Introduction
An abortion is the termination of a pregnancy by loss or destruction of a fetus before birth. Abortions have been performed since ancient times and at present still continue to be a hotly debated issue worldwide. Women and their partners who are faced with an unwanted pregnancy often consider abortion. The reasons of women for undergoing abortion are varied and may include terminating an unwanted pregnancy or aborting a fetus known to have birth defects. This reason of aborting a fetus because of an unwanted pregnancy is usually prevalent in teenagers who get pregnant. It cannot be denied that more and more teenagers around the world turn to abortion as a solution to an unwanted pregnancy.
However, issues such as religious, moral, legal, social and personal are often associated with abortion and usually present dilemmas in an individual’s choice of an abortion. The main disputes over abortion in recent years have largely concentrated on the legalization of abortion, raising arguments from pro-life advocates and movements that it should not be legalized since abortion itself is morally wrong.
An abortion may be spontaneous or induced. The latter is an act with ethical and legal ramifications and will be the topic of this paper. In the context of this paper, abortion here refers to induced abortion, unless otherwise stated. An overview of abortion and its two types will first be provided in order to be able to provide a clear discussion on the legal and ethical ramifications of induced abortion.
Medical Aspect
Spontaneous abortion, or miscarriage, occurs when the embryo fails to develop, when there is complete or incomplete expulsion of the products of conception – the embryo, or fetus, and placenta – or when the fetus dies prior to 20 weeks from the woman’s last menstrual period. If fetal death occurs at 20 weeks or more after the last menstrual period, it is termed late fetal death or a stillbirth. Perhaps as many as three-fourths of conceptions around the world are spontaneously aborted.
Induced abortion, on the other hand, is a procedure intended to terminate a suspected or known pregnancy and to produce a nonviable fetus at any gestational age. Different techniques are used to do this, depending on the trimester of the conception.
The technique for virtually all first-trimester pregnancy terminations utilizes a procedure called vacuum aspiration or vacuum curettage. Second-trimester induced abortion involves a more complicated procedure. Depending on the number of weeks, it could either be through dilation and evacuation, or through the injection of fluid containing saline solution or hormones called prostaglandins into the amniotic sac.
In France during the 1980s an abortion-inducing drug called RU 486 was proving 85 percent effective during the first 6 weeks after LMP, especially when used with prostaglandins. By the early 1990s the drug was licensed only in France, China, and the United Kingdom. Medical abortion, sometimes referred to as medication abortion, is also a kind of induced abortion that uses a regimen of mifepristone and misoprostol and has been shown to be a safe, effective and acceptable alternative to surgical abortion in many countries (Winikoff, 2005).
Spontaneous abortion is not illegal nor immoral since the individual who is pregnant did not do anything to abort the baby. However, induced abortion, whether it is done at the expense of saving the mother’s life or simply because of an unwanted pregnancy, is subject to a much heated debate that has been around for many years. This kind of abortion is subject to legal as well as moral ramifications worldwide.
Legal Aspects
The World Health Organization (WHO) defines unsafe abortion as "illegal." In its 1998 report Unsafe Abortion, the organization says, "For the purpose of these tabulations, unsafe abortion has been defined as an 'abortion not provided through approved facilities and/or persons.' " WHO continues: "What constitutes 'approved facilities and/or persons' will vary according to the legal and medical standards of each country," but at the same time it admits that "the legality or illegality of the services may not be the defining factor of their safety (Hussey, 2004).
Legal protection of an unborn baby from homicide expanded as medical knowledge increased. About half of the world’s populations live in countries where abortion is available on request, and another fourth live in areas where abortion is permitted to protect a woman’s health. The most restrictive policies tend to be found in fundamentalist Islamic countries and countries of sub-Saharan and Latin America.
Abortion rights of today do not conflict with the Constitution and are currently judged to be protected by it, but that does not preclude society's continued interest in protecting the life of its most fragile and vulnerable beings.
