unless there are other medical complications actively happening (in which case triage protocols would be appropriate) and all other treatment options that preserve BOTH patients (reasonable and reliable less than lethal alternatives are available) would be legally mandated for attempt before escalating to lethal force.
AFAICT every "abortion ban" proposed or implemented in any State of the US already includes exceptions for medical triage situations. I've read the "Doctors told me 'your condition needs to get worse before we can legally kill your baby'" 'horror stories' about "further endangering women" by waiting until the threat is imminent before taking a life. It's unpleasant reading, sure, but not nearly as horrific to me as the accounts of partial-birth abortions. I've also read several rebuttals by legal and medical professionals pointing out that those doctors were either ignorant of the law or deliberately spreading BS, because they absolutely could have legally acted sooner if they genuinely had a reasonable basis that the abortion was inevitably medically necessary to save the mother rather than treatable by other means. The self-defense argument isn't so much ignored as already solved for.
You can't morally choose to kill somebody until the situation forces you to choose WHICH person dies, not IF somebody dies. Frankly, depending on your preferred answer to the Trolley Problem, you might not be morally allowed to deliberately kill someone even then. Most people regard acts of commission morally worse than functionally equivalent acts of ommission. Likewise, most people will recognize that an act that merely has a low probability of a negative outcome is not equivalent to an act that has a high probability of a negative outcome, much less equal to an act with a guaranteed negative outcome. Allowing the child to be born naturally (act of omission) may present a low probability of negative outcome for the mother, whereas killing the unborn child (act of commission) has a guaranteed chance of negative outcome for the child. I know quite a few philosophical and ethical frameworks, but none that can both admit the child is a human being morally equal to the mother AND support allowing the mother to electively kill her child (at least, no philosophical framework that doesn't likewise allow parents to electively murder their children at any age).
There is no such thing as “well established medical ethics.” I believe that is the very reason for publications like Sensible Medicine? We are talking about humans making decisions with and for other humans. Not to mention continued advancements in medical technology, particularly fertility and genetic screenings, have made things quite gray.
The notion that any one person can predict an exact timeline of when a situation becomes critical is also a false premise. I may sincerely believe that I am about to die and that can be true or false but only one of those realities plays out and we can’t live out the other infinite possibilities. I might choose to use lethal force on an attacker even though that might not have been “necessary.” It will be other flawed humans who make that judgment for me as well.
Hey Google, "Is medical ethics a required course in medical school?"
Yes, medical ethics is considered a required course for medical school in the United States, with all accredited medical schools incorporating ethics training as part of their core curriculum due to the Association of American Medical Colleges (AAMC) mandating adherence to ethical principles for graduates; meaning every medical student will take a formal ethics course.
Key points about medical ethics in medical school:
Mandatory: All U.S. medical schools require medical ethics training.
AAMC requirement: The AAMC mandates that medical school graduates demonstrate a commitment to ethical principles.
Would you like some textbooks on that?
https://letmegooglethat.com/?q=medical+school+textbook+medical+ethics
The oldest recognized treatise on medical ethics is considered to be the "Hippocratic Oath," attributed to the ancient Greek physician Hippocrates, which outlines ethical principles for doctors and is considered the earliest expression of medical ethics in the Western world. The Hippocratic Oath is over 2,500 years old. Yes, medical ethics are 'well-established'. They're much older than most countries, older than the entire concept of "nations", quite literally "older than feudalism", older even than "Anno Domini". I'm not trying to be sarcastic here, but that's like saying "I don't think this whole "United States of America" thing is "well-established" in history, only an entire magnitude less accurate.
And yet, here we are existing in a world of constantly evolving treatments and protocols and ways of looking at life and quality of life, and death.
To ‘first, do no harm’ - we can all clearly define what that means in every medical situation that arises? It might be ethical to have the stated goal, but if one has a narrow view of what constitutes harm, then we do actually have to look beyond morality to utility (which was the basis of this author’s thesis).
Your “sarcastic” (read: condescending) tone is wildly unnecessary, so I felt somewhat compelled to respond in kind while also wondering why this conversation has to be so…
This argument shows a misunderstanding of what ethics are and do for us. We can debate what the facts are all day, known facts can change over time, but that doesn't change the ethical framework used to evaluate them. You're confusing the inputs to a process with the process itself.
For a comparison, the scientific method is also a well-established methodology. Do constantly evolving technologies and protocols and ways of looking at reality and the nature of reality ever invalidate or require an update to the scientific method? No, of course not. The scientific method works today just as it did in the past and just as it will in the future.
"First, do no harm" is fairly straightforward.
The saying “first do no harm” (\(primumnonnocere\) in Latin) is associated with the ethical principle of nonmaleficence. Nonmaleficence is the obligation to not cause harm to others.
