Examine and comment on the view that religious and/or moral principles provide essential guidelines for medical ethics with reference to abortions.
Examine and comment on the view that religious and/or moral principles provide essential guidelines for medical ethics with reference to the topic you have investigated
It is clear that medicine would progress faster without the restraining influence of moral and religious principles. An example of this is be a recent topic in the news today, that of three parent IVF. While this procedure is providing a possible solution to mitochondrial disease, some people argue that scientists are venturing too close to designer babies and cloning. This is seen as unnatural or by the Catholic Church ‘playing God’. Catholics also believe that the discarding of an embryo during the procedure is the eradication of a (potential) human being. In 2015, the Anglican and Catholic Church warned MPs that it would be irresponsible to pass the new laws allowing the DNA of a ‘second mother’ to be used to repair the genetic faults in an unborn child. Bishop John Sherrington said “There are serious ethical objections to this procedure which involves the destruction of human embryos as part of the process. The human embryo is a new human life, and it should be respected and protected from the moment of conception.” Most people agree that nobody wants medicine and science to be entirely unrestricted, especially when one examines the inhumane consequences of Nazi experimentation during the holocaust in World War Two. Nazi physicians performed brutal medical experiments upon helpless concentration camp inmates. As a result of this, their scientific discoveries were deemed as scientifically invalid because of their disregard for humanitarian ethics. Arnold Relman, editor of the New England Journal of Medicine, stated that the Nazi experiments were such a "gross violation of human standards that they are not to be trusted at all.”
Medicine and ethics should be inextricably linked together because the purpose of science is doing what is considered right. It is good to restrict medicine to some extent to avoid inflicting distress upon civilisation, however it should not be completely controlled, as it would delay beneficial discoveries to those who need them most. Therefore it is essential to explore some of the main religious and moral principles in order to ascertain whether or not they are essential guidelines for medical ethics. If one looks at the Hippocratic Oath in the field of medicine they will find the two key aims are to preserve life and to alleviate or prevent suffering. Despite these intentions working well together in most situations, when applied to abortion they easily contradict one another.
In order to decide whether moral or religious principles are essential, they need to be applied to a controversial issue within ethics, and in this case I will be discussing abortion. Abortion is the termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or foetus. This is the medical ethic I will be discussing throughout my essay
Abortion is an extremely emotional topic that splits the public into two minds, pro-life and pro-choice. Pro-life activists believe that life begins from the moment of conception; therefore abortion is the killing of a human being. They sometimes draw their opinion from religious principles such as ‘Thou shalt not kill’ (Exodus 20:13) The Sixth Commandment of the Bible’s Old Testament. However, pro-choice supporters believe that the foetus does not become a person until they are ‘viable’ outside the womb and so the mother’s rights outweigh that of a potential person.
One of the biggest questions that surrounds abortion is ‘when does life begin?’ There is some agreement between pro-life and pro-choice supporters that life begins at conception as embryology textbooks and pro-choice advocates concede that human life begins when the egg and sperm unite. “It is the penetration of the ovum by a sperm and the resulting mingling of nuclear material each brings to the union that constitutes the initiation of the life of a new individual.” Clark Edward and Corliss Patten’s Human Embryology, McGraw – Hill Inc., 30 This is further supported by the Bible, which states ‘Before I formed thee in the belly I knew thee; and before thou camest forth out of the womb I sanctified thee… ‘ (Jeremiah 1:5) Since there is evidence from both sides that biological life begins at conception, surely the law would deem abortion as murder? But, David Steel MP introduced the bill into parliament that became known as the 1967 Abortion Act. This law was created to prevent dangerous back alley abortions taking place. However Dr Bernard Nathanson, joint founder of NARAL in the US admitted “We aroused enough sympathy to sell our program of permissive abortion by fabricating the number of illegal abortions done annually in the US. The actual figure was approaching 100,000 but the figure we gave to the media repeatedly was 1,000,000.’ It is likely that figures were exaggerated to try and gain MP’s sympathy and promote the abortion industry. But even though the sole purpose of the law was to stop backstreet abortion, between 1968 and 1988 there were 986-recorded abortions performed illegally and 293 prosecutions in the UK. Illegal abortion was scarcely being controlled or condemned by the government once the Act was introduced. But just because abortion takes place does not mean there is enough reason to make it legal. Murder and rape cannot be prevented and happen on a daily basis, however there is no suggestion that these crimes should be legalised in order to impede them. The law does not condemn abortion as murder up until a certain time scale because the foetus is deemed to not become a person until they are viable outside the womb, and this occurs at 24 weeks.