Most physicians have little information about the abortion law and have been afraid of the consequences of doing even legal procedures. Moreover, there has been a lot of pressure by the Catholic Church to block women's access to legal abortion care (Adesse, 2005). Induced abortion is highly controversial as well as illegal in many Catholic countries as the Roman Catholic Church considers abortion immoral and condemns abortion along with "artificial" forms of birth control (Schuster, 2005).
In South Africa, medical abortion is safe and effective and has been approved for use in early termination of pregnancy since 2001 (Winikoff, 2005). In Brazil, abortion is legal only on two grounds: when there is no other way to save the woman's life and when pregnancy is a result of rape (Adesse, 2005).
In England, the advancement of medical science resulted in medical doctors believing that abortion before quickening was the killing of human life and therefore a crime. As medical knowledge became more sophisticated, and the concept of quickening became obsolete, laws in England and the United States were enacted to prohibit abortion before quickening without regard to gestation.
In England, Lord Ellenborough's Act of 1803 was the first statute passed that made abortions before quickening a criminal act (but not a capital crime like an abortion after quickening). The Act was amended in 1837 by abolishing the quickening distinction and made abortion at any time during pregnancy a crime by both the doctor and the pregnant woman (Lugosi, 2005).
However, abortion has become legal in England, Scotland and Wales since the Abortion Act was passed in 1967. Northern Ireland, in contrast, remains to be the only part of the United Kingdom which still considers abortion illegal (Wikipedia, 2006). The latest figures from Britain show that 6,217 women who had abortions there in 2004 comprise 800 women under the age of 20 and almost 50 were under the age of 16 (Carey, 2006).
Impact of Legalization
Organizations such as the United Nations’ World Health Organization report 40-50 million annual abortions worldwide with 70,000 abortion-related maternal deaths. Scanty data, however, make an accurate assessment of the status of abortion and abortion laws throughout the world a daunting, virtually impossible task. WHO's estimates are largely constructed by statistical estimation, based on meager data and poorly supported assumptions (Hussey, 2004).
Just as abortion continues to stir a storm of acrimony in many countries, controversy rages around the world over the procedure's legalization in the many countries that still prohibit or sharply limit it. The chief justification for making abortion legal is reducing maternal mortality (Hussey, 2004).
However, the legalization of abortion does nothing to solve the underlying problem of poor health care in the developing world. Some women still face numerous medical, political, institutional and social barriers even in countries where abortion is legal. In India, where abortion has been legal for over 30 years, 76% of abortion facilities are not licensed, 68% of abortion providers are not registered, and dilatation and curettage is the preferred method in 89% of facilities surveyed (Hessini, 2005).
Studies of long-term health consequences of abortion show that risks of spontaneous abortion, preterm delivery, and low birth weight for a second pregnancy following vacuum aspiration are no greater than for a first pregnancy, and have been unable to link abortion with long-term psychological problems. The psychologic problems associated with abortion are somewhat obscured today.
Before the legalization of induced abortions, it was thought that women who had an abortion would feel extremely guilty and experience attendant psychologic difficulties. However, today it is evident that psychologic problems are fewer or more subtle than was anticipated, and women who have induced abortions appear to be remarkably free of psychologic difficulties.
Legalization would very likely increase women's exposure to health risks, especially in underdeveloped countries where health care is of poor standard. Evidence indicates that the liberalization of abortion laws increases the number of abortions. Women generally at risk because they lack access to a doctor, hospital, or antibiotics before abortion's legalization will face those same circumstances after legalization. And if legalization triggers a higher demand for abortion, as it has in most countries, more injured women will compete for those scarce medical resources (Hussey, 2004).
Despite these facts, arguments about high levels of "unsafe" abortions and the need to legalize abortion to decrease maternal mortality still dominate the international abortion debate. Yet the facts suggest that maternal mortality can be reduced in the developing world the same way it has been done in the developed world since 1941--by improving basic and maternal health care and the general health status of women, not by legalizing abortion.
Ethical Aspects
Most opposition to abortion relies on the premise that the fetus is a human being, a person, from the moment of conception (Baird & Rosenbaum, 1993). Opponents of legalized induced abortion, the “right-to-life” movement, believe that human life begins at conception and that abortion is the intentional killing of a human being and is thus morally wrong.