Nonmaleficence is a fundamental principle of medical ethics in the Western world. It's often considered the first rule of medicine.
It's closely associated with the principle of beneficence, which is the obligation to do good.
Physicians must weigh the benefits and burdens of any treatment or intervention.
They must choose the best course of action for the patient.
Patients have the right to be free from harm and to have the risk of harm minimized.
Let's start from the inputs: the mother and child are BOTH 'patients'.
The child, as a patient, has the right to be free from harm. Abortion is death for the patient, the worst possible harm. The child therefore has a right to not be aborted.
The physician must choose the best course of action for the patient. Again, death is by definition the worst possible medical outcome, it literally CANNOT be the "best" course of action for the patient, therefore a course that does not unnecessarily harm the child must be chosen.
Physicians must weigh the benefits and burdens of any treatment or intervention. Death is the worst possible outcome for a patient, therefore literally ANY outcome for the mother short of her dying is necessarily a better outcome than the child dying.
There's logically no possible input other than a Trolley Program scenario (someone will die no matter what and intervention can only determine which person will die) aka medical triage, where the deliberate choice to even allow the child to die (much less actively seek the child's death) is at all compatible with the Hippocratic Oath. Abortionists are blatantly Hypocritical rather than Hippocratic.
You have certainly highlighted an imperative for a mother and fetus to have separate physician advocates. Except in such a limited ethical lens, the certain death of a fetus by abortion wins out every time - there is no scenario in which a mother with competing rights to life gets to choose a CHANCE for survival. It doesn’t matter if she is rearing other children, if she is a physician herself in a role of saving lives, etc.
Your framework also assumes that death is always the worst case scenario rather than cumulative human suffering. Death is simple to define so it’s easy to use it as an ethical benchmark. I don’t know how I would be convinced that physicians aren’t in the business of limiting human suffering.
Please clarify. A threat to the mother? If a woman cannot survive a pregnancy due to a medical condition, why has she not been sterilized? Why is absolute prevention of pregnancy not secured? Uh oh I screwed up hardly qualifies as a justification for murder.
It’s great you think that women should die in childbirth. My mother was a healthy, physically active, Physical Education teacher. Until pre-eclampsia escalated and caused her death when she was 32 weeks pregnant with me. Now we need to sterilize women? Come on. Just say you value potential life MORE than the woman carrying it.
How would you have solved the issue for your other? She apparently loved you more than her own life. I am sorry for your loss.
Hypertension in pregnancy is a real issue and should be addressed promptly and diligently. Pre-eclampsia and HELLP syndrome need to be treated aggressively and go to early c-section if inadequate response to treatment.
So please clarify how this justifies abortion , in particular since pre-eclampsia occurs 90% of the time at 34+ weeks gestation, and never prior to 20 weeks gestation.
It wouldn’t have. But if something comes up in pregnancy, a woman should absolutely be able to save her life, even if her baby dies. Why does it matter to you so much that babies enter this world? I have never understood this. Why does it matter what other people do with their bodies? I would have terminated my pregnancies in a heartbeat had my life been at risk. I will never know her love, and it is a pain that you, judging others behind your keyboard, cannot fathom.
There are indeed very few situations where the risk in pregnancy is guaranteed death or permanent disability, but that is the case in virtually all medical conditions. The point is that calling abortion murder automatically assumes there is no risk threshold under 100% for which a mother can decide the risk is too great.
Pregnancy is nearly 100% preventable with conscientious application of contraception; certainly 100% with permanent sterilization. It would appear that self defense should occur prior to becoming pregnant. Self control is part of self defense.
Key word is “nearly” - and in cases of rape or coercion or paternal abandonment? The whole point of these discussions is that we are asking philosophical questions that take into account all possibilities. If abortion is “murder” then it must be so in all cases because the fetus that results knows no difference.
Importantly, life-threatening conditions can arise after and as a result of pregnancy. I’m not sure how one can expect to “secure” the avoidance of things like cancer, infections, eclampsia, or catastrophic accidents.
In cases of rape there is ready availability of “Plan B” OTC to prevent implantation of a fertilized ovum. In 2023 there were 1,037,000 elective abortions in the U.S. How many were due to factors outside of the female’s control?
Plan B is also not 100% effective. Anyway you have taken my original comment, and its argument against abortion as murder, in another direction. If you feel that a pregnant woman in a catastrophic car accident having an abortion to help save her own life is murder, I don’t know that we have much else to discuss.
Yep, her pregnancy with me killed my mother. I guess I am a murderer too!
I'm so sorry you lost your mother. I have witnessed more than my share of maternal deaths and it is horrible in every way imaginable. But if you ever believe for one minute that you are responsible, please take it from this OBGYN that more often than not, mothers struggle for their babies much longer than it would seem to be humanly possible.