This is a preview of the whole essay
John Locke’s famous definition of a person is ‘a thinking intelligent being, that has reason and reflection, and can consider itself, the same thing, in different times and places’. For Locke, memory was good enough to allow for continuity, the changing of cells did not alter the person. However, this notion gives justification for killing non-communicative humans because a person is being defined as a conscious rational being. Pro-abortionists define a person as a human being with the capacity of reason and choice, as this sets us aside from being merely an animal. But, the word ‘capacity’ is too subjective, it does not outline whether it means potential capacity or actualised capacity. Instead, the definition I will be using of the term ‘person’ is when it is constituted as an entity with basic rights.
Throughout history, different proposals have been suggested as to when a foetus becomes a person. Ensoulment, suggested by Plato, was one of the early concepts that has formed modern abortion laws. The abortion laws are based upon the presupposition that there is a point at which the foetus becomes a person. This was the notion that the status of the foetus changed and attained the rights of a human being. Plato argued that we are both physical entity and metaphysical, and there is a point at which the foetus acquires a soul. This was developed by St Augustine who maintained that the soul was implanted at 46 days and St Thomas Aquinas who contended ensoulments took place in boys at 40 days and girls 90 days. Although medically there is no justification for this reasoning, this idea informed the modern abortion laws. Therefore, using Aquinas’s concept comes a point when aborting a foetus is not ethically sound. There is no biological evidence that ensoulment takes place at different times for different genders. In the modern Roman Catholic Church, ensoulment occurs at the moment of conception. The embryo is not a person, but has the potential to become one. In 1987 Pope John Paul II said the observation of the physical state of the embryo was not sufficient enough to establish whether it is or isn’t a person. ‘No experiment can be in itself sufficient to bring us to the recognition of a spiritual soul.’ This belief assumes that potential life, even in the earliest stages of gestation, enjoys the same value as any existing life. Only shortly after conception, a unique DNA code is formed which remains unchanged throughout the entire life of the foetus. The presence of a unique human DNA code is scientific evidence that this early stage is the start of a human life.
Methods that might determine foetal viability did not have the precision that the law usually requires until the twentieth century, such as birth, missed period and the quickening. They are unreliable as the biological indicators are different. Some thinkers place emphasis on the movement of the ‘quickening’ – when the mother first feels the foetus move in her womb. But modern ultrasound techniques have proven that this is inconsistent because the foetus has been moving before that time but was not large enough for its movement to be registered by the mother. Others believe the foetus is a person when brain activity is recorded, however the brain activity at this stage is only a precondition and does not show that the foetus is conscious. Birth is also an option; nevertheless there is debate as to when birth actually occurs. Is it when only part of the foetus is outside the mother’s body or all of it? It remains difficult to establish when a foetus becomes person, as it could even be when they are two years old, teenagers or fully-grown adults. Human life could begin at sixteen years old because this is when a child acquires the rights to leave home, and at eighteen they can rent a house or obtain a mortgage. Consequently they no longer have to rely on their parents. However, if life begins at these later stages, who is to say that killing children is wrong? Their lives cannot be taken away because they don’t have one. Furthermore, if there is confusion as to when life begins – why should a foetus be killed? Permitting abortion may be killing a human entity who has a full entitlement to life. From the moment of conception, the nature of prenatal existence is merely the evolving of human growth and development, which does not cease until death. ‘If there is harm then you shall pay life for life, eye for eye, tooth for tooth, hand for hand, foot for foot, burn for burn, wound for wound, stripe for stripe.’ (Exodus 21) So, the value of the foetus is in question if we assume life begins at a later stage. Being a potential person allows the foetus the right to life from the earliest stage of development, the moment when the egg is fertilised. But even if the foetus has an inherent right to life, the mother’s right to her autonomy supersedes their right. On the other hand, nobody has an unconstrained right to autonomy. A parent’s responsibility for their children lasts 18 years because parental bodies remain the means by which parents care for and protect their children. A potential person’s life is still of intrinsic value. The sanctity of life declares that all life is valuable and a gift of God, so irrespective of the condition of that life or its quality; it must always be valued and respected because God is the only one who has jurisdiction over life. ‘Then the Lord God formed man of dust from the ground, and breathed into his nostrils the breath of life, and the man became a living being.’ (Genesis 2:7)
If we are in the field of medicine, we clearly value life because we are trying to preserve it. The Hippocratic oath supports this ‘I will apply, for the benefit of the sick; all measures [that] are required. If it is given me to save a life, all thanks.’ The idea of value comes from the religious principle the sanctity of life and the moral principle that humans naturally have higher value than most beings. ‘I have no personal stake in these people, Jean-Claude, but they are good people. Good, bad, or indifferent, they are alive, and no one has the right to just arbitrarily snuff them out…’ Here Laurell K Hamilton is stating that despite the bad qualities that exist within a person, their lives are is still sacred and unique because they are intrinsically valuable. For this reason, no one has the right to take away life. However, what is the hierarchy of rights? Who takes precedence, the mother or the foetus? All rights are equal until the point when the potential person is viable outside the womb. This is the idea that the foetus is human, but it is a human that if born would not survive. We have to ask the question: do the rights of a human being that cannot live outside the mother’s womb take priority over a living human being the mother? To determine viability, the point at which the foetus can survive outside the womb, is a critical argument because after viability, the mother’s rights cannot take priority. Grosch questioned ‘Whether the foetus has rights and, if so, how are these balanced against the rights of the mother.’ But there is a problem when discussing viability. We are biological entities and develop at different rates; therefore each foetus gains viability at a different time. Furthermore, twenty-four weeks is not precise enough. What is the difference between twenty-four weeks six days and six hours? Biologically nothing, but in terms of the law it makes all the difference because it passes the cut off day.