Abortion is a moral issue because "an abortion kills the life of a baby after it has begun." Such a decision cannot be amoral. Anyone who has spent any time reading an embryology text or has seen a six-week transvaginal sonogram of the developing baby knows that to terminate a pregnancy one has to still a heartbeat. If this were not true, there simply would be no abortion controversy -- no moral problem (Larimore, 1997).
Pro-life holds as true that (a) human life begins at conception and (b) the right to life overrides all other rights and interests. The pro-choice view maintains that (a) human life begins at a later stage and (b) the right to control one's body overrides all remaining rights and interests given that the right to life has been set aside (as irrelevant). These truths in each case are supported by evidence and non-controversial inference rules (Frohock, 1985).
In contrast, “pro-choice” proponents generally believe that human life begins when the fetus can survive outside the womb and that before then, since the fetus is not a separate human, it is morally acceptable to terminate the pregnancy. The fundamental moral principle for pro-choice is the right to control one's own body against social regulation (Frohock, 1985). This right is deeply embedded in Western traditions. They also argue that legal abortion is safer than illegal abortion and relieves the psychological and social problems associated with bearing an unwanted child.
The key to all moral principles used in the pro-life position is the starting point for human life. The pro-life position is firmly committed to the view that life begins at conception. Two arguments support this view. One rests on a theory of being. All that any individual has genetically is present at conception. Therefore, in the sense of genetic endowment, a zygote is human. The second argument rests on a theory of becoming. A human conceptus develops into a human being, not anything else. Like acorns becoming oak trees, the process is natural. Only an external intervention or a deficiency within the process prevents the teleological end-state from being reached. Thus any effort to abort such a process is, ipso facto, the termination of the end-state - the fully developed sentient being (Frohock, 1985).
Some pregnant women find themselves in very difficult or even untenable situations -- poor health, abject poverty, lack of social support, the horrendous trauma of rape or incest. Those who are opposed to legal abortion cannot deny or ignore these problems; however, it is a very sad commentary on society that we have convinced women that adoption is too emotionally difficult in some or most of these situations and that abortion is a better answer - justifiable and pardonable (Larimore, 1997).
Induced abortion therefore has been in the midst of a paradigm shift, resulting from changing laws and social mores. In the past, decisions about abortion primarily reflected values about human life, whereas, today, emphasis on abortion decision making includes more consideration of the right to health and personal choice (Hanks, 2002).
Summarization and Conclusion
Abortion is both a legal and moral problem. It can be deduced that the dispute over the morality and legality of abortion is primarily due to differences in beliefs about the nature and status of the embryo or fetus. Pro-life and pro-choice advocates have conflicting and differing views as to whether a fetus can be considered as human. Each has their own reasoning behind their beliefs. The normative conclusions on abortion follow from conceptual claims on the meaning and interpretation of physical data -- put roughly, the significance of the biological states of human gestation. Or, individuals disagree over the morality of abortion because they disagree over the assignment of concepts to fetal life.
Abortion in itself is not a solution to an unwanted pregnancy, however, when the life of the mother is in danger, perhaps abortion can be used as an option or solution. This could coincide with the moral belief to choose the option that would do lesser harm. To save the life of the mother, the unborn child has to be sacrificed. To legalize abortion for medical and safety reasons could be morally acceptable, yet to legalize it because of unwanted pregnancies and personal choice is subject to moral discussion.
It has been said that the main reason for the legalization of abortion is to make it safe. Even before abortion became legalized, many women still undergo abortion and most of them are unsafe resulting to maternal complications and even death. The legalization of abortion has somehow lessened incidences of unsafe abortion procedures, but this could be largely seen only in the industrialized countries. The situation in the developing world is still the same even with the legalization of abortion. Maternal death and complications still ensue even after a legal abortion.
The debate on the legal and moral or ethical ramifications therefore is still not solved. No matter how much evidence is presented by advocates and opponents of abortion, each stands still in their beliefs. With abortion legalized in many countries, it is perhaps up to individuals to decide which is moral.