According to natural law once life has begun it is acceptable to terminate it. Aristotle said that all things are created with a purpose, which is eudemonia (fulfilment). If people manage to fulfil their purpose then they are good. Aquinas adapted this further by saying God gave us that purpose and there is a list of primary purposes which we must follow. However, secondary precepts are made to uphold these principles and although the purposes cannot be changed, some rules can be broken. Unlike the sanctity of life, if a purpose needs filling then it is not necessary to preserve life at all costs. Although an important natural law principle is preserving innocent human life, questions arise as to what that is. Francisco de Vitoria defined a non-innocent life as someone who intentionally intends harm, whereas Augustine argued that self-defence did not give you enough reason to kill an aggressor. Therefore if you were to follow natural law, you might terminate a pregnancy if the mother’s life was at risk in order to accomplish self-preservation.
The doctrine of double effect supports this as it permits the killing of an innocent life if it is not the primary intention and is not disproportionate to the good ends. But if the same situation presented itself and you were to take the sanctity of life approach, you would have to choose between strong or weak principle. Vitalism takes the view that nothing justifies the termination of human life because we are made in the image of God. ‘God is the author or life. He starts it and he should end it.’ (John 1:21) However, weak sanctity of life argues that agape should be the primary determining principle. It is argued that Vitalism makes life too absolute, so it becomes an idol of worship. Stanley Hauerwas argued that the Church permits the taking of life when the well being of others is at risk. ‘Appeals to the sanctity of life as an ideology make it appear that Christians are committed to the proposition that there is nothing in life worth dying for.’ If two lives are equally sacred and you have to choose between the two, you have to question what type of value each life has. In utilitarianism the quality of life is judged by the hedonic calculus, preference, ideal and welfare. However, the principle of utility dehumanises others, and Kant instantly dismisses it because it fails to treat people as an end in themselves. Utilitarianism also fails to mention what is meant by a valuable life; pleasure is too subjective as there are different types. Bernard Williams said that utilitarianism could erode personal integrity. If the two lives were equally sacred, sanctity of life would not let you choose either one. Peter Singer intended to solve this by creating a secular version of the sanctity of life, however his arguments were a developed version of Lock’s notion that the value of life depends on a person’s ability to have desires and preferences. This would mean that the mother’s life would have higher value than the foetuse’s. Although the right to life is paramount so it must supersede everything else, the secular view of the sanctity of life is useful for situations that require a different approach. This is shown in JJ Thompson’s violinist analogy. In this analogy, a famous violinist has a fatal kidney problem and is attached to a man in the hospital. The man has the right to unplug the violinist from himself, however if he does, the violinist will die. Thompson believes that it is the mother’s right to decide the fate of her baby and she is entitled to the choice. This is contrary to the view of the Catholic Church excluding extreme circumstances where it is permitted, such as death of the mother. However this promotes a culture in which human life is disposable and has little value. Pope Francis condemned it saying ‘what is thrown away is not only food and dispensable objects, but often human beings themselves who are discarded as ‘unnecessary.’ Even if the baby comes into the world unwanted, their life is valuable.
To conclude, religious and moral principles should operate as a guideline by which medical ethics should take into account otherwise brutal experiments like those committed by the Nazis run the risk of being repeated. However, they should be guidelines not rules. It is useful to have both religious principals and moral principles in a secular society because they provide an area of discussion by which a well-rounded answer can be reached. For example, a religious principle such as the sanctity of life declares the all life is sacred whereas a moral principle says that all life is sacred, but in order to preserve one life it is acceptable to sacrifice another. For those who do not follow religious principles, morals allow them to take an alternate view, which may be more useful to their situation, and vice versa. But is it always acceptable justifying the termination of a life for another? Especially if all life is considered equal. Surely the foetus’s entitlement to life is just the same as the mother because they too are a person? Although at this point the problem as to whether or not the foetus is a person. No one is entirely certain what characterises someone as a person for fear those who are disabled are left out of the category. This then leads to euthanasia becoming acceptable. It is much easier to say that from the moment of conception the foetus is a potential person and therefore has rights. No one has evidence to prove the foetus is or isn’t a person, therefore it is safer to declare the foetus is a person from the beginning. This clarifies the issue of whether or not termination of a foetus constitutes as unlawful killing. It also commends itself to many people by moving to the side of protecting the vulnerable.