An abortion is the termination of a pregnancy by loss or destruction of a fetus before birth. Abortions have been performed since ancient times and at present still continue to be a hotly debated issue worldwide. Women and their partners who are faced with an unwanted pregnancy often consider abortion. The reasons of women for undergoing abortion are varied and may include terminating an unwanted pregnancy or aborting a fetus known to have birth defects. This reason of aborting a fetus because of an unwanted pregnancy is usually prevalent in teenagers who get pregnant. It cannot be denied that more and more teenagers around the world turn to abortion as a solution to an unwanted pregnancy.
However, issues such as religious, moral, legal, social and personal are often associated with abortion and usually present dilemmas in an individual’s choice of an abortion. The main disputes over abortion in recent years have largely concentrated on the legalization of abortion, raising arguments from pro-life advocates and movements that it should not be legalized since abortion itself is morally wrong.
An abortion may be spontaneous or induced. The latter is an act with ethical and legal ramifications and will be the topic of this paper. In the context of this paper, abortion here refers to induced abortion, unless otherwise stated. An overview of abortion and its two types will first be provided in order to be able to provide a clear discussion on the legal and ethical ramifications of induced abortion.
Medical Aspect
Spontaneous abortion, or miscarriage, occurs when the embryo fails to develop, when there is complete or incomplete expulsion of the products of conception – the embryo, or fetus, and placenta – or when the fetus dies prior to 20 weeks from the woman’s last menstrual period. If fetal death occurs at 20 weeks or more after the last menstrual period, it is termed late fetal death or a stillbirth. Perhaps as many as three-fourths of conceptions around the world are spontaneously aborted.
Induced abortion, on the other hand, is a procedure intended to terminate a suspected or known pregnancy and to produce a nonviable fetus at any gestational age. Different techniques are used to do this, depending on the trimester of the conception.
The technique for virtually all first-trimester pregnancy terminations utilizes a procedure called vacuum aspiration or vacuum curettage. Second-trimester induced abortion involves a more complicated procedure. Depending on the number of weeks, it could either be through dilation and evacuation, or through the injection of fluid containing saline solution or hormones called prostaglandins into the amniotic sac.
In France during the 1980s an abortion-inducing drug called RU 486 was proving 85 percent effective during the first 6 weeks after LMP, especially when used with prostaglandins. By the early 1990s the drug was licensed only in France, China, and the United Kingdom. Medical abortion, sometimes referred to as medication abortion, is also a kind of induced abortion that uses a regimen of mifepristone and misoprostol and has been shown to be a safe, effective and acceptable alternative to surgical abortion in many countries (Winikoff, 2005).
Spontaneous abortion is not illegal nor immoral since the individual who is pregnant did not do anything to abort the baby. However, induced abortion, whether it is done at the expense of saving the mother’s life or simply because of an unwanted pregnancy, is subject to a much heated debate that has been around for many years. This kind of abortion is subject to legal as well as moral ramifications worldwide.
Legal Aspects
The World Health Organization (WHO) defines unsafe abortion as "illegal." In its 1998 report Unsafe Abortion, the organization says, "For the purpose of these tabulations, unsafe abortion has been defined as an 'abortion not provided through approved facilities and/or persons.' " WHO continues: "What constitutes 'approved facilities and/or persons' will vary according to the legal and medical standards of each country," but at the same time it admits that "the legality or illegality of the services may not be the defining factor of their safety (Hussey, 2004).
Legal protection of an unborn baby from homicide expanded as medical knowledge increased. About half of the world’s populations live in countries where abortion is available on request, and another fourth live in areas where abortion is permitted to protect a woman’s health. The most restrictive policies tend to be found in fundamentalist Islamic countries and countries of sub-Saharan and Latin America.
Abortion rights of today do not conflict with the Constitution and are currently judged to be protected by it, but that does not preclude society's continued interest in protecting the life of its most fragile and vulnerable beings.
Most physicians have little information about the abortion law and have been afraid of the consequences of doing even legal procedures. Moreover, there has been a lot of pressure by the Catholic Church to block women's access to legal abortion care (Adesse, 2005). Induced abortion is highly controversial as well as illegal in many Catholic countries as the Roman Catholic Church considers abortion immoral and condemns abortion along with "artificial" forms of birth control (Schuster, 2005).
In South Africa, medical abortion is safe and effective and has been approved for use in early termination of pregnancy since 2001 (Winikoff, 2005). In Brazil, abortion is legal only on two grounds: when there is no other way to save the woman's life and when pregnancy is a result of rape (Adesse, 2005).
In England, the advancement of medical science resulted in medical doctors believing that abortion before quickening was the killing of human life and therefore a crime. As medical knowledge became more sophisticated, and the concept of quickening became obsolete, laws in England and the United States were enacted to prohibit abortion before quickening without regard to gestation.
In England, Lord Ellenborough's Act of 1803 was the first statute passed that made abortions before quickening a criminal act (but not a capital crime like an abortion after quickening). The Act was amended in 1837 by abolishing the quickening distinction and made abortion at any time during pregnancy a crime by both the doctor and the pregnant woman (Lugosi, 2005).
However, abortion has become legal in England, Scotland and Wales since the Abortion Act was passed in 1967. Northern Ireland, in contrast, remains to be the only part of the United Kingdom which still considers abortion illegal (Wikipedia, 2006). The latest figures from Britain show that 6,217 women who had abortions there in 2004 comprise 800 women under the age of 20 and almost 50 were under the age of 16 (Carey, 2006).
Impact of Legalization
Organizations such as the United Nations’ World Health Organization report 40-50 million annual abortions worldwide with 70,000 abortion-related maternal deaths. Scanty data, however, make an accurate assessment of the status of abortion and abortion laws throughout the world a daunting, virtually impossible task. WHO's estimates are largely constructed by statistical estimation, based on meager data and poorly supported assumptions (Hussey, 2004).
Just as abortion continues to stir a storm of acrimony in many countries, controversy rages around the world over the procedure's legalization in the many countries that still prohibit or sharply limit it. The chief justification for making abortion legal is reducing maternal mortality (Hussey, 2004).
However, the legalization of abortion does nothing to solve the underlying problem of poor health care in the developing world. Some women still face numerous medical, political, institutional and social barriers even in countries where abortion is legal. In India, where abortion has been legal for over 30 years, 76% of abortion facilities are not licensed, 68% of abortion providers are not registered, and dilatation and curettage is the preferred method in 89% of facilities surveyed (Hessini, 2005).
Studies of long-term health consequences of abortion show that risks of spontaneous abortion, preterm delivery, and low birth weight for a second pregnancy following vacuum aspiration are no greater than for a first pregnancy, and have been unable to link abortion with long-term psychological problems. The psychologic problems associated with abortion are somewhat obscured today.
Before the legalization of induced abortions, it was thought that women who had an abortion would feel extremely guilty and experience attendant psychologic difficulties. However, today it is evident that psychologic problems are fewer or more subtle than was anticipated, and women who have induced abortions appear to be remarkably free of psychologic difficulties.
Legalization would very likely increase women's exposure to health risks, especially in underdeveloped countries where health care is of poor standard. Evidence indicates that the liberalization of abortion laws increases the number of abortions. Women generally at risk because they lack access to a doctor, hospital, or antibiotics before abortion's legalization will face those same circumstances after legalization. And if legalization triggers a higher demand for abortion, as it has in most countries, more injured women will compete for those scarce medical resources (Hussey, 2004).
Despite these facts, arguments about high levels of "unsafe" abortions and the need to legalize abortion to decrease maternal mortality still dominate the international abortion debate. Yet the facts suggest that maternal mortality can be reduced in the developing world the same way it has been done in the developed world since 1941--by improving basic and maternal health care and the general health status of women, not by legalizing abortion.
Ethical Aspects
Most opposition to abortion relies on the premise that the fetus is a human being, a person, from the moment of conception (Baird & Rosenbaum, 1993). Opponents of legalized induced abortion, the “right-to-life” movement, believe that human life begins at conception and that abortion is the intentional killing of a human being and is thus morally wrong.
Abortion is a moral issue because "an abortion kills the life of a baby after it has begun." Such a decision cannot be amoral. Anyone who has spent any time reading an embryology text or has seen a six-week transvaginal sonogram of the developing baby knows that to terminate a pregnancy one has to still a heartbeat. If this were not true, there simply would be no abortion controversy -- no moral problem (Larimore, 1997).
Pro-life holds as true that (a) human life begins at conception and (b) the right to life overrides all other rights and interests. The pro-choice view maintains that (a) human life begins at a later stage and (b) the right to control one's body overrides all remaining rights and interests given that the right to life has been set aside (as irrelevant). These truths in each case are supported by evidence and non-controversial inference rules (Frohock, 1985).
In contrast, “pro-choice” proponents generally believe that human life begins when the fetus can survive outside the womb and that before then, since the fetus is not a separate human, it is morally acceptable to terminate the pregnancy. The fundamental moral principle for pro-choice is the right to control one's own body against social regulation (Frohock, 1985). This right is deeply embedded in Western traditions. They also argue that legal abortion is safer than illegal abortion and relieves the psychological and social problems associated with bearing an unwanted child.
The key to all moral principles used in the pro-life position is the starting point for human life. The pro-life position is firmly committed to the view that life begins at conception. Two arguments support this view. One rests on a theory of being. All that any individual has genetically is present at conception. Therefore, in the sense of genetic endowment, a zygote is human. The second argument rests on a theory of becoming. A human conceptus develops into a human being, not anything else. Like acorns becoming oak trees, the process is natural. Only an external intervention or a deficiency within the process prevents the teleological end-state from being reached. Thus any effort to abort such a process is, ipso facto, the termination of the end-state - the fully developed sentient being (Frohock, 1985).
Some pregnant women find themselves in very difficult or even untenable situations -- poor health, abject poverty, lack of social support, the horrendous trauma of rape or incest. Those who are opposed to legal abortion cannot deny or ignore these problems; however, it is a very sad commentary on society that we have convinced women that adoption is too emotionally difficult in some or most of these situations and that abortion is a better answer - justifiable and pardonable (Larimore, 1997).
Induced abortion therefore has been in the midst of a paradigm shift, resulting from changing laws and social mores. In the past, decisions about abortion primarily reflected values about human life, whereas, today, emphasis on abortion decision making includes more consideration of the right to health and personal choice (Hanks, 2002).
Summarization and Conclusion
Abortion is both a legal and moral problem. It can be deduced that the dispute over the morality and legality of abortion is primarily due to differences in beliefs about the nature and status of the embryo or fetus. Pro-life and pro-choice advocates have conflicting and differing views as to whether a fetus can be considered as human. Each has their own reasoning behind their beliefs. The normative conclusions on abortion follow from conceptual claims on the meaning and interpretation of physical data -- put roughly, the significance of the biological states of human gestation. Or, individuals disagree over the morality of abortion because they disagree over the assignment of concepts to fetal life.
Abortion in itself is not a solution to an unwanted pregnancy, however, when the life of the mother is in danger, perhaps abortion can be used as an option or solution. This could coincide with the moral belief to choose the option that would do lesser harm. To save the life of the mother, the unborn child has to be sacrificed. To legalize abortion for medical and safety reasons could be morally acceptable, yet to legalize it because of unwanted pregnancies and personal choice is subject to moral discussion.
It has been said that the main reason for the legalization of abortion is to make it safe. Even before abortion became legalized, many women still undergo abortion and most of them are unsafe resulting to maternal complications and even death. The legalization of abortion has somehow lessened incidences of unsafe abortion procedures, but this could be largely seen only in the industrialized countries. The situation in the developing world is still the same even with the legalization of abortion. Maternal death and complications still ensue even after a legal abortion.
The debate on the legal and moral or ethical ramifications therefore is still not solved. No matter how much evidence is presented by advocates and opponents of abortion, each stands still in their beliefs. With abortion legalized in many countries, it is perhaps up to individuals to decide which is moral.
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